You don’t have to be slutty, but if you aren’t sexually active you don’t get the health benefits of a robust sex life. You’ll have to get your health benefits from other means, or just do as most of us do and lead an unhealthy life. (In my case, walking my dog is about the only exercise I get.)

In the psychiatric sector, symptoms are only regarded as dysfunction if they impact the patient negatively. This is how we rule out gay behavior or ace behavior as mental illness since one can be either and still function, contrast compulsively obsessing over cleanliness above all other personal needs, or sleeping for weeks at a time which tend to make it difficult to live.

I’d assume the medical sector would have a similar standard.