Tshedza and Mulweli have been married for five years. Mulweli sought psychological help after Tshedza complained about their lack of sexual intimacy. For the past year, Mulweli has been avoiding sex because of the painful feelings of inadequacy he suffered after his “failures.” He claims that he is faithful to his wife and that he is happily married. After four years of marriage, his wife told him that she wanted a baby, and this evoked anxiety in him. Although he has been unable to maintain an erection with his wife, he has been able to masturbate frequently while smelling her underwear – Which he finds distressing, Mulweli reported that he was not abusing any substances.

According to the DSM-5-TR classification system, Mulweli will most likely also receive the following diagnosis in the category of Other Conditions That May Be a Focus of Clinical Attention: