A language is a powerful tool, and how we use it not only expresses deep-seated attitudes but also influences the behavior of others. The term sexuality, for example, has a lot of weight behind it. And none of that weight has anything to do with the word’s meaning. We use it as a blanket term for sexual orientation, libido, gender, and many other tangential terms. These words are in no way synonymous, so let’s start by differentiating them.
Human sexuality is broad, encompassing our fantasies, roles, body image, intimacy, relationships, and personal values. Societal influences also have a part in sexuality. For example, some communities embrace polyamory while others prefer monogamy. Some enjoy BDSM while others shun masturbation. Mores vary, and behavior responds accordingly.
When a person’s sexual preferences vary from what their culture considers ‘normal’ they can feel outcast. They’ve been taught that who they are and/or what they like in bed is ‘wrong’ or taboo. This can range from nymphomania to oral sex. Struggling between personal desires and societal expectations can cause internal conflict. This can be worsened if your sexuality is considered atypical.
The DSM (Diagnostic and Statistical Manual of Mental Disorders [DSM-5]) labels these atypical desires as a paraphilia, and they include fetishes, exhibitionism, voyeurism, and some more troubling ones. However, these are classed as preferences rather than disorders. Actual disorders listed in the DSM-5 include premature ejaculation, orgasmic disorder (in women), and genitopelvic pain aka penetration disorder. Paraphilias are not considered a problem unless they cause distress to the patient or non-consensual harm to their sexual partners.
Disorders lasting sex– on the other hand – may need treatment through medication and/or sex therapy. The DSM-5 has three female disorders and four male disorders, but most people who seek help have more familiar sexuality challenges. These may involve anxiety over sexual orientation, disturbing sexual impulses, lack of interest in sex, or trauma from sexual abuse. They can all be treated and resolved by caring, well-trained sexual health experts.
Some studies believe sexuality is driven by nurture rather than nature. That said, it can be a physical issue, a mental one, or a mix of both. Psychologically, your sexuality is bound to be affected by depression, anxiety, PTSD, negative body image, or loss of trust within a relationship. Trust issues could even arise from previous relationships, or from incidences completely unrelated to your partner.
They sometimes arise from childhood, but not always. For example, a betrayal by a friend, colleague, or family member might be projected onto your romantic partner, interfering with your sex life. On the physical front, barriers to healthy sexuality include imbalanced hormones, side effects of medication, diabetes, heart problems, urinary infections, or discomfort in the bowels. The best approach is to identify what’s affecting your sexuality and address it with your partner, preferably under the guidance of sexual health professionals.