I Suffer from Sexual Anorexia

It's been years since I've even tried to be intimate with someone.

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The last time I attempted to have sex, it was the summer of 2010. I reluctantly agreed to go out with a guy whom I'd met through mutual friends. We went out on several dates, and I did enjoy his company. However, I have debilitating anxiety—particularly surrounding relationships—and had been burned before. One afternoon, he picked me up from work, and after a really pleasant, relaxing day, we found ourselves in his bed. But when we eventually got around to it, my body immediately tensed up. I felt like I couldn't breathe, and I started to cry.

My thoughts raced: What am I doing? Do I actually like this guy? Remember what happened last time you did this—you got hurt. Stop, just stop right now.

"Get off of me!" I shouted, pushing him off, while sobbing and gasping for air. He did, of course, and tried to do anything he could think of to calm me down. I explained that I was having a panic attack, and apologized profusely. Once my breathing got back to normal, we got dressed, and I said I wanted to go home. He offered to drive me, but I insisted on taking the bus. While waiting for the bus to come he said, "So, this isn't really going to work out, is it?"

I shook my head, hugged him goodbye and never saw him again. I haven't tried to have sex with anyone since.

I can't remember where I first heard the term "sexual anorexia," but I do remember exactly how I felt: simultaneously ill and relieved. Sexual anorexia is the compulsive avoidance of sexual activity resulting from extreme fear and anxiety of intimacy and sexual situations—I have it. In the same way that traditional anorexia patients starve themselves from food and nourishment, sexual anorexia patients starve themselves from intimacy. Many people conflate sexual anorexia with asexuality, assuming both are a lack of interest in sexual activity. While sexual anorexia specifically does not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it is considered an avoidance disorder. And it's devastating.

It all started a decade ago. I was 23, inexperienced in love, and I could not bring myself to believe that someone like James* would want anything to do with me.

He spent several months trying to convince me of his genuine attraction to and interest in me before I even let him kiss me. We clicked on so many levels: We both liked to clean while listening to The Supremes, we both read about obscure historical events and we often thought of the same sarcastic remark at the same time. He was handsome and a bit older, and even after he introduced me to his parents, I still could not convince myself that this was for real. Instead, I thought of it as some game or prank where he'd eventually end up pointing and laughing at me for thinking that I was worthy of love and affection.

He confirmed all my anxieties and just stopped contacting me. No break-up, no closure.

I always had issues with self-worth—it didn't start with James. In high school, every single one of my friends was part of a couple, except me. It's not that I didn't try—no one was ever interested. In college, what I thought were meaningful connections with guys just ended up being late-night booty call arrangements.

Turn out, my instincts were correct. After finally opening up to the idea of being in a relationship with someone, he confirmed all my anxieties and apprehensions and just stopped contacting me. No break-up, no closure.

Three years later, he surfaced again, telling me that he had made a mistake, and begged me to get together for at least a drink. Despite my better judgment (and the advice of all my friends), I met him for that drink. We slept together that night and it felt reassuring and comfortable and wonderful. The next several weeks were spent in constant contact, like no time had passed at all, with him trying to win over my friends (for the second time).

But after about three months, we were getting ready for bed when he suggested that I sleep in the spare room. When I asked why, he replied, "It's just...that I'm seeing someone" and proceeded to walk into the bathroom. Apparently, he had been seeing another woman for months. I was busy working on my doctorate at the time, so I appreciated the fact that he gave me my space. I did not, however, appreciate what he was doing with that space.

Once he made his little announcement, I grabbed my coat and ran out the door, down four flights of stairs and into a taxi. He called me repeatedly on my way home, but this time I didn't answer. Yes, he hurt me (again) but more than that, I was so disappointed in myself for letting this happen. I could not even possibly fathom being in a situation where I trusted a guy again.

I shut down. My always-present anxiety got so bad that I ended up in the hospital getting an EKG to make sure that I wasn't having a heart attack. The doctor informed me that my heart was fine (physically, at least)—I had been experiencing recurring panic attacks. While happy to be free of cardiac problems, I did not take it well that heartache could have such a profound effect on my mental and physical health. In fact, knowing that James was the cause of my panic attacks made me even more anxious.
I hated thinking that he still had any power over me, let alone such a large impact on my physical wellbeing.

I immediately blamed myself. If I hadn't let him back into my life, I wouldn't be sitting on an examining table wearing a paper gown and hooked up to an EKG machine. This is all my own doing, I thought. I had the ability to control this situation by not getting back together with him, but I made the wrong decision and now am paying the price.

For a long time after that, I mostly stopped socializing and stopped dating altogether.

I have had years of therapy for my sexual anorexia, but even that has presented a problem. It is so extreme that I avoid talking about it even with my therapist, who I partially sought out for help with this very condition. Whenever the subject comes up, I freeze, as if talking about it out loud makes it more real. My therapist is very understanding, but also aware of the fact that I am there to work through this, and tries to get me to open up about it for at least a few minutes each session.

Talking about my sexual anorexia makes me feel broken, like I'll be alone forever."

She asks me what, specifically, about intimacy scares me, and tries to help me imagine situations where I might be ready to start dating. She has asked if I wanted to talk about James, or any of my other previous relationships to pinpoint my triggers. I always turn her down because even though I should talk about it, doing so makes me so sad, and I don't want to leave therapy feeling worse than when I arrived.

Just the thought of talking about it gives me so much anxiety that I avoid it and move on to subjects like work and non-romantic relationships. Being single all my life, I have convinced myself that romantic relationships aren't the be-all-and-end-all—so much so that it feels frivolous to discuss this in therapy. Talking about my lack of relationships and sexual anorexia makes me feel broken, like there is something wrong with me, and I'll be alone forever.

I wish I could say that I had a breakthrough in therapy, but honestly, I haven't. Three years in and I still can't imagine pursuing or being in a relationship.

There are days when I desperately miss physical intimacy and closeness with another person, and chastise myself for being this way, knowing that I'm the only one who can change it. Last year I worked up the courage to go on three dates with a guy I was very interested in, and when things didn't work out it had a disproportionately negative effect on me, making my anxiety and depression worse in all aspects of my life.

It's more than the fear of rejection—it's real, and it's heartbreaking."

What's ironic is that my career involves sexual health and empowerment for women. This is a subject I write, teach and talk about a lot, but I feel like a fraud—no amount of knowledge can erase the fact that sex is something I am no longer able to engage in. I have considered that perhaps thinking about this topic professionally for several hours a day has contributed to my sexual avoidance, reminding me on a daily basis that I'm struggling, and not normal. I keep hoping that one day, things will change.

So far, that has not been the case, and my lack of boyfriends has not gone unnoticed. About once a year I have to "come out" to my mother as heterosexual woman, and friends search through their Facebook friends to find a single man to set me up with.

Until very recently, I used to just not talk about my condition at all. Then I realized that ignoring this struggle is only adding to its stigma and felt a professional responsibility to speak up on behalf of all the other people in my (non-sexual) position.

Sexual anorexia is something that should be discussed more; until it is recognized as a legitimate condition it's likely to continue to be dismissed as a fear of rejection. For many of us, it's more than that—it's real, and it's heartbreaking.

The first time I confided in a friend that I considered myself sexually anorexic—explaining what it was and why I knew I had it—she didn't say anything for a few minutes and just sat there with a wide-eyed look that I assumed was pity.

"Oh my god, that's a thing?" she asked, incredulously.

I nodded.

"That is exactly what I went through for several years, and just thought something was wrong with me," she continued, describing how upset it would make her when people just labeled her "asexual" when that was not the case.

I immediately felt relieved, less alone and for the first time in a long time, hopeful. My friend is now in a long-term, loving relationship with a wonderful man. Knowing that she started out feeling like me and eventually worked through it makes me cautiously optimistic. We are very similar in temperament, and the fact that she was able to overcome it makes me think that I might too.

*Name has been changed.

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