I have anxiety and body image issues. How can I stop being so frightened of sex?

In sexual situations, I freeze and panic, when all I want is to enjoy stress-free physical and romantic relationships

I’m a 26-year-old gay man who is desperately afraid of sex. I haven’t had much sex in the past year, and when I do I tend to freeze and panic, which means that I struggle with erection and orgasm even when I’m with someone I genuinely like. The last time this happened, I felt so sick during foreplay that I wanted to cry and leave. I have major anxiety and body image issues. I also identify as both “a side” (which means I’m not interested in anal sex), and demisexual (on the asexuality spectrum), so I feel as if I’m in this triple minority of being gay, not into anal sex and slow to get comfortable with someone intimately. While I have enjoyed sex in the past, I prefer non-sexual intimacy, such as cuddling. Still, I would like to not be so scared of sex, to be able to relax and engage in romantic and physical relationships stress-free.

Thinking of yourself as being in a “triple minority” is not helpful. Why categorise yourself? You deserve a far better self-view, and not only in terms of body image. Try to ignore the peer pressure. The three aspects of your sexuality you consider to be negative ones need to be reframed as the positive attributes they actually are. For example, allowing yourself adequate time to become comfortable with intimacy is a smart, self-protective way to approach a relationship, and is likely to improve the quality of your sexual connection. If you are not feeling very interested in sex generally, stop forcing yourself to try to do what you think will be approved of by others – although you should also recognise that you could have increased interest in the future if you learn to manage your anxiety, and if you meet someone with whom you feel perfectly safe. Essentially, you are who you are and you do not need to explain, label or excuse yourself. You may meet the arbitrary criteria for “a side” now – a perfectly valid preference, and a style that you’ve found genuinely gives you more options for pleasure – but any of this might change in the future. What matters is that you gather your confidence and always refuse to be anything other than your true, authentic self.

Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.