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Some asexual people engage in sexual activity despite lacking sexual attraction or a desire for sex, due to a variety of reasons, such as a desire to pleasure themselves or romantic partners, or a desire to have children.

It has been compared and equated with hypoactive sexual desire disorder (HSDD), in that both imply a general lack of sexual attraction to anyone; HSDD has been used to medicalize asexuality, but asexuality is generally not considered a disorder or a sexual dysfunction (such as anorgasmia, anhedonia, etc.), because it does not necessarily define someone as having a medical problem or problems relating to others socially.Unlike people with HSDD, asexual people normally do not experience "marked distress" and "interpersonal difficulty" concerning feelings about their sexuality, or generally a lack of sexual arousal; asexuality is considered the lack or absence of sexual attraction as a life-enduring characteristic.Contrasting Bogaert's 1% figure, a study by Aicken et al., published in 2013, suggests that, based on Natsal-2 data from 2000-2001, the prevalence of asexuality in Britain is only 0.4% for people between the ages of 16-44.Aicken, Mercer, and Cassell found some evidence of ethnic differences among respondents who had not experienced sexual attraction; both men and women of Indian and Pakistani origin had a higher likelihood of reporting a lack of sexual attraction.Regarding romantic or emotional aspects of sexual orientation or sexual identity, for example, asexuals may identify as heterosexual, lesbian, gay, bisexual, queer, People may also identify as a gray-A (such as a gray-romantic, demiromantic, demisexual or semisexual) because they feel that they are between being aromantic and non-aromantic, or between asexuality and sexual attraction.

While the term gray-A may cover anyone who occasionally feels romantic or sexual attraction, demisexuals or semisexuals experience sexual attraction only as a secondary component, feeling sexual attraction once a reasonably stable or large emotional connection has been created.

Alfred Kinsey rated individuals from 0 to 6 according to their sexual orientation from heterosexual to homosexual, known as the Kinsey scale.

He also included a category he called "X" for individuals with "no socio-sexual contacts or reactions." scholar Justin J.

689 subjects—most of whom were students at various universities in the United States taking psychology or sociology classes—were given several surveys, including four clinical well-being scales.

Results showed that asexuals were more likely to have low self-esteem and more likely to be depressed than members of other sexual orientations; 25.88% of heterosexuals, 26.54% bisexuals (called "ambisexuals"), 29.88% of homosexuals, and 33.57% of asexuals were reported to have problems with self-esteem. Nurius did not believe that firm conclusions can be drawn from this for a variety of reasons. looked into mental health variances between Caucasian heterosexuals, homosexuals, bisexuals, and asexuals.

Lehmiller stated, "the Kinsey X classification emphasized a lack of sexual behavior, whereas the modern definition of asexuality emphasizes a lack of sexual attraction.