Let’s say you’re someone who feels a strong urge to engage in sex—be that masturbation or with partners—or watching porn, and you often like one or both and a lot. Is there a problem with that? Not really, unless you’re violating a partners’ consent, acting in unethical ways, or your sexual behaviors make it difficult for you to hold a job or to take care of yourself and people who might depend on your reliability.
What if what you’re doing or watching doesn’t make you feel good anymore—and you want to cut back or stop it, or have already tried—and you’re still doing it anyway? You might feel pretty bad about this, experiencing shame, guilt, and maybe even self-doubt or self-hatred. You might wonder what is “wrong” with you, and be ready for any kind of answer, even if the answer is neither positive nor legitimate.
“Sex addiction” and “porn addiction” are all over the internet now, so much so that it’s hard to escape the terms, and they are used so loosely, broadly and poorly that just about anyone could become convinced they’re an addict within a reel or two.
Even if you sometimes feel out of control or obsessed with your sexual desires and needs—and the need to engage in sex or watch it can be pretty overwhelming sometimes—does this really mean you are addicted? Eh. Even if you may need to make some adjustments to some of your behaviors for your own well-being or someone else’s, you should know there’s a big difference between what might seem like compulsive or addictive behavior and actual, clinically defined and diagnosable addictions and sexual compulsions. There’s also a big difference between seeing something on social media that sounds like you, taking an internet quiz and then accepting a fake pathology like sex or porn addiction, or instead getting a bona fide diagnosis (or not) of whatever it is that’s troubling you.
So, even though a lot of people may talk about sex addiction as if it were legitimate, we need to consider if it’s really a mental health disorder. And we need to start with a legit definition of addiction.
Might you be addicted? That’s unlikely, primarily because science shows us that the addiction framework just isn’t something that can legitimately be applied to sex or media.
Defining addiction
The word “addiction” is overused and often wrongly used in an exaggerated way. For example, when we refer to “shopaholics,” “porn addiction,” and “gambling addiction,” we’re really talking about habits, only rarely about actual compulsions, and never about true addiction.
The U.S. National Institute on Drug Abuse (NIDA), defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness,” and is “the most severe form…of substance use disorders.” It is not a word to use lightly or loosely. It is a science-based, clinical diagnosis with a specific meaning.
Substances refers to manufactured chemicals, like alcohol and drugs. Our bodies and brains also make chemicals, like hormones and neurotransmitters like such as dopamine, and while levels of some of these can increase during sex, we cannot become addicted to them, even when we enjoy their effects. In fact, sex is one of the ways we can experience longer-lasting “slow dopamine,”external link, opens in a new tab to feel pleasure and an enhanced mood, along with exercise, sunshine, creating art, listening to music, and meditating.
One of the biggest problems with the idea of sex addiction is that it expands the definition of addiction to apply it to something completely different—sex and enjoying erotic material—based on a distorted notion of how brain chemistry works and with very little scientific evidence.
Another big problem is that sexual behaviors that are widespread and not at all unusual are called wrong and unacceptable by people who clearly don’t have much information—let alone training—about human sexual behavior. Such people often have a very narrow idea about sexual activities they consider acceptable or “normal.” So, there’s a very good chance that what you think may be compulsive, out of control, or addictive about your own behavior, actually may not be any of those things.
What you do, even if you do it a lot, is probably within the average range of what people generally do. And even if you’re a bit of an outlier, it still doesn’t mean you’re an addict. The span of healthy, consensual sexual behavior is very wide.
What’s in a diagnosis?
If you’re still worrying that you have a problem and need help, you need to know what sexual behavior problems are actually accepted by mental health professionals.
The two largest sources of information about mental health diseases in the Western world are 1) The Diagnostic and Statistics Manual of Mental Disorders (DSM 5-TR, 2022) (sometimes called DSM V) of the American Psychiatric Association and 2) The International Classification of Diseases (ICD-11, 2022), created and maintained by the World Health Organization. These are the go-to sources for medical and mental health providers, and are updated every few years.
Sex addiction has not been included as a bona fide problem in either book.
The DSM 5-TR rejected sex addiction as a mental health diagnosis in its latest revision, due to the lack of scientific evidence and serious questions as to whether an addiction model could even apply to sex. The latest edition of ICD-11 does include Compulsive Sexual Behavior Disorder (CSBD) as an impulse control disorder. It does not classify any kind of sexual behavior—including watching porn—as an addiction.
Other kinds of impulse control disorders include pyromania (setting fires), kleptomania (stealing), gambling, gaming, hairpulling, skin-picking, and explosive, out-of-proportion displays of anger and aggression. Substance-induced impulse control disorders are also included.
CSBD is not determined by having a high desire for sex or frequent sex or porn consumption. Here’s how CSBD is definedexternal link, opens in a new tab:
“…a persistent pattern of failure to control intense repetitive sexual impulses or urges, resulting in repetitive sexual behaviour over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.”
According to the diagnostic description, the “persistent pattern” could include:
- “repetitive sexual activities becoming a central focus of the individual’s life;”
- “numerous unsuccessful efforts to control or significantly reduce the repetitive sexual behaviour;”
- “continuing [the] sexual behaviour despite adverse consequences such as repeated relationship disruption;”
- “continuing [the] sexual behaviour even when he or she no longer derives any satisfaction from it.”
Many respected sexuality experts and organizations have also challenged the validity of sex and porn addiction. The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) took the positionexternal link, opens in a new tab that “its members utilize [treatment] models that do not unduly pathologize consensual sexual behaviors.”
The ASSECT statement explained: “AASECT 1) does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder, and 2) does not find the sexual addiction training and treatment methods and educational pedagogies to be adequately informed by accurate human sexuality knowledge.”
Another argument against sex and porn addiction is that this pseudo-diagnosis can distract from bona fide mental health conditions, like anxiety and depression. That means people can miss opportunities for evaluation and treatment they really need and that will actually help them.
Self-identification does not a diagnosis make
Often, people also come to self-diagnosis by way of bad actors—influencers and advocates of sex or porn addiction who personally benefit from it—or popular online “tests” for sex addiction that simply aren’t legitimate.
And in a 2024 studyexternal link, opens in a new tab of how even mental health practitioners (not patients) apply ICD-11 criteria to diagnose CSBD expressed concern that these categories “could contribute to pathologizing and stigmatizing normal behavior.”
That same study said such biases “could be based on moral judgments about sexual behavior, such as those coming from religious beliefs and may be particularly strong when there is an incongruence between an individual’s moral values and sexual behaviors.” Unfortunately, the study showed that half the mental health professionals participating in the study falsely diagnosed CSBD based on the client’s self-identification, apparently accepting bias and stigma, even though no mental illness was present. Researchers wrote,
“The high rate of false positive diagnoses may be related to differing views of non-normative sexual behavior that influence clinicians’ diagnostic decisions in assigning CSBD diagnosis as well as patients’ self-labeling.”
This is hardly a surprise. Clients who reveal their self-identification to a therapist have most likely found an online description of something they do—like watching porn and masturbating—on social media or a website about sex addiction. Then, because their religion or upbringing may have already made them feel they are wrong or sinful, they embrace the label of sex addict out of shame and guilt, and feel they need to be fixed. Yet all along, their behavior may be perfectly ordinary by most educated standards.
CSBD might seem like it validates sex addiction, but it doesn’t.
Sex addiction advocates might be rejoicing now that CSBD, which sort of-kind of-maybe looks like their concept of addictive sex, is in the international diagnostic manual.
However, as we mentioned earlier, ICD-11 is clear that psychological stress and moral incongruence—due to social, religious, or personal views about human sexual behavior—and/or a high desire for sex, or the amount or kind of sex a person has, is not enough to qualify a person for CSBD.
Another hazard is that many clinicians on board with the frameworks of sex addiction lack the sex education, training or comfort to even determine what is or isn’t healthy sexual behavior. The findings of that 2024 study suggest that many clinicians are not comfortable with sexual topics, are not adequately trained, or may hold mistaken beliefs about biology and neurology, like thinking brain chemicals are addicting.
What can you do instead of worrying if the amount or kind of sex you have is “normal”? For one thing, toss out the idea of “normal.” Human sexual behavior is extremely varied, so what’s “usual” is different for everyone. Let’s consider other, sounder, ways to think about sex.
Health benefits of sex
For those who want it, beyond pleasure and connection, sex has many long-proven benefits for our bodies and minds. So, it’s hard to understand how something so generally good for you could be considered “bad” or “addicting” based on wrong and outdated assumptions about human sexuality.
According to credible sources like WebMDexternal link, opens in a new tab, Singlecareexternal link, opens in a new tab, Healthlineexternal link, opens in a new tab, and right here, at Scarleteen, for example, some health benefits of sex can include:
- Stress reduction, thanks to endorphin and oxytocin release;
- Help with sleep, thanks to prolactin released during sex, particularly during orgasm;
- Boosted immune system, and an increase in antibodies that fight infections;
- Natural pain relief, due to endorphins;
- Help with menstrual cramps and promotion of consistent ovulation;
- Better mental health, including depression, due to endorphins, oxytocin, and dopamine;
- Stronger pelvic floor muscles, which helps prevent incontinence and pelvic organ prolapses;
- Better heart health, and less risk of hypertension, stroke, and other heart disease;
- Some protection against prostate cancer;
- Happier moods;
- More satisfaction and bonding in intimate relationships;
- The ways vaginal sex can keep vaginal tissues toned, preventing thinning of the vaginal walls (an effect of aging);
- Headache relief, including migraines and cluster headaches;
- And even some possible help preventing breast cancer.
Sexual activities can burn calories, strengthen muscles, and give your libido a boost. They can help strengthen memory and cognition in older adults. There’s even a correlation between sexual activity and confidence.
Pleasure is not only good for us, it’s essential to sexual health. Pleasures of all kinds enable us to enjoy our bodies and the situations we’re in. So what’s so wrong about engaging in sex or viewing porn to feel good, as long as we’re enjoying ourselves in ways that are not harming others? Nothing.
Even major organizations know this. For example, in 2021, the World Association for Sexual Health (WAS) issued its Declaration on Sexual Pleasureexternal link, opens in a new tab, which defines sexual pleasure as “the physical and/or psychological satisfaction and enjoyment derived from shared or solitary erotic experiences, including thoughts, fantasies, dreams, emotions, and feelings.” It also claims “sexual pleasure is a fundamental part of sexual rights, sexual health, and sexual well-being.”
In other words, sexual pleasure is part of a broader agenda, integral to sexual and gender human rights. And for those who are not interested or seldom interested in sexual activities, WAS also respects this right.
But isn’t porn and other sexual media unhealthy or wrong?
No. Not in a general way.
If no one was harmed or exploited in the creation of sexual media you’re viewing, and you’re not using it in a way that is unhealthy for you, specifically, no.
People of every culture and time have made and enjoyed erotic art, music, literature, and objects that can either attract or repel us, and sometimes even teach us.
It’s okay to want to learn more about sex—and viewing porn is one way to do it, even if it is largely based in fantasy—and it’s okay to enjoy sexy things for your own pleasure. However, you may need to negotiate how and when you do this in your relationships, and/or the home you share with others. If you find you are violating other people’s boundaries around this—or feeling that you need to take a break or change your habits for yourself—do the best you can to be more considerate but also be gentle with yourself. We can use just about anything in ways that aren’t right for us, and just like we can do when that’s the case with anything else, we can choose to change our habits with sexual media when the way we’re engaging with it doesn’t feel right for us.
It’s also common to have conflicting emotions around some kinds of erotic materials and topics. Fantasy content that might ordinarily repel you might also have an erotic charge for you. You might wonder if liking to watch a certain kind of porn automatically makes you a sick or bad person. Sexual responses can be complicated and your reactions could be a way to learn something about yourself. Again, be gentle.
If sexual activity and sexual pleasure are so integral and important to most people, garnering worldwide endorsement from scientifically astute organizations and individuals, why do other people—like sex addiction proponents and profiteers—want to police or pathologize private, consensual, human behaviors?
Sex addiction clinics and influencers are who benefit the most when you think you’re an addict
Influencers on social media take the unfounded concepts of sex and porn addiction in order to get followers and prestige, continuing the exploitation of vulnerable people started by the sex-and-porn addiction clinicians and clinics. They create programs or “therapies” as products which are marketed and sold. They get attention and professional prestige, and make money directly and indirectly through sponsorships, client fees, insurance payments, workshops, conversion camps for queer youth, sexual purity curricula, book deals, speaking engagements—including school appearances—and like the influencers who copy them by promoting their own “recovery” tips to followers, supporters of sex and porn addiction can become popular through social media, podcasts and videocasts, and mainstream news platforms.
Sadly, countless people in the U.S. and elsewhere have been labeled as sex and/or porn addicts and have paid the price, not just financially, but also in social and personal shame and guilt and lack of treatment for bona fide disorders. In addition, the “treatments” offered through sex addiction programs are not in alignment with best practices in mainstream sex therapy, are not grounded in science, and may even be exploitative, designed to prolong or repeat treatments, at great financial and personal cost to the clients.
People who engage in sex outside heteronormative, cisgender categories may be additionally pathologized for their desires. It may come as no surprise to you that sexual behaviors outside lowest common denominator norms for cisgender and heterosexual people are more likely to be presented as pathological by people telling others what sex addiction is. And they may even be at risk of being manipulated into the highly unethical, so-called conversion therapy that aims to “pray the gay away” or use other coercive techniques to squash the clients’ sexual and gender identities and preferences.
As you can see from the list of health benefits earlier in this piece, reputable authorities generally acknowledge the benefits of masturbation and partnered sex. But sexual pleasure doesn’t have to be practical, useful or even reputable to be valid. It offers so much more! It can be transformative. It can help us feel loved and loving. It’s a powerful way to understand ourselves and our bodies, to deepen intimacy with our partners, to enjoy just being alive, and it’s valid to do it a lot, a little, or not at all, whether or not you’re partnered or solo. And if you also want a good night’s sleep, why not?
Human relationships are complex. Sometimes emotions can be overwhelming. Sex of all kinds can range from amazing to ho-hum, and the next day, sex can be something else entirely different. That’s true for almost everyone who enjoys physical sex, but in your teens and twenties it’s not uncommon for some people to date a lot, try a lot, and get in and out of sexual and emotional situations, and make a lot of mistakes.
If you get into a place sometimes where your sexual desires feel too strong, remember that passion is often part of sexual pleasure. Or if you feel sad or embarrassed, try pausing and thinking about what is bothering you, and why. Are you dealing with depression, anxiety, shame, or a rough time of life? Are there people who have criticized you? Have you been misunderstood or experienced mixed signals in sexual communication with a partner? Do you need to accept yourself more fully? All of these (and more) can be hard to navigate.
When it feels like all too much, it might even be tempting to think, “If I didn’t want sex so much, wouldn’t I be better off?” Taking a break from sex and sexual relationships can be helpful sometimes, but you don’t need to give yourself a pseudo-diagnosis to do it. Instead, just give yourself permission to stay curious about yourself and your own inner erotic landscape. Think about where sex—and sexual partners—fit into your larger emotional and social life, into your goals and interests? If there’s something you need to adjust, you can generally find a way to do it.
If it’s still a lot, and you find you need help, don’t be shy. You don’t have to do everything yourself. You also don’t have to be an addict to get help. Seek out counseling or therapy if you need support, but make sure you check the qualifications of anyone you approach for assistance. If someone wants to shame you for your sexual desires or behaviors, look for the nearest exit or turn off the feed. You deserve to work with someone who won’t judge you, who understands both human sexuality and some of the challenges of your stage of life, who will support you, and work with you as long—or as little—as you need to get to the root of things.
Choose your own definition of sexual health and happiness, allow it to fluctuate as needed, and never, ever let someone else tell or convince you that seeking and having pleasure is deviant or wrong.
