2011) Pre-arousal aversive clitoral sensitivity during sexual relations: exploratory research consisting of the first case report and correlates from an anonymous survey, Sexual and Relationship Therapy, 26:2, 156-169, As illustrated by the case reported here, pre-arousal aversive clitoral sensitivity (PACS) is characterized by a sensation that is too strong to be pleasant prior to physiological sexual arousal but that becomes intensely pleasurable after sexual arousal is achieved. Using a self-administered computerized questionnaire, participants with PACS (18.5% of the 763 participants) turned in scores that were significantly more problematic on sexual satisfaction, sexual communication, depression and 5-item PACS scales than the majority of participants. Those with PACS were more likely to avoid sex, less likely to reach orgasm with their partners and less likely to have ever reached orgasm in response to manual stimulation of their genitals or cunnilingus. This is the first case report and the first research report on PACS. More research will be required to determine: (1) incidence and etiology of PACS, (2) whether to classify PACS as an abnormality or a variant of normal and (3) the most effective ways to help those with PACS.