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The DSM Diagnostic Criteria for Sexual Aversion Disorder

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Abstract

Sexual Aversion Disorder (SAD) is one of two Sexual Desire Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined as a “persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital sexual contact with a sexual partner” which causes distress or interpersonal difficulty. This paper reviews the short history of the diagnosis of SAD as well as the existing literature on its prevalence and etiology. Kaplan (1987) emphasized the phobic qualities of individuals with SAD who are highly avoidant of all forms of sexual contact. Much has also been written about the overlap between SAD and panic states, and the more obvious similarities between SAD and anxiety as opposed to sexual desire are described. There has been very little new published data on SAD since the publication of DSM-IV and the precise prevalence remains unknown. This paper critiques the placement of SAD as a Sexual Dysfunction and argues that it might more appropriately be placed within the Specific Phobia grouping as an Anxiety Disorder.

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Acknowledgments

The author is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders. I wish to acknowledge the valuable input I received from members of my Workgroup (Yitzchak Binik, Cynthia Graham, R. Taylor Segraves) and Kenneth J. Zucker. Feedback from DSM-V Advisors Richard Balon and Sheryl Kingsberg is greatly appreciated. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders V Workgroup Reports (Copyright 2009), American Psychiatric Association.

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Correspondence to Lori A. Brotto.

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Brotto, L.A. The DSM Diagnostic Criteria for Sexual Aversion Disorder. Arch Sex Behav 39, 271–277 (2010). https://doi.org/10.1007/s10508-009-9534-2

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