Quietly last month, the World Health Organization made the decision to classify compulsive sexual behavior as a mental-health disorder, and added it to the International Classification of Diseases (ICD-11), its expanding manual of diseases, injuries, and their corresponding codes, used to track health statistics and assist health-care providers in allocating resources. The new ICD, which will go into effect in 2022, will also include gaming disorder as an addictive disorder.
The ICD defines compulsive sexual behavior as, in part, “a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour” extending over a period of six months or more. In order to qualify as compulsive, this behavior must also interfere in one’s life by causing “marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.”
It’s important to note, by the way, that though “sex addiction” is often conflated with compulsive sexual behavior by popular culture and media, researchers have long argued to separate the two: The American Psychiatric Association has rejected the diagnosis, and the DSM does not include sex addiction among its list. Some experts question whether sex — or other compulsive behaviors like gambling and shopping — can really be “addictive” without a chemically addictive property, like that of drugs or alcohol, but others insist that compulsive sexual behavior changes the brain, and should therefore be treated like any other addiction. Therapists who work with sex addicts point to their patients’ suffering as evidence that the condition exists, and can be ruinous. “‘Sex addiction’ and ‘sex compulsivity’ are completely different issues,” says Nicole Prause, a neuroscientist who specializes in sexual behavior and addiction. “Addiction and compulsion manifest differently in the brain, have different patterns of behavior, and have different treatments.” Prause is also critical of clinics like those visited by Weinstein, and says their approach is unsupported by science.
Supporters of the WHO’s decision, though, hope that an official classification will result in more research on compulsive sexual behavior, and in turn, more support for those affected by it.