Asexuality: what it is and why it matters.

This article was downloaded by: [Harvard Library] On: 24 April 2015, At: 00:55 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

The Journal of Sex Research Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/hjsr20

Asexuality: What It Is and Why It Matters a

Anthony F. Bogaert a

Department of Health Sciences, Department of Psychology, Brock University Published online: 21 Apr 2015.

Click for updates To cite this article: Anthony F. Bogaert (2015) Asexuality: What It Is and Why It Matters, The Journal of Sex Research, 52:4, 362-379, DOI: 10.1080/00224499.2015.1015713 To link to this article: http://dx.doi.org/10.1080/00224499.2015.1015713

PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http:// www.tandfonline.com/page/terms-and-conditions

JOURNAL OF SEX RESEARCH, 52(4), 362–379, 2015 Copyright # The Society for the Scientific Study of Sexuality ISSN: 0022-4499 print=1559-8519 online DOI: 10.1080/00224499.2015.1015713

ANNUAL REVIEW OF SEX RESEARCH SPECIAL ISSUE

Asexuality: What It Is and Why It Matters Anthony F. Bogaert

Downloaded by [Harvard Library] at 00:55 24 April 2015

Department of Health Sciences, Department of Psychology, Brock University In this review article, human asexuality, a relatively understudied phenomenon, is discussed. Specifically, definitions and conceptualizations of asexuality (e.g., is it a unique category of sexual orientation?), biological and historical contexts, identity issues, discrimination against asexual people relative to other minorities, origins, and variations, including gender differences, are reviewed. Whether asexuality should be construed as a disorder is also discussed. The study of asexuality allows for a better understanding of an underrecognized sexual minority but also affords a unique opportunity to examine and better understand human sexuality.

In 2004, an academic paper on human asexuality appeared in the Journal of Sex Research (Bogaert, 2004), along with a media report on the phenomenon in New Scientist (Westphal, 2004). Since that time, a heightened degree of academic and public interest in this relatively understudied phenomenon has occurred, including the publication of a number of theoretical papers (e.g., Bogaert, 2006b; Chasin, 2011), empirical papers (e.g., Bogaert, 2013; Brotto, Knudson, Inskip, Rhodes, & Erskine, 2010; Prause & Graham, 2007), a special issue of a journal (Przybylo, 2013), a review paper (Van Houdenhove, Gijs, T’Sjoen, & Enzlin, 2014b), and many media reports (e.g., Bulwa, 2009), including a full-length documentary (Chevigny, Davenport, Pinder, & Tucker, 2011). There has also been a book on asexuality written for both academics and nonacademics (Bogaert, 2012b), and one written by a self-identified asexual woman on the asexual experience (Decker, 2014). In the present article, many of the issues raised in these recent academic publications and media sources are reviewed. There is a particular emphasis on issues reviewed in the recent book Understanding Asexuality by Bogaert (2012b), which was a broad overview of human asexuality. However, this article addresses additional issues, including some raised in more recent literature since the publication of this book. In the first part of the present article, introductory and contextual issues on asexuality are presented, including biological

and historical contexts, definitions=conceptualizations, and prevalence. In the second part, issues related to the development and psychological variations associated with asexuality are presented, including its origins, gender and other differences, and identity formation and discrimination. In the third part, medical=clinical issues are presented, along with a discussion of whether asexuality should be construed as a disorder. Throughout these sections, illustrations are presented on how the study of asexuality informs the nature of human sexuality, but a separate, later section will review these examples and expand on them further. In doing so, this paper addresses in part why studying asexuality is of importance to sex researchers and clinicians: Aside from gaining a deeper understanding of an understudied sexual minority, it affords a better view of sexuality. In part, this better view of sexuality may be achieved if we attempt to see sexuality from a distance or from an outsider’s perspective— in other words, ‘‘through the lens of asexuality,’’ to the extent this is possible. Finally, conclusions and future research directions are presented. Note that this review is meant to address a fairly wide range of issues and to be of interest to scholars of different disciplines, but it is also one written by a psychologist; thus, the psychology and closely related biomedical=clinical aspects of asexuality are emphasized throughout this review.

Correspondence should be addressed to Anthony F. Bogaert, Department of Health Sciences, Department of Psychology, Brock University, St. Catharines, Ontario L2S 3A1, Canada. E-mail: [email protected]

Biological and Historical Context

Introductory and Contextual Issues

In biology and related disciplines, the word asexual usually describes organisms that do not use sex (e.g., male


ASEXUALITY

and female variations) to reproduce. Indeed, asexuality has been the predominant form of reproduction for the majority of time that life has existed on the earth (e.g., Cowen, 2005) and still exists in many biologically simple organisms. However, some complex, large-sized, but phylogenetically older animals—sharks, for example— have the capacity to reproduce asexually (e.g., Chapman et al., 2007). In the majority of phylogenetically younger animals, such as mammals (including humans), there is no capacity to reproduce asexually; reproduction only occurs sexually, through a combining of genes from male and female variations (Cowen, 2005). Within sexually reproducing species, such as mammals, there is often evidence that a percentage of animals have no interest in, or attraction to, potential sexual partners and are thus construable as asexual (see section on definitions of asexuality). Lab-based rodents, for example, have been noted for their sexual variability. Some rodents are sometimes labeled ‘‘studs’’ for their hypersexualized behavior; others are labeled ‘‘duds’’ for their lack of sexual interest in partners (e.g., AdkinsRegan, 2005). In sheep, another well-studied group of domesticated animals, variation clearly exists in their sexual interests=attractions (e.g., Perkins & Fitzgerald, 1997; Roselli, Larkin, Schrunk, & Stormshak, 2004). Using a controlled experimental paradigm and special animal pens, researchers can study rams’ sexual inclinations by allowing them access to ewes in estrus or to other rams. The sexual inclinations of the ewes are more difficult to study in such a controlled setting. Most of the rams exhibit behaviors that evince heterosexual attraction. However, a significant minority of rams exhibit behaviors evincing marked attraction to the same sex (i.e., other rams) or both sexes (rams and ewes). There is also a significant minority of rams showing no interest or attraction for either rams or ewes. For example, Roselli and colleagues (2004) stated in their summary of research on these animals: ‘‘Over the past 2 years, 584 rams were tested. Of these, 12.5% were asexual’’ (p. 235). Rams may provide an important animal model of human sexuality in part because when same-sex attractions occur in these animals they seem to demonstrate a pattern of behavior similar to same-sex behavior in men (e.g., a percentage of rams actively pursue male partners and demonstrate a seeming exclusivity toward such partners; Perkins & Fitzgerald, 1997). As such, other atypical orientations—no sexual attraction—in rams may provide an important animal model of human asexuality. Thus, there may be similar brain and other developmental mechanisms giving rise to these atypical sexual attractions in both species (see Origins section). In a review of evidence of asexuality over human history, Bogaert (2012b) drew a number of conclusions. One was that throughout humans’ ancestral history it is very likely that a significant percentage in each generation did not mate, but this lack of sexual behavior with partners in some individuals does not indicate they

necessarily lacked sexual interest or attraction for others. Likely many factors beyond a lack of sexual interest in (or attraction for) heterosexual partners have contributed to a lack of partnered heterosexual behavior throughout human history, including same-sex attraction, the often harsh exigencies of mating competition, and the cultural influence on the importance of celibacy (or abstinence from sex; see Abbott, 2001). The latter factor— the importance of celibacy or sexual abstinence—cannot be overstated in human cultural history. In contrast to the often-held view in modern Western society that the absence of sex is a disorder, historically in many societies or within segments of society (e.g., many religions) celibacy has been seen as a godly virtue and something to which humans should aspire (Sigusch, 1998). A second conclusion was that much of the early cultural record was spotty in providing evidence of historical figures who were asexual, although there is some evidence of asexuality among notable figures such as Isaac Newton and Emily Bronte (but see White, 1999, and Davies, 2004, respectively). The modern cultural record is clearer in providing evidence of asexuality, including famous mathematician Paul Erdos (Schechter, 1998). A third conclusion was that, throughout human cultural history, artists have depicted figures and characters with an asexual aura in art and literature (e.g., Sherlock Holmes). Modern popular media—for example, the character Sheldon on the television show The Big Bang Theory—also portray (quasi-)asexual characters. These depictions of characters indicate that sexual variability, including its extreme forms, have been recognized throughout history. These depictions also illustrate that art (e.g., literature) often requires variability among characters to generate dramatic tension and that sexual variability can be a key weapon in the artist’s arsenal used toward creating this tension. The latter point is also an example of how understanding asexuality—in this case how it plays itself out in art—provides insight into sexuality, along with the human inclination for storytelling. Finally, Bogaert (2012b) concluded that the history of asexuality should include mention of the emergence of modern asexual ‘‘identities,’’ and relatedly, the recent visibility of individuals and groups providing information and support to those who may fall under the broad aegis of ‘‘asexual’’ (e.g., David Jay as the founding member of Asexuality Visibility and Education Network [AVEN]; Bulwa, 2009; Chevigny et al., 2011). Definitions/Conceptualizations When is someone asexual? Or, in other words, what best defines asexuality? In the previous section on biological and historical context, I suggested that asexuality is construable as a lack of sexual attraction or a lack of interest in others. Thus, this definition implies a lack of lustful inclinations=feelings directed toward others. This lack of sexual inclinations=feelings toward others 363


BOGAERT

should be of an enduring nature or imply an enduring disposition or orientation. For example, in Bogaert (2004; see also Bogaert, 2013), asexuality was defined as ‘‘never having felt sexual attraction to others.’’ This definition of asexuality as a lack of sexual attraction or desire for others has partly emerged in recent years in response to theory (e.g., Bogaert, 2006b; Chasin, 2011) and empirical work (e.g., Bogaert, 2004; Brotto et al., 2010) on asexuality, along with earlier theoretical work on sexual orientation (e.g., Storms, 1980). This definition is consistent with how AVEN, the most influential online community and Web site devoted to asexuality, defines asexuality. A consistency with AVEN’s definition does not provide any particular theoretical rationale for the use of this definition, but it is notable that it resonates with a number of influential asexual leaders and educators and how they view the phenomenon. As mentioned, usage of the term asexual as a lack of sexual attraction for others has partly emerged from theories of sexual orientation. For example, using Storms’s (1980) two-dimensional model of sexual orientation, heterosexual people are defined as those individuals having high heteroeroticism (i.e., high on other-sex attraction); homosexual people are those individuals high on homoeroticism (i.e., high on same-sex attraction); bisexual people are defined as those individuals high on both heteroeroticism and homoeroticism; and asexual people are those individuals who are low on both heteroeroticism and homoeroticism (i.e., low on both same-sex and other-sex attraction). Note that Storms’s model of sexual orientation has been argued to be an advance over Alfred Kinsey’s traditional, one-dimensional model of sexual orientation (i.e., a scale from 0 ¼ Exclusive heterosexuality to 6 ¼ Exclusive homosexuality; Kinsey, Pomeroy, & Martin, 1948) for a number of reasons. These reasons include the former’s emphasis on sexual attraction=eroticism (e.g., fantasies) over behavior, along with its ability to accommodate asexuals when two dimensions are used. However, Kinsey did recognize the existence of asexual (or nonsexual) people and the fact that they did not conform to his one-dimensional model of sexual orientation, calling them ‘‘Xs’’ (Kinsey et al., 1948; Kinsey, Pomeroy, Martin, & Gebhard, 1953). A definition of asexuality that centers on a lack of sexual attraction—including sexual fantasies—to either sex would not necessarily imply that an asexual person would lack sexual experience with either sex, although behavioral definitions of asexuality have been forwarded (e.g., Poston & Baumle, 2010) and there is evidence of reduced sexual behavior with others for those lacking sexual attraction (e.g., Bogaert, 2004). Thus, a definition of asexuality based on attraction would not necessarily include those who are chaste (e.g., prior to marriage) or celibate—those who actively eschew sex altogether—if they are still sexually attracted to others. 364

A lack of sexual attraction would not necessarily imply a self-identification as asexual, although clearly many people who lack sexual attraction would also identify as such. Note that a self-identification of asexuality would be defined as a labeling of oneself as asexual, just as self-identification of a person with same-sex attraction would entail labeling oneself as gay or lesbian, etc. Why not give precedence to self-identifications in defining=conceptualizing asexuality? A self-identification as asexual is important from developmental and sociocultural perspectives, which are discussed in a later section. Many major modern professional organizations in the social sciences and in mental health also recognize self-identifications and argue for sensitivity to anyone who chooses to self-identify with a sexual orientation– relevant label (e.g., the Diagnostic and Statistical Manual of Mental Disorders [DSM] by the American Psychiatric Association [APA]). Yet a number of issues are associated with defining asexuality merely by a selfidentification as asexual, including an inconsistent awareness of a self-label(s), hesitancies in coming out, fluctuating allegiances to a label, and political motivations (e.g., Bogaert, 2012b). Similar issues often occur, of course, in defining traditional sexual orientation (e.g., gay, lesbian, queer) using self-identification labels given the potential complexity and multidimensionality of sexual identity formation in sexual minorities (e.g., Diamond, 2003a; Seif, 1999; Vrangalova & Savin-Williams, 2012). Using a definition that centers on a lack of sexual attraction would not necessarily mean asexual people lack sexual desire. Sexual desire refers to an urge for sexual stimulation (including potentially an orgasm) and may include both partnered and nonpartnered stimulation (e.g., masturbation). It is notable, however, that one alternative but related definition of asexuality is in fact a lack of sexual desire. For example, Prause and Graham (2007) found evidence that many self-identified asexual people report very low (or absence of) sexual desire. More research needs to be conducted on the complex relationship between attraction and desire (Bogaert, 2013; Chasin, 2011), but recent evidence and theory suggest the lack of desire in asexuals may be primarily a lack of desire for others—not lack of desire per se; thus again, a lack of sexual attraction=desire for others may be a defining characteristic of asexuality (see Brotto et al. 2010; Chasin, 2011; Van Houdenhove, Gijs, T’Sjoen, & Enzlin, 2014a). In short, when there is evidence of a form of desire in asexual people, it is often a ‘‘solitary’’ desire—a desire that is unconnected to others or a nonpartnered desire. For example, there is evidence that a significant number of asexual people masturbate (e.g., Bogaert, 2013; Brotto et al., 2010), and thus asexual people may not lack all forms of sexual desire. Having a lack of sexual attraction would also not necessarily mean that these asexual individuals do not


ASEXUALITY

have a romantic=affectionate attraction for others. Indeed, it is important to make a distinction between romantic attraction (e.g., ‘‘feelings of infatuation and emotional attachment;’’ Diamond, 2003b), and sexual attraction [‘‘lust lure (for others)];’’ e.g., Bogaert, 2012b). The traditional assumption is that one implies the other, but this is not necessarily so (e.g., Diamond, 2003b). There is evidence that, in practical terms, one’s romantic inclinations do not always align with one’s sexual ones: We can have romantic inclinations toward, say, men, even though our primary sexual attraction is toward women (e.g., Diamond, 2003b). Similarly, in relationship literature, there is often a distinction made between love and sexual=passionate love (e.g., Fehr, 2013). Evidence from developmental psychology and evolutionary=neuroscience studies suggests that romantic=love and sexual attraction processes are distinct; for example, lust=sex systems have a phylogenetically older history and primarily reside in different brain structures than the phylogenetically younger romantic=love system (e.g., Diamond, 2003b; Fisher, 2004), which may have evolved relatively recently from our attachment processes=systems toward parents (e.g., Hazan & Shaver, 1987). In line with the distinction between romantic and sexual attraction, evidence suggests that asexual people are not necessarily aromantic (e.g., Bogaert, 2004, 2006b; Carrigan, 2011; Hinderliter, 2009). For example, although having a lower percentage than sexual people, a significant percentage of asexual people have been found to be in long-term relationships (e.g., approximately 33%; Bogaert, 2004). However, even a nontrivial percentage of nonpartnered asexual people may still be romantic, as a lack of long-term relationships among many asexual people may partly reflect their (perceived) inability to attract or maintain a partner who may want a sexual relationship. Thus, some asexual people may still have heteroromantic inclinations, others homoromantic inclinations, while still others have biromantic inclinations. Indeed, given the assumption of a close alignment between romantic and sexual inclinations, some asexual people may report their sexual orientation as gay, straight, or bisexual based on their romantic attractions (e.g., Bogaert, 2012b, 2013; Chasin, 2011), insofar as the concept of a ‘‘romantic orientation’’ may be less familiar to people than the concept of sexual orientation. In sum, it is important to keep in mind that an asexual person may be romantically inclined, despite his or her lack of sexual inclinations. Similarly, the converse may also be true: A sexual person may evince little romantic inclinations, despite having strong sexual inclinations. This point is also relevant to a main theme of this article (see also Bogaert, 2012b), in other words, understanding asexuality informs our understanding of sexuality, as asexual people demonstrate that romantic inclinations can be decoupled from sexual inclinations.

Finally, the definition of asexuality as a lack of sexual attraction (or lack of sexual desire for others) does not necessarily imply that asexual people lack physiological sexual arousal experiences. The capacity for erection and vaginal lubrication in asexual people may be fully intact (e.g., Brotto & Yule, 2011). For example, one asexual person indicated: ‘‘I did, you know, test the equipment . . . and everything works fine, pleasurable and all; it’s just not actually attracted to anything’’ (Brotto et al., 2010, p. 612).

Additional Conceptual Issues A number of other issues=considerations related to the definition of asexuality include the following. First, Bogaert (2006b) argued that ‘‘subjective’’ sexual attraction is the relevant psychological component in defining sexual orientation, including an asexual orientation. Subjective refers to one’s own internal or mental experience and does not necessarily include evidence of physiological arousal=attraction. Often physiological attraction is assessed by measures of physiological arousal (e.g., erection, vaginal lubrication) using psychophysiological devices, such as the penile strain gauge and vaginal photoplethysmograph. Note that not all sexologists would give precedence to subjective attraction over physiologically based attraction in defining sexual orientation (including asexual orientation), but Bogaert’s (2006b) rationale for subjective attraction was as follows: First, using a subjective definition of attraction seems to best capture the ‘‘psychology’’ of sexual orientation (e.g., the study of the ‘‘mind,’’ including perceptions). Second, it may be more linked to actual sexual behavior than physiological arousal=attraction. For example, a person who does not perceive sexual attraction toward women despite exhibiting physiological arousal patterns toward them (e.g., in the laboratory) is unlikely to engage in sexual behavior with these partners. Notable in this regard is that women’s subjective sexual attraction patterns often do not match their genital arousal patterns, which show arousal to female targets that is nearly equal to arousal to male targets (Chivers, Rieger, Latty, & Bailey, 2004). Despite this, the large majority of these women would report their subjective sexual attraction patterns (and would identify) as heterosexual. (p. 244)

Thus, genital arousal patterns are important and informative in understanding sexuality, particularly for men, but these patterns should not necessarily trump subjective attraction in determining sexual orientation. A related issue is whether including asexuality as a separate and unique category of sexual orientation is a conceptual=theoretical error, modern models of sexual orientation notwithstanding. Bogaert (2006b, 2012b) argued that it is not a conceptual error and that asexuality can be construed within a sexual orientation 365


BOGAERT

framework. Certainly asexuality can be described as an absence of the three main designations of sexual orientation—heterosexual, homosexual, or bisexual— and even as an absence of an orientation altogether, given that there is little or no sex-based orienting or directionality to their sexuality (Bogaert, 2004). However, given that (subjective) sexual attraction arguably defines sexual orientation (e.g., Bailey, Dunne & Martin, 2000; Bogaert, 2003; Money, 1988; Storms, 1980; Zucker & Bradley, 1995), or is the psychological core of sexual orientation (e.g., Bogaert, 2003), then if one lacks (subjective) attraction for others, asexuality is construable as a separate, unique category within a sexual orientation framework (Bogaert, 2006b). Thus, using a model similar to Storms (1980), asexuality is construable as the fourth category of sexual orientation, i.e., those evincing low or no (subjective) eroticism= attraction to either sex, or those having an ‘‘orientation’’ to neither sex (see Figure 1). In sum, in this article (see also Bogaert, 2006b, 2012b) precedence is given to subjective sexual attraction (over physiological attraction=arousal) in defining sexual orientation; and asexuality can be understood within a sexual orientation framework. Thus, if an individual does not subjectively experience sexual attraction—his or her mind is not registering (or attuned to) sexual attraction to others—regardless of his or her physiological experiences, he or she can be designated as having an ‘‘asexual’’ orientation. One possible counterargument against construing asexuality as a separate category of sexual orientation is that asexuality may be caused by an atypical biological process (e.g., low levels of circulating hormones, atypical prenatal mechanisms; see section on origins); and, if these biological processes were altered, then the true sexual orientation (heterosexual, homosexual, bisexual) of an ‘‘asexual’’ person would be revealed. Thus, it may be argued that it is wrong, or at least premature, to indicate that an asexual person has a

Figure 1. Model of sexual orientation based on eroticism=attraction toward the sexes (after Storms, 1980).

366

unique orientation that differs from the traditional three designations. However, this reasoning may contain a logical error, because the origins of asexuality should not be confused with the phenomenology of asexuality. Moreover, more broadly, we should unconfound the origins from the phenomenology (or lived experience) of sexual orientation (see Bogaert, 2006b). As an example, if a man is attracted to other men because of an atypical biological process—including a biological process that is atypical for his sexual orientation and that process may be alterable—does this negate the lived experience of his (subjective) attraction to men? In short, he no longer has (or had) same-sex attraction; thus is not, or was not, homosexual? It is argued here—and likely most would agree—that, no, he is still homosexual because his subjective attraction is to men, regardless of the cause of that subjective experience, even if the cause potentially differs from the main processes underlying homosexuality for most individuals, and even if that process might be alterable at some point in time. Aside from these conceptual=theoretical arguments, recent research also gives support to the idea that asexuality is understandable within a sexual orientation framework. Specifically, the same biological factors underlying differences in traditional sexual orientation (e.g., gay versus straight) may also underlie asexuality (e.g., Yule, Brotto, & Gorzalka, 2014a). Moreover, results from one small study on arousal patterns in asexual women (n ¼ 7) are consistent with a traditional sexual orientation model of asexuality, not a sexual dysfunction one (Brotto & Yule, 2011). Thus, there is some additional empirical evidence from research studies—albeit with one of the studies being of small sample size—in favor of asexuality as a separate category of sexual orientation, even if one is not convinced by these theoretical arguments. In summary, there are a number of definitions of asexuality, although a lack of sexual attraction (or a lack of desire for others) is, arguably, the most common definition in both recent literature and among individuals who support the most popular chat=Web site (AVEN) devoted to asexuality issues. Also notable is that a lack of attraction is, at least to some degree, independent of other facets of psychosexual functioning (e.g., sexual desire, sexual behavior, physiological arousal, romantic inclinations). It should also be noted that other definitions of asexuality (e.g., no sexual desire, selfidentifications) have been forwarded. Moreover, given that research on asexuality is relatively recent and that the phenomena of asexuality are likely diverse, it is best to construe a lack of sexual attraction as an open definition that may fluctuate over time (Bogaert, 2012b; see also Van Houdenhove et al., 2014b). The degree to which the definition does change over time may have interesting implications for studying asexuality’s origins, for clinical issues, and for how we view asexuality as a unique category of sexual orientation.

ASEXUALITY


Prevalence of Asexuality How many people are asexual? Bogaert (2012b) summarized the available data and discussed issues related to prevalence rates of sexual minorities, including asexual people. Of historical interest, Kinsey reported that 1.5% of his male sample were Xs (Kinsey et al., 1948), whereas the number of asexual women in his sample varied depending on whether they were married or not, with 1% to 3% of women designated as Xs if they were married, and 14% to 19% designated as Xs among unmarried women (Kinsey et al., 1953). Kinsey’s definition of asexuality was largely, although not exclusively, behavioral in nature (see Poston & Baumle, 2010), which, as mentioned, differs to some extent from most modern definitions (e.g., a lack of sexual attraction). In addition, most modern researchers interested in the prevalence of sexual minorities, including asexual people, typically rely on information from national probability samples, which better represent the population than convenience samples do. In the first study examining this issue in a national probability sample, Bogaert (2004) found that 1% of a British national sample (National Survey of Sexual Attitudes and Lifestyles [NATSAL]-I) reported that they had ‘‘never felt sexual attraction’’ to others. Analyzing a subsequent national sample from Britain (NATSAL-II), albeit with a sample having a more restricted age range than the original sample, Bogaert (2013) found that 0.5% of the sample reported never having felt sexual attraction to others (see Aicken, Mercer, & Cassella, 2013; for a similar figure in Australia, see Smith, Rissel, Richters, Grulich, & de Visser, 2003). In a national cross-sectional population-based sample of high school students in New Zealand, 1.8% reported no sexual attraction to either sex (Lucassen et al., 2011). In a recent population sample of Finnish twins, 3.3% of the women and 1.5% of the men reported having experienced no sexual attraction within the past year (Ho¨glund, Jern, Sandnabba, & Santtila, 2014). The latter two studies are limited in the age range of participants (i.e., high school students) and in the time span of interest in the questioning (i.e., one year), respectively. There are also national samples containing data on low or absent desire, and usually these figures are higher than the figures reported previously for an enduring lack of sexual attraction (e.g., 3% to 11% in Ventegodt, 1998; 14% to 33% in Laumann, Paik, and Rosen, 1999; 7% in Parish et al., 2003; see Bogaert, 2008). However, some of these studies may have limited applicability to the questions of prevalence of asexuality (even if one assumes a ‘‘desire’’ definition of asexuality), given that some of these studies did not assess a total absence of sexual desire—only ‘‘low’’ desire. Moreover, like one of the studies on sexual attraction mentioned (Ho¨glund et al., 2014), there is no way of knowing whether those who have a low (or absent) desire do so beyond a limited period specified in questioning (e.g., in the past year).

Bogaert (2012b) concluded that 1% may be a reasonable ‘‘working figure’’ for the prevalence rate of asexuality, but at this point we cannot be sure of an exact figure for a number of reasons (see also Van Houdenhove et al., 2014b). The reasons for this ambiguity include the complication of different assessments of asexuality, reflecting the fact that there is not a consensus on a single, definitive conceptualization of the phenomenon. There are also sampling and recruitment issues, even in national or probability samples. For example, many sexual surveys, even if well conducted, may underestimate the number of asexual people, because there may be a lack of interest=motivation for asexual people to participate in such sexuality-based surveys (Bogaert, 2012b). Interestingly, this issue raises again a main theme of this review paper—that studying asexual people affords a better understanding of sexuality—as a methodological weakness may occur in our studies of sexuality, potentially affecting our understanding of sexual people. For example, those with (temporary) low desire and those with other sexual dysfunctions may actively avoid being recruited for sexual studies for similar reasons (see related research on volunteer bias in sexuality studies; e.g., Bogaert, 1996; Boynton, 2003; Strassberg & Lowe, 1995).

Development and Variation Identity Issues In a number of recent publications (e.g., Bogaert, 2012b; Emens, 2014; Gressga˚rd, 2013; Scherrer, 2008; Van Houdenhove, Gijs, T’Sjoen, & Enzlin, 2014c) researchers have addressed issues related to the development of an asexual identity. Some periods of time throughout history are likely to be particularly relevant to understanding the emergence of a minority identity, as these time periods offer individuals heightened information about themselves, such as how similar they are to other minorities and=or how distinct they are from the majority. Certain time periods may also offer strong challenges to, along with increased opportunities for, the advancement of minority human rights, and thus these time periods are relevant to understanding identity formation, as identities often serve political ends aside from psychological ones. For example, the 1970s (post-Stonewall in 1969) and 1980s and 1990s (AIDS crises) may have been particularly important for understanding the emergence of identities associated with same-sex attraction (e.g., coming out as gay, lesbian, queer; see Terry, 1999). Similarly, the current period in Western society may be particularly important in understanding the emergence of asexual identities (Bogaert, 2012b), as an unprecedented array of information on sexualities is available through the Internet; hitherto such information has likely been essentially invisible in all societies. It is often more difficult to recognize the absence of 367


BOGAERT

something, sexual or otherwise, than it is to recognize the presence of something. Asexual identities may also have relevance in a modern context, as they offer a political rallying point against being perceived by the public and the clinical= medical community as having a sexual disorder, such as hypoactive sexual desire disorder (HSDD), in the face of the modern medicalization of sexuality (Bogaert, 2012b; see also Cacchioni & Tiefer, 2012). Similar to other sexual minorities, asexual people stand in contrast to a heterosexual majority. As such, sexuality is the key characteristic in what makes them different from the majority group, and hence sexuality may become a very relevant ‘‘personal construct’’ for some asexual people, even if they have never engaged in sex (Bogaert, 2012b). In addition, asexual people may face similar discrimination challenges to other sexual minorities. Thus, Bogaert (2012b) speculated that some identity issues and stages of development— recognizing one’s own attractions, identifying=labeling oneself, public disclosures or coming out, and identity pride (e.g., Cass, 1979; Coleman, 1982; Floyd & Stein, 2002; Troiden, 1989)—theorized to occur in lesbian, gay, bisexual, and transgender (LGBT) people—may also occur in the development of some asexual people’s identity formation. On the other hand, in contrast to other sexual minorities, asexual people are, by definition, not sexual beings (e.g., lacking in sexual attraction for others and=or potentially having no sexual desire whatsoever). Thus, for at least some asexual people, sexuality is likely a nonissue in their lives and thus does not take center stage when their (broader) identities are being formed. Consider this quote from one asexual person discussing identity: ‘‘Outside of AVEN or conversations specifically about sexuality, I don’t really consciously think of myself as asexual. Like being an atheist or nonHispanic or a non-driver (all apply), asexuality is something I’m not and never was, rather than something I am. The label is mostly a useful marker. So, my asexual identity is important in certain contexts, and I can’t imagine my life if I weren’t asexual, but it is not specifically important to me’’ (Scherrer, 2008, p. 630). Discrimination A number of publications have addressed discrimination toward asexual people (e.g., Bogaert, 2012b; Emens, 2014; MacInnis & Hodson, 2012). On the one hand, it may be the case that asexuals—as a relatively invisible minority—may be assumed to be less at risk for overt discrimination than other, more visible sexual minorities (see Bogaert, 2012b for a discussion). On the other hand, there is evidence that asexual people may suffer similar challenges to other sexual minorities (see Scherrer, 2008). There may also be unique facets to asexuality that bring special and intensified forms of discrimination. At a structural level, there is evidence that 368

many societies’ legal systems privilege sexual over asexual people (Emens, 2014; Gressga˚rd, 2013). For example, those in conjugal partnerships (e.g., marriages) often have additional rights and benefits over single individuals or those in nonsexual partnerships. Although not all asexual people are single and, of course, not all single people are asexual, there is evidence that asexual people are less likely to have had a long-term relationship than sexual people (e.g., Bogaert, 2004); thus, this form of structural discrimination against nonconjugal people may have a heightened relevance to asexual people. On an individual, psychological level, MacInnis and Hodson (2012) found evidence that heterosexual people often view asexual people with more disfavor than other sexual minorities (e.g., gays, lesbians) and may characterize them as ‘‘less than human.’’ The MacInnis and Hodson study again illustrates how the study of asexuality helps us to better understand sexuality, in particular how sex influences prejudice along with, more broadly, how people perceive the nature=essence of humanity. As MacInnis and Hodson (2012) wrote: ‘‘Sexuality appears to be perceived as a key component of humanness. The dehumanization measures employed did not explicitly reference sexuality, yet asexuals were strongly biased against on these measures. Thus, characteristics=emotions representing humanness are clearly intertwined with sexuality and= or sexual desire’’ (p. 734). Variation Masturbation is an important activity in a number of ways for understanding the significant variation that likely exists among asexual people (Bogaert, 2012a, 2012b). For one, variability in masturbation demonstrates that not all asexual people exhibit a complete absence of activities construable as sexual. For example, a significant number of asexual people masturbate (e.g., Bogaert 2013; Brotto et al., 2010), although the evidence, particularly data from a national sample, suggests it is at a lower level than sexual people (Bogaert, 2013). The lower rate of masturbation among asexual people relative to sexual people suggests that many asexual people may find masturbation less intensely rewarding and pleasurable than sexual people. For example, masturbation is less likely to occur at a high frequency when it is not accompanied by intensely rewarding, pleasurable feelings (e.g., Clifford, 1978). Indeed, when masturbation occurs among some asexual people, this activity may merely serve an utilitarian=health function. In a study that included interviews and qualitative analyses, one asexual person reported that masturbation was used to ‘‘clean out the plumbing’’ (Brotto et al., 2010, p. 611). However, the finding that a significant number of asexual people masturbate is also consistent with the notion that some asexual people may contain a non-partner-oriented (or nondirected) sexual desire.


ASEXUALITY

In other words, for some asexual people, there may be lustful feelings=sensations that are ‘‘diffuse’’ and with no direction toward, or connection to, others. Finally, and related to this last point, these findings reinforce the need to be sensitive to different definitions of asexuality (e.g., some who evince some solitary, nondirected desire and some without desire altogether), although, as mentioned, both of these variations may be compatible with a definition of a lack of sexual desire for (or attraction to) others, at least at some basic sexual level. Masturbation in asexual people, particularly if in conjunction with sexual fantasies (see Brotto et al., 2010; Yule, Brotto, & Gorzalka, 2014b), also raises questions about the possibility of some asexual people having a paraphilia, an unusual sexual attraction (Bogaert, 2008, 2012a, 2012b). Bogaert (2012a, 2012b) suggested that some asexual people may have a ‘‘target-oriented’’ paraphilia, in which there is an inversion, reversal, or disconnection between the self and the typical target=object of sexual interest=attraction (e.g., Blanchard, 1991). For example, some asexual people may be attracted to themselves, called automonosexualism (Bogaert, 2008), in which the target of their sexual attractions may be turned inward onto themselves. A variation on automonosexualism occurs in the phenomenon of autogynephilia, a target-oriented paraphilia in which a man is sexually attracted to himself but as a woman (e.g., Blanchard, 1989; Lawrence, 2011). Some asexual people may have other similar paraphilias in that they themselves, or their identities, are disconnected from their sexuality; in other words, there is no identity or ‘‘self’’ or ‘‘I’’ involved with their sexual expressions (e.g., in their fantasies). This disconnect between the ‘‘self’’ and a sexual target=object has been termed autochorissexualism (Bogaert, 2012a). For example, an asexual person wrote this about his masturbatory fantasies on AVEN: ‘‘I almost invariably think of fictional characters. My thoughts have never involved people I know, and they have never involved myself’’ (Vicious Trollop, 2005). Similarly, another AVEN participant wrote: ‘‘It’s scenes in the third person; I may have a generic male character which is kind of me, but it’s still separate from me, mentally watched rather than participated in’’ (Teddy Miller, 2005). If these individuals have, arguably, some form of sexual attraction to others, for example, by generating sexual stimuli (e.g., fantasy) that contain other people or perhaps view sexual imagery of people in pornography, then it raises a question about whether these individuals do have a (traditional) sexual orientation— whether they are ‘‘sexual’’ with an inclination toward others and thus are not ‘‘asexual’’ as defined as lack of sexual attraction (to others). As Bogaert (2012b; see also Bogaert, 2008) suggested, this is an interesting conceptual=definitional issue in sexuality, particularly in understanding what is and what is not a sexual orientation. Bogaert (2012b) also suggested, however,

there is an argument in favor of construing such individuals as asexual (including a lack of sexual orientation to others), because they still lack a form of ‘‘subjective’’ attractiveness (to others), given that the ‘‘I’’ or ‘‘self’’ is missing from their sexuality. In other words, there is no ‘‘self’’ sexually connected to others, even though there may be some level of physical response (and some level of brain regulation) responding to sexual stimulation. Bogaert (2012b) concluded that more research needs to be conducted on this potential sexual ‘‘disconnect’’ between the self and others in some asexual people, including examining additional content in their sexual fantasies (if they exist) or in their use of pornography, along with their physiological arousal behavior. Understanding identity-less sexuality in asexual people may help illuminate typical processes in sexual people. Thus, it reveals what is implicit in most sexual expressions, in other words, that sexual individuals usually have a ‘‘self’’ engaged in and connected to their sexual objects=targets. In one’s sexual fantasies, for example, sexual individuals usually assume the role of a protagonist in engaging in sexual behavior with others. Thus, although people’s fantasies may vary in the degree to which the protagonist is proceptive (initiating=directing the action) or receptive (responding to other’s actions) and, relatedly, whether the protagonist views others or presents himself or herself as an ‘‘object of desire’’ (e.g., Bogaert, Visser, & Pozzebon, 2015), there still is usually a ‘‘self’’ (or ‘‘I’’) as the protagonist in people’s sexual fantasies. Yet as the fantasies mentioned suggest, some asexual people evidently do not have this ‘‘I’’ connected to their sexuality. Second, understanding identity-less sexuality puts into relief other identity-related phenomena that characterize human sexuality. For example, in many heterosexual men’s sexual targeting of women, there is an objectification where men may visualize female bodies or parts of their bodies without a face or any semblance of a personality; and thus their sexual targets can be perceived to be devoid of any discernable identity. Thus, identity issues are very relevant and worthy of understanding in both the subject (e.g., ‘‘I’’ or ‘‘self’’ as a protagonist) in sexual activities, including fantasies, and in the perception of the object=targets in human sexual expressions. Much still needs to be understood about how the self operates within sexual expressions, and the study of asexuality may help illuminate these processes. There is also notable variation in asexuality based on gender. For one, there is evidence more women than men are asexual (e.g., Bogaert, 2004, 2013; Brotto et al., 2010; Ho¨glund et al., 2014). For example, Bogaert (2004) found that approximately 70% of the asexual people in NATSAL-I were women (i.e., reported never experiencing sexual attraction to others). In several publications Bogaert (2004, 2012b, 2013) raised a number of possibilities for why this gender difference 369


BOGAERT

in asexuality occurs. One of these possibilities was related to masturbation. Men masturbate more than women do, particularly during adolescence (e.g., Petersen & Hyde, 2010). Such self-stimulation may be construed, at least partially, as ‘‘learning=conditioning’’ trials leading to enduring sexual attractions to others (e.g., Bogaert, 2012b). If people of a particular gender are regularly the object of one’s desire in fantasies (e.g., self-induced imagery or imagery in viewed pornography) during masturbation, then people of that gender may become part of one’s permanent sexual attractions. If so, in some women who do not masturbate, or do so very rarely, there may be little development of strong sexual attractions. Another possibility is related to women’s sexuality, relative to men’s, being more flexible, responsive, and open to social=cultural influences (e.g., Baumeister, 2000). If so, women may have an increased likelihood to developing asexuality if life circumstances are atypical or perhaps not conducive to traditional sexualization. An additional related consideration includes the possibility that women are less socialized to be sexual beings and=or have more atypical sexual socialization experiences relative to men (e.g., Aubrey, 2004; Oliver & Hyde, 1993; Petersen & Hyde, 2010), and thus an absence of sex (e.g., lacking in sexual attractions to others) may be compatible with how they describe their inclinations and their overall sense of (sexual) selves. In a number of publications Bogaert (2004, 2006b, 2012b) argued that our conceptualization and measurement of sexual orientation might also play a role in finding a gender difference in asexuality. As sexologists, we have traditionally viewed sexual orientation in a ‘‘target-oriented’’ way, in other words, people’s sexual orientation is construed as being directed sexually toward or to others, either men or women, or both if bisexual. Our questions assessing sexual orientation also imply this target-oriented view of sexual orientation. For example, consider the often-used sexual orientation question: ‘‘To whom are you sexually attracted?’’ This type of question implies a ‘‘target’’ group of individuals (men, women, or both) to whom we direct sexual interests. This question assumes our sexuality is inherently directed toward others. However, such a conceptualization may be unduly influenced by a male model of sexuality, because men are usually more category specific in their arousal (e.g., Chivers et al., 2004) and are more proceptive (versus responsive) and objectifying in their sexuality (e.g., Basson, 2002; Baumeister, 2000; Bogaert & Brotto, 2014; Diamond, 2003b; Meana, 2010; Wallen, 1995) relative to women. Thus, men are, arguably, more target oriented in their sexuality (e.g., Bogaert, 2004, 2012b, 2013) than women are. If so, traditional, target-oriented questions of sexual orientation may not resonate with some women and their subjective experience of sexuality. As a consequence, some of these 370

women may report not being sexually attracted to others (hence asexual). A second gender-related variation concerns gender roles=identities. It is clear that some sexual minorities— for example, gay and lesbians—on average do not conform to traditional gender roles (e.g., Rieger, Linsenmeier, Gygax, & Bailey, 2008). It is unclear, however, whether asexual men and women on average also do not conform to traditional gender roles. For example, to the author’s knowledge there is no research examining how asexual people score on traditional measures of gender roles. Bogaert (2012b) did speculate that asexual people are likely untraditional in some aspects of gender roles, in part because sexual development may make boys and men more traditionally masculine and girls and women more traditionally feminine (see Hundhammer & Mussweiler, 2012). In addition, there is some evidence that an elevated percentage of asexual people do not identify as either male or female, thus having a nontraditional gender identity (Brotto et al., 2010; Gazzola & Morrison, 2012). For example, approximately 13% of the asexual people studied in Brotto and colleagues’ (2010) research did not identify as male or female. These figures reinforce a main idea forwarded in this section on variability: that asexual people likely form a very diverse group—in other words, ‘‘one size does not fit all’’—but also that one of the important variations may run along basic gender identity lines. There is also some noteworthy evidence that asexual men and women may share some aspects of sexual functioning with sexual individuals of their same gender. For example, using psychophysiological measures of sexual arousal, self-identified asexual women have been found to evince patterns of arousal similar to other women; in other words, they are non–category specific in their response (see Brotto & Yule, 2011). To date, there is no published research on patterns of psychophysiological sexual arousal in asexual men. Similarly, evidence suggests that both asexual men and women share some patterns of masturbation with their biological sex (men > women), with asexual men having an elevated frequency of masturbation relative to asexual women (e.g., Bogaert, 2013; Brotto et al., 2010). The fact that asexual men masturbate more than asexual women suggests that paraphilias—to the degree that they exist in asexual people (e.g., Bogaert, 2012a)—may be elevated among asexual men relative to asexual women. Such a conclusion may be warranted for two reasons. First, the content of one’s masturbatory fantasies is related to one’s sexual attractions=inclinations (e.g., MacCulloch, Snowden, Wood, & Mills, 1983; Storms, 1980). As such, asexual men’s elevated rate of masturbation, some of which is accompanied by fantasy (Yule et al., 2014b), is not likely of typical content, given that asexual people do not exhibit sexual attractions to people. Thus, asexual men may have elevated paraphilic attractions relative to asexual women, given that they masturbate


ASEXUALITY

more than do asexual women, and such masturbation may, at times, be accompanied by atypical fantasies. Second, this conclusion is consistent with evidence that men exceed women in the incidence of paraphilias (Cantor, Blanchard, & Barbaree, 2009). However, an increased incidence of paraphilias among asexual men relative to asexual women remains a speculation, as limited research exists on the content of sexual fantasies (Yule et al., 2014b), along with other evidence of unusual attractions, in asexual people. As a final note in this section, a theme in this article is, as mentioned, that understanding asexuality helps us understand sexuality, and this is certainly true in the context of gender differences in sexuality. For example, we may understand better how women’s sexuality, relative to men’s, may be less target oriented, which may have implications for a number of aspects of sociosexual functioning, including women’s reporting of sexual attraction (or their lack of attraction) to others. Origins A number of research studies have addressed the origins of human asexuality. One line of research focuses on markers=correlates of early biological development, similar to work on traditional sexual orientation (e.g., LeVay, 2010; Wilson & Rahman, 2005). Bogaert (2004, 2013) found evidence that asexual men and women have, on average, a shorter stature than sexual people. Bogaert (2004, 2013) also found evidence that asexual women have, on average, atypical menstrual characteristics relative to sexual women (see Ingudomnukul, Baron-Cohen, Wheelwright, & Knickmeyer, 2007). These correlates are suggestive of early biological influences on asexuality, as both are potential markers of early biological determinants, including prenatal factors (e.g., Bogaert & Liu, 2013; but see Bogaert & McCreary, 2011). Yule and colleagues (2014a) found evidence that non-right-handedness in both men and women and the number of older brothers in men are associated with asexuality. Handedness is particularly relevant to explanations of early biological determinants in asexual development, because it is a clear marker of prenatal development (e.g., Hepper, Shahidullah, & White, 1991). Handedness patterns have also been linked to other nonheterosexual sexual orientations and other sexual inclinations (e.g., Bogaert, 2001; Lalumie`re, Blanchard, & Zucker, 2000), suggesting that asexuality shares a common origin with these other sexual orientations=inclinations. An elevated number of older brothers may also be relevant to prenatal influences on sexual orientation development, as it has been linked to homosexuality in men (e.g., Blanchard & Bogaert, 1996) and this linkage is likely the result of prenatal influences (Bogaert, 2006a). The most well-articulated prenatal explanation of the ‘‘older brother’’ (or ‘‘fraternal birth order’’) effect is the maternal immune hypothesis,

where a mother develops an immune response against a male-specific protein important in brain development after being exposed to one or more male pregnancies (Blanchard & Bogaert, 1996; Blanchard, 2004; Bogaert & Skorska, 2011). The biological research on low desire issues—such as evidence of low circulating testosterone (e.g., Bolour & Braunstein, 2005; Riley & Riley, 2000)—may be relevant as well, if we are to define asexuality broadly and to include instances where individuals evince no or very low desire (e.g., Prause & Graham, 2007), or if such conditions ultimately contribute to a lack of (subjective) sexual attraction and=or to an asexual identity in some people. There is also some evidence that at least some asexual people (i.e., those who report no sexual attraction for others) have elevated physical health issues (Bogaert, 2004, 2013), with some conditions potentially impacting adult testosterone levels. On the other hand, to the author’s knowledge, there is no direct research on those individuals who report a lack of sexual attraction for others, or self-identified asexuals, having lower levels of testosterone. In addition, assuming that animal models are applicable to understanding human asexuality, there is no or little evidence that ‘‘asexual’’ (noncopulating) rodents differ from sexual ones in their testosterone levels (e.g., Alexander, Stellflug, Rose, Fitzgerald, & Moss, 1999). Moreover, as mentioned, there is evidence that many asexual people still exhibit solitary desire and masturbate (e.g., Bogaert, 2013; Brotto et al., 2010); thus, altered testosterone levels may not be applicable in most cases. Interestingly, some qualitative research on asexual women (Van Houdenhove et al., 2014c) suggests that a high percentage of asexual people may have ‘‘always felt different,’’ similar to the often-reported sense among many gays and lesbians of always ‘‘being different’’ from the heterosexual majority (see Sage, 2013; Wilson & Rahman, 2005). Such reflections suggest, although they do not demonstrate, that the origins of asexuality, like other enduring sexual orientations, may reflect in part very early influences, including potential prenatal ones. Bogaert (2012b) also speculated that some psychosocial factors might be relevant, including atypical or extreme environmental conditions, such as early sexual trauma. Such early sexual influences have been argued to play some role in other atypical sexual inclinations of an enduring nature (e.g., Seto, 2008). However, there is little evidence that self-identified asexuals are motivated by avoidance=aversion issues (Prause & Graham, 2007), assuming, for example, that sexual trauma is sometimes linked to avoidance=aversion issues. It is also important to note that no research to date has examined the impact of such environmental influences on asexuality directly, although there is some evidence that broad societal or macrolevel environmental variables 371


BOGAERT

(e.g., lower socioeconomic status and education, higher religiosity) may be correlated with asexuality (e.g., Bogaert, 2004). Assuming such influences do play a role in some forms of asexuality, again some sensitivity to variability and different patterns of expression of asexuality is warranted, as some asexual people may be more ‘‘hardwired’’ while others may reflect responsivity to certain strong environmental factors. If there are different ‘‘forms’’ of asexuality based on origins, does this mean that the potential ‘‘hardwired’’ form is the ‘‘real’’ form of asexuality while the more responsive form is an ‘‘unreal’’ type? As suggested, the perspective taken in this article (also Bogaert, 2006b, 2012b) is that such distinctions are dubious. It is necessary to unconfound the origins of asexuality from both the phenomenology of asexuality as an orientation and, relatedly, with whether it may be construed as a disorder. Thus— again using homosexuality as an example—if two people have an enduring subjective sexual attraction toward the same sex, yet the origins of that subjective attraction differ for these individuals, it does not negate the ‘‘realness’’ (or phenomenology) of their orientation as homosexual for either one of them. Prause and Graham (2007) found evidence that self-identified asexuals have lower sexual ‘‘excitatory’’ propensities but not necessarily higher ‘‘inhibitory’’ ones. Bancroft, Graham, Janssen, and Sanders (2009) have argued in their dual control model that sexual functioning is influenced by both excitatory (high) and inhibitory (low) mechanisms. Thus, from a developmental perspective, processes related to lower excitatory (versus higher inhibitory ones) may be particularly relevant to understanding asexuality. Both excitatory and inhibitory processes are likely influenced by multiple factors, including biological and sociocultural ones. As such, Prause and Graham’s (2007) research, although not isolating a specific causal factor underlying asexuality per se, may provide some direction for specific causal factors within a broad model of sexual functioning. Bogaert (2012b) argued that understanding gender differences in asexuality may also offer clues to understanding the origins of asexuality. Potential causal explanations were raised in the gender section in this article, but here two more are discussed. As mentioned, there is some evidence that an elevated percentage of asexual people eschew identifying as either male or female (e.g., Brotto et al. 2010). There is also evidence of a somewhat higher rate of asexuality among transgender individuals (4%; Grant et al., 2011) relative to the rate of asexuality in general populations (e.g., 1%, Bogaert, 2004). From a biological perspective, these findings suggest there may be both demasculinizing and defeminizing prenatal mechanisms (e.g., alteration of hormones, male- and female-specific proteins) operating in some asexual individuals; and as a consequence these mechanisms also ‘‘desexualize’’ the individual. Implicit in this perspective is that biological processes 372

related to sexual differentiation not only create biological sex=gender but also underlie sexual orientation and, ultimately, sexualize the individual (e.g., Bao & Swaab, 2011; Breedlove, 2010). From a psychosocial perspective, there may be socializing factors related to gender that may make individuals more or less sexualized. For example, Bogaert (2012b) speculated that not identifying with one or both of the two traditional genders may reduce traditional sexualization, given that gender roles contain sexual expectations that girls and boys may internalize.

Medical/Clinical Issues Asexuality and Its Relation to Sexual Problems/ Disorders What is the similarity between asexuality and various forms of diagnosable sexual dysfunctions, such as HSDD as defined by the DSM-IV and the DSM-5, or female sexual interest=arousal disorder (FSIAD) as defined in the DSM-5? HSDD is defined by the DSMIV-TR as ‘‘persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity’’ (American Psychiatric Association, 2000, p. 539). Note HSDD, still diagnosable in men, no longer exists for women in the DSM-5, but similar criteria for sexual interest issues exist for FSIAD in the DSM-5. For example, one of FSIAD’s criteria is ‘‘Absent=reduced interest in sexual activity’’; another is ‘‘Absent=reduced sexual=erotic thoughts or fantasies.’’ A clinician must make the judgment of what entails a reduced or absent interest. A diagnosis also includes a symptom duration of at least six months. Both HSDD and FSIAD can be divided into certain subcategories or specifications, such as generalized versus situational and lifelong versus acquired. For HSDD and related FSIAD variations=disorders, a diagnosis is only applied if the patient=client is in distress. Certain medical conditions, along with depression and the use of certain drugs known to lower sexual desire are excluded from a main diagnosis of HSDD or FSAID. Thus, if such conditions fully explain the low=absent desire, a separate diagnosis is applied (e.g., FSIAD or HSDD due to major depressive disorder). Notably, in contrast to previous DSM editions, the wording in the DSM-5 now allows for someone to ‘‘self-identify’’ as asexual and thus not be diagnosed as having lifelong HSDD or FSAID (e.g., ‘‘If a lifelong lack of sexual desire is explained by self-identification as ‘asexual,’ then a diagnosis of female sexual interest= arousal disorder would not be made’’ (American Psychiatric Association, 2013, p. 434). Some recent literature on theoretical issues (Bogaert, 2006b), research on distress in self-identified asexual people (e.g., Brotto et al., 2010; Prause & Graham, 2007), as


ASEXUALITY

well as the work of asexual activists (e.g., Brotto, 2010; Bulwa, 2009; Hinderliter, 2013), were likely influential in the decision to add this provision to the DSM-5. Given the DSM-5’s recent exclusion criteria on self-identification as an asexual, does there remain any overlap between asexuality, as defined previously (e.g., as a lack of sexual attraction or a lack of desire for others), and HSDD=FSAID and related diagnoses? There is indeed still potential overlap between asexuality and forms=variations of HSDD=FSAID, at least on a theoretical level (Bogaert, 2006b, 2012b; Flore, 2013; Hinderliter, 2013). For example, people who have had a lifelong absence of sexual thoughts=fantasies and=or sexual desire and are markedly distressed about this situation (lifelong SIAD or HSDD) would not likely have had any sexual attraction to (or desire for) others. Thus, these individuals may be construable as asexual, even if, for example, at this point in their lives they may not self-label or identify as such. In short, the overlap or similarity between asexuality and a lifelong HSDD and FSIAD (and related conditions) is notable, at least theoretically. On the other hand, there are also important differences between some forms of asexuality and FSAID= HSDD (along with related disorders). First, it is important to remember that most forms of HSDD=FSIAD are not necessarily lifelong in duration. As asexuality is an enduring lack of sexual attraction or desire for others, it may not overlap with the most frequently diagnosed forms of HSDD and FSIAD. Second, it is important to remember that additional conditions=criteria (e.g., marked distress) must occur before a diagnosis of HSDD=FSIAD is established. If so, likely many people who have enduring lack of sexual thoughts=fantasies and=or sexual desire (and hence are asexual) would not be diagnosable with HSDD=FSIAD because they are not distressed. In summary, there is some theoretical overlap between lifelong HSDD and FSIAD and asexuality, and some asexuals, broadly defined (e.g., lifelong lack of sex attraction; lifelong lack of desire for others) may still be diagnosed if, for example, they exhibit distress, while others (e.g., who have no distress or who self-identify) would not. Part of this overlap may cause some confusion among clinicians as to when a diagnosis of HSDD=FSIAD should apply—a confusion that stems in part from a largely research-based definition of asexuality that is centered on a lack of sexual attraction to others while the DSM-5 largely focuses on desire (e.g., HSDD) and an exclusion criterion based on self-identification. Is Asexuality a Disorder? A broader but related issue is this: Should asexuality be viewed as a pathology or a disorder that needs correcting? For example, was the DSM-5 committee wrong

in adding language to allow self-identified asexuals to not be diagnosed as having a sexual problem? Conversely, has the DSM not gone far enough, and thus should there be a full depathologizing of asexuality, as occurred for homosexuality in 1973 in the DSM-II? In a series of publications Bogaert (2006b, 2008, 2012b) addressed empirical research and theoretical issues on whether asexuality should be construable as a pathological state. He concluded that asexuality, per se, should not be construed as a pathology. Some of the evidence and arguments consistent with this perspective are given here (see Bogaert, 2012b, for additional arguments). One argument against pathologizing asexuality was that although only a small portion of the population is asexual, statistical rarity, at least by itself, is a poor basis for pathologizing a condition or variation. For example, other sexual variations are also rare, but individuals having these variations (e.g., gays and lesbians) are not construed as pathological merely because of their minority status. Also, it is important to recognize that statistically rare conditions in various domains of life are, at least at times, valued and life-enhancing (e.g., exceptional musical talent). Another issue raised was whether distress and other mental health issues in people lacking sexual attraction=desire should be used to determine pathology. As mentioned, most modern medical and psychological approaches, including those informing the diagnostic criteria in the DSM-5, often limit sexual pathology=dysfunction (and the need for treatment) to when these inclinations entail distress. Although more research is needed, there is some evidence that self-identified asexual people are not significantly distressed by their lack of sexual interest=attractions per se (Brotto et al., 2010; Prause & Graham, 2007). Some research has also addressed whether asexual people have other mental health and interpersonal problems. There is evidence that certain mental health issues, such as depression, anxiety, and interpersonal problems, are elevated in asexual people relative to other groups (Brotto et al., 2010; Yule, Brotto, & Gorzalka, 2013). There is also some evidence of elevated rates of asexuality among individuals with autism spectrum conditions (Gilmour, Schalomon, & Smith, 2012; Ingudomnukul et al., 2007). However, it is also important to note that elevated rates of mental health issues in asexual people do not necessarily mean that all (or even a majority) of asexual people have these issues. For example, the significant effects associated with group differences in Yule and colleagues’ (2013) study were typically small in terms of effect size. Research on mental health issues in other sexual minorities is also worthy of considering in this context. Lesbians, gays, and bisexuals have been found to have elevated mental health issues, including sometimes experiencing distress about their sexual orientation (e.g., Meyer, 2003). However, it is also true that many individuals with same-sex 373


BOGAERT

attraction have mental health within the normal range (e.g., Busseri, Willoughby, Chalmers, & Bogaert, 2006). Moreover, modern medicine and clinical psychology excludes homosexuality as a diagnosable disorder and thus does not view homosexuality as pathological. Similarly, even though mental health issues seem to occur in asexual people at an elevated rate, this does not necessarily mean that we should use this information to pathologize asexuality, generally speaking. Also, the distress and mental health issues in sexual minorities have an additional complication. Should we pathologize someone for feeling distressed (or having other mental health issues) if it is a response to a society that does not value them—and, indeed, may actively discriminate against them? In other words, it is important to consider the sources of the distress and mental health issues in sexual minorities. Distress and other mental health issues may be very understandable (and even rational) responses to a society that discriminates against and devalues these individuals (Bogaert, 2012b; Yule et al., 2013). An additional consideration is associated with the origins of asexuality. If atypical prenatal development (along with physical health considerations) underlies at least some forms of asexuality (e.g., Bogaert, 2004; Yule et al., 2014a), should such a linkage imply that asexuality is a pathology? Such associations are, of course, important for understanding the origins of asexuality, but it is also important to keep in mind a number of qualifications relevant to this linkage. First, these markers of physical health and atypical prenatal development, at least currently, account for only a modest amount of variation in asexuality. Thus, even if research demonstrates that a percentage of asexual people have, for example, serious health problems, this does not imply that all asexual people, or that asexuality per se should be pathologized. Second, and perhaps more important, using a research finding that an unusual prenatal event is (causally) associated with a trait to imply that someone with that trait currently has a disorder is problematic. Again, research on other sexual minorities is worthy of considering in this context. For example, there is evidence that unusual prenatal events—such as developmental instability; maternal immune response, maternal stress (e.g., Blanchard, 2004; Bogaert & Skorska, 2011; Ellis & Cole-Harding, 2001; Lalumie`re et al., 2000)—may play a causal role in same-sex attraction, and yet we currently do not pathologize homosexuality. In addition, returning to another example mentioned previously, it is possible that some forms of high musical talent are determined by unusual prenatal events (e.g., higher-than-typical exposure to testosterone; Manning, 2002), yet we do not pathologize high musical ability. In short, it is important to caution against confounding origins, atypical or otherwise, with an understanding of what is construable as a current pathological state (Bogaert, 2006b, 2012b). 374

In addition, existing psychophysiological research does not support the notion that asexual women have what would be currently regarded as a diagnosable physical arousal disorder. For instance, Brotto and Yule’s (2011) research indicates that self-identified asexual women have similar arousal responses to sexually functional women (i.e., non-category-specific arousal). Based on these findings, the authors suggest asexuality should not necessarily be construed as a (physical arousal) disorder, as asexual women do not evince abnormally low arousal responses. Instead, as mentioned, these authors suggest the patterns of arousal responses in their data are consistent with a sexual orientation model of asexuality in women. As a cautionary note, to date there are no published data on the psychophysiological arousal patterns of asexual men and, as mentioned, Brotto and Yule’s (2011) study, although interesting, contained only a small sample of asexual women (n ¼ 7). As an additional argument against pathologizing asexuality, Bogaert (2012b) suggested that, in a thought experiment, if we view broadly and ‘‘deconstruct’’ sexuality, it can be viewed as a debilitating behavior with odd, even bizarre, rituals and movements. Bogaert (2012b) also provided evidence that sexuality is often associated with extreme and risky behaviors along with impaired cognitive functioning. Bogaert (2012b) concluded that sexuality is suggested as a form of ‘‘madness’’ (broadly defined). Bogaert also concluded that, although sexuality is often a source of intense passion and pleasure and a ‘‘condition’’ most sexual people suffer from gladly, it should give us pause about what is and what is not a disorder.

Why Asexuality Should Matter to Sexologists Why should the absence of sexuality be of interest to sexologists, those scholars devoted to studying sexuality, construable as the polar opposite of asexuality? For one, it allows us to understand an understudied sexual minority. In recent years, research on asexuality has increased (e.g., Przybylo, 2013), but asexual people are still not well understood as a minority on the sexuality spectrum. Related, asexual people highlight the broad range of this spectrum and, more fundamentally, the nature and extent of human variability of which both sexual and asexual people belong. Finally, and perhaps equally as important for sexologists, is that understanding asexuality can increase our understanding of sexuality. This idea is discussed in the following sections. Through the Lens of Asexuality In the same way that studying homosexuality allows us to examine and potentially better understand heterosexuality and vice versa, the study of asexuality allows


ASEXUALITY

for a broader view and, potentially, a deeper understanding of sexuality. Examples were given throughout this review paper, and this conclusion—of providing a deeper understanding of sexuality—should be seen as a main theme throughout. One example was that studying asexuality can provide insight into the difference between romance and sexuality; for example, asexual people demonstrate that these processes are potentially de-coupleable. It was also suggested that studying asexuality allows for a better understanding of methodological weaknesses present in the study of sexuality, such as volunteer bias. Moreover, studying asexuality reveals insight into gender differences in sexual functioning: how, for example, an (implicit) target-oriented view of sexuality and sexual orientation in particular—as an attraction to something—may not apply as directly to women as it does to men. It was also suggested that literature and other forms of dramatic arts=media often require variability in characters to generate dramatic tension and that use of sexual variability in character—including ones with an asexual aura—is a literary technique of creating this tension. Thus, how asexuality plays itself out in art provides insight into sexuality and, more broadly, human nature. In addition, it was suggested that prejudicial views against asexual people—viewing them as ‘‘less than human’’—indicate that sexuality is a key element that humans use (perhaps implicitly) to understand what comprises the nature of being human. It was also suggested that studying asexuality and considering whether it should be construed as a disorder may reveal the strangeness (even the ‘‘madness’’) of sex. Beyond the examples presented throughout this article, Bogaert (2012b) also suggested that studying asexuality—for example, taking an asexual person’s perspective, to the degree that such a view is possible for a sexual person—reveals how sex is deeply embedded in our worldview=culture. For example, for centuries artists needed to walk a very fine line in how they portrayed the human body, specifically to avoid appealing to prurient interests. Thus, artists often felt compelled to avoid presenting an unclothed human body in a ‘‘naked’’ way, which implied some (explicit or shameful) sexuality, and instead portrayed ‘‘nude’’ bodies, which were construable as a nonshameful celebration of the human form (e.g., Clark, 1956). Yet the ubiquity of the unclothed female body—be it in a ‘‘naked’’ or ‘‘nude’’ form in art, particularly as depicted by heterosexual male artists—shows that our sensibilities, including our artistic ones, are deeply influenced, likely in hitherto unrecognized ways, by sexuality. Similarly, in the news and popular media, the interest in sex scandals, even in an arguably postmodern Western world presumably jaded by such information, provides another example of how enduringly and intricately embedded sexuality is within our psyches and culture. Bogaert (2012b) also examined sexual humor: its ubiquity and

function. Modern psychological models of humor are often consistent with the notion that it may serve in part as a (coping) mechanism that helps us negotiate our way through tensions and complex social rules (e.g., McGraw & Warren, 2010). Sexuality is an activity fraught with tensions and complex social-cultural rules and thus lends itself particularly well to the subject of humor. If so, one might speculate that asexual people do not appreciate sexual humor given their lack of need to negotiate the tensions and complex social-cultural rules associated with sex, or at least not to the same degree as average sexual people. However, Bogaert (2012b) suggested that many asexual people likely appreciate, or at least understand to a degree, sexual humor because everyone—sexual or not—is inundated by sexual references and information in our culture. Given how embedded and influential sex is in our culture, along with how sexual humor is likely a coping mechanism to deal with tensions and socio-cultural rules surrounding sex, Bogaert (2012b) also suggested it is an interesting question to ask what our humor would be like without sex.

Summary and Future Research Although a wide range of sexual variability has been recognized throughout human history, and asexual people were noted by pioneering sexologists such as Kinsey, asexuals remain an understudied sexual minority. In the present article, empirical research and theoretical perspectives on human asexuality were reviewed. This review concentrated on four main areas: introductory and contextual issues (i.e., biological and historical contexts, definitions, and prevalence), psychological development and variations (i.e., identity and discrimination, origins, variation based on gender and masturbation), medical=clinical issues (DSM diagnoses, whether asexuality is a disorder), and why sexologists should study asexual people. Many research questions and scholarly issues remain (e.g., Bogaert, 2012b; Van Houdenhove et al., 2014b), and sex researchers as well as colleagues of allied disciplines may be able to address a number of gaps in the literature on asexuality in future work. First, conceptual and definitional issues still exist, as there is no consensus on how to best define asexuality. Such definitional issues present challenges in a number of domains, including in the meaning and conceptualization of sexual orientation and how sexual disorders such as HSDD and FSIAD are construed and diagnosed. Methodological challenges include a heavy reliance on one Web site=forum for participants (AVEN; see Brotto & Yule, 2009; Hinderliter, 2009), and the potential undersampling of those who would likely never participate in a sex-related study, including asexuals (Bogaert, 2012b). The study of asexuality’s origins, identity formation, and variation 375


BOGAERT

also remains in its early stages. Using other sexual minorities as models of development (e.g., on origins, identity formation) may be helpful to a degree, but asexual people likely have unique aspects to their psychology toward which researchers need to act sensitively. New research on gender and masturbation=fantasies, along with other sources of variability among asexual people, will also help to understand the range of asexual expressions. Asexuality will also likely continue to challenge medical scholars and clinicians as to what is or is not a sexual disorder. In addition, more research is needed on the mental health of asexual people, along with whether a potential increased incidence of mental health issues occurs in asexual people, in part as a result of a society that often mistrusts and devalues them. Finally, the degree to which sexuality is embedded in our society will likely make the study of asexuality an important counterpointing view for scholars of culture. These and related future research questions= endeavors will help to understand this understudied sexual minority, but studying asexuality may also reveal a rich cache of untapped knowledge on sexuality, including psychological and sociocultural aspects—a main theme of this article. Thus, the asexual world is worth exploring (or at least considering), even for those primarily interested in understanding the sexual one. Acknowledgments I would like to thank Kelsey Fallis and Katie Ross for their comments on a previous draft of this manuscript. I would also like to thank four anonymous reviewers for their suggestions. References Abbott, E. (2001). A history of celibacy. New York, NY: Da Capo Press. Adkins-Regan, E. (2005). Hormones and animal social behavior. Princeton, NJ: Princeton University Press. Aicken, C., Mercer, C., & Cassella, J. (2013). Who reports absence of sexual attraction in Britain? Evidence from national probability surveys. Psychology and Sexuality, 4, 121–135. doi:10.1080= 19419899.2013.774161 Alexander, B. M., Stellflug, J. N., Rose, J. D., Fitzgerald, J. A., & Moss, G. E. (1999). Behavior and endocrine changes in high performing, low-performing, and male-oriented domestic rams following exposure to rams and ewes in estrus when copulation is precluded. Journal of Animal Science, 77(7), 1869–1874. doi:=1999.7771869x American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text revision). Washington, DC: Author. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Aubrey, J. S. (2004). Sex and punishment: An examination of sexual consequences and the sexual double standard in teen programming. Sex Roles, 50, 505–514. doi:10.1023=B:SERS.0000023070. 87195.07

376

Bailey, J. M., Dunne, M. P., & Martin, N. G. (2000). Genetic and environmental influences on sexual orientation and its correlates in an Australian twin sample. Journal of Personality and Social Psychology, 78, 524–536. doi:10.1037=0022-3514.78.3.524 Bancroft, J., Graham, C. A., Janssen, E., & Sanders, S. A. (2009). The dual control model: Current status and current directions. Journal of Sex Research, 46, 121–142. doi:10.1080=00224490902747222 Bao, A. M., & Swaab, D. F. (2011). Sexual differentiation of the human brain: Relation to gender identity, sexual orientation, and neuropsychiatric disorders. Frontiers in Neuroendocrinology, 32, 214–226. doi:10.1016=j.yfrne.2011.02.007 Basson, R. (2002). Women’s sexual desire—Disordered or misunderstood? Journal of Sex and Marital Therapy, 28, 17–28. doi:10.1080= 00926230252851168 Baumeister, R. F. (2000). Gender differences in erotic plasticity: The female sex drive as socially flexible and responsive. Psychological Bulletin, 126, 347–374. doi:10.1037=0033-2909.126.3.347 Blanchard, R. (1989). The concept of autogynephilia and the typology of male gender dysphoria. Journal of Nervous and Mental Disease, 177, 616–623. doi:10.1097=00005053-19891000000004 Blanchard, R. (1991). Clinical observations and systematic studies of autogynephilia. Journal of Sex and Marital Therapy, 17, 235–251. doi:10.1080=00926239108404348 Blanchard, R. (2004). Quantitative and theoretical analyses of the relation between older brothers and homosexuality in men. Journal of Theoretical Biology, 230, 173–187. doi:10.1016=j.jtbi. 2004.04.021 Blanchard, R., & Bogaert, A. F. (1996). Homosexuality in men and number of older brothers. American Journal of Psychiatry, 153, 27–31. doi:10.1176=ajp.153.1.27 Bogaert, A. F. (1996). Volunteer bias in human sexuality research: Evidence for both sexuality and personality differences in males. Archives of Sexual Behavior, 25, 125–140. doi:10.1007= BF02437932 Bogaert, A. F. (2001). Handedness, criminality, and sexual offending. Neuropsychologia, 39, 465–469. doi:10.1016=S0028-3932(00)00134-2 Bogaert, A. F. (2003). Number of older brothers and sexual orientation: New tests and the attractive=behavior distinction in two national probability samples. Journal of Personality and Social Psychology, 84, 644–652. doi:10.1037=0022-3514.84.3.644 Bogaert, A. F. (2004). Asexuality: Prevalence and associated factors in a national probability sample. Journal of Sex Research, 41, 279–287. doi:10.1080=00224490409552235 Bogaert, A. F. (2006a). Biological versus nonbiological older brothers and men’s sexual orientation. Proceedings of the National Academy of Sciences (PNAS), 103, 10771–10774. doi:10.1073= pnas.0511152103 Bogaert, A. F. (2006b). Toward a conceptual understanding of asexuality. Review of General Psychology, 10, 241–250. doi:10.1037= 1089-2680.10.3.241 Bogaert, A. F. (2008). Asexuality: Dysfunction or variation? In J. M. Caroll & M. K. Alena (Eds.), Psychological sexual dysfunctions (pp. 9–13). New York, NY: Nova Biomedical Books. Bogaert, A. F. (2012a). Asexuality and autochorissexualism (identity-less sexuality). Archives of Sexual Behavior, 41, 1513–1514. doi:10.1007= s10508-012-9963-1 Bogaert, A. F. (2012b). Understanding asexuality. Lanham, MD: Rowman & Littlefield. Bogaert, A. F. (2013). The demography of asexuality. In A. Baumle (Ed.), International handbook on the demography of sexuality (pp. 275–288). New York, NY: Springer Press. Bogaert, A. F., & Brotto, L. (2014). Object of desire self-consciousness theory. Journal of Sex and Marital Therapy, 40, 323–338. doi:10.1080=0092623X.2012.756841 Bogaert, A. F., & Liu, J. (2013). Physical size and sexual orientation: Analysis of the Chinese Health and Family Life Survey. Archives


ASEXUALITY of Sexual Behavior, 42, 1555–1559. doi:10.1007=s10508-0130110-4 Bogaert, A. F., & McCreary, D. (2011). Masculinity and the distortion of self-reported height in men. Sex Roles, 65, 548–556. doi:10.1007=s11199-011-0003-8 Bogaert, A. F., & Skorska, M. (2011). Sexual orientation, fraternal birth order, and the maternal immune hypothesis: A review. Frontiers in Neuroendocrinology, 32, 247–254. doi:10.1016= j.yfrne.2011.02.004 Bogaert, A. F., Visser, B. A., & Pozzebon, J. A. (2015). Gender differences in object of desire self-consciousness sexual fantasies. Archives of Sexual Behavior. Advance online publication. doi:10.1007=s10508-014-0456-2 Bolour, S., & Braunstein, G. (2005). Testosterone therapy in women: A review. International Journal of Impotence Research, 17, 399–408. doi:10.1038=sj.ijir.3901334 Boynton, P. M. (2003). ‘‘I am just a girl who can’t say no’’: Women, consent, and sex research. Journal of Sex and Marital Therapy, 29, 23–32. doi:10.1080=713847130 Breedlove, S. M. (2010). Minireview: Organizational hypothesis: Instances of the fingerpost. Endocrinology, 151, 4116–4122. doi:10.1210=en.2010-0041 Brotto, L. A. (2010). The DSM diagnostic criteria for hypoactive sexual desire disorder in men. Journal of Sexual Medicine, 7, 2015–2030. doi:10.1111=j.1743-6109.2010.01860.x Brotto, L. A., Knudson, G., Inskip, J., Rhodes, K., & Erskine, Y. (2010). Asexuality: A mixed methods approach. Archives of Sexual Behavior, 39, 599–618. doi:10.1007=s10508-008-9434-x Brotto, L. A., & Yule, M. A. (2009). Reply to Hinderliter [Letter to the editor]. Archives of Sexual Behavior, 38, 622–623. doi:10.1007= s10508-009-9514-6 Brotto, L. A., & Yule, M. A. (2011). Physiological and subjective sexual arousal in self-identified asexual women. Archives of Sexual Behavior, 40, 699–712. doi:10.1007=s10508-010-9671-7 Bulwa, D. (2009, August 24). Asexuals leave the closet, find community. SF Gate. Retrieved from http://www.sfgate.com/cgi-bin/ article.cgi?f=/c/a/2009/08/24/MNC6194GN4.DTL Busseri, M., Willoughby, T., Chalmers, H., & Bogaert, A. F. (2006). Same-sex attraction and successful adolescent development. Journal of Youth and Adolescence, 35, 563–575. doi:10.1007= s10964-006-9071-4 Cacchioni, T., & Tiefer, L. (2012). Why medicalization? Introduction to the special issue on the medicalization of sex. Journal of Sex Research, 49, 307–310. doi:10.1080=00224499.2012.690112 Cantor, J., Blanchard, R., & Barbaree, H. (2009). Sexual disorders. In P. H. Blaney & T. Millon (Eds.), Oxford textbook of psychopathology (pp. 527–548). New York, NY: Oxford University Press. Carrigan, M. (2011). There’s more to life than sex? Difference and commonality within the asexual community. Sexualities, 14, 462–478. doi:10.1177=1363460711406462 Cass, V. C. (1979). Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4, 219–235. doi:10.1300=J082v04n03_01 Chapman, D. D., Shivji, M. S., Louis, E., Sommer, J., Fletcher, H., & Prodo¨hl, P. A. (2007). Virgin birth in a hammerhead shark. Biology Letters, 3, 425–427. doi:10.1098=rsbl.2007.0189 Chasin, C. J. D. (2011). Theoretical issues in the study of asexuality. Archives of Sexual Behavior, 40, 713–723. doi:10.1007=s10508011-9757-x Chevigny, K., Davenport, B., Pinder, J. (Producers), & Tucker, A. (Director). (2011). (A)sexual [Documentary]. United States: Arts Engine. Chivers, M. L., Rieger, G., Latty, E., & Bailey, J. M. (2004). A sex difference in the specificity of sexual arousal. Psychological Science, 15, 736–744. doi:10.1111=j.0956-7976.2004.00750.x Clark, K. (1956). The nude: A study in ideal form. New York, NY: Pantheon Books. Clifford, R. (1978). The development of masturbation in college women. Archives of Sexual Behavior, 7, 559–573. doi:10.1007= BF01541922

Coleman, E. (1982). Developmental stages of the coming out process. Journal of Homosexuality, 7, 31–43. doi:10.1300=J082v07n02_06 Cowen, R. (2005). History of life (4th ed.). Malden, MA: Blackwell. Davies, S. (2004). Emily Bronte: Heretic. London: The Women’s Press. Decker, J. S. (2014). The invisible orientation: An introduction to asexuality. New York: Carrel Books. Diamond, L. (2003a). Was it a phase? Young women’s relinquishment of lesbian=bisexual identities over a 5-year period. Journal of Personality and Social Psychology, 84, 352–364. doi:10.1037= 0022-3514.84.2.352 Diamond, L. (2003b). What does sexual orientation orient? A biobehavioral model distinguishing romantic love and sexual desire. Psychological Review, 110, 173–192. doi:10.1037=0033-295X. 110.1.173 Ellis, L., & Cole-Harding, S. (2001). The effects of prenatal stress, and of prenatal alcohol and nicotine exposure, on human sexual orientation. Physiology and Behavior, 74, 213–226. doi:10.1016= S0031-9384(01)00564-9 Emens, E. F. (2014). Compulsory sexuality. Stanford Law Review, 66, 303–386. Fehr, B. (2013). The social psychology of love. In J. A. Simpson & L. Campbell (Eds.), The Oxford handbook of close relationships (pp. 201–233). Oxford, UK: Oxford University Press. Fisher, H. (2004). Why we love: The nature and chemistry of romantic love. New York, NY: Henry Holt. Flore, J. (2013). HSDD and asexuality: A question of instruments. Psychology and Sexuality, 4, 152–166. doi:10.1080=19419899. 2013.774163 Floyd, F. J., & Stein, T. S. (2002). Sexual orientation identity formation among gay, lesbian, and bisexual youths: Multiple patterns of milestone experiences. Journal of Research on Adolescence, 12, 167–191. doi:10.1111=1532-7795.00030 Gazzola, S. B., & Morrison, M. A. (2012). Asexuality: An emergent sexual orientation. In T. G. Morrison, M. A. Morrison, M. A. Carrigan, & D. T. McDermott (Eds.), Sexual minority research in the new millennium (pp. 21–44). Hauppauge, NY: Nova Science. Gilmour, L., Schalomon, P. M., & Smith, V. (2012). Sexuality in a community-based sample of adults with autism spectrum disorder. Research in Autism Spectrums Disorders, 6, 313–318. doi:10.1016=j.rasd.2011.06.003 Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Keisling, M. (2011). Injustice at every turn: A report of the National Transgender Discrimination Survey. Retrieved from http://www.thetaskforce.org/downloads/reports/reports/ntds_ full.pdf Gressga˚rd, R. (2013). Asexuality: From pathology to identity and beyond. Psychology and Sexuality, 4, 179–192. doi:10.1080= 19419899.2013.774166 Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511–524. doi:10.1037=0022-3514.52.3.511 Hepper, P. G., Shahidullah, S., & White, R. (1991). Handedness in human fetus. Neuropsychologia, 36, 531–534. doi:10.1016= S0028-3932(97)00156-5 Hinderliter, A. (2009). Methodological issues for studying asexuality [Letter to the editor]. Archives of Sexual Behavior, 38(5), 619– 621. doi:10.1007=s10508-009-9502-x Hinderliter, A. (2013). How is asexuality different from hypoactive sexual desire disorder? Psychology & Sexuality, 4, 167–178. doi:10.1080=19419899.2013.774165 Ho¨glund, J., Jern, P., Sandnabba, N. K., & Santtila, P. (2014). Finnish women and men who self-report no sexual attraction in the past 12 months: Prevalence, relationship status, and sexual behavior history. Archives of Sexual Behavior, 43, 879–889. doi:10.1007= s10508-013-0240-8 Hundhammer, T., & Mussweiler, T. (2012). How sex puts you in gendered shoes: Sexuality-priming leads to gender-based

377


BOGAERT self-perception and behaviour. Journal of Personality and Social Psychology, 103, 176–193. doi:10.1037=a0028121 Ingudomnukul, E., Baron-Cohen, S., Wheelwright, S., & Knickmeyer, R. (2007). Elevated rates of testosterone-related disorders in women with autism spectrum conditions. Hormones and Behavior, 51, 597–604. doi:10.1016=j.yhbeh.2007.02.001 Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia, PA: W. B. Saunders. Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. H. (1953). Sexual behavior in the human female. Philadelphia, PA: W. B. Saunders. Lalumie`re, M. L., Blanchard, R., & Zucker, K. J. (2000). Sexual orientation and handedness in men and women: A meta-analysis. Psychological Bulletin, 126, 575–592. doi:10.1037=0033-2909. 126.4.575 Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537–544. doi:10.1001= jama.281.6.537 Lawrence, A. A. (2011). Autogynephilia: An underappreciated paraphilia. Advances in Psychosomatic Medicine, 31, 135–148. doi:10.1159=000328921 LeVay, S. (2010). Gay, straight, and the reason why: The science of sexual orientation. New York, NY: Oxford University Press. Lucassen, M. F., Merry, S. N., Robinson, E. M., Denny, S., Clark, T., Ameratunga, S., Crengle, S., & Rossen, F. V. (2011). Sexual attraction, depression, self-harm, suicidality and help-seeking behaviour in New Zealand secondary school students. Australian and New Zealand Journal of Psychiatry, 45, 376–383. doi:10.3109= 00048674.2011.559635 MacCulloch, M. J., Snowden, P. R., Wood, P. J. W., & Mills, H. E. (1983). Sadistic fantasy, sadistic behaviour, and offending. British Journal of Psychiatry, 143, 20–29. doi:10.1192=bjp. 143.1.20 MacInnis, C. C., & Hodson, G. (2012). Intergroup bias toward ‘‘Group X’’: Evidence of prejudice, dehumanization, avoidance, and discrimination against asexuals. Group Processes and Intergroup Relations, 15, 725–743. doi:10.1177=1368430212442419 Manning, J. T. (2002). Digit ratio: A pointer to fertility, behavior, and health. New Brunswick, NJ: Rutgers University Press. McGraw, A. P., & Warren, C. (2010). Benign violations: Making immoral behavior funny. Psychological Science, 21, 1141–1149. doi:10.1177=0956797610376073 Meana, M. (2010). Elucidating women’s (hetero)sexual desire: Definitional challenges and content expansion. Journal of Sex Research, 47, 104–122. doi:10.1080=00224490903402546 Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual and research evidence. Psychological Bulletin, 129, 674–697. doi:10.1037= 0033-2909.129.5.674 Money, J. (1988). Gay, straight, and in-between. New York, NY: Oxford University Press. Oliver, M. B., & Hyde, J. S. (1993). Gender differences in sexuality: A meta-analysis. Psychological Bulletin, 114, 29–51. doi:10.1037= 0033-2909.114.1.29 Parish, W. L., Laumann, E. O., Cohen, M. S., Pan, S. M., Zheng, H. Y., Hoffman, I., . . . Ng, K. H. (2003). Population-based study of chlamydial infection in China: A hidden epidemic. Journal of the American Medical Association, 289, 1265–1273. doi:10.1001= jama.289.10.1265 Perkins, A., & Fitzgerald, J. A. (1997). Sexual orientation in domestic rams: Some biological and social correlates. In L. Ellis & L. Ebertz (Eds.), Sexual orientation: Toward biological understanding (pp. 107–127). Westport, CT: Greenwood. Petersen, J. L., & Hyde, J. S. (2010). A meta-analytic review of research on gender differences in sexuality, 1993–2007. Psychological Bulletin, 136, 21–38. doi:10.1037=a0017504

378

Poston, D. L., Jr., & Baumle, A. K. (2010). Patterns of asexuality in the United States. Demographic Research, 23(18), 509–530. doi:10.4054=DemRes.2010.23.18 Prause, N., & Graham, C. A. (2007). Asexuality: Classification and categorization. Archives of Sexual Behavior, 36, 341–356. doi:10.1007=s10508-006-9142-3 Przybylo, E. (2013). Afterward: Some thoughts on asexuality as an interdisciplinary method. Psychology and Sexuality, 4, 193–194. doi:10.1080=19419899.2013.774167 Rieger, G., Linsenmeier, J. A.W., Gygax, L., & Bailey, J. M. (2008). Sexual orientation and childhood gender nonconformity: Evidence from home videos. Developmental Psychology, 44, 46–58. doi:10.1037=0012-1649.44.1.46 Riley, A., & Riley, E. (2000). Controlled studies of women presenting sexual drive disorder: I. Endocrine status. Journal of Sex and Marital Therapy, 26, 269–283. doi:10.1080=00926230050084669 Roselli, C. E., Larkin, K., Schrunk, J. M., & Stormshak, F. (2004). Sexual partner preference, hypothalamic morphology, and aromatase in rams. Physiology & Behavior, 83, 233–245. doi:10.1016= j.physbeh.2004.08.017 Sage, B. (Director). (2013). Nature of things: Survival of the fabulous. Canada: Canadian Broadcasting Corporation. Schechter, B. (1998). My brain is open: The mathematical journeys of Paul Erdos. New York, NY: Simon and Schuster. Scherrer, K. S. (2008). Coming to an asexual identity: Negotiating identity, negotiating desire. Sexualities, 11, 621–641. doi:10.1177= 1363460708094269 Seif, H. (1999). To love women, or to not love men: Chronicles of lesbian identification. Journal of Lesbian Studies, 3, 33–44. doi:10.1300=J155v03n03_04 Seto, M. C. (2008). Understanding pedophilia and sexual offending against children: Theory, assessment, and intervention. Washington, DC: American Psychological Association. Sigusch, V. (1998). The neosexual revolution. Archives of Sexual Behavior, 27, 339–351. doi:10.1023=A:1018715525493 Smith, A. M., Rissel, C. E., Richters, J., Grulich, A. E., & de Visser, R. O. (2003). Sex in Australia: Sexual identity, sexual attraction, and sexual experience among a representative sample of adults. Australian and New Zealand Journal of Public Health, 27, 138–145. doi:10.1111=j.1467-842X.2003.tb00809.x Storms, M. D. (1980). Theories of sexual orientation. Journal of Personality and Social Psychology, 38, 783. doi:10.1037= 0022-3514.38.5.783 Strassberg, A., & Lowe, K. (1995). Volunteer bias in sex research. Archives of Sexual Behavior, 24, 369–382. doi:10.1007=BF01541853 Teddy Miller. (2005, July 25). Masturbating A’s: What do you think about when masturbating? [Online forum post]. Retrieved from http://www.asexuality.org/en/index.php?/topic/9980-masturbatingas-what-do-you-think-about-when-masturbating/ Terry, J. (1999). An American obsession: Science, medicine, and homosexuality in modern society. Chicago, IL: University of Chicago Press. Troiden, R. R. (1989). The formation of homosexual identities. Journal of Homosexuality, 17, 43–73. doi:10.1300=J082v17n01_02 Van Houdenhove, E., Gijs, L., T’Sjoen, G., & Enzlin, P. (2014a). Asexuality: A multidimensional approach. Journal for Sex Research. Advance online publication. doi:10.1080=00224499. 2014.898015 Van Houdenhove, E., Gijs, L., T’Sjoen, G., & Enzlin, P. (2014b). Asexuality: Few facts, many questions. Journal of Sex and Marital Therapy, 40, 175–192. doi:10.1080=0092623X.2012. 751073 Van Houdenhove, E., Gijs, L., T’Sjoen, G., & Enzlin, P. (2014c). Stories about asexuality: A qualitative study on asexual women. Journal of Sex and Marital Therapy. Advance online publication. doi:10.1080=0092623X.2014.889053 Ventegodt, S. (1998). Sex and quality of life in Denmark. Archives of Sexual Behavior, 27, 295–307. doi:10.1023=A:1018655219133

ASEXUALITY Wilson, G., & Rahman, Q. (2005). Born gay: The psychobiology of sex orientation. London, UK: Peter Owen. Yule, M., Brotto, L., & Gorzalka, B. (2013). Mental health and interpersonal functioning in self-identified asexual men and women. Psychology and Sexuality, 4, 136–151. doi:10.1080= 19419899.2013.774162 Yule, M., Brotto, L., & Gorzalka, B. (2014a). Biological markers of asexuality: Handedness, birth order, and finger length ratios in self-identified asexual men and women. Archives of Sexual Behavior, 43, 299–310. doi:10.1007=s10508-013-0175-0 Yule, M., Brotto, L., & Gorzalka, B. (2014b). Sexual fantasy and masturbation among asexual individuals. Canadian Journal of Human Sexuality, 23, 89–95. doi:10.3138=cjhs.2409 Zucker, K. J., & Bradley, S. J. (1995). Gender identity disorder and psychosexual problems in children and adolescents. New York, NY: Guilford Press.


Vicious Trollop. (2005, July 25). Masturbating A’s: What do you think about when masturbating? [Online forum post]. Retrieved from http://www.asexuality.org/en/index.php?/topic/ 9980-masturbating-as-what-do-you-think-about-when-masturbating/ page__p__237288#entry237288 Vrangalova, Z., & Savin-Williams, R. C. (2012). Mostly heterosexual and mostly gay=lesbian: Evidence for new sexual orientation identities. Archives of Sexual Behavior, 41, 85–101. doi:10.1007= s10508-012-9921-y Wallen, K. (1995). The evolution of female sexual desire. In P. R. Abramson & S. D. Pinkerton (Eds.), Sexual nature=sexual culture (pp. 57–79). Chicago, IL: University of Chicago Press. Westphal, S. P. (2004, October). Glad to be asexual. New Scientist, 184, 40–43. White, M. (1999). Isaac Newton: The last sorcerer. Reading, MA: Helix Books.

379

Is mindfulness Buddhist? (and why it matters).

Why it matters.

What is temporal fine structure and why is it important?

Dengue: what it is and why there is more.

Animal coloration research: why it matters.

Mentoring: why it matters even after training.

Bioimpacts of nanoparticle size: why it matters?

WHAT IS THE MOVEMENT SYSTEM AND WHY IS IT IMPORTANT?

Food Security-A Commentary: What Is It and Why Is It So Complicated?

Totipotency: what it is and what it is not.

What is vitamin A and why do we need it?

Why developmental niche construction is not selective niche construction: and why it matters.

Social dominance in childhood and its evolutionary underpinnings: why it matters and what we can do.

Inositol acylation of glycosylphosphatidylinositol membrane anchors: what it is, and why it may be important.

Intermediate filament dynamics: What we can see now and why it matters.

Wilcoxon's signed-rank statistic: what null hypothesis and why it matters.

Medical Information Bureau: what it is and what it isn't.

Understanding 'energy insecurity' and why it matters to health.

Redefining 'stress resistance genes', and why it matters.

Estimating coverage in metagenomic data sets and why it matters.

Measuring the shapes of macromolecules - and why it matters.

Desire thinking: what is it and what drives it?

Presbycusis: what is it?

Collegiality: what is it?