Asexuality is commonly defined as the experience of little or no sexual attraction toward others. Despite growing international research recognizing asexuality as a valid sexual orientation, misconceptions remain widespread within medical and mental health systems, particularly in South Asia. One recurring misconception is the assumption that libido, masturbation, or pornography consumption are incompatible with asexuality. Drawing upon observations from the ANOAQA helpline and existing academic literature, this editorial examines how asexual individuals—especially asexual transgender individuals—continue to face pathologization when seeking healthcare. The editorial argues that masturbation and sexual attraction are distinct phenomena and that medical professionals must develop a more nuanced understanding of asexual experiences to avoid harmful interventions, including conversion-oriented practices and unnecessary hormonal treatment.
Introduction
For many people, sexual attraction, libido, masturbation, and sexual behavior are often assumed to be interconnected. However, contemporary research on asexuality demonstrates that these experiences are not necessarily linked. Asexuality refers to a lack of sexual attraction toward others, whereas libido refers to physiological sexual drive, and masturbation refers to a behavior that may or may not be motivated by attraction to another person.
Within South Asian contexts, where public understanding of asexuality remains limited, many asexual individuals report being treated as though their orientation is a medical problem requiring correction. ANOAQA’s internal helpline observations indicate that callers frequently contact the organization seeking reassurance after being told by healthcare providers that their absence of sexual attraction is abnormal, pathological, or a symptom of excessive masturbation or pornography consumption.
Libido Without Sexual Attraction
One of the most persistent myths surrounding asexuality is the belief that an asexual person should have no libido and should never masturbate. Or asexuals are losing their sexual desire due to excessive masturbation. Research has consistently challenged this assumption.
Yule, Brotto, and Gorzalka (2017) found that many asexual individuals engage in masturbation despite reporting little or no sexual attraction toward other people. The researchers concluded that masturbation among asexual individuals may serve a variety of functions unrelated to attraction, including stress relief, physical release, relaxation, curiosity, or management of physiological arousal. Importantly, the study found that many asexual participants reported fantasies that did not involve other people at all, demonstrating that sexual attraction and masturbation are not equivalent experiences.
Many ANOAQA community members describe masturbation as a practical response to bodily arousal rather than a desire for partnered sexual activity. Some women report heightened libido during certain phases of the menstrual cycle, particularly in the days preceding menstruation. Similarly, some men report morning erections or periods of spontaneous physiological arousal. In these situations, masturbation is often described as a means of achieving comfort, concentration, emotional regulation, or physical relief rather than fulfilling attraction toward another person.
Several ANOAQA members have reported that without occasional masturbation, they experience difficulty concentrating, disrupted sleep, increased bodily tension, or diminished emotional well-being. These experiences align with broader sexological research indicating that libido and sexual attraction operate as distinct psychological and physiological systems.
Medical Pathologization and Misdiagnosis
According to ANOAQA helpline observations, many callers initially approach healthcare providers seeking information about whether their lack of sexual attraction requires treatment. Alarmingly, a substantial proportion report receiving responses that immediately frame their experience as a problem to be corrected.
A recurring pattern involves physicians asking whether the individual watches pornography or masturbates regularly. When the answer is yes, callers frequently report being advised to discontinue masturbation or pornography use on the assumption that doing so will eventually restore sexual attraction toward others.
This approach reflects a fundamental misunderstanding of asexuality. Scientific research does not support the claim that masturbation causes a lack of sexual attraction, nor that abstaining from masturbation will create sexual attraction in an asexual individual. Asexuality is increasingly recognized as a legitimate sexual orientation rather than a dysfunction requiring treatment.
Such assumptions can contribute to unnecessary distress. Individuals often leave medical consultations believing they have caused their own asexuality through masturbation or pornography use, despite the absence of scientific evidence supporting such conclusions.
The Particular Challenges Faced by Asexual Trans-mans
The situation becomes even more complex for asexual trans-sex individuals. ANOAQA helpline observations suggest that many trans-sex asexual people encounter healthcare providers who understand gender dysphoria but remain unfamiliar with asexuality.
Several callers have reported being told that their lack of sexual attraction is simply a temporary consequence of hormone-related factors or a consequence of gender dysphoria . Some have been assured that sexual attraction will naturally emerge after transition-related treatment.
One particularly concerning pattern involves healthcare providers interpreting continued absence of sexual attraction after transition as evidence of hormonal inadequacy. Community members have reported cases in which hormone dosages were increased specifically to encourage sexual attraction. In some instances, individuals experienced adverse physical or psychological effects while still not experiencing sexual attraction because the underlying issue was never hormonal deficiency but rather asexual orientation.
These experiences illustrate how asexual transgender individuals can become vulnerable to a form of medical pathologization that misunderstands both gender identity and sexual orientation. Increasing testosterone or estrogen levels may influence libido, but there is no evidence that hormone treatment can create a sexual orientation where none previously existe
Distinguishing Libido, Attraction, and Behavior
Research increasingly emphasizes the importance of distinguishing among three separate concepts:
- Sexual Attraction: Feeling sexually drawn toward another person.
- Libido or Sexual Drive: Physiological experiences of arousal, sexual tension, or desire for sexual release.
- Sexual Behavior: Actions such as masturbation, partnered sex, or consumption of sexual media.
An individual may possess one, two, all, or none of these characteristics in varying combinations. For example:
- A person may experience strong libido but no sexual attraction.
- A person may masturbate regularly but have no desire for partnered sexual activity.
- A person may experience sexual attraction but have little interest in masturbation.
- A person may engage in sexual behavior for intimacy, curiosity, or relational reasons despite lacking attraction.
The existence of masturbation among asexual individuals therefore does not invalidate their asexual identity.
Asian Network of A-Spec Queer Activists
Final Thoughts
The experiences documented through ANOAQA’s helpline point to an urgent need for improved professional education regarding asexuality.
Healthcare providers should:
- Recognize asexuality as a legitimate sexual orientation.
- Distinguish sexual attraction from libido and masturbation.
- Avoid assuming that masturbation causes asexuality.
- Refrain from recommending conversion-oriented interventions intended to create sexual attraction.
- Understand that hormone therapy may influence libido but does not determine sexual orientation.
- Respect patient self-identification and lived experiences.
For asexual transgender individuals in particular, clinicians must avoid conflating gender dysphoria, hormonal treatment, libido, and sexual orientation.
Conclusion
The experiences reported through ANOAQA’s helpline reveal a significant gap between contemporary academic knowledge and everyday clinical practice. While scientific literature increasingly recognizes that masturbation, libido, and asexuality can coexist, many healthcare providers continue to interpret the absence of sexual attraction as a symptom requiring correction.
Such misunderstandings can result in inappropriate advice, unnecessary medical interventions, and significant psychological distress. Greater awareness of asexuality within healthcare systems is therefore essential, particularly in South Asian contexts where public understanding remains limited.
Recognizing that masturbation is a behavior and that asexuality is an orientation allows clinicians to move beyond outdated assumptions and toward more ethical, evidence-based, and affirming forms of care.
If you’d like to talk more about your feelings, feel free to reach out to the ANOAQA Helpline at +880 1682-624275.
