A new report by Stonewall led by Yasmin Benoit and Robbie de Santos highlights how a visit to the GP can do more harm than good for asexual people
Content Warning: Mention of conversion therapy
When she came out as asexual to her GP, an anonymous participant in Stonewall’s new Ace in the UK report was told, “You have complex psychological issues around sex.” Although she ultimately relented to his demand that she see a psychosexual therapist before receiving a gynaecological referral, what followed was over a year of waiting to receive the treatment she had initially been seeking: “Three months of waiting to receive the compulsory therapy, another three months before the pelvic exams, seven months before her in-person appointment”, explains Yasmin Benoit, the 27-year-old activist who co-led the report for Stonewall, “and the result was extensive muscular damage to her pelvis for the extra year spent waiting to be treated.”
Following a similar pattern, other respondents spoke about having to go through smear tests, despite being uncomfortable doing so, since the tests can be especially painful and traumatic for people that have never had penetrative sex. One respondent described facing “excruciating pain” during the test – even though she hadn’t had sex before, she was put through it anyway by her doctors, who didn’t believe her. She recounted being told by her doctor, “You’re a twenty-five-year-old woman, of course you’re sexually active.” Benoit says about this situation, “There isn’t much clarity about who these tests are for. Should they be used only when you’re sexually active, is it for anyone regardless of sexual activity? What was obvious in the report is that even some of the doctors didn’t know what the criteria was, or what provisions were in place for people who hadn’t been sexually active, and would experience a lot of pain.”
As per a VICE investigation which came out earlier this year, hundreds of women have been denied similar gynaecological healthcare on the grounds of their virginity, which exemplifies how inconsistent these systems can be for people that don’t have penetrative sex. As Benoit points out, having provisions in place to include these individuals would be helpful for those women as well. “It would help asexual people, virgins, and also those who don’t have penetrative sex, such as queer women,” she tells us.
For Benoit, who identifies as asexual herself, stories like these are more than simply cautionary tales of NHS incompetence, or examples of how a broken system operates. Instead, they demonstrate how disproportionately broken that system is, and how certain groups are more vulnerable to slipping through the cracks than others. She tells The Glasgow Guardian that the overt neglect and horrifying experiences which asexual people often face in healthcare have a very clear origin: the very institutions that govern the medical field.
“Asexuality has been so medicalised by the World Health Organisation through the international classification of diseases (ICD). That’s the basis for the training that healthcare professionals get, and so when you describe being asexual to them, chances are they are going to assume there’s something wrong with you,” she says. The report posits that asexuality continues to be pathologised under ‘Hypoactive Sexual Desire Disorder’, which is included in the ICD-11.
As of 2018, Asexual people were 10% more likely than those of other sexual orientations to report undergoing or being offered conversion therapy, an alarming phenomenon which Benoit and her collaborator on this project, Robbie De Santos, believe has roots in the WHO’s actions (or, more accurately, lack thereof). Benoit tells us, “What we’ve seen [through our research] is that the recommendation of conversion therapy often came through gynaecology and mental healthcare, because those are the situations where you’re more likely to be asked about sexual activity, and once you give an answer, that’s all they want to focus on.”
The researcher and activist points out that, while religion is frequently marked out as a rationale for conversion therapy, in the case of Stonewall’s research into asexuality, healthcare was the largest proponent. She also mentions how asexuality is frequently left out of conversations around the conversion therapy discourse, and the effort to ban it. “Everything the asexual community is currently experiencing,” she adds, “is part of a pattern we have seen with all other identities, so I find it quite strange when people don’t extend their understanding [of conversion therapy] beyond only gay and bi experiences. We have seen the medicalisation of homosexuality, we’ve seen that happen to the trans community, and we’ve seen how medicine can play a role in promoting conversion therapy. It’s not just because of religion. It’s all part of the same thing.”
Aside from reproductive and gynaecological healthcare, participants in the report also mentioned similar experiences in mental healthcare, with professionals refusing to take their identity seriously, and instead insisting that it must be associated with past trauma. One participant said, “When a mental health professional is telling you that [your sexuality] is because of problems you’ve had in the past – someone you trust to know what they’re talking about – of course you think you should be brave and force yourself to do things you’re not comfortable with. It’s really bad.” Reflecting on responses like these, Benoit tells us, “I think most people’s instinct when you talk about asexuality is that there must be something physically or mentally wrong with you, or that something negative must have happened to make you that way. I definitely heard that a lot in secondary school when I first tried to come out.”
The assertion made by the mental health practitioner, that asexual people should try to conform to societal expectations, is a familiar one for Benoit: “I think it’s sad that people have that inclination. Think about how much they might be suppressing within themselves for the sake of conforming,” she says. To the healthcare professionals and everyday people who encourage queer and asexual people to conform, she has this concluding message: “If you want to live like that, you do you, but I personally do not want to have to change who I am just so other people find me more palatable.”
Read Stonewall’s full report here: https://www.stonewall.org.uk/resources/ace-report