There is a heavy book that burdens the bags of psychology students, the shelves of counselors, and stacks of reference libraries. It is hefty at three pounds, but also in the weight of what it contains. This book is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), made by over a decade of research by hundreds of experts, and used to diagnose clients every day. One diagnosis that is not found among its pages is “sex addiction,” in fact, the introduction specifically acknowledges that it and its counterpart, “hypersexuality disorder” were specifically excluded. Despite this, “addiction” is used to refer to high-frequency sexual behaviors in about 37% of research articles. Even though scientific studies have shown that sex is not addictive, these terms are used frequently, in articles, headlines, and court proceedings. In family law, it is a phrase used to demonize unfit spouses and parents, and in administrative law, treatment for it is used as a reprimand for individuals who have had their licenses revoked or suspended. Most worrisome, however, is its application in criminal law. It is used as a defense, to get a lesser conviction for the defendant in return for a requirement for medical treatment. The diagnostic language of sexual behaviors and disorders can dramatically and unjustly affect court convictions and settlements when it is used falsely by the defense to pursue treatment instead of jail time. The concept of “sex addiction” must be better defined in courts of law and public opinion so that only medical conditions supported by scientific research affect convictions in courts of law.

While the DSM-5 may agree that sex addiction is not a mental disorder and therefore cannot be diagnosed or treated as such, many prominent sex therapists use and encourage sex “addiction” treatments that follow a traditional addiction treatment model. They argue, as Dr. Robert Weiss does, that, “the process of sexual addiction treatment does not vary significantly from addressing a chemical addiction.” This author goes as far as to suggest the 12-step program for treatment but does not support this with any evidence. Patrick Carnes, Ph.D., similarly prescribes the 12-step program, however an amended 12 step program. In this program, they “explore basic spiritual issues as a way of understanding and facing their anxiety.” This highlights two prominent underlying causes of the claim of sex “addiction” while conceding that to have any hope of positively affecting sex “addiction” clients, this program must be adapted to the reasons they believe themselves “addicted” which may be different for every client based on their religious beliefs, morals, and specific underlying conditions. While these researchers and counselors seem to concede that more research is needed into the construct before it can be added to the DSM-5, they ignore the research that has already been done in this regard.

The diagnoses of hypersexuality and sex “addiction” are not supported by the electroencephalographic study done by UCLA and Mind Research Network researchers in 2013. Their study concluded that the brain stimuli response of “addicted” individuals mimicked high desire, but was not disordered when prompted with sexually explicit images. It is specifically the disordered response that classifies something as addictive, therefore sex “addiction” or hypersexuality does not fit this condition and cannot be treated as such. Nicole Prause, a researcher in this study also asserted at the 2016 meeting of the Society of Personality and Social Psychology that individuals with sex “addiction” do not reflect the same response to their addictive object, sex, over time as is descriptive of true addiction. In the case of addiction, their brains should light up when they encounter the object, in this case, sex. In the study, it showed that they displayed no higher response to sexual images than the control group. They should also experience an altered brain response to sex over time where they begin to need, not want it. Prause asserts that even people who claimed a severe addiction to sex continued to display the same brain response over time when shown explicit material. This reaction to the pleasure centers of the brain is therefore not divergent from people eating something delicious like ice cream. Therefore, sex “addiction” cannot be anything “more than high libido coupled with low impulse control.”

Additionally, no empirical research has been done that proves the effectiveness of 12 Step Sex Addicts Anonymous or related programs. Therefore, referral to these programs does not reflect an expected growth of character or increase in the ability to control their compulsions. The research into the actual disorder which is called “sex addiction” has displayed it is not an addiction at all. The treatment programs which center around addiction principles of psychology and are currently employed for individuals with this false diagnosis are therefore ineffective and cannot with good faith be trusted with the remediation of those who have committed acts of sexual violence unless they are amended as Carnes’ program is. Under this altered program it can be seen that treatments of the underlying causes of what makes someone believe they have an addiction can actually be effective. Additional counselors have explored concepts that may contribute to the sex “addiction” claim and introduced additional recovery strategies. Treatment now includes ideas like relational depth, connecting on a deep and emotional level with the client, and also examining the elements of shame and guilt. While expanding these treatments might be effective, treating these conditions without the false title of sex “addiction” could be more potent in the treatment as well as preventing the further spread of misinformation about this disproven term.

In matters of counseling, the highest importance is not placed on the language of the diagnosis, but on the treatment and progress of the client. It is important that individuals who use this claim of sex “addiction” receive treatment that is tailored to the legitimate causes of any disordered actions or compulsions they may have. However, the nuance of the language that is used to formally diagnose them is vital in the courtroom, which is why the elimination of the term “sex addiction” is so critical. Especially with those accused of sexual violence, precise and scientific diagnoses and appropriate treatment are needed “rather than intuitively derived diagnoses and referrals to 12 Step Sex Addicts Anonymous self-help groups.” If a disorder is defined wrong as has been demonstrated with sex “addiction” then it can lead to ineffective treatment. If it is not treated correctly there can be no assumption that these individuals will pose any less threat of becoming repeat offenders in the future, which is an essential component to sentences and settlements in court proceedings. The applications of the poorly defined term “sex addiction” may then be examined in different sects of law, of which three are highlighted.

Before the different areas of law are examined it is necessary to highlight a difficulty in this conversation. The claim of sex “addiction” in court proceedings is not exclusive to defendants that identify as male, cases involving female identifying defendants in this manner are simply less prevalent. The closest female example to those of the males that will be presented below comes from Stephanie Montgomery Graham’s article of Canadian cases involving sex “addiction” defense strategies. In this case from 2011, a man argues that he had committed aggressive sexual acts because the female victim had allegedly told him that she was a sex addict. This testimony was later discredited by the judge as “completely unsupported by the evidence.’’ We see that cases involving females occur less often, that females are less likely to use this term to remove blame from themselves, and that when this claim is used by others to attempt to villainize a victim, it does not stick. This conversation will then prove most effective when looking at the harmful use of this language in administrative, family, and civil law proceedings in which the defendants are men.

Administrative law is that which regards the powers given to government agencies, and in cases of sex “addiction” concerns the licensure of those professional practices such as medical providers and lawyers. Christopher Driskill was an obstetrician whose license was suspended after allegations came forward that he had drunkenly performed medical procedures, had sex with multiple patients, and failed to properly attend to patients under his care. He settled with the Medical Board prosecutors to reinstate his license following treatment at a Sexual Recovery Institute. This decision does not include considerations of his substance use, nor does it properly consider a correct diagnosis of the proposed affliction. Another example is of a former police officer in Canada who was fired for repeatedly having sexual intercourse while on duty. The former officer then applied to receive paralegal licensure which, because of the terms of dismissal from his last employment, required an assessment of good character by the Law Society Panel. The applicant testified that his past behavior was no longer an issue as it was caused by “sex addiction, anxiety, and stress as well as undiagnosed depression during the time of the incidents, which caused him to act hypersexually.” No empirical evidence of any kind was presented to affirm his statement, but the panel ultimately decided to grant the paralegal license based on his testimony that he could now successfully manage his previous afflictions. While personal testimony and character evidence are important to a full understanding of events in court proceedings, mental disorders in particular must find ground in empirical evidence if they are to influence legal decisions. This is the danger of failing to properly diagnose the underlying conditions of sex “addiction.” A pattern has been established in which defendants who have committed unlawful sexual acts are allowed to return to normal society and jobs once they are assigned treatment for their sex “addiction.” Regardless of their specific underlying conditions, a false diagnosis and corresponding treatment cannot be what allows someone to retain their licensure.

The next example specifically confounds the pattern we have seen so far; in family law, “sex addiction” is not used in an exculpatory fashion but to tarnish the image of partners in child custody and divorce proceedings. An example from 2003 concerns a husband who was sued by his wife for sole custody. The allegations included that the husband was addicted to sex and pornography, and even took unsolicited nude pictures of her in the shower. His parental custody was rescinded by the Courts as a result of these allegations and on the concern for the children’s best interests. However, studies conducted on similar Canadian cases in family law showed that “the allegations of sex addiction rarely carried much weight in the small number of family law cases reviewed (n ¼ 9) because this sample of female spouses presented as angry, theatrical, or mentally unwell.” The most important conclusion from this is not that claiming sex “addiction” didn’t affect the case in the way those women intended. The takeaway is that the term was used at all, which reflects mass misinformation in which an unrecognized disorder may appear in court proceedings once again because members of the public still believe it is a valid diagnosis. This additionally does show that sex “addiction” claims do not apply equally in all areas of law. In the case of family law these claims might discredit the accuser and the accused alike but the term is shown to be firmly in the vernacular regardless.

The last and most potent area of law in which sex “addiction” is used is in criminal law. In this area, it is not two people against each other but the government deciding whether or not to sentence someone for an act or omission. The most serious of these cases are those in which the defendant faces the death penalty, as happened in North Carolina to a man who raped and murdered a member of the state board of education. The strategy of the defense during this case was to take away culpability from the defendant to reduce his sentence. They brought forth witnesses to testify to his “severe sex addiction”, which they then argued meant he had “diminished capacity” at the time his crimes were committed and therefore held less volition in the act and should be punished according to this reduced blame. The jury, in this case, did reduce from capital punishment to a life sentence in prison without parole. The applications of the sex addiction construct are most concerning in cases like these in which violent offenders are granted reduced sentences without empirical evidence to support their supposed condition. In this case, the defense attorneys revealed during an interview that they were not even aware that “sex addiction” had not been included in the DSM-5. This demonstrates that it is currently a term that is widely used enough in the media and defenses that they had not even considered it might be an inherently false claim.

In three recent cases of sexual violence which appeared in the media, that of Anthony Weiner, Harvey Weinstein, and the suspect of the Atlanta spa shootings, the term “sex addiction” appeared in the defense strategy of these men. It is important to note that the earliest of these cases began in 2017. The DSM-5 was published without the term “sex addiction” in 2013, and significant additional research in this field was done to the affirmative of that exclusion in the years of 2013 to 2017. Three headlines of note appeared in Psychology Today, the Washington Post, and NBC news. All three of them refuted the claims of their respected defendants to this “sex addiction.” This can be applauded as it means a greater awareness of this facade of defense is being spread however the fact that this must be debated over and over again is still presently concerning. The first of the articles came out in 2017 with the last in 2021, 4 years, all continuing the same argument. Additionally concerning is the fact that this discussion is happening in the media but not the courtroom. The third matter of concern is that none of these sources, or any that could be found, pinpointed the root causes of what these men misidentified as an addiction. A name is needed for the underlying causes of these actions that does not necessitate quotes, as the researchers mentioned above all concluded, more research is needed.

The discussion of the sex “addiction” myth is not new, nor is it close to finished. Other terms such as sexual perversion and sexual compulsion have come and gone, with hypersexuality being the most recent adaptation. The DSM-5 references hypersexuality disorder but doesn’t include it specifically because there is insufficient research. The research that has been done has shown that these individuals’ sex drives are not more heightened than the control group, they just feel more shame. It is then clear that more research and clarity are needed in the psychological area of this discussion so that public knowledge and courtroom convictions alike can attain greater clarity. Currently, these claims only serve to make the waters of justice murky as culpability is removed or given and the true motives of an act or omission are left unclear in the courts. A long road to break legal precedence must begin, and it will start with greater support of research in this field. Once we understand more, we can diagnose better, and once we diagnose better, we can treat effectively and convict justly. Those who have committed acts of sexual violence must be held accountable for their actions.

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