UNDERSTANDING SEXUAL ANOREXIA: COMPULSIVE SEXUAL AVOIDANCE OF SEXUAL INTIMACY
Sexual anorexia, a term popularized by Dr. Patrick Carnes in his book Sexual Anorexia: Overcoming Sexual Self-Hatred, refers to the compulsive avoidance of sex and intimacy. While most people associate anorexia with food, “anorexia” simply means “without appetite.” In this case, sexual anorexia implies an absence of sexual desire or an intense avoidance of sex. Carnes controversially classifies this avoidance as a form of sex addiction—defined not by compulsive pursuit, but rather by a compulsive avoidance of sexual activities.
What is Sexual Anorexia?
People with sexual anorexia may experience profound fear and discomfort with intimacy and sex-related matters. Their aversion goes beyond simple lack of interest, often becoming an obsession with avoidance that severely impacts their relationships and self-image. Some common features include:
Fear of intimacy and sexual contact: People may avoid not only sex but also intimate touch or affectionate gestures, fearing they might lead to more intimate encounters.
Preoccupation with sexual matters: Ironically, those with sexual anorexia may become overly focused on sexual issues—judging their own sexual adequacy, scrutinizing others’ sexual behaviors, or excessively monitoring their own.
Rigid and negative attitudes toward sex and the body: This includes viewing sexual activity as shameful, and they may hold harsh, judgmental views about sexuality in general.
Shame and self-loathing around sexual experiences: This can lead to intense negative feelings about themselves and their bodies, further reinforcing the cycle of avoidance.
Self-destructive or avoidant behaviors: To prevent potential intimacy, individuals may engage in behaviors that push people away or sabotage relationships.
Who is at Risk?
Sexual anorexia can affect anyone, regardless of gender, but it is often linked to past experiences of sexual trauma or rejection. Survivors of abuse, in particular, may struggle with feelings of self-loathing, anxiety, or discomfort around sex, yet may not always connect these feelings to past events.
People who come from strict social or religious backgrounds with negative or repressive views on sexuality are also more prone to developing these avoidant behaviors. Additionally, sexual anorexia can co-occur with other compulsive behaviors, such as substance use or food addictions.
Can Someone with Sexual Anorexia Have Sex?
Despite their aversion to intimacy, some people with sexual anorexia do engage in sexual relationships. Sometimes they even end up with partners who have opposite sexual challenges, such as a partner with sex addiction. The dynamics between these two extremes—overcontrol versus undercontrol of sexuality—can lead to complex and often painful relationship patterns.
Treatment and Support
Sexual anorexia is not a recognized diagnosis in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders), but it is acknowledged by many therapists who specialize in sexual health, relationships, and trauma recovery. For those struggling with sexual anorexia, finding a therapist who understands these unique challenges can be immensely beneficial.
Here are some initial steps for getting help:
Seek a referral from your doctor: Many healthcare providers can connect you to therapists with experience in sexual health.
Look for a licensed sex therapist: Sex therapy is a specialized field, and a professional with training in this area can provide tailored support.
Contact organizations like the Society for the Advancement of Sexual Health (SASH): SASH is dedicated to supporting individuals with sexual health challenges, including sexual addiction and avoidance.
Recovery from sexual anorexia involves exploring the roots of these compulsive avoidant behaviors, whether that’s past trauma, cultural messaging, or internalized shame. With time, many people find that they can build healthier, more fulfilling relationships with themselves and with others.