Some people have a problem with sex. It’s not necessarily that they don’t want it, can’t get it up, or don’t like going down (although these things happen too). It’s that they can’t stop obsessing about, or acting on, real or imagined sexual behavior despite repeatedly attempts to make it go away. It’s that these behaviors are a dominant focus of their life and they don’t derive pleasure from these behaviors (see additional criteria here).
Unfortunately, there’s limited consensus among professionals in the field of sexual health about what to call it and how to treat problematic sexual behavior.
Problem One: Is it a man thing?
There is a lot more research on problematic sexual behavior for men than women and gender non-conforming folx. A lot of research suggests that 3 % to 6 % of the general population identifies with this problem, while other research suggests that 10% of men, and 7% of women view their sexual behavior as problematic, although most women don’t report it out of shame.
Problem Two: How to refer to it.
Labels work well for some and can be stifling for others. They can be useful if employed in the service of helping someone understand their behavior in a healthy and constructive way. They can be dangerous if offered as a simple rationale to justify or excuse misogynistic or otherwise bad behavior.
The labels most used to describe problematic sexual behavior include “sex addiction,” “compulsive sexual behavior disorder,” “hypersexuality,” “impulsivity,” and “out of control sexual behavior.” Any label can help conceptualize a course of action for treating the behavior.
Problem Three: How to treat it.
The problem may be viewed as a behavioral addiction, an impulse control disorder, or an intimacy desire disorder (more info on all three here). Regardless of framework, what’s known is that it often stems from early childhood trauma, emotional abuse alongside anxious and avoidant attachment styles.
Fortunately, recent strides in the field of sexuality have created an actual diagnosis for problematic sexual behavior. The diagnosis appears in the current edition of the International Classification of Diseases (ICD-11), a big book of physical and mental health disorders that is meant to keep the diagnosing and coding of all recognized medical diseases/disorders uniform. Spoiler alert: They see it as an impulse control disorder.
Twelve step programs that address it as an addiction can foster a sense of belonging and accountability. Working with a skilled and trained therapist is also helpful. And there are intensive programs that can jumpstart recovery, as well as medications that may help with some of the obsessive thoughts and behaviors.
Problem Four: Bias.
Not every problem is a problem for everyone. It’s important to stay curious with ourselves and others about how culture, values, religion, family and other social environmental factors influence our perception of what is a problem.
That means that even if all of those who diagnose and label this sort of thing could agree on what to call problematic sexual behavior, the complexity of understanding and experiencing this behavior goes deeper than just treat x with y.
Bottom line: If you feel like you have a problem with sex, then sex is a problem. That doesn’t mean all sex is problematic, or that you can’t have sex that doesn’t feel like a problem. If there are some behaviors, thoughts or fantasies that are creating significant impairment in your life, perhaps it’s time to choose your own healing adventure.
