If it's not in the DSM, is it real?
The science of compulsive sexual behavior is more complicated than a yes-or-no answer.
Sean wants to know whether he has an addiction.
Alice wants to know whether that explanation is legitimate or simply an excuse.
Both discover something surprising.
Sex addiction is not a standalone diagnosis in the DSM-5-TR, the diagnostic manual widely used by mental health professionals in the United States.
Does that mean Sean's problem isn't real?
Not so fast.
The World Health Organization recognizes Compulsive Sexual Behaviour Disorder (CSBD) in its International Classification of Diseases, ICD-11. CSBD is currently classified as an impulse-control disorder, rather than an addictive disorder.
This distinction matters scientifically. Researchers continue to investigate the mechanisms underlying compulsive sexual behavior and which approaches to treatment are most effective.
But a diagnostic classification is not a verdict on whether someone's suffering is real.
What science can tell us
There are important questions that deserve serious investigation.
Why do some individuals repeatedly engage in sexual behavior despite significant negative consequences?
What role might genetics, brain function, psychological factors, and environmental influences play?
Which treatments are most effective, and for whom?
And how should clinicians distinguish a disorder from sexual behavior that is merely unconventional or inconsistent with someone's moral beliefs?
These questions require rigorous, independent research.
They cannot be settled by slogans, ideology, or assumptions.
Nor does a diagnosis remove personal responsibility. Understanding behavior and taking responsibility for its consequences are not mutually exclusive.
AFAR's role
AFAR supports scientific research intended to improve understanding of problematic sexual behavior and recovery.
Our supported genomic research at the University of Alberta is one example of this commitment. Sequencing has been completed, and scientific papers based on the work are in development.
Through education, we aim to make findings understandable to professionals, individuals, partners, and families.
Through advocacy, we work to bring evidence into discussions about recognition, treatment, and public policy.
The debate continues. The suffering is real.
The answer is not to abandon the debate.
It's to make sure the debate is informed by better science.
Help advance the research.
AFAR's 2026 Year-End Appeal has a goal of $150,000 to advance research, education, and advocacy.
A gift of $50, $100, $250, $500, or any amount helps move this mission forward.
Please give what you can.
Thank you,
Timothy B. Stein
Board Chair
Research. Recovery. Restoration.
Sean and Alice are fictional characters, but their struggles reflect experiences familiar to individuals and families affected by compulsive sexual behavior and betrayal trauma.
They are all of us, and none of us specifically.
If you or someone you know is in immediate emotional crisis in the United States, call or text 988.
American Foundation for Addiction Research
Advancing the understanding and treatment of Sex Addiction.
info@addictionresearch.com
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