Skip to main content
Log in

The DSM Diagnostic Criteria for Sexual Aversion Disorder

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript


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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • Apt, M., & Hurlbert, E. D. (1992). Motherhood and female sexuality beyond one year postpartum: A study of military wives. Journal of Sex Education and Therapy, 18, 104–114.

    Google Scholar 

  • Basson, R., Leiblum, S., Brotto, L., Derogatis, L., Fourcroy, J., Fugl-Meyer, K., et al. (2003). Definitions of women’s sexual dysfunction reconsidered: Advocating expansion and revision. Journal of Psychosomatic Obstetrics and Gynaecology, 24, 221–229.

    Article  PubMed  Google Scholar 

  • Binik, Y. M. (2009). The DSM diagnostic criteria for vaginismus. Archives of Sexual Behavior, Doi: 10.1007/s10508-009-9560-0.

  • Choy, Y., Fyer, A. J., & Lipsitz, J. D. (2007). Treatment of specific phobia in adults. Clinical Psychology Reviews, 27, 266–286.

    Article  Google Scholar 

  • Crenshaw, T. L. (1985). The sexual aversion syndrome. Journal of Sex and Marital Therapy, 11, 285–292.

    PubMed  Google Scholar 

  • DSM-V Task Force Document. (2009, March 23). Draft guidelines for making changes to DSM-V (Available from the DSM-V Task Force, American Psychiatric Association, Washington, DC; e-mail:

  • Finch, S. (2001). Sexual aversion disorder treated with behavioural desensitization [Letter to the Editor]. Canadian Journal of Psychiatry, 46, 563–564.

    Google Scholar 

  • Janata, J. W., & Kingsberg, S. A. (2005). Sexual aversion disorder. In R. Balon & R. T. Segraves (Eds.), Handbook of sexual dysfunction (pp. 43–65). Boca Raton, FL: Taylor and Francis Group.

    Google Scholar 

  • Kaplan, H. S. (1987). Sexual aversion, sexual phobias, and panic disorder. New York: Brunner-Mazel.

    Google Scholar 

  • Kaplan, H. S. (1988). Intimacy disorders and sexual panic states. Journal of Sex and Marital Therapy, 14, 3–12.

    PubMed  Google Scholar 

  • Katz, R. C., Gipson, M. T., Kearl, A., & Kriskovich, M. (1989). Assessing sexual aversion in college students: The Sexual Aversion Scale. Journal of Sex and Marital Therapy, 15, 135–140.

    PubMed  Google Scholar 

  • Katz, R. C., Gipson, M. T., & Turner, S. (1992). Recent findings on the Sexual Aversion Scale. Journal of Sex and Marital Therapy, 18, 141–146.

    PubMed  Google Scholar 

  • Katz, R. C., & Jardine, D. (1999). The relationship between worry, sexual aversion, and low sexual desire. Journal of Sex and Marital Therapy, 25, 293–296.

    PubMed  Google Scholar 

  • Kingsberg, S. A., & Janata, J. W. (2003). The sexual aversions. In S. B. Levine, C. B. Risen, & S. E. Althof (Eds.), Handbook of clinical sexuality for mental health professionals (pp. 153–165). New York: Brunner-Routledge.

    Google Scholar 

  • Meyer, T., Miller, M., Metzger, R., & Borkovec, T. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.

    Article  PubMed  Google Scholar 

  • Mowrer, O. H. (1947). On the dual nature of learning: A reinterpretation of “conditioning” and “problem-solving”. Harvard Educational Review, 17, 102–148.

    Google Scholar 

  • Murphy, C., & Sullivan, M. (1981). Anxiety and self-concept correlates of sexually aversive women. Sexuality and Disability, 4, 15–26.

    Article  Google Scholar 

  • Noll, J. G., Trickett, P. K., & Putnam, F. W. (2003). A prospective investigation of the impact of childhood sexual abuse on the development of sexuality. Journal of Consulting and Clinical Psychology, 71, 575–586.

    Article  PubMed  Google Scholar 

  • Schiavi, R. C. (1996). Sexual desire disorders. In T. A. Widiger, A. J. Frances, H. A. Pincus, R. Ross, M. B. First, W. Davis, & M. Kline (Eds.), DSM-IV sourcebook (Vol. 2, pp. 1091–1101). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Schover, L. R., & LoPiccolo, J. (1982). Treatment effectiveness for dysfunctions of sexual desire. Journal of Sex and Marital Therapy, 8, 179–197.

    PubMed  Google Scholar 

  • Spielberger, C. D., Gorusch, R. L., & Lushene, R. E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Toronchuk, J. A., & Ellis, G. F. R. (2007). Criteria for basic emotions: Seeking disgust? Cognition and Emotion, 21, 1829–1832.

    Article  Google Scholar 

  • Wolpe, J., & Lang, P. J. (2007). A Fear Survey Schedule for use in behavior therapy. In E. J. Thomas (Ed.), Behavior modification procedures (pp. 228–311). New Brunswick, NJ: Transaction Publishers.

    Google Scholar 

Download references


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.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Lori A. Brotto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brotto, L.A. The DSM Diagnostic Criteria for Sexual Aversion Disorder. Arch Sex Behav 39, 271–277 (2010).

Download citation

  • Published:

  • Issue Date:

  • DOI: