Sex Therapist Q&A

Is sex something that some people can simply live without? "20/20's" JuJu Chang reported on a growing number of people who classify themselves as asexual. They say they're living happy lives without any sexual activity.

Sex therapist Joy Davidson suggests that asexuals may want to explore underlying psychological or physical issues, before labeling themselves asexual.

Lisa in New Jersey Writes:

I am 19 years old, and I've been having a lot of trouble convincing my parents that I do not experience sexual attraction. After watching the asexuality story on "20/20," my father looked at me during your comments and gave me a very snide "See?" as if he feels that I should force myself to do something that I have absolutely no interest in. Is there anything I can say to my parents that will make them understand that sex just is not for me?

Davidson Responds:

I hope you can see the weird humor in having a dad who says, "Be more sexual!" while most of your friends' folks are probably saying, "Wait!" But I would hate to think you're rebelling against your father's pressure. Rebellion may be part of growing up, but knowing when someone has a good point, (even if it IS your dad!) is part of being a grown-up. In this instance, your dad is picking up on the idea that lack of interest in sex can be based on something other than an irreversible condition called asexuality.

I totally believe that you're not inclined toward having sex right now. But do I know for sure that you will never be interested? Not without a crystal ball. We all develop sexually at different paces. Some of us are sexually precocious, and some of us are late bloomers. Just because someone is in her late teens or early 20s doesn't mean she is necessarily in full bloom. What you feel now may not be who you are so much as where you are in your own unique cycle of development. By labeling yourself too soon, you run a serious risk of mislabeling yourself, then feeling duty-bound to live up to it.

There's no doubt that when you feel like an outsider, when all your friends seem boy crazy or girl crazy and you're not, you'll want to gravitate to a group that better reflects where you stand. I'd be down with that 100 percent if the group in question stood for accepting how you feel right now but also supported the possibilities for change. I'd be more comfortable, too, if the group offered education instead of an "if you think you are, you are" approach to the matter of asexuality. Lay psychology is sometimes intuitive and smart, and sometimes more about inclusion than pure wisdom.

In addition to the timing of sexual development, there are plenty of other legitimate reasons that someone could feel asexual without being in a permanent or irreversible state. The short list includes endocrine imbalances, history of trauma or abuse, subconscious negative attitudes about sex, fear of being swept up or losing control, depression, anxiety, and the effects of undiagnosed medical conditions. Some people might even just like feeling "special" or "unusual." In fact, there are so many convoluted possibilities that only a trained person can help you sort them out.

Is it scary to dig around in your emotional and physical recesses? Good grief, yes! But when you have another 70 or 80 years of life ahead of you, don't you owe it to yourself to spend a few of them doing that kind of excavating? Even if, in the end, you are more convinced than ever that you're incapable of being attracted to anyone, male or female, at least you will have come to that conclusion after educated and responsible consideration. I'd really like to see you give yourself the advantage of time, and, ideally, have at least a few sessions with a qualified sex therapist so that you can talk about all your feelings beyond the pressure imposed by either your family or your peer group.

Cecelia in San Antonio, Texas, Writes:

We've been married for 13 years and haven't had sex in over 11 years. Looking back at the first year of our marriage, I realized I had been the one to initiate anything physical. It was my second marriage, and I have one child; it was his first marriage and we met, got engaged, married and went on a weeklong honeymoon all in less than three months. Before we married he claimed to have too much respect for me to resort to sex before marriage. We have wonderful vacations in remote and romantic settings; we love to cuddle. We sleep late on the weekends and take afternoon naps together, but on his part there is absolutely not a hint of desire or passion much less sex, I've seen the uninterested look on his face and his less than willingness to touch me anywhere! I sometimes wake up in a panic, knowing I will never in the boundaries ... of this marriage have the pleasure of sex again. I married at 39. I am now 52 and extremely frustrated!

Davidson Responds:

Unfortunately, you can't "work out" a sexual problem with an unwilling partner. What you can do, however, is tell your husband that you love him dearly but don't want to live a sexless existence forever. You need make no apologies for desiring a new level of intimacy in your relationship. Let him know you understand and respect the fact that he has blocks and resistances to sex with you , but that you'd like to explore them with him in counseling. If he is willing to consider couples therapy, don't wait another day. If he is not, I urge you to get counseling for yourself. You deserve some help in considering all your options and making clear and responsible decisions about your future.

This is a good place to mention that I highly recommend that anyone who chooses to see a sex therapist select one who is certified by the American Association of Sexuality Educators, Counselors and Therapists. AASECT's standards for education, training, and supervision are rigorous, and knowing that someone is AASECT certified is the only way to be certain that they have the qualifications you need in a sex therapist. Many general therapists call themselves sex therapists because they talk to clients about sexual matters, but the only gold standard for training and certification among sexuality professionals is AASECT. A therapist in your area can be found on its Web site at

Frederick in Pennsylvania Writes:

I am 56 years old. I have been married for 11 years. My wife and I have not had sex or any affectionate relations for many years. We have a 17-year-old son and an 11-year-old daughter. We rationalize and claim that we do not want to divorce for the children's sake. Recently, we realized that we are not diplaying an accurate representation of the type of loving relationship we would want our children to experience in their lives. Any suggestions ?

Davidson Responds:

I applaud you for realizing that staying together for the sake of the children may not be doing them a real service. The absence of touching, kissing, and general physical affection -- not to mention the void in romantic energy between you -- offers your children no reliable template for intimacy. If you do plan to stay together, you need to get serious about rekindling the romantic and affectionate side of your relationship. If doing it for yourselves seems awkward and embarrassing after all these years, think of it as a hurdle you need to leap for the children. This may be where "for the sake of the kids" actually means something!

There are many books that can help you find direction, including David Schnarch's "Passionate Marriage." You will probably need some counseling as well, since change of this nature can be difficult even with help, and head-spinning without it.

If you're unable to re-ignite intimacy within your marriage, counseling can help you separate in a way that supports your ongoing relationship as co-parents and generates the least amount of disruption or insecurity for your children.

Karen in Cincinnati Writes:

I had sex numerous times in my 20s and 30s (I am currently 43), but I only did it because the males in my life wanted it. Sex has always been extremely uncomfortable for me. I guess I could say that it hurts. However, I have performed it because the men in my life wanted it.

My husband, though, is not asexual, but has an EXTREMELY low sexual libido, and has chosen to be abstinent concerning sex with me. So, we had sex a very few times when we dated, but we haven't had sex one time since we have been married because he knows that sex is painful for me.

Even though sex is painful for me, I can become aroused with the "right" movie, etc. I can also get "hot" with kissing, etc. However, I can only remember getting aroused one time in the five years we have been married and it was when I was watching a movie.

So, should I go to a doctor again to see if there is a way for me to have pain-free sex, or should I just be content with my asexual lifestyle or can you recommend another solution for me?

Davidson Responds:

We live in a culture that is saturated with sexual images, yet it is pitifully devoid of real sexual education for young people, which translates into a poor foundation for adult relationships. Uninformed teens grow into adults who may spend years, even decades, basing relationships on the minimal or incorrect information they accumulated as youngsters. Today's emphasis on abstinence-only education leaves many couples without basic knowledge about how their bodies work or what to expect in a relationship. Much of your own suffering -- as well as your husband's -- might have been prevented had you acquired comprehensive information about sexual health and pleasure. Nevertheless, I'm so glad you wrote now! You've described a complex situation, but there are two points that stand out: First, no one should ever have sex that is painful or even uncomfortable. Pain is a symptom that something is amiss and needs attention. And having sex because someone else insists is a surefire way to feel disempowered, which can erase whatever authentic desire you might otherwise have felt. If you were having sex you didn't want, then you were certainly insufficiently aroused and lubricated, which could have caused sexual intercourse to be painful. In addition, certain medical conditions also make intercourse -- and sometimes even gentle sexual touch -- painful. Given your background, the precise cause of your pain can only be determined by a thorough sexual history and physical exam.

I would urge you to see a doctor, but, this time, be sure to see someone who is well-trained in the practice of sexual medicine and comfortable discussing the extent of her expertise working with patients who have sexual pain conditions. Anyone who is reluctant to have this conversation with you or doesn't supply satisfactory answers is not the right doctor.

The second key point is this: Many people think that sexual desire is supposed to hit like a bolt from the blue; that a woman should merely look across the room at her partner and feel overcome with sexual urgency. If she doesn't feel that way, she may imagine that there is something wrong with her or with her relationship. The reality is quite different. Many people -- especially women in long-term relationships -- feel desire only after they have experienced sexual pleasure and arousal. So, a long, lovely kissing session, or the right kind of caresses, or the mental stimulation of an erotic movie or conversation, could initiate the arousal that leads to a desire for more. However, building up arousal to the point where you are ready for intercourse -- physically and emotionally -- can be a slow process. Many women simmer "on low" for a long time before their heat begins to rise. Along the way, any disruption can turn the flame down and leave her cold. A partner who rushes, the experience of pain, even a major mental distraction can snuff out the fire. Anybody who has had only a few poor sexual experiences may conclude she is just not very sexual, when, in fact, it is pretty healthy not to feel sexual under circumstances that are uninspiring, counter-erotic or unpleasant!

I hope you'll see a doctor about your pain, as well as learn more about your sexuality by taking advantage of the many resources -- books, films and Web sites -- that provide exceptional adult sexuality education. I have a list of some of the very best sources on my Web site, www., and invite you to have a look. You'll also find answers to nearly every sexual question at And the Web site has referral information to sex therapists and a list of excellent sex education books written by its members.

Chuck Writes:

Is it possible to become asexual after you've been married eight-plus years, with a child?

Davidson Responds:

It's certainly possible to lose desire for sex in a long-term relationship, but losing desire is not the same as being asexual. People who believe they are asexual claim they have never had interest in sex.

There are many reasons why a woman would turn off to sex -- some are medical or hormonal but most have to do with the changes in her relationship. Lack of trust or feelings of anger and resentment can play a huge role. So can the inability to communicate sexual needs or have them met by your partner. Illness, depression, anxiety and certain medications can also have an impact.

Complaints of ebbing sexual desire in marriages, whether by the female or male partner, are the most common reason that people visit sex therapists. You are not alone in your frustration or sense of loss. I'd like to suggest that you look through some of the reading resources I've suggested, and then perhaps contact for a therapist referral. Best of luck!

Molly in Naperville Writes:

I have been married for two years, and I have never had an orgasm. I had two sexual partners before I was married and never had an orgasm then. I am in my mid-20s and starting to think there is something wrong with me. My husband and I have a healthy sex life, but the fact I have never had an orgasm comes up every so often. I am sort of OK with the fact that it hasn't happened, but in the back of my mind I know it bothers my husband a lot. I feel guilty. I don't blame either of us. ... I just want it to happen once or occasionally. I could really use some advice on this topic. Please help.

Davidson Responds:

You don't say how you're trying to have an orgasm, so I'll presume that you're going for the Big O during intercourse, which is the least likely way to achieve a climax. Rest assured, there is nothing wrong with you; only about a third of women have orgasms during intercourse. The vast majority of women have them through separate oral or manual stimulation of the clitoris. Even women who do climax during intercourse often require simultaneous clitoral stimulation. However, if you're an "orgasm virgin" the cooperative choreography required to master that can be tricky.

Learning to orgasm is much easier as a do-it-yourself project. Once you become adept at self-pleasuring, you can share your newfound successes with your partner. For step-by-step help, pick up a copy of Lonnie Barbach's classic book, "For Yourself, or Julia Heiman's "Becoming Orgasmic" or my book, "Fearless Sex."

Donna in Spokane Writes:

In 1993 I began suffering from pain in my neck. After a year of tests, CTs, strange behavior and projectile vomiting, I was referred to a neurologist. He ordered an MRI and found two, large fluid-filled cysts on the frontal lobes of my brain. During this time my libido had diminished significantly and caused a rift between my husband and me.

After brain surgery to drain the cysts my personality was back to normal but not my libido.

It has been 13 years, many doctor visits, counseling and a divorce and still no libido. I have accepted it, but my ex-spouse still blames me for his impotence. "Use it or lose it." I have not been able to get any answers from doctors or counselors. In fact, no one seems able or willing to help me solve the reason for this loss.

My ex has proposed remarriage, but I'm hesitant, as he will want to have a sexual relationship, and I don't even want him to touch me in a sexual way. I have gained a lot of weight and have difficulty losing it. I believe it's my way to avoid being sexy. That hasn't thwarted him. I am so turned off.

Davidson Responds:

It might help you to understand that libido is not a commodity that exists in isolation, separate from your psyche, body and spirit. So, rather than talk about libido the way we'd talk about blood pressure, let's talk about the desire you feel, or don't feel, for the very real person with whom you are considering signing on for life again. Given the anger and recrimination in your relationship, it puzzles me why either of you would consider remarrying one another, but under the circumstances, I'm hardly surprised that being sexually intimate is a turnoff. In fact, I'd be more worried if you were turned on by someone you believe still blames you for being ill and sees your suffering as a sexual inconvenience. Your best bet is to find a new therapist who can help you clear your sexuality of its toxic associations with your ex so that you can reclaim your own sexually and sense of desire.