Sex: Starting the Conversation Around Sexual Anorexia

Kyle sits awake at 2 AM, the glow of his laptop revealing a single word in the search bar: “avoidance.” He scrolls past harsh phrases like fear of intimacy and sexual withdrawal that feel like accusations. Then one term stops him—“sexual anorexia.” For the first time, he wonders: What if I’m not broken, but scared? And what if scared has a name?

This episode of Mental Health Rewritten explores the little-discussed realm of sexual anorexia, a term for fear-driven intimacy avoidance often rooted in trauma. Though not officially listed in the DSM-5, sexual anorexia is a profoundly real experience, marked not by mere disinterest but by an instinctual, protective shutdown of the body and emotions in the face of intimacy. It’s a concept that can help survivors put a name to what was once shrouded in shame.

Narrative storytelling and expert insight intertwine as we follow Kyle’s journey and others like him. Survivor Janet Bentley shares her struggle with physical closeness after sexual abuse, describing how discovering the term sexual anorexia transformed her self-understanding from silent shame to shared understanding. Janet’s personal account — from feeling isolated and “broken” to finding hope in healing after sexual abuse — illustrates the power of naming trauma and seeking support. Her experience led her to found the Courageous Survivors nonprofit, creating a safe space for those with similar stories.

Renowned clinician Dr. Alexandra Katehakis offers compassionate commentary on why the mind and body respond this way. She explains how deeply embedded trauma can hijack the nervous system (drawing on the Polyvagal Theory of Dr. Stephen Porges) and cause a fight, flight, or freeze response during intimacy. Listeners learn how the body may literally shut down or go numb when triggered — not as dysfunction, but as the nervous system’s attempt to feel safe. Dr. Katehakis discusses somatic healing techniques and the slow rebuilding of safety, trust, and consent in a relationship, highlighting the neurobiology behind why “the body remembers what the mind wants to forget.”

The episode also explores how these trauma responses fit (or don’t fit) into clinical labels. We delve into Female Sexual Interest/Arousal Disorder (FSIAD), the official diagnosis for low sexual desire in women, and why such labels often fail to capture the nuance of trauma-related intimacy avoidance. This discussion shines light on the inadequacy of one-size-fits-all diagnostic terms when intergenerational shame and personal trauma histories are involved. By blending Kyle’s fictional story, Janet’s real-life testimony, and Dr. Katehakis’s scientific expertise, the narrative challenges the stigma around sexual avoidance. Intimacy avoidance born from trauma is recast not as a life sentence of dysfunction, but as a protective response that can gradually be understood and healed.

Join host Dominic Lawson in this conversation that destigmatizes sexual anorexia and offers hope for trauma recovery. From the quiet pain of avoidance to the slow steps of reconnection, Mental Health Rewritten invites you to reconsider intimacy after trauma through a new lens — one of empathy, understanding, and the radical act of naming our truth out loud. This episode is a compassionate guide toward healing after sexual abuse, reminding listeners that what feels like “brokenness” can, in time, become a story of courage and reconnection.

Mental Health Rewritten, created by the OWLS Education Company, in collaboration with theUmmah Collective Group is hosted, written and produced by me, Dominic Lawson

 

Executive Producers Kenda Lawson and Dr. Whitney Howzell

 

Cover art was created by Alexandria Eddings of Art Life Connections. 

 

Some music was provided by DJ Krate Digga of the Mighty SoundChampz Crew

Major Themes Covered

Understanding Sexual Anorexia: Defining sexual anorexia as an extreme fear of sexual intimacy and compulsive avoidance of sex, viewed through a trauma-informed lens rather than as mere lack of desire.

Intimacy as a Triggering Threat: How past sexual abuse or deep-seated shame can make intimacy avoidance a self-protective response, with the body’s nervous system instinctively shielding the survivor (e.g. freezing or shutting down during closeness).

Personal Story of Recovery: Janet Bentley’s candid account of her journey healing after sexual abuse – from decades of feeling alone with intimacy fears to discovering the term sexual anorexia and finding empowerment in naming her experience.

Expert Insight and Somatic Healing: Dr. Alexandra Katehakis’s commentary on trauma and the body – discussing Polyvagal Theory, somatic therapy, and how understanding the neurobiology of trauma (e.g. fight/flight/freeze responses) can inform gentle healing and the rebuilding of trust and consent in relationships.

Beyond Diagnostic Labels: An exploration of clinical terms like Female Sexual Interest/Arousal Disorder (FSIAD) and why such diagnoses may fall short. The conversation highlights the limitations of traditional labels in addressing trauma-related intimacy issues, questioning whether what is often pathologized as dysfunction is actually a normal adaptive response to abnormal experiences.

Intergenerational Shame and Stigma: Insight into how shame around sexuality – often passed down through families or cultural messages – can compound trauma, and the importance of breaking silence and stigma. The episode emphasizes creating a supportive social context that validates survivors’ experiences instead of adding to their shame.

The Power of Naming and Storytelling: A central theme of turning “silent shame into shared understanding,” demonstrating how putting words to one’s experience (like calling it sexual anorexia) can be a first step in trauma recovery. Through Kyle’s fictional narrative and Janet’s real story, the show illustrates that naming the problem opens the door to community, professional help, and hope for change.

Resources & Mentions

Courageous Survivors – Nonprofit founded by Janet Bentley to support adult survivors of sexual trauma. 

The B Word Podcast (Episode with Janet Bentley)* – Janet shares her story of sexual trauma and healing. 

Book – Sexual Anorexia: Overcoming Sexual Self-Hatred by Patrick J. Carnes, PhD – A pioneering look at sexual anorexia and its ties to trauma (Hazelden, 1997). (Explores fear of intimacy and provides recovery strategies.)

Book – The Sexual Healing Journey by Wendy Maltz, LCSW – A compassionate guide for survivors of sexual abuse to reclaim healthy intimacy (Updated Edition, 2012).

Polyvagal Theory (Dr. Stephen Porges) – An influential framework explaining how the autonomic nervous system (vagus nerve) responds to trauma and safety cues. (Helps make sense of “freeze” and shutdown responses in intimacy.)

Center for Healthy Sex – Dr. Alexandra Katehakis’s therapy center in Los Angeles, offering resources on sex addiction, sexual anorexia, and trauma recovery. 

 

Sources

Diagnostic status of “sexual anorexia”: Medical News Today – “Sexual anorexia: Symptoms, treatment, causes, and more.” Confirms that sexual anorexia is not an official DSM-5 diagnosis. 

Patrick Carnes definition: Patrick Carnes’ book Sexual Anorexia defining it as “the emptiness of profound deprivation, a silent suffering”. Also describes the fear-driven avoidance and how it can mask as disinterest. 

DSM-5 Female Sexual Interest/Arousal Disorder: (NIH/NLM) – “Female Sexual Interest/Arousal Disorder.” Explains that FSIAD in DSM-5 merged the prior desire and arousal disorders for women and is distinct to females. 

Polyvagal freeze response: Reclaim Therapy Blog – “Understanding the Freeze Trauma Response” by Sarah Herstich, LCSW. Provides an overview of Polyvagal Theory (Dr. Stephen Porges) and the three neural pathways: social engagement, fight/flight, and dorsal vagal freeze when threat overwhelms. 

Trauma and sexual dysfunction statistic: Journal of Sexual Medicine review (Pulverman, 2018) – “Impact of Childhood Sexual Abuse on Women’s Sexual Health.” Indicates that in random community studies, 25–59% of women with CSA histories have sexual dysfunction, highlighting the strong link. 

Avoidance behaviors and symptoms: LovePanky (educational blog) – “Sexual Anorexia: 19 Signs…” Enumerates signs like fear of sex, avoidance of anything sexual (even revealing clothes or media), and judging one’s own sexuality – matching the episode’s descriptions. 

Marital rape legal history: CriminalDefenseLawyer.com – “Marital Rape Laws.” States that marital/spousal rape is illegal in all US states only since 1993, and notes the prior marital exemption laws. 

Current bodily autonomy debates: The Nation (June 2023) – “The Supreme Court Has Dealt Another Devastating Blow to Women.” Describes a recent SCOTUS ruling (Medina v. Planned Parenthood) as part of “the assault on bodily autonomy.” Illustrates ongoing legal battles over women’s control of their bodies.

Simone de Beauvoir on women’s bodies: The Second Sex via PhilosophyNow summary – Beauvoir observed that society makes a young woman feel her body is objectified and shameful (e.g. men’s leering causing her to wish to be “invisible”). 

Virtual reality therapy for sexual trauma: ABC News (Apr 2018) – “Inside the VR therapy designed to help sexual assault survivors heal by facing attackers.” Reports on psychologists using VR scenarios to help rape survivors confront fears in a safe, controlled way.