为什么性感缺失/性欲低下是一种精神障碍（除非患者自认为是无性恋）？

Why is absent/low sexual desire a mental disorder (except when patients identify as asexual)?

—原载《心理学与性学》2023年第14卷，3月28日在线发布—

<Psychology & Sexuality> 2023, Volume 14, Published online: March 28

【摘要】这篇分析文章挑战了将性感缺乏/性兴趣低下/性欲缺失/性唤起低下视为精神障碍的精神病学实践。它通过提醒人们注意无性恋与其他非异性恋取向的对待不同这一事实来做到这一点。目前的DSM不包含以同性性欲为主要症状的精神病学诊断。然而，同一DSM还提供了诸如男性性欲减退障碍和女性性兴趣/性唤起障碍等诊断，其主要症状是性感缺乏/性兴趣低下/性欲缺失/性唤起低下。将性欲缺失/性欲低下视为一种精神障碍的不幸后果之一是，它延续了一种错误的信念，即那些体验与异性恋“性社会”规范不同的性行为的人健康状况较差，功能失调程度更高。这也令人不安，因为隐含的性别偏见：女性比男性更有可能经历性感缺乏/性兴趣低下/性欲缺失/性唤起低下，并且更有可能被诊断为性兴趣/性欲望/性唤起障碍。因此，女性的性欲或缺乏性欲更有可能被视为异常。由于这种判断长期以来一直被用来迫使女性进行她们不想要的性行为，因此不可避免的推论是，将性欲缺失/性唤起低下诊断为病态的精神病学传统已经并将继续使女性面临更大的性风险、性剥削和性虐待。补救措施：停止将性欲缺失/性唤起低下视为病态。认识到人们在性别上是不同的，并且有权对性有很多、很少或根本没有性欲——无论他们觉得合适什么。

【关键词】无性恋；性别认同；性取向；性别；精神病学

[Abstract] This analytic essay challenges the psychiatric practice of treating absent/low sexual interest/desire/arousal as a mental disorder. It does so by calling attention to the fact that asexuality is treated differently than other non-heterosexual orientations. The current DSM contains no psychiatric diagnosis which has, as its primary symptom, same-sex sexual desire. Yet, the same DSM offers diagnoses such as male hypoactive sexual desire disorder and female sexual interest/arousal disorder which have, as their primary symptom, absent/low sexual interest/desire/arousal. One of the unfortunate consequences of treating absent/low sexual desire as a mental disorder is that it perpetuates the false belief that those who experience their sexuality differently than the heterosexual ‘sexusociety’ norm are less healthy and more dysfunctional. It is also troubling because of the implied gender bias: women are more likely to experience absent/low sexual interest/desire/arousal than men and more likely to be diagnosed with a sexual interest/desire/arousal disorder. Women’s sexual desires, or the absence thereof, are, thus, more likely to be seen as abnormal. Since that judgment has long been used to pressure women to engage in sex they do not want, the unavoidable inference is that the psychiatric tradition of diagnosing absent/low sexual desire as pathological has placed, and continues to place, women at greater risk of sexual exploitation and abuse. The remedy: stop treating absent/low sexual desire as pathological. Recognize that people are sexually different and are entitled to desire sex a lot, a little, or not at all—whatever feels right for them.

[Key words] Asexuality; sexual identity; sexual orientation; gender; psychiatry

论文原文：Leslie Margolin (2023). Why is absent/low sexual desire a mental disorder (except when patients identify as asexual)? Psychology & Sexuality, Volume 14, Published online: 28 Mar 2023.

https://doi.org/10.1080/19419899.2023.2193575

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