Keywords
Sexuality
Sexual behavior
Diagnosis
Review
Sexual behavior
Diagnosis
Review
How to Cite
Campo-Arias, A., Guerra-Castillo, M. J., & Herazo, E. (2019). Asexuality: Critical review of the concept. Duazary, 16(2), 406–413. https://doi.org/10.21676/2389783X.2934
Abstract
The concept of asexuality has recently taken on importance in the medical context. However, extensive polysemy is evident in scientific publications. The aim of the present review was to synthesize the concept of asexuality in biomedical publications. It Was designed a review and qualitative analysis of narrative reviews published between January 1, 2000 and June 30, 2018. Review followed the PRISMA recommendations suggested for this type of review. The search was conducted in PubMed and the Virtual Health Library. It was used as descriptors or keywords: asexuality and revision. A synthesis was made for the definition of asexuality in three steps: coding of the text 'line by line', the development of 'descriptive themes', and the generation of 'analytical themes', typical of qualitative analysis. Eight articles were included. The analytical themes showed four components for the definition of asexuality: attraction/sexual desire as the principal component, sexual relations, loving affective relationships, and self-identification. Asexuality is a multidimensional construct. It is necessary to reach a consensus for the criteria of the definition and thereby design instruments or interviews to define the prevalence and associated factors in different contexts.References
1. Brotto LA, Yule MA, Gorzalka BB. Asexuality: An extreme variant of sexual desire disorder? J Sex Med. 2015; 12(3):646-60.
2. Prause N, Graham CA. Asexuality: Classification and characterization. Arch Sex Behav. 2007; 36(3):341-56.
3. Brotto LA, Knudson G, Inskip J, Rhodes K, Erskine Y. Asexuality: A mixed-methods approach. Arch Sex Behav. 2010; 39(3):599-618.
4. Walton MT, Lykins AD, Bhullar N. Beyond heterosexual, bisexual, and homosexual: a diversity in sexual identity expression. Arch Sex Behav. 2016; 45(7):1591-7.
5. Greaves LM, Barlow FK, Lee CH, Matika CM, Wang W, Lindsay CJ, et al. The diversity and prevalence of sexual orientation self-labels in a New Zealand national sample. Arch Sex Behav. 2017; 46(5):1325-36.
6. Bogaert AF. Toward a conceptual understanding of asexuality. Rev Gen Psychol. 2006; 10(3):241-50.
7. Yule MA, Brotto LA, Gorzalka BB. Human asexuality: What do we know about a lack of sexual attraction? Cur Sex Health Report. 2017; 9(1):50-6.
8. Conrad P. Medicalization and social control. Ann Rev Sociol. 1992; 18(1):209-32.
9. Castiel LD, Álvarez-Dardet C. La salud persecutoria. Rev Saude Publica. 2007; 41(3): 461-466.
10. Michiels-Corsten M, Donner-Banzhoff N. Beyond accuracy: hidden motives in diagnostic testing. Fam Pract. 2017; 35(2):222-7.
11. Tiefer L. The medicalization of sexuality: Conceptual, normative, and professional issues. Ann Rev Sex Res. 1996; 7(1):252-82.
12. Cacchioni T, Tiefer L. Why medicalization? Introduction to the special issue on the medicalization of sex. J Sex Res. 2012; 49(4):307-10.
13. Epstein S, Mamo L. The proliferation of sexual health: Diverse social problems and the legitimation of sexuality. Soc Sci Med. 2017; 188: 176-90.
14. Tiefer L. Medicine, sexual norms, and the role of the DSM. Virtual Mentor. 2014; 16(11):923-7.
15. Earp BD, Sandberg A, Savulescu J. The medicalization of love. Cambridge Q Health Care Ethics. 2015; 24(3):323-36.
16. Nazareth I, Boynton P, King M. Problems with sexual function in people attending London general practitioners: cross sectional study. BMJ. 2003; 327 (7412):423.
17. Shifren JL, Johannes CB, Monz BU, Russo PA, Bennett L, Rosen R. Help-seeking behavior of women with self-reported distressing sexual problems. J Women Health. 2009; 18(4):461-8.
18. Peck SA. The importance of the sexual health history in the primary care setting. J Obstetr Gynecol Neonatal Nurs. 2001; 30(3):269-74.
19. Quinn C, Happell B, Welch A. Talking about sex as part of our role: Making and sustaining practice change. Int J Mental Health Nurs. 2013; 22(3):231-40.
20. Odey K. Legitimizing patient sexuality and sexual health to provide holistic care. Gastrointest Nurs. 2009 7(8):43-7.
21. Hendry A, Snowden A, Brown M. When holistic care is not holistic enough: The role of sexual health in mental health settings. J Clin Nurs. 2018; 27(5-6):1015-27.
22. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Meth. 2018; 8:45. doi.org/10.1186/1471-2288-8-45
23. Strauss A, Corbin J. Basic of qualitative research. Techniques and procedures for developing ground theory. London: Sage Publications, Inc.; 1998.
24. de Casterle BD, Gastmans C, Bryon E, Denier Y. QUAGOL: A guide for qualitative data analysis. Int J Nurs Stud. 2012; 49(3):360-71.
25. Averett P, Benson M, Vaillancourt K. Young women's struggle for sexual agency: The role of parental messages. J Gender Stud. 2008; 17(4):331-44.
26. Van Houdenhove E, Gijs L, T’Sjoen G, Enzlin P. Asexuality: Few facts, many questions. J Sex Mar Ther. 2014; 40(3):175-92.
27. Pinto SA. ASEXUally: On being an ally to the asexual community. J LGBT Iss Counsel. 2014; 8(4):331-43.
28. Van Houdenhove E, Gijs L, T’Sjoen G, Enzlin P. Stories about asexuality: A qualitative study on asexual women. J Sex Mar Ther. 2015; 41(4):262-81.
29. Bogaert AF. Asexuality: What it is and why it matters. J Sex Res. 2015; 52(4):362-79.
30. MacNeela P, Murphy A. Freedom, invisibility, and community: A qualitative study of self-identification with asexuality. Arch Sex Behav. 2015; 44(3):799-812.
31. Robbins NK, Low KG, Query AN. A qualitative exploration of the “coming out” process for asexual individuals. Arch Sex Behav. 2016; 45(3):751-60.
32. Brotto LA, Yule M. Asexuality: Sexual orientation, paraphilia, sexual dysfunction, or none of the above? Arch Sex Behav. 2017; 46(3):619-27.
33. Crooks R, Baur K. Our sexuality. 13th edition. Belmont: Wadsworth; 2017.
34. Lobel SA, Quinn RE, Clair LS, Warfield A. Love without sex: The impact of psychological intimacy between men and women at work. Organ Dynam. 1994; 23(1):5-16.
35. Friedland R, Mohr JW, Roose H, Gardinali P. The institutional logics of love: measuring intimate life. Theory Soc. 2014; 43(3-4):333-70.
36. Organización Mundial de la Salud. Clasificación Internacional de las Enfermedades (CIE). Trastornos mentales y del comportamiento. Criterios diagnósticos de investigación. 10 Edición. Madrid: Meditor; 1993.
37. Asociación Psiquiátrica Americana. Guía de consulta de los criterios diagnósticos del DSM-5. Barcelona: Masson; 2013.
38. Cranney S. The temporal stability of lack of sexual attraction across young adulthood. Arch Sex Behav. 2016; 45(3):743-9.
39. Yule MA, Brotto LA, Gorzalka BB. Sexual fantasy and masturbation among asexual individuals. Can J Hum Sex. 2014; 23(1):89-95.
40. Lamberg L. Gay is okay with APA—forum honors landmark 1993 events. JAMA. 1999; 280(1):97-9.
41. Mendelson G. Homosexuality and psychiatric nosology. Aust N Z J Psychiatry. 2003; 37(6):678-83.
42. Campo-Arias A, Herazo E. Novedades, críticas y propuestas al DSM-5: el caso de las disfunciones sexuales, la disforia de género y los trastornos parafílicos. Rev Colomb Psiquiatr. 2018; 47(1):56-64.
43. Herek GM. The psychology of sexual prejudice. Cur Direction Psychol Sci. 2000; 9(1): 19-22.
44. Herek GM. Confronting sexual stigma and prejudice: Theory and practice. J Soc Iss. 2007; 63(4):905-25.
45. Herek GM, McLemore KA. Sexual prejudice. Ann Rev Psychol. 2013; 64:309-33.
46. Burke SE, Dovidio JF, LaFrance M, Przedworski JM, Perry SP, Phelan SM, et al. Beyond generalized sexual prejudice: Need for closure predicts negative attitudes toward bisexual people relative to gay/lesbian people. J Exp Soc Psychol.2017; 71:145-50.
47. Pirlott AG, Cook CL. Prejudices and discrimination as goal activated and threat driven: The affordance management approach applied to sexual prejudice. Psychol Rev. 2018. [Epub ahead of print] doi: 10.1037/rev0000125.
48. Di Segni S. Sexualidades. Tensiones entre la psiquiatría y los colectivos militantes. Buenos Aires: Fondo de Cultura Económica; 2013.
49. Turner D, Schöttle D, Bradford J, Briken P. Assessment methods and management of hypersexuality and paraphilic disorders. Curr Opin Psychiatry. 2014; 27: 413-22.
50. Maslow AH. A theory of human motivation. Psychol Review. 1943; 50(4):370-96.
51. Relman AS. The new medical-industrial complex. N Engl J Med. 1980; 303(17):963-70.
52. Hugh Middleton. Psychiatry reconsidered. From medical treatment to supportive understanding. NewYork: Palgrave/McMillan; 2015.
53. Fisher WA, Barak A. Online sex shops: phenomenological, psychological, and ideological perspectives on internet sexuality. CyberPsychol Behav. 2000; 3(4):575-89.
54. Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Prom Int. 1996; 11(1):11-18.
55. Torrone EA, Morrison CS, Chen PL, Kwok C, Francis SC, Hayes RJ, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. PLoS Med. 2018; 15(2), e1002511.
56. Bashford, A. (2008). World population, world health and security: 20th century trends. J Epidemiol Community Health. 2008; 62(3):187-90.
57. Campo-Arias A. Essential aspects and practical implications of sexual identity. Colomb Med. 2010; 41(2):179-85.
58. Van Houdenhove E, Enzlin P, Gijs L. A positive approach toward asexuality: Some first steps, but still a long way to go. Arch Sex Behav. 2017; 46(3):647-51.
59. Chasin CD. Theoretical issues in the study of asexuality. Arch Sex Behav. 2011; 40(4):713-23.
60. Van Houdenhove E, Gijs L, T'Sjoen G, Enzlin P. Asexuality: A multidimensional approach. J Sex Res. 2015; 52(6):669-78.
2. Prause N, Graham CA. Asexuality: Classification and characterization. Arch Sex Behav. 2007; 36(3):341-56.
3. Brotto LA, Knudson G, Inskip J, Rhodes K, Erskine Y. Asexuality: A mixed-methods approach. Arch Sex Behav. 2010; 39(3):599-618.
4. Walton MT, Lykins AD, Bhullar N. Beyond heterosexual, bisexual, and homosexual: a diversity in sexual identity expression. Arch Sex Behav. 2016; 45(7):1591-7.
5. Greaves LM, Barlow FK, Lee CH, Matika CM, Wang W, Lindsay CJ, et al. The diversity and prevalence of sexual orientation self-labels in a New Zealand national sample. Arch Sex Behav. 2017; 46(5):1325-36.
6. Bogaert AF. Toward a conceptual understanding of asexuality. Rev Gen Psychol. 2006; 10(3):241-50.
7. Yule MA, Brotto LA, Gorzalka BB. Human asexuality: What do we know about a lack of sexual attraction? Cur Sex Health Report. 2017; 9(1):50-6.
8. Conrad P. Medicalization and social control. Ann Rev Sociol. 1992; 18(1):209-32.
9. Castiel LD, Álvarez-Dardet C. La salud persecutoria. Rev Saude Publica. 2007; 41(3): 461-466.
10. Michiels-Corsten M, Donner-Banzhoff N. Beyond accuracy: hidden motives in diagnostic testing. Fam Pract. 2017; 35(2):222-7.
11. Tiefer L. The medicalization of sexuality: Conceptual, normative, and professional issues. Ann Rev Sex Res. 1996; 7(1):252-82.
12. Cacchioni T, Tiefer L. Why medicalization? Introduction to the special issue on the medicalization of sex. J Sex Res. 2012; 49(4):307-10.
13. Epstein S, Mamo L. The proliferation of sexual health: Diverse social problems and the legitimation of sexuality. Soc Sci Med. 2017; 188: 176-90.
14. Tiefer L. Medicine, sexual norms, and the role of the DSM. Virtual Mentor. 2014; 16(11):923-7.
15. Earp BD, Sandberg A, Savulescu J. The medicalization of love. Cambridge Q Health Care Ethics. 2015; 24(3):323-36.
16. Nazareth I, Boynton P, King M. Problems with sexual function in people attending London general practitioners: cross sectional study. BMJ. 2003; 327 (7412):423.
17. Shifren JL, Johannes CB, Monz BU, Russo PA, Bennett L, Rosen R. Help-seeking behavior of women with self-reported distressing sexual problems. J Women Health. 2009; 18(4):461-8.
18. Peck SA. The importance of the sexual health history in the primary care setting. J Obstetr Gynecol Neonatal Nurs. 2001; 30(3):269-74.
19. Quinn C, Happell B, Welch A. Talking about sex as part of our role: Making and sustaining practice change. Int J Mental Health Nurs. 2013; 22(3):231-40.
20. Odey K. Legitimizing patient sexuality and sexual health to provide holistic care. Gastrointest Nurs. 2009 7(8):43-7.
21. Hendry A, Snowden A, Brown M. When holistic care is not holistic enough: The role of sexual health in mental health settings. J Clin Nurs. 2018; 27(5-6):1015-27.
22. Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Meth. 2018; 8:45. doi.org/10.1186/1471-2288-8-45
23. Strauss A, Corbin J. Basic of qualitative research. Techniques and procedures for developing ground theory. London: Sage Publications, Inc.; 1998.
24. de Casterle BD, Gastmans C, Bryon E, Denier Y. QUAGOL: A guide for qualitative data analysis. Int J Nurs Stud. 2012; 49(3):360-71.
25. Averett P, Benson M, Vaillancourt K. Young women's struggle for sexual agency: The role of parental messages. J Gender Stud. 2008; 17(4):331-44.
26. Van Houdenhove E, Gijs L, T’Sjoen G, Enzlin P. Asexuality: Few facts, many questions. J Sex Mar Ther. 2014; 40(3):175-92.
27. Pinto SA. ASEXUally: On being an ally to the asexual community. J LGBT Iss Counsel. 2014; 8(4):331-43.
28. Van Houdenhove E, Gijs L, T’Sjoen G, Enzlin P. Stories about asexuality: A qualitative study on asexual women. J Sex Mar Ther. 2015; 41(4):262-81.
29. Bogaert AF. Asexuality: What it is and why it matters. J Sex Res. 2015; 52(4):362-79.
30. MacNeela P, Murphy A. Freedom, invisibility, and community: A qualitative study of self-identification with asexuality. Arch Sex Behav. 2015; 44(3):799-812.
31. Robbins NK, Low KG, Query AN. A qualitative exploration of the “coming out” process for asexual individuals. Arch Sex Behav. 2016; 45(3):751-60.
32. Brotto LA, Yule M. Asexuality: Sexual orientation, paraphilia, sexual dysfunction, or none of the above? Arch Sex Behav. 2017; 46(3):619-27.
33. Crooks R, Baur K. Our sexuality. 13th edition. Belmont: Wadsworth; 2017.
34. Lobel SA, Quinn RE, Clair LS, Warfield A. Love without sex: The impact of psychological intimacy between men and women at work. Organ Dynam. 1994; 23(1):5-16.
35. Friedland R, Mohr JW, Roose H, Gardinali P. The institutional logics of love: measuring intimate life. Theory Soc. 2014; 43(3-4):333-70.
36. Organización Mundial de la Salud. Clasificación Internacional de las Enfermedades (CIE). Trastornos mentales y del comportamiento. Criterios diagnósticos de investigación. 10 Edición. Madrid: Meditor; 1993.
37. Asociación Psiquiátrica Americana. Guía de consulta de los criterios diagnósticos del DSM-5. Barcelona: Masson; 2013.
38. Cranney S. The temporal stability of lack of sexual attraction across young adulthood. Arch Sex Behav. 2016; 45(3):743-9.
39. Yule MA, Brotto LA, Gorzalka BB. Sexual fantasy and masturbation among asexual individuals. Can J Hum Sex. 2014; 23(1):89-95.
40. Lamberg L. Gay is okay with APA—forum honors landmark 1993 events. JAMA. 1999; 280(1):97-9.
41. Mendelson G. Homosexuality and psychiatric nosology. Aust N Z J Psychiatry. 2003; 37(6):678-83.
42. Campo-Arias A, Herazo E. Novedades, críticas y propuestas al DSM-5: el caso de las disfunciones sexuales, la disforia de género y los trastornos parafílicos. Rev Colomb Psiquiatr. 2018; 47(1):56-64.
43. Herek GM. The psychology of sexual prejudice. Cur Direction Psychol Sci. 2000; 9(1): 19-22.
44. Herek GM. Confronting sexual stigma and prejudice: Theory and practice. J Soc Iss. 2007; 63(4):905-25.
45. Herek GM, McLemore KA. Sexual prejudice. Ann Rev Psychol. 2013; 64:309-33.
46. Burke SE, Dovidio JF, LaFrance M, Przedworski JM, Perry SP, Phelan SM, et al. Beyond generalized sexual prejudice: Need for closure predicts negative attitudes toward bisexual people relative to gay/lesbian people. J Exp Soc Psychol.2017; 71:145-50.
47. Pirlott AG, Cook CL. Prejudices and discrimination as goal activated and threat driven: The affordance management approach applied to sexual prejudice. Psychol Rev. 2018. [Epub ahead of print] doi: 10.1037/rev0000125.
48. Di Segni S. Sexualidades. Tensiones entre la psiquiatría y los colectivos militantes. Buenos Aires: Fondo de Cultura Económica; 2013.
49. Turner D, Schöttle D, Bradford J, Briken P. Assessment methods and management of hypersexuality and paraphilic disorders. Curr Opin Psychiatry. 2014; 27: 413-22.
50. Maslow AH. A theory of human motivation. Psychol Review. 1943; 50(4):370-96.
51. Relman AS. The new medical-industrial complex. N Engl J Med. 1980; 303(17):963-70.
52. Hugh Middleton. Psychiatry reconsidered. From medical treatment to supportive understanding. NewYork: Palgrave/McMillan; 2015.
53. Fisher WA, Barak A. Online sex shops: phenomenological, psychological, and ideological perspectives on internet sexuality. CyberPsychol Behav. 2000; 3(4):575-89.
54. Antonovsky A. The salutogenic model as a theory to guide health promotion. Health Prom Int. 1996; 11(1):11-18.
55. Torrone EA, Morrison CS, Chen PL, Kwok C, Francis SC, Hayes RJ, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: An individual participant data meta-analysis of 18 HIV prevention studies. PLoS Med. 2018; 15(2), e1002511.
56. Bashford, A. (2008). World population, world health and security: 20th century trends. J Epidemiol Community Health. 2008; 62(3):187-90.
57. Campo-Arias A. Essential aspects and practical implications of sexual identity. Colomb Med. 2010; 41(2):179-85.
58. Van Houdenhove E, Enzlin P, Gijs L. A positive approach toward asexuality: Some first steps, but still a long way to go. Arch Sex Behav. 2017; 46(3):647-51.
59. Chasin CD. Theoretical issues in the study of asexuality. Arch Sex Behav. 2011; 40(4):713-23.
60. Van Houdenhove E, Gijs L, T'Sjoen G, Enzlin P. Asexuality: A multidimensional approach. J Sex Res. 2015; 52(6):669-78.
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