Taylor, a 31-year-old in Los Angeles who asked that only her first name be used for privacy, started having casual sex several times a week in college. Her friends warned her she could be a sex addict. At age 21, she was a victim of revenge porn, which her therapist considered evidence that her friends’ sex addiction theory had merit. “I thought it was all my fault,” she said. “That’s when I surrendered and accepted the ‘diagnosis’ of sex and love addict.”
For four years, Taylor attended volunteer-run Sex and Love Addicts Anonymous (SLAA) meetings, which follow the 12-step model of Alcoholics Anonymous. Members suggested she had repressed childhood sexual trauma and urged her to be celibate for a year. Once she’d made it nine months, she followed the other women in the group’s example and committed to only having sex within monogamous relationships. Whenever she felt desire, she said, “I berated myself and dragged myself to a meeting in fear of falling back into ‘old habits.’ I felt like a zombie.” Over time, Taylor wondered why she was being encouraged to think of sex like a disease. At meetings, she asked, “Who decides how much sex is too much? How do we know if we’re addicts?”
After receiving unsatisfying responses, Taylor saw a sex therapist. “Is it possible that you’re not a sex addict, and maybe you’re just a woman who enjoys sex in a society that shames women for enjoying sex?” he asked. She cried with relief on his couch.
Sex addiction has never been a formal diagnosis. Though treatment centers and books like Patrick Carnes’s 1983 Out of the Shadows: Understanding Sexual Addiction have popularized the term, the mental health field is increasingly critical of it, based on research suggesting that sex does not affect the brain like an addictive substance. A 2016 study by sex researcher Nicole Prause in PLOS One, for example, found that people who engaged in risky sexual behaviors were more sensitive to genital stimulation, not desensitized, as the sex “addiction” model would predict.
The American Psychiatric Association repeatedly rejects proposals to add sex addiction or “hypersexual disorder” to the Diagnostic and Statistical Manual. In the 2018 edition of the International Classification of Diseases, the World Health Organization also rejected the label of sex addiction and instead included “compulsive sexual behavior disorder.” Many psychologists favor the latter label because it describes a behavioral pattern, not an addiction, and focuses on treating the underlying issues rather than directly changing sexual behavior itself.
Before he was trained as a sex therapist, psychotherapist Joe Kort adopted a sex addiction treatment model due to sex-negative cultural messages he’d received earlier in his life and career. But as he saw this approach repeatedly fail, he abandoned it. “The training is loaded with addiction and trauma information and education, but not sexuality,” he said. Kort feels the term is over-applied to people simply because they enjoy sex without emotional attachment. “The sex addiction therapist misunderstands sexual health and imposes their own bias and moral beliefs onto what could be completely natural for the client,” he said.
LGBTQ people may be more frequently mislabeled as sex addicts, says Prause. A 2014 review in Current Sexual Health Reports found a lack of scientific evidence for porn addiction—which is often studied for sex addiction research because it’s easier to show people images of sex than to sexually stimulate them—and pointed out that a disproportionate number of those who report it are LGBTQ people with religious conflicts. “Assessments claiming to help diagnose ‘sex addiction’ are well-replicated to discriminate against gay men,” said Prause. “Questionnaires identify more gay men as having a problem than is statistically reasonable. I think the overrepresentation of homosexual men in sex addiction centers is strong evidence that the diagnosis is primarily used for social control of sexuality, rather than treating any actual disease that should affect all men equally.”
Sex workers are also pathologized. Daniella Valenti, a 32-year-old legal sex worker in Hawaii and Nevada, was put into therapy by an anti-trafficking program and diagnosed with sex addiction. “Sex is my job, and I am super safe with it. I’m not addicted to anything, and I’m not a danger to myself or anyone else. I don’t display any type of compulsive behavior,” she said. “I think my psychologist was judging me for enjoying sex work and labeling it as a disorder because it’s a reality he didn’t want to accept.”
Prause said issues involving sexual behavior should be addressed individually, rather than grouped together as an addiction. “If you are failing to consistently use condoms when you should, there are excellent empirically supported interventions to improve condom use,” she said. “If you are engaging in sex outside your monogamy agreement with a partner, there are excellent empirically supported interventions to treat infidelity that include risk reduction. If you are having sex to deal with depression, there are dozens of excellent empirically supported treatments for depression.”
Nevertheless, some women believe in the value of the sex addiction model. Erica Garza, author of Getting Off: One Woman’s Journey Through Sex and Porn Addiction, said SLAA meetings—which prompted her to give up sex, porn, and masturbation for various periods of time—and other sex addiction treatments helped her replace her compulsions with healthier behavioral patterns. “I’m less likely to seek out the shame-and-pleasure combo I was hooked on,” she said. “I have revised my learned beliefs that sex is something dirty and bad […] so that I can engage in healthy, honest, safe, yet still open-minded sex.”
Alexandra Katehakis, sex therapist and Clinical Director for the Center for Healthy Sex, argued that sex addiction is real, pointing to a study in JAMA Network Open showing that 8.6 percent of Americans report “clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behaviors.” She isn’t against alternative labels like compulsive sexual behavior, but she believes they are separate from sex addiction. Sex addiction is characterized by feelings of withdrawal when someone ceases certain sexual behaviors, desensitization, and always seeking the next “high,” according to her approach, while sexual compulsivity is more about problems with impulse control.
If someone thinks they’re a sex addict because of a conservative upbringing or gender norms, Katehakis won’t treat them for sex addiction. But if their sexual behavior causes harm or feels out of control to them, she will use cognitive behavioral therapy to help them stop whatever behaviors they feel are destructive. “Both sides have to be careful about either minimizing the problem, or making something into a problem that’s not really a problem,” she said.
Today, Taylor has a happy sex life that has included an open relationship and multiple casual partners. The solution to using sex to cope with anxiety and depression was not to have less sex, but to begin seeing a therapist and learning to communicate with others about her mental health and reduce shame around sex. “My relationship to sex is beautiful because it’s so authentic, but most important, because it’s mine,” she said. “I have the kind of sex that I want to have, with men that I want to have sex with, as little or as often as I please, and I don’t see any need to explain it to anyone who doesn’t understand.”
Stressed Students, Bridesmaids Drama, And More: An Advice Column From A Total Amateur
Hi! A while ago I asked the BuzzFeed Community to tell me a problem they’re having, so that I — a person with absolutely zero professional qualifications to help anyone — could give them advice. So, here are the results! NBC 1. “Dear Andy,I have NO idea where I should go to school… I’m applying…
Hi! A while ago I asked the BuzzFeed Community to tell me a problem they’re having, so that I — a person with absolutely zero professional qualifications to help anyone — could give them advice. So, here are the results!
I have NO idea where I should go to school… I’m applying to 12 schools, 10 on the west coast and two in BC. I’m a high achieving student (I’m in five AP classes, president of two clubs, volunteering and a job, etc.) and I don’t want to go somewhere that’s all about the pressure, but I still want a high quality education. I’m so lost, help!”
—The Overwhelmed Student
You posted this just to dunk on all of us academically, didn’t you?
Kidding. In all seriousness, you can get a very good education at a bunch of different schools. And when you’re done, you’ll have a degree that probably nobody will ever verify! In my completely amateur opinion, the only reason people think the “Ivy League” schools are better is because a lot of wealthy, well-connected people go there (and have gone there), and therefore when you graduate from one, you’re more likely to get in at some fancy law firm or whatever because of your connections. So if you aren’t planning on being like, IDK, the CFO of Waystar Royco or something, just pick the school that you really want to go to. Where are you going to be happy living? Is one of the schools in a city you already want to move to and/or the city that has jobs in your future profession? Is it important for you to be close to home? How many Wendy’s are there on campus, and do they carry Spicy Nuggets? These are the questions you should be asking.
Oh, wait, actually…forget all that. Go to the school that will cost the least when you factor in tuition, room & board, and any scholarships you might get. Student loans are a curse and you want as little of them as possible. In the end, you might not even end up doing the thing you studied in college. Wanna know what degree I have? A BFA in Theater Performance. An acting degree. And now here I am, writing for a website. You’ll be fine.
I got married this summer, and I decided to choose only family to be my bridesmaids. For me this included three female cousins and my (now) sister-in-law. My husband, on the other hand, decided to do a mix of family as well as friends from high school for his groomsmen. I had no problem with this at all.
I had a few friends who I knew would expect to be bridesmaids, so I made it clear to them from the very beginning that I would be choosing family only as to not have a huge wedding party, but I told them they were not any less important to me and that I still wanted them to be involved in the wedding as much as they felt comfortable with. Most of the friends I had this conversation with were very understanding, however one straight up told me that she was disappointed (this was two years before the wedding).
Now it’s been a few months since I got married and this friend (a friend from childhood) started talking about the wedding. She told me she felt left out of the wedding since she wasn’t part of the wedding party. It particularly bothered her that my husband included friends and I didn’t. She then proceeded to tell me that it was difficult for her to be there the day of my wedding because of these feelings. AT MY WEDDING. She also included the fact that she didn’t want to upset me and that it doesn’t change our friendship. But if that is the case then why say anything in the first place? I’ve already said one too many times the reason for my bridesmaid choices and how important she is to me regardless. And she says she understands. I just wish she would let it go. Ever since this conversation I feel like I’ve been seeing her in a whole new light.
I do care about her feelings, but I stick by my decision and I don’t regret anything. I feel like I’ve done everything I can to make her feel better.”
—The Besieged Bride
[TL;DR: Bride had only family as bridesmaids, groom had some friends in the mix, bride’s childhood friend felt left out and complained about it a few months after the wedding.]
Question one: How drunk was your friend when she brought this up to you? If she was like, a 6 or more out of 10, I say let’s give it a pass and hope she got it out of her system.
Question two: Has your friend had a wedding of her own yet? If yes, then she should’ve understood the situation, because wedding planning is a special kind of hell and inevitably you have to make difficult decisions like this one that might hurt people’s feelings. So if you’ve planned your own wedding, you know the deal and you’re able to say to yourself, “It’s their wedding, I’m just going to be supportive and have fun.” If she hasn’t gotten married yet, she’ll realize later that it was totally inappropriate to complain about this to you. Hopefully.
I have been taking so many of the relationship quizzes on BuzzFeed but they all say I’m single. The major problem is I have an S.O. Is she just faking or am I?? Help me!! Is my girlfriend not actually mine or are we real?”
—The Quizzical Quiz-Taker
You’re not real. This is all a simulation.
—Andy (or am I?)
I’m not sure where to live. I live in Milwaukee, WI, right now. Moved here three years ago for school, but that fell through because Milwaukee is friggin expensive. My family wants me to move back to the other side of the state, towards Minneapolis/St. Paul. What should I do?”
—Meandering the Midwest
Get the fuck out of there, it’s so cold! Listen, I used to live in Michigan, and it was depressing because it was grey and miserable nine months out of the year. Now I live in Southern California, it’s sunny and beautiful and my vitamin D levels are through the roof. Migrate south, seriously.
But if you HAVE to stay, I will say that everybody who lives in Minneapolis seems to LOVE Minneapolis for some reason.
My problem is that I struggle with feeling attractive. I started taking birth control when my boyfriend and I started dating (six years ago). I started gaining the weight right after. I’m now a size 12 and my boyfriend is a slender guy. I haven’t felt attractive in the last year. I gained so much weight at one point I was a size 16. I’m back to a 12 and trying to lose weight again. I don’t feel sexy or beautiful in any way. I prefer to keep my shirt on during sex now. I don’t know why my boyfriend still finds me attractive. I have a tummy, I have rolls when I sit down, I just don’t know what he sees anymore. Any advice you could give me would be much appreciated.”
—Struggling With Size
First off, don’t worry about your boyfriend. Clearly he finds you attractive, and when you actually care about someone, the size tags on their clothes don’t matter to you at all. Appreciate that fact and find some security there.
Now, consider the possibility that if your boyfriend finds you attractive at any size, you can too! It’s not easy. It requires shedding every bit of toxic influence that the media and our society overall has thrown at you for your entire life. That takes time and work.
But if you are worried about your physical health at all, consult a doctor. There are many different types of birth control and like 40 different pills, and everyone reacts to each one differently. It can take time to find the right one, and not every doctor is going to be helpful about it. Advocate for yourself if you’re unhappy with your medication. You may have done all of this already and I’m just sitting here mansplaining BC to you, but if so at least you can cross that off your Mansplaining Bingo Card.
That’s it for this week. But if you’re having a problem that you need advice about, let me know! It could be anything: petty arguments that you need a judge to decide who was right and who was wrong, help making life decisions, relationship issues — I’m your completely unqualified man. Email firstname.lastname@example.org (for total anonymity) or leave a comment here!