My boyfriend knows I don’t orgasm – but not that I feel no pleasure in sex at all

I’m a 22-year-old woman who has never had an orgasm. Growing up, I didn’t feel attracted to boys, so I assumed I must like women. As I got older I dated girls and boys, but it would end after the first make-out session, where I would find myself trying to watch television over their shoulder instead. I thought I must be asexual until I realised I do want to have sex when I fancy people, but as soon as it gets to touching private parts, mine feel no different than if someone were touching my knee. The missing ingredient is pleasure. I have tried masturbation but nothing works (I found myself laughing at porn as I couldn’t take it seriously). I have dated and had intercourse with a small number of people I trust and even discussed this issue with them. They were all understanding, but ultimately it led to the end of a few relationships as my partners felt guilty for not giving me pleasure and assumed I just didn’t like them. I am currently in a long-term relationship with a man who is gorgeous, ridiculously kind, a giver in bed and knows that I’ve never had an orgasm. What he doesn’t know is that I don’t feel any pleasure full stop. I worry that this is going to put a downer on our relationship.

You seem smart and insightful about your plight, and I’m sorry this is so hard for you. Human sexual responses are very complex. They involve physiological and anatomical mechanisms as well as psychologically and biologically driven elements. Hormonal factors play a large role, but so do less commonly understood issues such as distractibility. If there is a problem in any of the many foundational areas – for example, genital nerve damage – the system of desire, arousal, or orgasm can be affected. Since you want to experience pleasure, and since the source of your anhedonia (the inability to experience pleasure) is a mystery to you, I recommend you start exploring – with help from a sexual medicine specialist – each dimension in turn until you find answers and a way forward.