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Ace on the Couch by Anneliese Knop

Disclaimer: This is not a professional case study, but a story from my personal life I have permission to share.


She never had crushes growing up. All the way through high school she never felt that heart-fluttering, face-flushing attraction her friends and family discussed, lauded, and mocked. She pretended to, even though no one pressured her to. Maybe if she just faked it she’d make it happen. Of course, it didn’t work.

She had one boyfriend in college. Their first kiss certainly caused some heart-pounding, but it was pure nerves. Once lips touched and hands closed around each other, the anxiety didn’t transform into blissful sparks and delight. It was the same when he drew her coyly into a darkened alcove at the aquarium and showed her what a “make-out session” was really like. She was bored.

Romantic movies bored her. Romantic songs frustrated her with their illogical and unhealthy lyrics. She couldn’t relate to characters’ romantically or sexually driven decisions in books, movies, or TV. Conflict based on romantic tension or sexual misconduct seemed so contrived she couldn’t understand why any audience tolerated it. The solutions were so obvious!

When she got engaged she found herself invited to a Bible study for nearly-wed and newly-wed women at her church. Young women her age shared honeymoon stories, sweet and funny and disappointing and hilariously problematic. She voiced her concerns to these women who talked openly about sex. She’d never found anyone, male or female, “hot” or “sexy.” She wasn’t “attracted” even to her fiancé, and had never cared about sex her entire life. Even kissing was still boring!

“Oh don’t worry about it, it was the same for me!” they assured her. “Once you just do it, everything’ll make sense.” Every single one of them had some version of this story. Then they moved on to talking about summer travel plans.


She didn’t feel reassured. She felt unheard.

She never asked anyone else about her concerns.

When things didn’t “just work” even six months after the honeymoon she went to three OBGYNs, two therapists, her mother, a Biblical counselor, her girlfriends. She didn’t hear the word “asexual’ applied to humans until she’d been married and frustrated for three years. It took her another three years to accept it. Ten to really own it.

And in the meantime she struggled with feeling broken and selfish. She wondered if she was gate-keeping, had unrealistic expectations, or a tumor. Was she abusive for never wanting to satisfy her husband’s sexual needs?


Her third therapist admitted to not knowing much about aces. She’d finally found a therapist who didn’t make her feel broken for her feelings and didn’t want to try again, so her therapist agreed to learn about asexuality and the ace dynamic in marriage alongside her.

I’ve always liked the nickname “ace” for “asexual.” I think it speaks to our need to learn how to value ourselves and our needs despite living in communities that often vehemently deny or pathologize our existence. It’s not just the typical “white heteronormative cis-male” villain, though. The LGBTQ+ community, medical, an


d healthcare professionals are as guilty as everyone else when it comes to the so-called Invisible Orientation.

Counseling with Aces

If you encountered asexuality as an orientation in your graduate studies, congratulations. Your program was remarkably complete. My guess is that if you did see the word, you got a paragraph including a Definition and an admonition to make sure their needs are heard in relationship, or a warning against discrimination.

Very helpful, right?

Sex therapists and therapists who focus on sexual orientation and identity work may receive some training on how to spot an ace, but there’s very little training available on the subject. And there’s a growing need for it.

Statistics indicate that aces are so few it might not seem cost-effective to invest in ace-aware training, but considering that it can take decades before someone even hears the term “asexual” related to something other than an amoeba, let alone feel confident in understanding and owning the label, I anticipate that an increased awareness among healthcare professionals will result in rising numbers of visible aces in the next 20-30 years.

I’m a counselor, and an ace. Here are some things I think we as mental health professionals can do to improve our ability to work with asexual clients.

1. Intake Forms As Welcome Signs

When I fill out intake paperwork for any new healthcare professional I always look for “asexual” in the sexual health section. I’ve never found it there. That starts me wondering “do they even know ace exists? If I mention it will they try to argue me into submission to their own sex-centered beliefs?”

All this could be solved by simply adding one word to the list of orientations on your intake forms. If you want to get fancy, here are some other terms under the asexual umbrella, but just having the word “asexual’ on your forms tells clients you see and respect who they are in bed.

2. Ask About Needs

It may seem counter-intuitive but aces have what might be termed “sexual needs,’ or just “intimacy needs” in relationships. Yes, aces can and do enter intimate relationships. I myself have been married for eight years, and I’m hardly an exception in the ace community.

Not all aces are sex-averse. Not all aces have been sexually abused or traumatized. Not all aces know what they need in terms of intimacy, safety, quality time, physical touch, or other love languages – just like any other human being. It takes time and trust in the therapeutic relationship to help an ace , like anyone else, to identify and speak about needs in relationships.

Many couples’ counseling techniques will work just fine with aces in relationships; you may not need a whole new playbook. Boundaries, communication, and respect all apply to those who care little to nothing for sex. The key thing to do is to accept and honor an ace’s responses equal to those from any non-ace.

Ace-Awareness Takes Effort

When a client identifies as asexual or displays a pattern of asexual characteristics we have choices. We have the same choices in this situation as at any other time when a client presents us with any other unfamiliar detail. Ignore, pathologize, research, refer. If the concept of asexuality brings up strong feelings we can take it to supervision.

Aces exist in society. Aces exist in spectrum. Aces exist in relationship. Please welcome the ace on your couch.







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