Are antidepressants making you asexual?

Gen Z is often described as a sexless generation. We are having less sex than previous generations did at the same age. We are less likely to have been on a date. More of us identify as asexual. In fact, according to this Stonewall report, more Gen Z Brits identify as asexual (5 per cent) than gay (2 per cent) or lesbian (3 per cent).

All kinds of cultural and social influences could explain this. Early exposure and addiction to online porn might be one. I’ve written about risk-aversion and fear of rejection as another. Increased awareness of asexuality too. But there is also, I think, a medical explanation. More specifically: the widespread use of SSRIs and their sexual side-effects.

SSRIs (Selective Serotonin Re-uptake Inhibitors) are a common class of antidepressants used to treat depression, anxiety and other mental health problems. Popular SSRIs include Fluoxetine (Prozac), Escitalopram (Lexapro), and Sertraline (Zoloft). Something well established about these drugs is that they have sexual side-effects. In fact, between 40 and 65 per cent of people who take an SSRI are thought to experience some form of sexual dysfunction. What few people know, though, is these side effects can persist even after they come off the drugs – a condition called Post-SSRI Sexual Dysfunction (PSSD).

This is more than just low libido. It can be a total loss of libido, genital numbness, erectile dysfunction, an inability to orgasm and complete lack of sexual attraction. Emotional blunting is also common, with sufferers describing a numbing of positive emotions, no romantic feelings, and difficulty connecting with others. PSSD can occur immediately – after just a few pills – and persist for years, decades, even permanently. There is no treatment. Despite PSSD being in the medical records since the 1990s, patients aren’t properly warned of the risk. A risk thought to be 1 in 216.

Which terrifies me given the surge in SSRI prescriptions among Gen Z. In the UK, 1 in 3 teenagers aged 12 to 18 has been prescribed antidepressants. In 2022 alone, the number of children aged 13 to 19 taking antidepressants rose by 6,000 to 173,000. That’s kids taking drugs known to cause sexual dysfunction – drugs that the Royal College of Psychiatrists admits to using to castrate sex offenders – right during puberty.

And increasingly before puberty. In the UK, antidepressant prescriptions for children aged five to 12 years increased by more than 40 per cent between 2015 and 2021. Aged five! Before they’ve even had the chance to develop normally. Online forums are already full of people sharing their experiences of puberty on SSRIs and now dealing with sexual dysfunction as adults. Stories of starting Zoloft at age 11 and never developing normal sexual sensation. Of being prescribed Prozac at 14 and not knowing what it’s like to have a libido. Of taking Lexapro for less than a month and still having genital numbness six years on. We talk endlessly about giving puberty blockers to children, which I think is important, but if we are worried about the chemical castration of our youth we also need to acknowledge the millions in Gen Z taking SSRIs during vital stages of their sexual development – and potentially being told their side-effects are a valid identity.

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This seems especially true for girls and young women. In the US, 86 per cent of those identifying as asexual are female, and 91 per cent are aged between 18 to 27. Which is also the demographic with some of the fastest-rising rates in the use of mental health medication. Women and adults aged 18 to 29 in America have the highest rates of current depression or depression treatment. Women are also twice as likely to take antidepressants than men. In the UK, too, it’s young women driving the rise in prescriptions for anti-anxiety and antidepressant drugs. What are the chances that at least some are suffering from sexual dysfunction and thinking it’s asexuality? When we know that antidepressant use during developmental years can significantly impair women’s sexual desire in adulthood?

At the same time, there’s all these activists and influencers and companies desperate to normalise and de-stigmatise asexuality. Being Asexual is Totally Fine, teens are told, we didn’t need science to figure this out. They are reassured ‘there’s nothing wrong with you’ and that ‘not experiencing sexual attraction isn’t a flaw – it’s just part of your unique brand of humanness’.

But is it always ‘completely normal’ to not feel any sexual attraction? Should we celebrate that asexuality is ‘finally breaking free from medical stigma’ to the point where we ignore potential causes? I’m not saying that asexuality is always a medical problem. I’m saying we can’t pretend that it isn’t a possibility. We now live in a culture so desperate to immediately validate every expression of identity and soothe any sign of emotional distress that we stop caring about its causes. And so we have young people all over #asexual TikTok dismissing other explanations like medication or illness after discovering asexuality. Like this young woman who had no sex drive and feared it could be her hormones. So she googled ‘why do I not want to have sex’ and found asexuality. Then stopped questioning it.

The problem is I think Gen Z are very aware of asexuality. Much more so than PSSD. We have asexual flags in train stations and International Asexuality Day and asexual merchandise and asexual dating apps and a TikTok hashtag with billions of views. But hardly anyone has heard of PSSD. Even when some do link their lack of sex drive to SSRIs, responses online either shut them down or are strangely lax about it. Like this post on an asexual Reddit forum where a user who has been taking Prozac for almost six years asks ‘can SSRIs cause asexuality?’ Replies include ‘it doesn’t really matter’ and ‘it’s theoretically possible… that said, who cares?’ Elsewhere others are either dismissed with accusations of acephobia or met with an empty ‘you’re valid no matter what!’

Who cares? Who cares if it could be chemical castration? Well that plays nicely into the hands of the pharmaceutical industry. An industry that makes billions from antidepressants. That ignores negative results. That pays the panel members deciding the diagnostic criteria for disorders. And which has proven, time and again, that patient wellbeing – particularly women’s wellbeing – is not the priority. Companies like Eli Lilly, for example, who developed the drug Sarafem to treat Pre-Menstrual Dysphoric Disorder (PMDD). What they didn’t disclose to millions of women, though, was that Sarafem was actually Prozac, just coloured pink. With their patent on Prozac expiring, Eli Lilly needed to target a new market – so the ‘drug came before the disorder.’ PMDD wasn’t formally recognised until a decade after Sarafem was first sold – and even then, the decision was influenced by a panel on which nearly 70 per cent of the members had connections to drug companies. Now add to these pharmaceutical giants all these new direct-to-door medication companies like hers encouraging young women to buy Prozac and Paxil for break-ups and job stress and premenstrual symptoms. (Hey but at least hers can deliveroo you some Desire Libido supplements and Libido Gummies if you get chemically castrated.) Forgive me if I’m not rushing to their defence.

And can we please forgive those who are sceptical? I don’t accept that it’s ableist or stigmatising to discuss the side-effects of medication. Or discriminatory against asexual people to say that sometimes this could be sexual dysfunction. Maybe SSRIs saved your life, but that doesn’t mean they haven’t devastated the lives of others. And maybe you are asexual and have never taken antidepressants. But how dare you shut someone down who has? It’s so strange to me how progressives seem to reject any scepticism of the mental health industry now. We are a generation more medicalised than any other in history. We are a generation whose identities are more determined and inner lives more colonised by arbitrary diagnoses than ever before. Don’t we deserve answers? Doesn’t this at least deserve a discussion? Honestly this might be the one instance where young people are victims and are being convinced by a progressive movement that they aren’t.

So my fear is this: you might not be asexual. You might be suffering from PSSD. You might not be a victim of stigma against your sexual identity; you might very well be a victim of the pharmaceutical industry. Trust me, that is discrimination. That is a trillion-dollar industry pushing drugs that are also used for chemical castration. And please don’t be placated by a progressive movement demanding all this be normalised or telling you that your scepticism is dangerous. There’s a growing network of people out there screaming that they’ve been shut down, unplugged, dulled, their soul vacuumed out, that they feel completely asexual, and nobody is listening. Nobody is fighting for them. Companies are staying silent to protect their profits and victims are shut down for fear of offence.

Which means prescriptions will continue to soar. SSRIs will continue to be pushed with little warning. We will continue prescribing them to children for stress and sadness and social anxiety, playing down the side-effects and potentially applauding them. Enough. We are a sexless generation. We are also a sedated generation. And I’m asking for the courage to at least investigate the connection between the two. You deserve to know if your sexual identity is a side-effect. And if enough of us speak up about this, the pharmaceutical industry deserves what’s coming to them.

This article first appeared on Freya India’s Substack, Girls.