Ace Awareness Week

Being asexual is a central part of my identity as a queer person. In honor of Ace Awareness Week, which runs from Oct. 24­_­­­­­­­­­­­­­­­­­­­­­­­­­­­ -Oct. 30 this year, here’s a quick rundown of asexuality, the split attraction model, and why learning about asexuality and other gender, sexual and romantic minorities (GSRMs) is important for everyone, especially here at the School of Medicine.

I’ve Got an Ace Up My Sleeve!

What does it mean to be asexual? It means joking about being a genetic dead end and buying “I’ve got an ace up my sleeve! It’s me, I’m ace and I’m in these sleeves” shirts. It means getting excited any time you see the colors purple, black and white near each other. It means meeting online communities full of accepting people. It means preparing an in-depth explanation of your identity — complete with asterisks, footnotes and citations — whenever you decide to come out to someone. It means occasionally questioning if you’re queer enough for inclusion within queer spaces. It means sometimes feeling immense pride in who you are, and other times, immense loneliness and guilt about who you’re not.

The official definition of asexuality is “experiencing little to no sexual attraction.” But that general definition looks different for each asexual individual (or ace, as we like to refer to ourselves).

Asexuality exists as a spectrum encompassing a wide range of experiences. Other identities falling under the broader asexual umbrella include demisexuality (in which sexual attraction develops after a close emotional connection has been formed with another person) and graysexuality (in which someone’s levels of sexual attraction may change over time), just to name a few. Some people are fine with physical intimacy, while others shy away from it completely. Some people are asexual for their whole lives, while others develop it over time, whether due to trauma or something else entirely.

To highlight even more diversity within the ace community, I also want to distinguish sexual attraction from sexual drive. For the majority of non-asexual people who tend to experience both at the same time, the two concepts may seem synonymous. But, as explained in more detail here, individuals in the ace community who experience little sexual attraction to others may still have sexual desires that they choose to act upon. Some terms used within the community to describe different attitudes towards sex include sex-favorable, sex-neutral and sex-repulsed, and are all equally valid variations of the ace experience.

In addition, being asexual doesn’t necessarily mean you can’t be interested in other people romantically.

The Split Attraction Model

We often think of sex and romance as interlinked. But this isn’t always the case, especially for aces who experience romantic attraction. The split attraction model proposes that there are different types of attraction that can be experienced distinctly from each other. In other words, an individual’s sexual and romantic orientations may not be the same. What does this look like for people who identify as ace? Some aces may identify as aromantic, or experience little to no romantic attraction to others. Other aces who do experience romantic attraction may identify as homoromantic, biromantic (like yours truly!), grayromantic or demiromantic — the list goes on! For more information, consult this useful overview of romantic orientations and other types of attraction.

Although the split attraction model has been criticized for promoting disunity within the queer community in various ways, such as through the use of hyperspecific labels, I believe it’s a useful framework for understanding ourselves a bit better, by giving those of us still exploring our identities more language to express how we experience attraction. Given how varied the asexual and aromantic communities are, having these micro-identities also provides individuals the chance to find and form smaller support networks with others who share common experiences.

So, why is learning about all of this important? It can feel incredibly isolating to live in a society structured heavily around amatonormativity. Whether it’s spousal privileges in the form of legal protection, health care coverage or financial benefits or simply hearing people say, “You’ll find the right person some day!,” there are lots of ways society tells us that romance and marriage are central to feeling happy and fulfilled. This alienates people in the ace community, especially individuals who also identify as aromantic and those who choose to be in queerplatonic, sexless, open or polyamorous relationships, by implying that what they have is not normal and not enough.

The Medicalization of Asexuality and Other GSRMs

Misunderstanding and lack of awareness about asexuality have also had a tangible impact within professional medical circles.

Recently, we first-year medical students finished learning about the sexual history component of standardized patient interviews. In our curriculum, lack of sexual activity within marriages was painted as a potential medical problem to be discussed and fixed, without first questioning if lack of sexual activity was the patient’s preference to begin with. Perhaps I shouldn’t have felt invalidated to the extent that I was. After all, this does seem like a minor thing to nitpick about. But these small transgressions are also present on a larger, systemic scale. In the past, the DSM listed asexuality as a form of hypoactive sexual desire disorder, requiring medical treatment — suggesting that asexuality is an abnormal state of being and ignoring the lived experiences of individuals within the ace community. And, if you’re at all familiar with LGBTQ+ history, you’ll know that asexuality is far from the first group to be medicalized. Moreover, research done with the intention of better understanding queer populations tends to focus on distinct biological mechanisms, rather than the systems of discrimination in place that actively oppress those populations.

Finally, physicians and other health care professionals who aren’t aware of the unique issues and experiences of their patients are less likely to have positive interactions with them. GRSM individuals are already less likely to seek out health care services, for fear of being ostracized or mistreated. Within the ace community, this is especially true for asexuals of color, and those who are also gay, bi, trans, or nonbinary; in fact, in a recent study, as many as three-quarters of surveyed aces also identified as genderqueer or nonbinary, which is just one example of the intersectionality between different identities that we must be aware of in order to provide inclusive and equitable health care.

There’s so much to say on this topic beyond a blog post. Perhaps most importantly, however, medical schools should incorporate specific education on LGBTQ+ health care and health disparities into medical training that goes beyond simply giving trainees a script for asking patients if they would feel comfortable providing their pronouns. It’s also important for schools to solicit input from queer individuals themselves when thinking about how to design more diverse and inclusive curriculums.

I hope this brief introduction to asexuality provides context on what is an important week for me. For those interested in learning more, please check out AVEN, or the books The Invisible Orientation, by Julie Sondra Decker, and Ace, by Angela Chen.

In the meantime, if you ever hear me say “I don’t give a f---”, just know that I mean it. Sincerely.

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• Reflections on Pride Month As a Gay Scientist
• “Emerge”ing Insights into Health Care for Transgender Adolescents
• LGBTQ+ Health Disparities: Compassionate Care Is Admitting Ignorance

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