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Arch Sex Behav DOI 10.1007/s10508-016-0802-7

TARGET ARTICLE

Asexuality: , , , or None of the Above?

1 2 Lori A. Brotto • Morag Yule

Received: 30 December 2015 / Revised: 15 June 2016 / Accepted: 27 June 2016 Ó Springer Science+Business Media New York 2016

Abstract Although lack of was first quantified Introduction by Kinsey, large-scale and systematic research on the preva- lence and correlates of has only emerged over the Prior to 2004, asexuality was a term that was largely reserved past decade. Several theories have been posited to account for for describing the reproductive patterns of single-celled organ- thenatureofasexuality.Thegoalofthisreviewwastoconsider isms.Sincethen,however,empiricalresearchonthetopicof the evidence for whether asexuality is best classified as a psy- asexuality—often defined as a lack of sexual attraction— chiatric syndrome (or a symptom of one), a sexual dysfunction, or has grown. Estimates from large-scale national probabil- a paraphilia. Based on the available science, we believe there is not ity studies of British residents suggest that approximately 0.4 % sufficient evidence to support the categorization of asexuality as a (Aicken,Mercer,&Cassel,2013;Bogaert,2013)to1%(Bogaert, psychiatric condition (or symptom of one) or as a disorder of 2004, 2013; Poston & Baumle, 2010) of the adult human popu- . There is some evidence that a subset of self-iden- lation report never feeling sexually attracted to anyone, with rates tified asexuals have a paraphilia. We also considered evidence closer to 2 % for high school students from New Zealand supporting the classification of asexuality as a unique sexual orien- (Lucassen et al., 2011),andupto3.3%ofFinnishwomen tation. We conclude that asexuality is a heterogeneous entity that (Ho¨glund, Jern, Sandnabba, & Santtila, 2014). likely meets conditions for a sexual orientation, and that researchers Although the definition of asexuality varies somewhat across should further explore evidence for such a categorization. these studies,‘‘lackof sexual attraction’’is the generally accepted definition by the Asexuality Visibility and Education Keywords Asexuality Á Sexual orientation Á Paraphilia Á Network (AVEN) (www.asexuality.org).Itisimportant to note, Sexual dysfunction however, that individuals can experience sexual attractions that are not directed towards others—an idea that we elab- orated on more fully later in this article. When we refer to asexuals in this article, we mean‘‘self-identified asexuals’’as self-identificationisthecriterionusedmostoftenbyresearchers studying asexual samples. Interestingly, the definition of asex- uality on AVEN has changed over time as awareness about asexuality has increased. There is recognition that some asex- uals can experience sexual attraction in isolated instances, or withparticularindividuals,andthiswouldbeincludedunderthe & Lori A. Brotto ‘‘Gray A’’spectrum.1 The creation of AVEN in 2001 by David [email protected]

1 Department of Obstetrics and , University of British Columbia, 2775 Laurel Street, 6th Floor, Vancouver, BC V5Z 1M9, Canada 1 AVEN defines Gray A as the community of individuals whofall some- 2 Department of , University of British Columbia, whereinthespectrumbetweenasexual andsexual.Some,within AVEN, Vancouver, BC, Canada also refer to this as the‘‘Ace umbrella.’’ 123 Arch Sex Behav

Jay has had a noteworthy effect on cultivating a sense of com- to position scientists and theoreticians to be able to answer some munity2 for those contemplating their asexual identity, for of these intriguing questions about the nature of asexuality. The housing the largest body of education and information pertain- objective of this brief review is to review and critically evaluate ing to the experiences of asexual individuals, and for serving as a data which address some of the putative classifications of asex- hub for research participants to the academic community. In uality, specifically as to whether asexuality might be a psychi- many instances, hypotheses about the correlates and charac- atric condition (or symptoms of one), a sexual dysfunction, or a teristics of asexuality,thatbecame the focus offuture research, paraphilia.Althoughwe recognizethat these possiblecategories were first discussed on the AVEN forum by members. As of ofasexualityarenotmutuallyexclusive,andthat onemayhavea December 2015, there were approximately 120,000 registered mental health concern, a sexual dysfunction, and a paraphilia membersonAVENaroundtheglobe.Therelationshipbetween simultaneously, we chose to consider each of these separately, AVEN and researchers is bidirectional. In particular, discus- as a possible explanation for asexuality given that such an intel- sions on the forum often pertain to the published research on lectual exercise may help to consider the phenomenon of asex- asexuality and to questions that researchers have posed to uality more deeply. Ultimately, like Bogaert (2006, 2012a), we asexual individuals. For example, Bogaert’s questioning in surmise that the available evidence points toasexualitybeingbest regard to asexuals’ fantasies triggered a lively exchange on conceptualized as a unique sexual orientation. the forum about the contents of asexuals’ fantasies (Bogaert, 2015,personalcommunication).Forthepastfewyears,AVEN has also carried out an annual Community Census, intended to Asexuality as a describe the demographic characteristics of AVEN members. The2014census, which was based onover14,000respondents Could asexuality represent a symptom of a mental disorder (or a (10,000ofwhomwereself-identifiedasexuals;Ginoza,Miller, mental disorder itself)? Furthermore, could distress associated & MembersoftheAVENSurveyTeam,2014),highlightedcon- with asexuality be part of a psychiatric condition, or is it a by- siderable diversity in the experiences and identities of those productofsocietaljudgmentstowardsasexuality?Theavailable identifying as asexual. This diversity needs to be borne in mind science is equivocal with regard to the association between as we consider the research findings that follow, with the caveat asexuality and psychological/psychiatric symptoms. Nurius that any conclusions drawn may not pertain to the entire popu- (1983), who defined asexual individuals as those who chosetonot lation who identify as asexual. have sex, found small but statistically significant higher rates of Early reactions to the flurry of media attention and the exis- depression and self-esteem problems among the asexuals com- tence of asexuality were largely negative, particularly from pared to the other sexual orientation groups, but group diffe- prime-time talk show figures. For example, Williams (2007) rences in self-esteem disappeared when controlling for back- doubted David Jay’s ability to resist having sex‘‘whenhe saw ground characteristics and sexual attitudes. Larger quantitative agirlwalk outof aroom inlingerie’’and Carlson(2006)reported studies have found that self-identified asexual individuals had the on national television that after a few sexual encounters, an same rates of depression as population norms (Brotto, Knudson, asexualwould likelygrowtolovesex, inthesameway thathis Inskip, Rhodes, & Erskine, 2010), but were more likely to endorse initial aversion to goat cheese transformed into indulgence symptoms of Social Withdrawal on a self-report screener for per- after a few ingestions. The opinions among some sex ther- sonality symptoms, and to report more interpersonal difficulties in apists were also negative, with claims that asexuality is likely a general (Yule, Brotto, & Gorzalka, 2013). These researchers also manifestation of trauma, personality disturbance, or problematic found that asexual individuals were more likely to report symp- attachments early in life (Asexuality on 20/20, 2006). Given the toms of , and to endorse more symptoms of suicidality com- centrality of sexual attraction as a core feature of being human, pared to sexual participants. In a follow-up qualitative investigation critics have also argued that asexuality is a manifestation of some withasubgroupofasexual individuals who participated in a larger underlying psychopathology (Johnson, 1977), or that it rep- quantitative study (Brotto et al., 2010), seven out of the 15 par- resents an extreme variant of a sexual desire disorder (Childs, ticipants interviewed reported believing that they had traits of 2009; Westfall, 2004). Some have suggested that at least a subset Schizoid Personality Disorder, and several discussed the associ- of asexually identified individuals may be paraphilic (Bogaert, ation between Asperger Syndrome and asexuality, which had 2006). been discussed at length by members on AVEN. Further support Over the past 10 years, there has been a burgeoning of of this potential association comes from a study by Ingudom- empirical studies on asexuality, and there are now data available nukul, Baron-Cohen, Wheelwright, and Knickmeyer (2007), who found that 17 % of asexual women met criteria for an autism 2 As the reviewer pointed out, it is noteworthy that the drive to seek out spectrumdisorder,andconversely, thereisevidenceofahigher others with a similar disinterest in sex is so strong, and this highlights the rate of asexuality among individuals on the Autism Spectrum centrality of sexuality in human experience. It may also be that such a strong sense of community helps to challenge perceived stigma against compared to a community control group (Gilmour, Schalomon, asexuality. &Smith,2012). This figure is in comparison to approximately 123 Arch Sex Behav

14.7per1000childreninthegeneralpopulation meeting criteria that for some asexuals, their distress arises from these mental for an Autism Spectrum condition (Developmental Disabilities health conditions, rather than from the asexuality itself. Monitoring Network Surveillance Year 2010 Principal Inves- tigators, 2014). Of note, the association between asexuality and either Asperger Syndrome or autism spectrum has been based on cross-sectional study designs, and although several members Asexuality as a Sexual Dysfunction of AVEN endorse the link between asexuality and Asperger/ Autism spectrum, large-scale studies further elucidating this rela- Could asexuality be a symptom of a sexual dysfunction (de- tionship must be performed. fined as a clinically significant disturbance in a person’s ability Some have also suggested that the lack of sexual attraction to respond sexually or experience sexual pleasure) (American may represent a reaction to trauma, or an aversive or Psychiatric Association, 2013)? In other words, could a lack of reactiontoviewingthegenitals(Asexualityon20/20,2006;for sexual to sexual triggers underlie and account for asexual adiscussion,seeGressga¨rd,2013).Neitherofthesehypotheses individuals’ lack of attraction? This conclusion would be in line have been supported by quantitative data (Brotto et al., 2010); with incentive models which propose that motivation however, one qualitative study found considerable variability for sexual activity is triggered by first (Both, in asexual participants’ reactions to viewing genitals, with some Everaerd, & Laan, 2007). To explore whether sexual arousal having a sex-neutral view, and others being more sex averse wasdifferentbetweenasexualandsexualparticipants,genital (Van Houdenhove, Gijs, T’Sjoen, & Enzlin, 2015a). Whether sexual response was tested in a small group of asexual women these reports of aversion towards genitals represent an anxious in response to sexually explicit erotic films. Although the asexual and/or phobic-like reaction to sex and genitals, or reflect an women self-reported no increase in desire for sex after viewing indifferencetothem,wasnotfullyexploredinthestudy.Onthe theerotic films,theirgenitalresponse,asmeasuredwithavaginal other hand, at least some asexual individuals reported appre- photoplethysmograph, did not significantly differ from the other ciatingtheartisticvalueofgenitals,asinMichelangelo’sstatue sexual orientation groups (Brotto & Yule, 2011). Whether genital of David, even though seeing them did not trigger sexual attrac- arousal patterns of asexual men differ from other sexual ori- tion or desire (Brotto et al., 2010). entation groups is unknown, and is currently the subject of at Although there is some evidence for higher rates of psy- least two ongoing studies—one collaboration between the chiatricsymptomsinasexualindividuals,ithasbeensuggested University of British Columbia and Brock University, and a that at least some of those symptoms may be explained by second at Northwestern University. asexuals’ tendency to experience stigmatization and dehuman- Disorders of sexual desire, such as the DSM-5’s Female Sex- ization. For example, when college students were provided with ual Interest/Arousal Disorder (FSIAD), bear resemblance to definitions of different sexual orientation groups, asexual indi- asexuality in that they both pertain to a lack of interest in sex. viduals received the most negative evaluations, and were Indeed, many have speculated that asexuality represents the endorsed as the least likely to possess ‘‘human nature traits’’ polar lower end of the sexual desire continuum, and thus likely (MacInnis & Hodson, 2012). Furthermore, participants were falls within the sexual dysfunction umbrella. However, one least likely to report wanting future contact with asexual indi- key difference between asexuality and a sexual desire disorder viduals compared to the other sexual orientation groups, and the is that those experiencing the latter are required to experience findingswerenotaccountedforbyasexualindividuals’greater clinically significant personal distress, whereas asexual indi- likelihood of being single. Therefore, similar to the experiences viduals’ lack of sexual attraction is egosyntonic, and as reviewed of , gay, and bisexual individuals (e.g., D’Augelli & earlier, when distress is present, it is typically in reaction to per- Hershberger, 1993; Toomey, Ryan, Diaz, Card, & Russell, ceived social disapproval of their asexual status, rather than a 2010), it is likely that the distress and psychological symptoms personally derived distress. Moreover, the goal in treatment experienced by asexual individuals is secondary to their expe- for the person with a sexual desire disorder is to increase their rience of prejudice and discrimination, rather than asexuality interest in sex, whereas an asexual person in therapy would be beingtheresultofanunderlyingpsychologicaldisturbance.As more likely to benefit from a focus on self-acceptance (Hinde- a result, elevated levels of distress, when they do exist among rliter, 2013), or on developing skills around navigating relati asexual individuals, should not be used to pathologize asexual onships, especially if their partner was sexual and motivated to individuals or asexuality more broadly (Bogaert, 2006;Yule have sex. In the DSM-5, the accompanying text for the sexual et al., 2013). Like Prause and Graham (2007), we believe that desire disorders (both FSIAD in women and hypoactive sexual asexuality should not be classified as a psychiatric diagnosis, desire disorder [HSDD] in men) explicitly mentions asexuality norbeseenasasymptomofone.Instead,weagreewithGressga¨rd as an exclusion criterion. (2013) who urges for discussions that move from pathology to To further explore similarities and differences between a identity.Ofcourse,theputativerelationshipbetweenasexuality, sexual desire disorder and asexuality, we recruited 400 men and Asperger Disorder, and Autism Spectrum conditions suggests women to an online study and administered a battery of vali 123 Arch Sex Behav dated questionnaires assessing sexual behaviors and response. Brotto, & Gorzalka, 2014a, but see Yule, Brotto, & Gorzalka, Participants who met diagnostic criteria for HSDD were sig- in press for an exception for men), suggests that asexual indi- nificantly more likely than asexuals to be in a relationship (80 viduals may possess a non-partner-oriented sexual desire under- vs 22 %), to masturbate (88 vs 73 %), and to have engaged in lying their masturbatory behaviors. There may be lustful feelings kissing and petting behaviors (84 vs 36 %) (Brotto, Yule, & thatarediffusewith nodirection toward orconnectiontoothers.A Gorzalka, 2015). After controlling for age, asexual individuals qualitative exploration into the for rev were also significantly more likely to have never engaged in ealed at least some asexual individuals to liken their behavior to (78 vs 12 %), and to have never had a sexual ‘‘cleaning out the plumbing’’(Brotto et al., 2010;Prause&Gra- fantasy(38vs16 %)comparedtothosewithlowdesire.Alogistic ham, 2007; Scherrer, 2008), and this has been replicated by more regression predicting to group found that (higher) sex-related recent research in which asexual individuals reported being much distress, (higher) levels of sexual desire, (partnered) relation- less likely to masturbate for reasons such as sexual pleasure than shipstatus,and(lower)alexithymiascores(i.e.,inabilityto for more functional reasons, such as to relieve tension (Yule et al., identify and express emotions) significantly predicted to the in press). In other words, according to some asexuals, masturba- HSDD group over the asexual group. tion is a physiological act unrelated to sexual incentives. How- Taken together, these findings suggest that asexuality is not ever, the presence of masturbation plus sexual fantasies, which likely to fit under the sexual dysfunction umbrella, at least not may characterize at least half of asexual individuals, raises the as a sexual desire disorder, nor as a disorder of physical sexual possibility that there may be a great deal of variability across arousal response (at least among women). In support of this, asexual individuals in their motives for masturbation, with some another qualitative study found that asexual individuals were having a paraphilic component. Bogaert (2012b) discussed this not worried about their level of sexual desire, nor did they wish further within the context of automonosexualism, a term coined to speak to a health professional about their lack of attraction originally by Magnus Hirschfeld (1914), to reflect an inward direc- (Prause & Graham, 2007). Whereas a diagnosis of a sexual dy tionofone’ssexualinterestssuchthattheasexualindividualmaybe sfunction is made by a trained clinician, one need not have a attracted to themselves. third partyassign thelabelasexual;ratheranindividual’sown Bogaert (2006) rejected the possibility that all asexual indi- identification with asexuality is deemed sufficient for its adop- vidualsareparaphilic,inpartbecauseextremeparaphiliaswithout tion (Hinderliter, 2013). Of course, this does not rule out the possi- any human interest are rare, and also because there seems to be bility that at least some of the individuals diagnosed with lifelong more women than men identifying as asexual (Bogaert, 2004, HSDD may not better be classified as asexual, given that in the 2013), whereas are more common in men. Never- studybyBrottoetal.(2015)therewerefewdifferencesbetween theless, Bogaert (2012b) goes on to speculate that a specific ty those with lifelong HSDD and asexuals on measures of sexual pe of paraphilia might characterize some asexual individuals. behavior and sexual desire. We have also previously suggested Specifically, autochorissexualism, which Bogaert defined as that overlap between lifelong HSDD and asexuality may point to an‘‘identity-less sexuality,’’such that while there is usually a the fact that these individuals are part of the same group, except sense of self within one’s sexual fantasies, an individual with that they differ in self-reported distress. Clearly, fuzzy bound- autochorissexualism may lack a sense of identity as the pro- aries between individuals with lifelong HSDD and asexuality tagonist within a . There is some indirect empirical warrants further investigation to decipher whether these are, in support for this possible link between asexuality and autocho- fact, distinct or the same groups. rissexuality in that among asexuals who report having experi- enced a sexual fantasy, 11 % of them reported that their fantasies Asexuality as a Paraphilia did not depict any human persons, whereas this was the case for only 0.5 % of those in an age-matched sexual comparison group Paraphilias are defined as atypical sexual attractions that are (Yule et al., 2014a). Further indirect support for this stems from not,bythemselves,considereda disorder (AmericanPsychiatric our earlier finding of significantly higher rates of alexithymia tra Association,2013).Tomeetcriteriaforaparaphilicdisorder,the its in asexuals compared to sexual participants (Brotto et al., DSM-5 requires that individuals with paraphilic interests expe- 2010). It is possible that some shared underlying attribute con- rience significant personal distress or that their desires/behavior tributes to both the lack of emotional attachment (in alexithymia) creates distress for someone else, or involve an unwilling partner. and to lack of sense of self during a fantasy or behavior (auto- Given that asexual individuals’ sexual interests fall outside of the chorissexuality). Future research should aim to explore the experiencestypicalofmostpeople, Bogaert(2006, 2012a) association between these constructs among asexually identify- wonderedwhetherasexualityisaformofparaphilia.Thefinding ing individuals. thatasexualindividualsmasturbate—albeitatalowerfrequency Another studyinthis special issue presentedthe results ofa than sexual individuals—with approximately half of asexual thematic analysis of the sexual fantasies shared by 351 asexual individuals masturbating monthly and over 80 % of sexually individuals and 388 sexual persons, with the primary aim of identified individuals masturbating at least monthly (Yule, exploring the contents of their sexual fantasies (Yule et al., 123 Arch Sex Behav

2016).Asexualparticipantsweresignificantlymorelikelythan aced on the content of sexual fantasies as being indicators of an sexual participants to fantasize about scenes that did not involve individual’s primary erotic preference and, instead, focus on themselves,butrather,involvedromanticscenes(likely reflecting the effect of particular sexual fantasies when labeling someth- the finding that asexual individuals have romantic attractions that ingasabnormal(Joyaletal.,2015).Itisworthnoting,however, varyconsiderablyfromromantictoaromantic;Ginozaetal., that non-paraphilic individuals have sexual fantasies with largely 2014).Asexual women were more likely thansexual women non-paraphilicthemes (and someparaphilicthemes)whereas to fantasize about fictional characters. The asexual partici- paraphilic individuals have mostly paraphilic themes asso- pants were also more likely to report feeling disconnected ciated with their sexual fantasies. Future research should aim and/or dissociated from the contents of their fantasies, pro- to document the frequency of paraphilic fantasies exhibited viding additional support for Bogaert’s (2012b)theoryof among asexual individuals as a means of discerning whether autochorissexuality. thisisanisolatedexperienceorarecurrentpatternoffantasies On the AVEN forum under the discussion title‘‘Masturbating that accompany masturbatory behavior. A’s: What do you think about when masturbating?,’’answers by AVEN members included: ‘‘At the risk of sounding like a 12- year-old girl, I almost invariably think of fictional characters. My thoughts haveneverinvolvedpeopleIknow,and theyhavenever Asexuality as a Unique Sexual Orientation involved myself’’by Vicious Trollop;‘‘I usually think of my favorite fictional characters having sex. But never myself’’ According to LeVay and Baldwin (2012), sexual orientation is byTangerinePanda;‘‘Generallyspeaking,Ionlyreallythinkof defined as an internal mechanism that directs a person’s sexual cuddling,believeitornot.Usually,notaspecificpersonorany- andromantic dispositiontoward females,males, orboth, to thing, just a ‘generic human.’ Gender not really defined as: I don’t varying degrees.Many researchers endorsethis view, andplace actually think about sex itself’’by Shivers (AVEN Forum, 2005). a stronger emphasis on sexual attraction, rather than overt Could some asexuals experience erotic target location errors behavior, in conceptualizing sexual orientation based on the (ETLE)? ETLEs can involve preferential attention to a peripheral notion that sexual attraction is the psychological core of sexual or inessential part of an erotic target, manifesting as fetishism, or orientation(Bogaert,2003).Acriticismofthisdefinitionisthat mislocationofanerotictargetonto one’s own body, manifesting itsuggeststheco-developmentandconcordanceofsexualdesire as the desire to impersonate or become a facsimile of the erotic and romantic attraction, yet a largebodyofresearchchallenges target(Blanchard,1991;Lawrence,2009).In otherwords, could their inter-connectedness (Diamond, 2003). If one adopts this de some asexuals who lack sexual attraction towards other finition of sexual orientation, then one might conclude that experience sexual attraction to a particular inanimate object (e.g., asexuality is actually the absence of sexual orientation (and clothing) or to some imagined self? This is possible, and may we would argue that this question has been inadequately expl account for the finding that a proportion of asexuals who, by ored by the existing science). Asexual advocates have main- definition,lacksexualattractiontoothershavefantasiesthatdo tained, however, that asexuality is a unique sexual orientation not depict humans, and in some cases, depict fictional characters group, and have lobbied for its inclusion in sexual minority or scenes. Unfortunately, the questions asked about the contents and pride day events. Scherrer (2008) highlighted the ofsexualfantasiesintheavailable researchhavebeenimprecise, similarities between asexuality and other sexual minorities, sp and we are unsure whether the imagined scene/character/activity ecifically in that both have challenged the connection with in the asexual’s fantasy is an‘‘imagined self’’of the individual, or medical institutions (with historically being whether they are eliciting the fantasy simply as a means of classified as a psychiatric illness, and skeptics of asexuality focusing attention on an object for the purposes of becoming suggesting that it is a manifestation of a psychological disor- sexually arousedandhavinganorgasm(cf.Brotto etal.,2010). der). Both have also used networking to create identity-based We encourage other researchers to deploy more precision in communities (e.g.,Jay,2008).Weacknowledgethatrelyingon the questions asked about whether or not there is an imagined these socio-cultural similarities between asexuals and other ‘‘self’’in these fantasy scenes. sexual minority groups, alone, to justify asexuality as a unique Whereas these data provide some support for the possibility sexual orientation might be inappropriate, and that stronger evi that asexuality may be an expression of paraphilic interest, it dence supporting asexuality as a unique orientation is needed to must be noted that recent studies have shown that a substantial make this conclusion. proportion of sexual individuals also engage in fantasies that The focus on sexual attraction, rather than on sexual behav- might be considered paraphilic, and some have queried whe- ior, fits other definitions of sexual orientation, and fits Bogaert’s ther what has been traditionally considered to be‘‘paraphilic’’ (2006) definition, which emphasizes that attraction is the might actually reflect normative sexual interests (Ahlers et al., psychologicalcoreofsexualorientation.Byextension,Bogaert 2011; Joyal, Cossette, & Lapierre, 2015; Ogas & Gaddam, 2011). (2015) also proposed that asexuality be considered as a unique These researchers, in particular, urge for less emphasis being pl- sexual orientation. The finding that asexual individuals have 123 Arch Sex Behav reported‘‘alwaysfeelingthisway’’(Brottoetal., 2010;Van rigan, 2011; Scherrer, 2008; Van Houdenhove et al., 2015a)rev Houdenhove et al., 2015a) suggests that their lack of attraction ealasexualindividuals to have‘‘alwaysfeltthiswayeversinceI may be lifelong, and is an innate personal characteristic rather can remember,’’and to deny a significant event in their life that than a reaction to an adverse (sexual) encounter. triggered the loss of sexual attraction. The rise of the Internet, One piece of indirect evidence supporting the innate develop- and AVEN in particular, may have facilitated language and a ment of a sexual orientation stems from biomarkers research. conversation around asexuality, but the empirical literature com Bogaert(2004,2013)postulatedthat asexualwomen’stendency bined with discussions on the AVEN forum converge to pa- to have atypical menstrual characteristics relative to sexual int a picture in which the asexual identity has always been women, shorter stature, and a greater number of health problems present. provides support for the role of early biological influences on In regard to Seto’s (2012) second criterion pertaining to asexuality. Further evidence for the prenatal origins of asex- behavior, he noted that‘‘the strongest test of sexual orientation uality comes from a study of 1283 individuals where asexual iswhomapersonwouldchooseinahypotheticalsituationwhere women had a significantly greater chance of being non-right- theycouldfreelyhavesex,without negativeconsequences,when handed(OR = 2.51)thanandrophilicwomen,andasexualmen presented with alternate choices’’(p. 234). Whereas there is great were similarly more likely to be non-righthanded (OR = 2.39) variability in the extent of romantic attraction (ordesire for a than gynephilic men, with over a quarter of the asexual par- romantic partner) held among asexual individuals, there is ticipants being non-righthanded (Yule, Brotto, & Gorzalka, relative consistency in their lack of motivation for sex. Many 2014b). Given that handedness has been regarded as a bio- reportthat sex is something that they, frankly,can livewithout. logical marker associated with sexual orientation develop- Among asexual individuals who do engage or have engaged ment(Lalumie`re,Blanchard,&Zucker,2000),thesefindings in sexual activity, it is likely that partnership with a sexually provideindirectevidenceforasexualityasasexualorientation. identifying individual accounts for their sexual activity (Van In the same study, further evidence for the prenatal origins of Houdenhoveetal.,2015a).Ifthisis true, thenasexualitywould asexuality stemfromthe findingthatasexualrighthandedmale indeed meet Seto’s second criterion for asexuality as a sexual participants had significantly more older brothers than right- orientation since their (relative) lack of sexual behavior par- handed gynephilic participants (Yule et al., 2014b). The mag- allels their lack of sexual attraction. nitude of the non-righthanded effect seen in Yule et al. was The third criterion, temporal stability, refers to the stability in nearlytwicethatofobservedinthemeta-analysisofgaypartici- one’s preferences (or lack thereof in the case of asexuality) over pants (Lalumie`reet al.,2000)(OR= 2.39–2.51 vs1.39,respec- time.UsingdatafromWavesIIIandIVfromtheNationalLong- tively), providing noteworthy support for the strength of this asso- itudinal Study of Adolescent Health (Add Health), Cranney ciation in asexuals. (2016) examined the temporal stability for the item‘‘lack of sex- Fraternal birth order, another biomarker associated with sex- ual attraction’’from Waves III to IV. Among 25 participants in ual orientation in men (Blanchard, 2008; Blanchard & Bogaert, Wave III who reported no sexual attraction, most did not continue 1996), is associated with the maternal immune hypothesis, by toreportalackofsexualattractioninWaveIV,andonlythreepar- which a greater number of maternal older brothers is linked with ticipants who reported no sexual attraction during Wave III went a greater likelihood of (homosexual) sexual orientation in men. ontoreportnosexualattractionduringWaveIV.Akappascoreof Yule et al. (2014b) found that asexual men (and androphilic men) 0.17shows a relativelyweak agreement across waves for the asex were more likely to have older brothers than gynephilic men, ual individual’s sexual orientation, and slightly higher kappas and interestingly,asexual womenhad significantlyfewer older (0.2–0.4) for the other sexual minority groups. Moreover, the brothers than androphilic women. These somewhat conflicting existence of demi-sexual individuals (i.e., a person who identifies findings raise the possibility that asexual men and asexual women as asexual until they form a strong emotional connection with have different origins of their asexuality, as is likely the case with someone) and gray-sexual individuals, who fall somewhere in gayand lesbianindividualsaswell.Thattheasexualmen appeared the spectrum betweenasexualandsexual,suggests thatthere may to have an even greater number of older brothers than the be fluidity associated with asexuality identification. Sexual flu- (though this effect was not significant) in the study by Yule et al. idity has been especially described in samples of women more (2014b) also strengthensthe study’s conclusion aboutthe potential so than men (as reviewed by Diamond, 2012), and although asex innateness of asexuality. uals have not been studied in this body of research, we cannot rule Seto’s (2012) exploration of whether should be out that fluidity also applies to asexually identifying individuals. considered a unique sexualorientation may be useful for explor- Two large population-based studies found a greater proportion of ing whether asexuality similarly fits the definition of a sexual females than males identifying as asexual (after weighted analyses) orientation. Seto suggested that three criteria need to be (Bogaert, 2004,2013). These two observations (fluidity among ase considered: namely age of onset, one’s sexual and romantic xuals and greater prevalence among women over men) may be behavior,andthestabilityof the attractionover time.Regarding related, and should be explored in the future. In light of these the first criterion, qualitative studies (Brotto et al., 2010;Car- findings, we conclude that there may be only weak support for 123 Arch Sex Behav

Seto’s (2012) third criterion of temporal stability among asexual experiences their asexual identity is likely to differ compared individuals, though ofcourse, the presence of fluidity does not neg to others who fall under the same asexual umbrella. Future ate something as constituting a sexual orientation. research should aim to explore the different trajectories that Taken together, asexuals would meet only criteria one and had led these different subgroups toward adopting an asexual two, but not criterion three, of Seto’s conditions for meeting a identity. sexual orientation label; however, we must be mindful of the concerns about studying temporal stability of orientation in young adults. Conclusions

Kinsey first defined the lack of sexual attraction inherent to Challenges to Considering Asexuality as a Unique asexualityasbelongingtocategoryX(Kinsey,Pomeroy,& Sexual Orientation Martin 1948), yet rigorous empirical research on this category has emerged only over the past decade. Research employing a There has been a strong drive from within the asexuality com- variety of methodologies, and drawn from many different dis- munity to accept asexuality as a sexual orientation, and an ciplines, has examined the nature of asexuality, with a focus on associated openness to research efforts directed at finding evi- howtobestconceptualizeit.Here,webrieflyrevieweddata dence for biological innateness, presumably because the‘‘born addressing the possibility that asexuality is a psychiatric dis- that way’’argument may attenuate stigma directed towards order (or a symptom of one), or that it is a sexual dysfunction. asexuals.However,wemustcriticallyevaluate thetenetthat We conclude that there is not sufficient evidence to support either evidence of biological correlates or predispositions to asexu- of these classifications for asexuality. There is some preliminary ality are sufficient for classifying asexuality as a unique sexual support, however, for at least a subgroup among asexual individ orientation.Weagree withBogaert(2006),who arguesagainst uals to have a paraphilic characterization, and more rese thislineofreasoning, andnotesthat‘‘even ifanessentialistposition arch exploring the persistence and pervasiveness of paraphilic is correct, a biological predisposition is not the same as an actual fantasies may be useful to this line of inquiry. Using criteria that sexual orientation’’(pp. 246–247). Gressga¨rd (2013) also adopts have been applied to considering whether pedophilia should be this cautionary view with regard to asexuality. Furthermore, the cau considereda unique sexual orientation ornot, we conclude that se(s)ofasexualorientationshouldnotbeequatedwiththepheno- there is modest support for asexuality’s placement as a unique menonitself,andtheremaybemultiplecausesleadingtothefinal sexual orientation. There is, however, likely as much variability (asexual) outcome. amongasexualindividuals’lackofsexualattraction(andwhether One must also consider whether sexual orientation classi- it also extends to lack of romantic attraction) as there is among fication is a process of exclusion, as we have done in this brief sexual individuals’ presence of sexual attraction. review by first considering whether asexuality is a psychiatric Other articles in this special issue consider some of the dimen- condition, a sexual dysfunction, and a paraphilia. However, th sions of sexual orientation such as sex/gender of the preferred ese categories are not mutually exclusive, and even if asexu- target, as well as age of the preferred target. Might asexuality rep- alitywerebestplacedwithinasexualorientationclassification, resent another dimension on which orientation is based, such that thisdoesnotexcludethepossibilitythatitcanalsooverlapwith subjective falls at one end (e.g., the individual with a sense of theothercategories.Inotherwords,itispossiblethatanindivid identityasa sexualagent)andnon-subjectivefallsatthe otherend ual may have an asexual orientation, have a psychiatric dis- (e.g., the autochorissexual who experiences a complete identity- order (e.g., major depressive disorder), and have a sexual less sexuality).3 Within such a spectrum, this would account for dysfunction (orgasmic disorder) simultaneously. In a similar the experiences of Gray As, who experience sexual attraction so vein, self-identified asexuals are a heterogeneous group (with me of the time, and for demisexuals, who experience sexual respect to romantic attraction, extent of partnered and solitary attraction only after developing a strong romantic attraction to sexual behavior, frequency and content of masturbatory fan- wards a particular individual. Studying asexuality as a sub- tasies, relationship status, medical and psychological correlates; jective/non-subjective dimension or orientation might guide Van Houdenhove, Gijs, T’Sjoen, & Enzlin, 2015b), thus we future research questions that will ultimately lead to greater und must recognize the possibility that it does not fall neatly into erstanding of asexual subtypes. a single category for all asexually identifying individuals. The category of individuals who adopt the label‘‘asexual’’ Acknowledgments The authors wish to thank Tony Bogaert for pro- appears to be becoming more heterogeneous since Bogaert’s viding helpful comments on an earlier draft of this paper. We also wish to thank Paul Vasey and an anonymous reviewer for very valuable com- (2004) original paper. The most recent AVEN Community Ce ments that have led to a strengthened paper. nsus (Ginoza et al., 2014) revealed widespread diversity in que stions about participants’ sexual orientation, , 3 The authors thank Dr. Paul Vasey for suggesting this dimension of and . As such, it is likely that how one orientation. 123 Arch Sex Behav

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