{"id":1524,"date":"2018-11-04T18:14:19","date_gmt":"2018-11-04T18:14:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=1524"},"modified":"2018-11-04T20:21:22","modified_gmt":"2018-11-04T20:21:22","slug":"how-healthcare-practitioners-can-better-understand-asexual-identities-and-offer-culturally-competent-care","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2018\/11\/04\/how-healthcare-practitioners-can-better-understand-asexual-identities-and-offer-culturally-competent-care\/","title":{"rendered":"How healthcare practitioners can better understand asexual identities and offer culturally competent care"},"content":{"rendered":"

Catriona Jones, University of Hull (@Free_wheeler68)<\/p>\n

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This week\u2019s EBN Twitter Chat is on Wednesday 7th<\/sup>November (8-9 pm UK time) and will explore issues around asexuality and how healthcare practitioners can provide culturally competent care to people who identify as asexual.<\/p>\n

Asexuality is generally defined as a lifelong lack of, or an absence of, sexual attraction.\u00a0 Research indicates that identifying as asexual is a process which starts with an experience of being \u2018different\u2019 from a peer group (Carrigan 2012).\u00a0 This is typically, but not exclusively during adolescence.<\/p>\n

If we take sexuality to mean all aspects of social life and subjective experience that have erotic significance, adolescents who later go on to self-identify as asexual, when confronted with sexuality, often feel unable to engage with it to the same extent – and in the same way – as their peer group. \u00a0When their friends talk about \u2018fancying\u2019 other people, they can\u2019t relate to it, when they start \u2018dating\u2019 and are confronted with the prospect of sexual intimacy, they are not interested in it, and when their friends appear highly motivated to find themselves a sexual partner, they don\u2019t share that level of motivation. These experiences range from being indifferent to sexuality, to being repulsed.\u00a0 Lack of sexual behaviour or activity has also been used to define asexuality (Rothblum & Brehony 1993); however contemporary definitions should not depend upon the presence or absence of sexual activity, given that that some asexuals do engage in sexual intercourse (Brotto et al<\/em>, 2010)\"\"<\/p>\n

There are a number of sub-identities within the overall identity which help to illustrate the more nuanced models of attraction and relationship formation that exist in the asexual community. The sub \u2013 identities; grey asexual, aromantic asexual, pan romantic asexual, (there are many more), help further categorise the asexual experience, and reflect the fact that some asexuals fall in love, some don\u2019t; some feel romantic attraction, others don\u2019t; some engage in sexual activity under certain circumstances, for example, once a deep emotional bond and connection has been established, and some don\u2019t.<\/p>\n

Before realising that they might be asexual, many self-identified asexuals don\u2019t have enough information to hand to enable them to apply a label to how they are feeling.\u00a0\u00a0 However, at some point they discover, either through internet searching, or though talking to other people, that they may be asexual. For many, this can be empowering, enabling them to apply a name to their experience, and providing access to others who identify in the same way.<\/p>\n

Research suggests that how sexual minority groups are accepted and treated in healthcare will largely be determined by how informed and educated practitioners are about these patient groups (Albarran and Salmon 2000).\u00a0 Today\u2019s mainstream view on sex is that it is positive, healthy and desirable, and individuals who are not interested in sexuality may be viewed as having a disorder (Yule et al<\/em>, 2014). On occasion, when asexuals disclose their asexual identity in healthcare (particularly mental health) settings, they encounter insistent attempts to \u2018correct\u2019 their sexual orientation; linking it to a previous trauma.\u00a0 Evidence suggests that asexuals are at risk of others invalidating their orientation and refusing to believe it\u00a0exists (Robbins et al<\/em>, 2016).\u00a0 Having some understanding of what it means to identify as asexual and respecting the choices made by asexuals can improve the experiences of those who embrace this identity when engaging with healthcare.\u00a0 Whilst asexuality is not new to human sexuality, it is relatively new to public discourse (Smith, 2012); healthcare practitioners therefore may not be familiar with the term, or with what the identity represents.<\/p>\n

Jones et al<\/em>\u00a0(2017) in a systematic review and qualitative analysis of interview data from self-identified asexuals, proposed three significant features of asexuality; romantic differences coupled with sexual indifference, validation of identity through engagement with asexual communities, and a diversity of sub-identities.\u00a0This work was undertaken to provide health professionals and practitioners working in clinical settings with some insights of the features of an asexual identity to facilitate culturally competent care.<\/p>\n

The questions that will be explored during the Twitter chat will include;<\/p>\n