Conclusion

Sexual aversion disorder clearly represents an overlooked topic in the sexual disorders literature. Our concern is that the diagnostic criteria have been sufficiently vague and overlapping with hypoactive sexual desire, to leave clinicians and researchers confused about how and when to make an accurate diagnosis. We have proposed a revision to the diagnostic criteria, which may help both to better define sexual aversion disorder and to distinguish it more clearly from hypoactive sexual desire.

In our proposed revision, primary aversion would be diagnosed when an individual's initial sexual experience, either directly or vicariously, is negative. Secondary aversion is to be diagnosed when the patient has had normal, pleasurable sexual development and experiences until a traumatic or painful experience, either direct or vicarious, negatively reconditions sexual interactions with a partner.

With advances in diagnostic clarity, better estimates of incidence and prevalence can be obtained. Anecdotal evidence suggests that this disorder is more prevalent than many clinicians may be aware, particularly in men, who may not be as likely to present for treatment as are women.

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