Asexuality — experiencing little to no sexual attraction — has a prevalence of 0.4%–4%1

Asexuality is an umbrella term that includes demisexuality (only experiencing sexual attraction after emotional bonds form) and greysexuality (experiencing sexual attraction rarely or under specific circumstances).2 Asexual people may engage in sex and experience romantic attraction.2

Asexual people have a higher prevalence of anxiety, depression and other mood disorders than people of other sexualities3

These adverse mental health outcomes often result from minority stress and stigma, which are further exacerbated by discrimination at other intersections.2 Asexual people also have unique physical and sexual health needs, such as navigating arousal without attraction and learning to set boundaries in relationships.2

Asexual people often face barriers to accessing affirming health care because of misunderstandings and pathologization

Pathologization — considering the absence of sexual attraction as inherently disordered — in health care settings has been reported by many asexual people and can lead to health care avoidance.4

Improving health care requires acknowledging asexuality as an identity, not a pathology2

Providers can use inclusive, affirming language (e.g., using “‘if” rather than “when” for questions about sex); allow patients to self-identify; avoid assuming lack of sex is problematic; connect patients to asexual communities; ensure approaches are asexual-specific rather than generalized to the entire LGBTQIA2S+ community; include asexual-friendly options on forms and questionnaires; and educate themselves on asexuality.2 Providers should also upskill in nonbinary-affirming care, as asexual communities often have higher proportions of nonbinary gender identification.5

Asexuality is distinct from disorders of sexual arousal and desire5

Desire and arousal pertain to physiologic experiences of wanting sex.5 Attraction pertains to targeting desire to particular individuals.5 Desire and arousal disorders refer to distressing decreases in a person’s typical level of arousal and desire.5 If a patient presents with concern, providers should ask questions to elucidate whether desire and arousal or attraction are absent, and establish the patient’s goals.5

Footnotes

Competing interests: Stella Schneckenburger reports funding from the University of Toronto Excellence Award. No other competing interests were declared.

This article has been peer reviewed.

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