- WHO includes compulsive sexual behavior disorder in its list of diseases and conditions
- There is still a debate among experts as to whether the condition is real
(CNN) — For the first time, compulsive sexual behavior — commonly called sex addiction — is classified as a mental health disorder on the World Health Organization’s International Classification of Diseases list — a decision not without controversy.
Updated in June, the list (called the ICD-11) is the foundational document that clinicians and scientists around the world use to identify and study health problems, injuries and causes of death.
The ICD-11 defines compulsive sexual behavior disorder as a “persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour.”
The disorder is not about how many sexual partners a person has or how much sex they have; rather, it is when someone’s sexual behavior becomes a “central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities.”
The disorder may interfere with someone’s ability to go to work or finish school. It can hurt relationships. And although someone with this disorder may want to resist their constant need for sex, they’ve been unsuccessful. They may not even get pleasure from the repeated sexual activity.
A person with this disorder has had to be dealing with it over an extended period of time, according to the definition, which gives an example of six months or more.
What compulsive sexual behavior disorder is not, according to the definition, is “distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviours.”
As when WHO added gaming disorders to the list of mental health disorders in June, not all clinicians agree that the condition is worthy of inclusion. Some debate whether it is astandalone disorder. Others doubt whether sex can be addictive and view the label as potentially shaming.
The Diagnostic and Statistical Manual of Mental Disorders, which American clinicians use to diagnose mental health problems, did not include compulsive sexual behavior as a separate category in its last update in 2013. The condition didn’t even make the appendix. That’s in part because there’s still a limited amount of research to explain this behavior.
“For centuries, people have been trying to understand what is the cause of hypersexuality. It has been called all sorts of names over the years, but it’s really only been in the last 40 years that we’ve tried to understand it from an academic perspective,” said Dr. Timothy Fong, a clinical professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles.
Fong wrote a 2006 paper that lays out many of the scientific definitions and management strategies for this behavior.
Like with gambling addiction, Fong said, some experts have questioned whether compulsive sexual activity can be an addiction, since there is no substance like a drug or alcohol being abused, but some of the science is starting to suggest that this repeated behavior changes brain function, he said.