The World Health Organisation has recognised “compulsive sexual behaviour” as a mental disorder, but said it remained unclear if it was an addiction on a par with gambling or drug abuse.
The contentious term “sex addiction” has been around for decades but experts disagree over whether the condition exists. In the latest update of its catalogue of diseases and injuries around the world, the WHO takes a step towards legitimising the concept, by acknowledging “compulsive sexual behaviour disorder”, or CSBD, as a mental illness. But the UN health body stops short of lumping the condition together with addictive behaviours like substance abuse or gambling, insisting more research is needed before describing the disorder as an addiction.
“Conservatively speaking, we don’t feel that the evidence is there yet… that the process is equivalent to the process with alcohol or heroin,” WHO expert Geoffrey Reed said.
In the update of its International Classification of Diseases (ICD), published last month, WHO said CSBD was “characterised by persistent failure to control intense, repetitive sexual impulses or urges… that cause marked distress or impairment”. It said the scientific debate was still ongoing as to “whether or not the compulsive sexual behaviour disorder constitutes the manifestation of a behavioural addiction”.
Reed said it was important that the ICD register, which is widely used as a benchmark for diagnosis and health insurers, includes a concise definition of compulsive sexual behaviour disorder to ensure those affected can get help.
“There is a population of people who feel out of control with regards to their own sexual behaviour and who suffer because of that,” he said pointing out that their sexual behaviour sometimes had “very severe consequences.” “This is a genuine clinical population of people who have a legitimate health condition and who can be provided services in a legitimate way,” he said.
It remains unclear how many people suffer from the disorder, but Reed said the ICD listing would likely prompt more research into the condition and its prevalence, as well as into determining the most effective treatments. “Maybe eventually we will say, yeah, it is an addiction, but that is just not where we are at this point,” Reed said.
But even without the addiction label, he said he believed the new categorisation would be “reassuring”, since it lets people know they have “a genuine condition” and can seek treatment.
No excuse for rape
Claims of “sex addiction” have increasingly been in the headlines in step with the #MeToo movement, which has seen people around the world coming forward with allegations of sexual mistreatment.
The uprising has led to the downfall of powerful men across industries, including disgraced Hollywood mogul Harvey Weinstein, who has reportedly spent months in treatment for sex addiction.
Reed said he did not believe there was reason to worry that the new CSBD listing could be used by people like Weinstein to excuse alleged criminal behaviours. “It doesn’t excuse sexual abuse or raping someone … any more than being an alcoholic excuses you from driving a car when you are drunk. You have still made a decision to act,” he said.
Symptoms and treatment
Some indications that you may be struggling with compulsive sexual behavior include:
- You have recurrent and intense sexual fantasies, urges and behaviors that take up a lot of your time and feel as if they’re beyond your control.
- You feel driven to do certain sexual behaviors, feel a release of the tension afterward, but also feel guilt or remorse.
- You’ve tried unsuccessfully to reduce or control your sexual fantasies, urges or behavior.
- You use compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety or stress.
- You continue to engage in sexual behaviors that have serious consequences, such as the potential for getting or giving someone else a sexually transmitted infection, the loss of important relationships, trouble at work, financial strain, or legal problems.
- You have trouble establishing and maintaining healthy and stable relationships.
When to see a doctor
Seek help if you feel you’ve lost control of your sexual behavior, especially if your behavior causes problems for you or other people. Compulsive sexual behavior tends to escalate over time, so get help when you first recognize there may be a problem.
Seeking help for compulsive sexual behavior can be difficult because it’s such a deeply personal matter. Try to:
- Set aside any shame or embarrassment and focus on the benefits of getting treatment.
- Remember that you’re not alone — many people struggle with compulsive sexual behavior. Mental health professionals are trained to be understanding and discreet. But not all mental health professionals are experienced in treating compulsive sexual behavior, so make sure you find a therapist who is competent in this area.
- Keep in mind what you say to a doctor or mental health professional is kept confidential, except in cases where you report that you’re going to hurt yourself or someone else, you report sexual abuse of a child, or you report abuse or neglect of someone in a vulnerable population.