We Have a Lot to Learn About Women and Sex Addiction

Our culture tends to champion men who unapologetically pursue sex, but we're typically less comfortable with women going out of the way to quell their libidinous desires. As a result, many people — including some mental health professionals — are quick to draw a line (and become incredibly judgmental) about female promiscuity, even though women are typically excluded from clinical research.

Bad Research on Bad Sex

A new paper published in Currents Sexual Health Reports, which analyzed more than 60 studies on hypersexuality, finds women are underrepresented in this research, which may mean professionals should think twice before diagnosing and characterizing their female patients. The analysis suggests men are typically given a pass when it comes to reckless sexual behaviors, even when these behaviors put themselves and others in danger. Quite simply, women are held to a different standard, which may be due to long-held cultural (mis)understandings about sexuality that are clearly getting in the way of conducting any meaningful research. The authors suggest that while men who are especially sexually expressive are seen as hypermasculine, women are characterized as manipulative.

"We have little understanding of the appropriateness of the [hypersexual disorder] diagnosis for women," write the researchers. "The lack of empirical inquiry into out-of-control sexual behavior in women may be complicated by socio-cultural expectations of female sexuality held by researchers, clinicians, and even hypersexual women themselves."

One study reviewed by the authors proves this point. It involved a cohort of male and female college students. Each participant filled out a Women's Sexual Addiction Screening Test (W-SAST), a short questionnaire developed by a male addiction specialist and author of a book on sex addiction. The researchers of that particular study concluded that 32 percent of the college women required further screening for sex addiction. However, only 17 percent of the college men in the sample were potentially in need of treatment for sex addiction.

Is Sex Addiction Really a Thing?

Professionals estimate sex addiction affects between eight and 40 percent of women, a margin that, perhaps, demonstrates researchers' willful ignorance about the subject. Part of the problem is that psychiatrists and other mental health professionals have an ongoing dispute about whether sex addiction and hypersexuality is, in fact, a real mental disorder, or simply a symptom of another underlying condition such as depression, bipolar disorder, or borderline personality disorder. However, some experts do argue that reckless sexual behavior that interferes with a person's life should be diagnosed and treated as an isolated condition.

To Diagnose or Not to Diagnose Women

In 2013, the board of the American Psychiatric Association reviewed a set of proposed criteria for sex addiction and hypersexuality, drawn up by members petitioning to include the diagnosis in the updated fifth edition of the Diagnostic Statistical Manual (DSM-5). Their proposed criteria for diagnosing hypersexual disorder and sex addiction was anyone who, for at least six months, engages in repetitive and uncontrollable sexual acts and thoughts or behaviors that lead to damaging consequences and that impair a person from conducting daily routine tasks. They also suggested that the reasons for these behaviors are not completely understood, but that some research links reckless sexual behaviors to sexual abuse and assault early in life.

The APA passed on the proposed criteria. Part of the problem, they said, was that research on hypersexuality was far too limited to draw any conclusion. The other problem was the lack of research that involved clinical treatment for these behaviors. While it's well established that, say, 12-step programs are effective for treating alcoholism and that cognitive behavioral therapy can work wonders for OCD, experts haven't really identified the right therapies for what might be characterized as sex addiction.

Treating So-Called Sex Addiction

The limited research that does exist suggests that many of these forms of therapy could be helpful for treating sexually impulsive behaviors. But the authors also propose that the best therapy for female patients might be talking with other women who feel judged, distressed, or shamed by society and shrinks. That in itself might help professionals determine exactly what women want — especially in times of personal crisis.