Sexual Desire Disorders
The DSM-IV-TR (6) category of Sexual and Gender Disorders is divided into three parts, one of which is Sexual Dysfunctions. One of the group of sexual dysfunctions is “Sexual Desire Disorders” (SDD) of which there are two kinds: (A) hypoactive sexual desire disorder (HSDD) and (B) sexual aversion disorder (SAD). No distinction is made between SDDs that affect men and those affecting women. The assumption is evidently made that sexual desire and desire problems are the same in both gender groups—a concept that is debatable.
In the description of HSDD in DSM-IV-TR (6), three criteria are necessary
to establish the diagnosis: first, a deficiency or absence of sexual fantasy and desire for sexual activity; second, the fact that it causes “marked distress or inter- personal difficulty”; and third, that the disorder is not better viewed as a result of a major psychiatric or medical condition, or of substance abuse (this third criterion being somewhat problematic—see Sections “Etiology” and “Summary and Conclusions”).
According to DSM-IV-TR (6), the principal distinguishing feature of SAD is a “persistent or recurrent aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner.” The diagnosis is somewhat controversial in that some observers think that sexual desire problems exist on a continuum, rather than in separate categories. As the diagnosis of SAD is rarely made in men, and because a Pubmed search failed to reveal any articles with this diagnosis in the title, the issue will not be discussed further.