Gender and Sexual Disorders 499
Sexual Aversion Disorder
Another type of desire disorder is sexual aversion disorder, whose hallmark is a
persistent or recurrent extreme aversion to and avoidance of most genital sexual
contact with a partner (see Table 11.5). People with this disorder may have normal
desire, interest, and sexual fantasies and may masturbate. However, even the idea
of contact with a partner’s genitals or of being touched by a partner makes them
anxious, like the man in Case 11.9; if such sexual physical contact occurs, they may
panic (Kaplan, 1987).
Sexual Arousal Disorders
Sexual arousal disorders occur when a person cannot become aroused or cannot
maintain arousal during a sexual encounter. These disorders can arise when the nor-
mal progression through the excitement phase is disrupted. This disruption can hap-
pen in three ways: (1) when the pleasurable stimulation gets interrupted (e.g., when
a couple stops their sexual behavior because their young child enters their bedroom),
(2) when other external stimuli interfere (e.g., when a car alarm goes off outside), or
(3) when internal stimuli interfere (e.g, when the person becomes anxious, afraid,
sad, or angry or has thoughts that intrude) (Malatesta & Adams, 2001).
Like sexual desire, sexual arousal involves neurological and other biologi-cal components (responses to stimuli and stimulation), cognitive components
(thoughts), and emotional components, including a subjective sense that a response
to a particular stimulus is “sexual” (Rosen & Beck, 1988). And any, or any com-
bination, of these components can contribute to the problem. For example, a man
Sexual Aversion Disorder
CASE 11.8 • FROM THE OUTSIDE: Hypoactive Sexual Desire Disorder
Crystal is a 35-year-old married software engineer who is a team leader in a highly competi-
tive company. She works 12-hour days and says she has no time for exercise or relaxation. Her
husband is also an engineer. She has been trying to get pregnant for the past 8 months. They
have been having scheduled intercourse on the 13th and 15th days of her regular cycle without
success. She states that sex seems like work and she just wants to get it over with. When she mar-
ried 5 years ago, her sex life was satisfying and she had no diffi culty with interest or orgasm.
(Candib, cited in Hicks, 2005)Sexual Arousal Disorders
CASE 11.9 • FROM THE OUTSIDE: Sexual Aversion Disorder
A 33-year-old stockbroker sought treatment because of “impotence.” Five months previously,
a close male friend had died of a coronary occlusion, and within the following week the pa-
tient developed anxiety about his own cardiac status. Whenever his heart beat fast because
of exertion, he became anxious that he was about to have a heart attack. He had disturbing
dreams from which he would awaken anxious and unable to get back to sleep. He stopped
playing tennis and running.
The patient began to avoid sexual intercourse, presumably because of his anxiety about
physical exertion. This caused diffi culties with his wife, who felt that he was deliberately de-
priving her of sexual outlets and was also preventing her from becoming pregnant, which she
very much desired. In the past month, although no longer worried about his heart, the patient
had avoided sexual intercourse entirely. He claimed to have some desire for sex, but when
the situation arose, he could not bring himself to do it. He became so upset about his sexual
diffi culties that he began to have trouble concentrating at work. He felt himself to be a failure
both as a husband and as a man....
Four years previously, at 29 and after 3 years of marriage, he had presented himself for treat-
ment with the complaint that he had never attempted to have sexual intercourse with his wife.
Sexual activity consisted of his obtaining an erection without either his wife or himself touching
his penis, and ejaculation occurred by rubbing his penis on his wife’s abdomen. He was unable
to touch his wife’s genitalia. [He and his wife had treatment at that time, using behavioral tech-
niques discussed below in the treatment section; treatment was a dramatic success.]
(Spitzer et al., 2002, p. 288)Sexual aversion disorder
A sexual dysfunction characterized by a
persistent or recurrent extreme aversion to
and avoidance of most genital sexual contact
with a partner.