You could be forgiven for thinking that the World Health Organization (WHO) now lists sex addiction as a treatable mental-health condition. After the WHO put up its most recent update of an International Classification of Diseases(ICD-11) online, the fiery headlines started rolling in:
“Sex addiction now a mental illness,” read one. “Sex addiction IS a mental health disorder,” another said.
Actually, no. There’s nothing in the new WHO language that suggests compulsions around sex are now classified as “sex addiction.”
There are other addictions that the WHO does recognize, including gambling, substance abuse problems, and the recently added gaming disorder.
- The World Health Organization released an updated listing of roughly 55,000 injuries, diseases, and causes of death this summer, after more than a decade of revisions to the International Classification of Diseases.
- The new ICD-11 lists “Compulsive Sexual Behavior Disorder” as an impulse-control disorder.
- But that’s not the same as an addiction, and the WHO says more research is needed to determine whether the problem qualifies for that standard.
As for sex, the latest edition of the ICD-11 includes Compulsive Sexual Behavior Disorder, a new condition that was not listed in the ICD-10. The manual says this compulsion is “characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour.”
Some of the symptoms someone might be having trouble with this kind of sex compulsion, according to the WHO, may include:
- Repetitive sexual activities becoming a central focus of the person’s life, to the point of neglecting health and personal care or other interests, activities and responsibilities.
- Numerous unsuccessful efforts to significantly reduce repetitive sexual behavior.
- Continued repetitive sexual behavior, despite adverse consequences or deriving little or no satisfaction from it.
That’s a potentially life-crippling problem, but it may not work the same way that addictions do, and more research is needed.
Getting more help for people with compulsive sexual behaviors
Christian Lindmeier, a communications officer at the WHO headquarters in Geneva, told in an email that the inclusion of compulsive sexual disorders in the ICD-11 is meant to help people who might be seeking treatment for sex issues get better care.
Some news reports have suggested that the change, which would officially go into effect in 2022 (after WHO member states adopt the new text), could mean that people with compulsive sex behaviors might be able to get help that’s covered by the UK’s national health care plan.
But therapists and psychologists are still hotly debating what merits the label of “addiction” outside the realm of substances like alcohol or drugs that include physical withdrawal symptoms. There’s still vigorous argument among professionals about whether an obsession with sex could ever qualify as an addiction because it’s not clear if it has the tell-tale signs of tolerance and dependence that activities like drinking and gambling can.
According to the American Association of Sexuality Educators, Counselors, and Therapists, there’s not “sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder.”
The term “sexual addiction” is also not in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-5), the go-to guide for American psychiatrists. The DSM-5 was updated to include gambling as a potentially addictive activity, however, because the cravings that people report for that are very similar to physical urges for drugs or stimulants.
Sex addiction programs tend to follow 12-step recovery models similar to Alcoholics Anonymous, with a mix of group sessions and one-on-one therapy. Some programs also prescribe patients antidepressants, mood stabilizers, or anti-androgen drugs, which reduce sexual urges.
“Real sex addiction has a characteristic of inner conflict and stress and helplessness,” certified sex addiction therapist Jenner Bishop told last year. “These are people who have sworn repeatedly to themselves, – ‘I’ll never do this again,’ – people who’ve tried putting up barriers to the behavior and find themselves running over them anyway and find themselves in despair.”
Other clinicians argue that things like technology, sex, and porn can all become addictions, they’re just a different kind without physical withdrawal symptoms.
Endocrinologist Robert Lustig told earlier this year that many activities that can bring feelings of pleasure, like shopping, eating, playing video games, using porn, and even using social media all have addictive potential when taken to extremes.
“It does the same thing to your central nervous system as all those drugs do,” he said. “It just doesn’t do the peripheral nervous system part. That doesn’t make it not addiction. It’s still addiction, its just that it’s addiction without the peripheral effects.”