Sexual Addiction Close to Becoming an Official Mental DisorderS

"Sex addiction" is an easy thing to mock and dismiss—oh, everybody likes sex, right? Nice try, Casanova! Pass the sexahol! Because it seems, on the surface, like an easy out for an unrepentant cheater, moral laziness trussed up like victimhood. Increasingly, though, amidst one million hacky David Duchovny jokes, the boundaries of legitimate sexual addiction—the line between problematic sexual behavior and disordered sexual behavior—seem to be coalescing. So much so, in fact, that the disorder is being considered for inclusion in the Diagnostic and Statistical Manual (DSM), the American Psychiatric Association's standardized classification of all known mental disorders (which famously included homosexuality up until 1974).

So what are the boundaries? It's not just liking sex a lot, any more than liking happy hour a lot constitutes alcoholism. To my understanding, to qualify as an addiction, sexually compulsive behavior must tangibly interfere with the patient's life, and persist even in the face of negative consequences. You can tell you're crossing a line when fun ceases to be fun.

Via the Atlantic:

A patient diagnosed with HD would typically experience "recurrent and intense sexual fantasies, urges, and behavior" for at least six consecutive months. Their hypersexuality would be uncontrollable and distressing, interfering with their normal life and leading to the possibility of self-harm. The disorder would only be diagnosed in patients over the age of 18. The disorder can take the form of masturbation, pornography, sex "with consenting adults," cybersex, phone sex, "adult entertainment venues/clubs," or — because some things you just can't anticipate — "other."

The research seems pretty strong that hypersexuality disorder is a thing, and not just an offshoot of other addictions. Though substance abusers did report high levels of problematic sexual behavior—loose boundaries, self-destructive tendencies, and so on—they only exhibited those behaviors while under the influence of addictive substances. Not so with the HD patients. Patients with other addictions could have concurrent hypersexual disorder, but researchers found it to be identifiably discrete.

And damaging:

The higher the level of hypersexuality reported by patients, the more problems were associated with their behavior. As a result of what they certainly saw as a dysfunction, about 28 percent of the patients interviewed had contracted an STI at least once. Almost 40 percent had ended a relationship over their behavior, while most said they had emotionally hurt a loved one (and for 68 percent, they had done so several times). Over half lost money, and 17 percent had lost at least one job. These are also signs pointing to disorder, as is the way they tended to understand their actions: 78 percent felt that the behaviors associated with their hypersexuality had interfered with healthy sex.

There are some indications that patients struggling with depression and anxiety fall into hypersexual behavior as a sort of palliative self-care. Attention can be pretty powerful (if counterproductive) medicine. So it's possible that hypersexual behavior is more of a symptom than a disorder in itself. But there are always exceptions, and, the Atlantic points out, "[researchers] also noted a pattern of escalation: problems with hypersexuality tended to get worse with time, providing a strong case for the need for treatment."

Either way, these behaviors exist and they deserve validation and study. Even if hypersexual disorder sets off all your bullshit detectors, even if there are a few lying jerks claiming "sex addiction" in bad faith, there are still human beings out there whose lives are being irreparably damaged by this behavior. And, perhaps more importantly, there are those human beings' partners and families to consider. I can't even imagine the terror and shame of admitting, "We're getting divorced because of his sex addiction," to a nation of skeptics and a culture of mockery. Ugh.

'Sex Addiction' Redefined [Atlantic]

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