Note: This guide presumes a passing familiarity with the asexual identity. For some basic 101, you can view Asexuality: Basics for Health Professionals.
There are many issues to bear in mind when conducting therapy with a client who identifies under the asexual umbrella. Aces may have unique needs and experiences that challenge traditional practice and conventional wisdom within the mental health field. It’s best to educate yourself and learn how to account for these differences in order to preempt damage to the therapist-client relationship, or, worse, compounding the hurts you’re supposed to heal.
However, in order for you to even be aware that your client is ace in the first place, they’ll need to decide to disclose their sexuality to you. This can be a fraught decision to make, especially in our dealings with mental health professionals. If you wish to signal to clients that you can be trusted with this information (and to attract clients who may be looking specifically for an ace-friendly therapist), here are some preliminary steps you can take.
Presenting Yourself as an Ace-Friendly Therapist
In some ways, you can think of this goal as similar to presenting yourself as LGBT-friendly — although it’s worth noting that because not all LGBT-friendly therapists are ace-friendly (and because the LGBT and asexual communities have a complicated relationship), people who identify with asexuality may need additional, specific assurance.
If you have an online or written bio that notes you’re “LGBT-friendly” or some similar variation of that idea, aces might look for signals such as an ambiguous acronym (LGBTQ+) or a variation of the acronym that includes an “A” (LGBTQIA), but the clearest cue possible is an explicit “asexual-friendly” statement or a mention of the asexual spectrum.
If you have a rainbow symbol or safe space icon somewhere in your office space, you might print out a similar image for aces, such as the inclusivity poster you can find here. If you require clients to fill out any standardized forms on the subjects of libido or “intimacy,” at least see about providing a N/A option for each and every question, even the questions you would assume are always applicable.
Presenting yourself as ace-friendly extends into the therapy session itself, as well. Never assume there is any “normal” when it comes to sex and sexuality, and make that a general habit when working with all your clients. Many things are common; few things are universal. Puberty, sensuality, and desire can all be experienced (or not experienced!) in a myriad of ways. Conventional dating scripts, “levels of intimacy,” and “progressions” in a relationship may not apply.
Be careful not to steer clients toward a certain “default” way you would expect their sexuality to unfold over their lives. Asexuality is something you should preemptively take into account even with clients who do not identify themselves to you as ace, especially since many people haven’t heard of asexuality as a sexual orientation in people. When you’ve done the research to become knowledgeable of common ace experiences, you can be prepared to notice similarities with these in the experiences of your clients and recognize when a client might benefit from being introduced to the concept of asexuality.
When A Client Comes Out As Asexual, Gray-Asexual, or Demisexual
An ace who’s doing therapy might come out to their therapist for a multitude of reasons. Although you should be prepared for the possibility, don’t assume that just because they’re informing you of their sexuality that it’s something they’ve come to therapy to “work on” or that their orientation itself is a source of distress. Sometimes, the client’s ace identity may be necessary prerequisite knowledge they need to impart before they can explain something else going on in their lives (they could be an asexual education activist, for example!). An ethical therapist would not want clients to keep secrets out of shame or fear that revealing certain information about themselves might alter the course or the quality of their therapy.
When a client comes out to you as ace, they’ll likely be gauging your reaction and looking for clues as to whether or not you’ll accept their identity. Be prepared to offer them reassurance, and make it clear that this will not interfere with your willingness to help them work on their stated goals.
Remember: coming out can be scary! Especially coming out to a mental health professional, given that asexuality is a sexual identity that is popularly pathologized. Your client may have received judgmental, dismissive, or hostile responses to their sexuality in the past, or they may have read about these responses being received by others who share their identity, and they may be bracing themselves for the worst. Do not assume that your client acting tense or nervous around the subject means that their identity itself is the problem. Rather, it may be that they’re merely unsure whether it’s safe to be talking about it with you.
To address these fears, you may want to think of something to say in advance. For example, a nod, a smile, and a comment about “I’ve heard of that before” can go a long way. Affirming acknowledgements such as “That’s normal” or “Sexuality is a spectrum” can be helpful as well. This applies no matter the age of the client. Never tell anyone they’re “too young to know” or that they “might not be asexual forever.”
As always, let your client’s concerns guide the session. How relevant asexuality may or may not be to their reasons for seeing you is up to them, and how much they want to share is up to them, too. Some aces are comfortable answering questions on the subject. If you choose to ask some, pay attention to your client’s body language and how they seem to handle curiosity. You don’t want them to feel like they’re being interrogated or like their identity’s legitimacy is on trial. Most basic questions can be answered with a google search outside of the therapy session. Don’t rely on your client to educate you. Bear in mind, also, that you only need to know what’s relevant to helping your client reach their therapy goals (You may be proud of the research you’ve done, but it’s not appropriate to spring a question like “So what’s your romantic orientation?” on someone if that has nothing to do with why they’re seeing you).
As previously mentioned, the LGBT community and the asexual community have a complicated relationship (as well as considerable overlap). When you are responding to a client’s disclosure of asexuality, it’s not a good idea to say something like, “I’ve heard Dan Savage talk about that.” You may think that citing a popular gay rights activist should earn you credibility, but in fact, the well-publicized dismissive and demonizing things that Dan Savage has said about asexual people in the past, even if he carries different beliefs in the present, means that if you bring him up in this context, an ace client is more likely to cringe and become more wary of you rather than less. In general, it’s best to avoid specific namedrops.
Ethical, Informed, Ace-Friendly Therapy
So now you’ve been informed that one of your clients identifies, to whatever degree, with asexuality. Here are some tips on how to proceed.
Firstly, no matter if your client is questioning or uncertain, no matter how much it challenges what you’ve been taught, do not tell your client what they “really” are or try to steer them away from an ace identity. In fact, you shouldn’t be steering at all. Your job is to facilitate their journey, not take over for them.
Your prior education might tell you that a low sex drive can be a symptom of other illnesses, and that may be true, but it’s not always appropriate to broach the subject — you don’t need to bring it up unless you recognize other symptoms. Asexuality and pathologization is a touchy subject, and a low or absent sex drive alone is not cause for concern. If the client is concerned about their sex drive and asks you about it, mentioning related illnesses would be appropriate, but so would introducing them to the concept of asexuality or offering reassurance that sex drives are unnecessary for a happy, healthy life.
Despite what the current DSM may lead you to believe, identifying as asexual does not necessarily preclude someone from being “distressed” about low sexual desire. When considering a sexual disorder diagnosis, do not operate off a dichotomy that sorts people as either disordered or asexual based on whether or not they “experience distress.” Remember, also, that people who might benefit from the asexual label often haven’t heard of asexuality as a legitimate orientation before. It’s fairly common for aces to go through complex periods of questioning, self-doubt, and even self-hatred before and while identifying as ace. An absence of proud proclamation and confidence in the identity, or even not mentioning it at all, doesn’t mean someone is not ace.
During the therapy session, you may feel called upon to encourage your client to question their assumptions and thought processes. This can be helpful and healing in many situations. It is not necessarily helpful, and may even be damaging, to take that approach to identification under the asexual umbrella. Undermining your client’s confidence in calling themselves ace is unethical and unproductive. If anything, the most helpful thing may be to encourage them not question themselves so much, when it comes to this matter, especially if their doubt spirals are consistently inconclusive and distressing.
An asexual identity can coincide with a wide variety of experiences, traits, diagnoses, preferences, and other identities. It is also not necessarily indicative of anything else. This is a key point to remember. You shouldn’t assume, for example, that an ace identity and a gay, bi, and/or transgender identity are mutually exclusive or indicative of a problem.
If your client is ace and also gay, lesbian, bi, or trans, don’t try to convince them on the basis of one of the latter that they’re not really the former. It does not help your client to hear their identities pitted against each other or to be told, rather than asked, how they “really” feel. It’s up to the client to determine how to conceptualize their own experiences.
With trans clients, it’s your responsibility to accept that trans people can have the same wide range of sexual orientations as people who are not trans, and that means that trans people can be ace, too. Accessing their “real” sexuality is not necessarily dependent on physical transition. If your trans client is pursuing surgery, do not express an expectation that their orientation will change as a result.
Additionally, make space for greyness, ambiguity, and “contradictory” experiences. Don’t assume that knowing your client is ace can tell you anything about their relationship preferences or how they feel about romance (as aces are highly diverse when it comes to this subject and many others).
Direct your ace clients toward ace-specific resources, if they need them. For example, if they mention they wish they knew other aces in person, you can suggest they find a local meetup. There are also ace-specfic resources for survivors of sexual violence and eating disorders.
That said, although these resources may be invaluable for some, involvement in the asexual community is not an instant solution or respite from life’s problems any more than therapy is. There are several persistent intracommunity issues to contend with, such as varying levels of conflict between aces who are sex-averse and aces who aren’t. Another huge site of contention is the frequent debates over which aces are allowed to reclaim the slur of “qu**r” for themselves — it’s a very stressful question on all sides of the issue, and there is no legitimate reason to broach this subject during a session unless your client brings it to the table themselves. Thanks to ace-specific issues like these, and the more general kinds of common community problems like racism and homophobia, your ace client may have unique baggage from interactions with ace communities. While you shouldn’t expect your client to educate you on Asexuality 101, it may be helpful (when appropriate) to ask your client about their experiences with ace community and invite them to explain any relevant politics among aces if you suspect these may be informing an unusual concern of theirs. For instance, fears about not being a “good ace” or a “normal ace,” or being too much of a “stereotypical ace” or “bad for the community image,” may point towards this, as unfortunately, ace spaces are not always safe for everyone.
Understand that aces can be abused. Coercing someone into sex, for example, doesn’t become morally acceptable just because the relationship would be sexless otherwise. As a therapist, you should already be familiar with signs of abuse in general, but you can also educate yourself on abuse tactics that are commonly used on asexual-spectrum people in particular.
If a client is coming to therapy for the purpose of working through harmful beliefs about sex or recovering from damaging experiences related to the topic, do not anticipate that successful progress on this goal will correlate with reducing personal sex aversion or increasing sexual desire. In your sessions, be careful to separate the harmful ideology from a personal preference that itself does no harm. Do not focus on “overcoming” sex aversion and developing “normal” sexual responses as the only valid measuring stick of real progress.
If a client is a survivor of sexual violence, “liking sex” or “renewed interest in sexual activity” shouldn’t be your yardstick, either. Disinterest in and aversion to sex are valid experiences unto themselves, regardless of personal history and you shouldn’t invalidate those by arguing they can only be products of the client’s trauma and that they’re a problem to be resolved. Please consult this link compilation for additional guidance on giving survivor-competent & ace-competent advice. Although that piece is geared toward an audience of non-professionals, much of it should still be applicable.
By now, hopefully you will have realized that there are a vast array of considerations to take into account to make your therapy practices more informed and inclusive. You may want to print or bookmark this guide to refer back to at a later time, as it can be a lot to take in if this is a new area for you. However, the most overarching takeaway might be this: Every ace client is different, and be careful about what assumptions you make.