Asexuality Disclosure in Healthcare: Attachment and Patient-Reported Experiences in a Cross-Sectional Pilot Survey

Asexual adults often report misunderstandings during clinical encounters. We described romantic attachment (ECR-R anxiety/avoidance) in an asexual sample and tested whether disclosure in medical settings was associated with feelings of misunderstanding, stigma, and a (dis) comfort-discussing orientation.

This was a cross-sectional online pilot survey (N = 47, aged 18-67 years). Variables: Disclosure (no/never, depends/sometimes, yes/always), Likert outcomes (1-5), ECR-R (1-7), and age. Analyses: ordinary least squares (OLS) with HC3 robust SEs; ordered logit sensitivity analyses (odds ratios, 95% CI) in Supplement S1; multiplicity controlled via Benjamini-Hochberg FDR.

Mean ECR-R scores: anxiety 3.28 (SD 1.30), avoidance 3.47 (SD 1.41). Avoidance was higher in sex-averse than in sex-favourable participants (Hedges' g = 1.285; 95% CI 0.449-2.769). Relative to never disclosing, "depends/sometimes" was associated with greater misunderstanding (OR 5.69; 95% CI 1.45-22.32) and stigma (OR 5.32; 1.30-21.80), whereas "yes/always" was associated with less discomfort (OR 0.05; 0.00-0.68). Estimates for "always" disclosure reflect a small subgroup (n = 4). Key contrasts were robust to FDR adjustment, and ordinal models were directionally consistent.

Disclosure patterns are related to reported healthcare experiences of asexual patients. Non-presumptive sexual history taking, patient-led disclosure options (e.g., an "asexual" field), and asexuality-competent communication training may improve care. Larger multi-site studies are warranted.