Sex addiction, also called sexual dependency or sexual compulsivity, refers to any sexually-related compulsive behavior that stands in the way of one's normal life and causes severe stress on family, friends, work environment. US sex addiction expert Patrick Carnes also speaks about sexual anorexia, which is defined as obsession with avoiding romantic-sexual interaction. In sexual addiction or sexual anorexia, like in any other addiction, such as chemical use, compulsive gambling or eating disorder, the addict sees the addiction as a way to deal with all stress and difficulties in life.
According to research carried out by Carnes, 3 percent to 6 percent of people are affected by sex addiction. Carnes posits that sex addicts most often come from severely dysfunctional families, mostly families where at least one other member has another addiction. In many cases, sex addicts also have another addiction, the most common being chemical addiction, followed by eating disorder, compulsive working, compulsive spending and compulsive gambling. A big percentage of the sexual addicts included in Carnes's survey said they had been victims of emotional, sexual or physical abuse as children.
According to Carnes, sex addicts are most often men and rarely female with a ratio three to one. Some behavioral patterns that are seen as indicators of a potential sex addiction problem are compulsive masturbation, indulging in pornography, having chronic affairs, exhibitionism, dangerous sexual practices, prostitution, anonymous sex, compulsive sexual episodes and voyeurism. These behavioral patterns usually lead to problems such as loss of partner or spouse, marital or relationship problems, loss of career opportunities, unwanted pregnancies, abortions, suicide attempts, exposure to AIDS and venereal diseases, legal risk from nuisance offenses and rape.
Although sex addicts often experiences adverse consequences due to their behavioral patterns, they are not able to stop and continue with the addictive cycles. This can be explained by the fact that sexual arousal releases peptides, which have the same function as opiates but are much more powerful. As with most addictions, the body eventually develops a tolerance to the stimulatory effects of the peptides, which makes sex addicts intensify their sexual behaviors in order to achieve the same level of satisfaction as before.
As a result of this tolerance, sexual addicts start dedicating more and more time to their sexual activities, which makes them lead a dual life. They spend one part of their life pursuing and obtaining sexual pleasure and dealing with the social consequences of the addiction. In the rest of the time the addicts try to maintain a normal social image through repression and denial. For such people sexual addiction takes a central position in life, displacing other factors that are usually considered more important, such as family, friends, work or social values.
According to Carnes, there are three different levels of sexual addiction. The first level includes so-called victimless crimes such as prostitution, pornography, anonymous sex and compulsive relationships. Addictions from level two involve intrusive sexual acts, for example exhibitionism, voyeurism, indecent phone calls and indecent liberties (such as unwanted touch). Examples of third-level addictions are child molestation, rape and incest. This represents the point of view of the promoters of the concept of sexual addiction.
However, US sex therapist Marty Ralph Klein (1950–) argues that the use of the sex addiction concept is a sex-negative model of enhancing sexual health in society. According to Klein, many sociologists do not share the assumptions that form the basis of the sex addiction concept. These assumptions include that sex and sexual desire are dangerous; there is only one best way to express sexuality, sex should enhance intimacy and imagination in sex is not healthy. In addition, supporters of the sex addiction concept consider that people need to be told what kinds of sex are wrong/bad and that sexual health is defined by laws and social norms.
Klein underlines that the behavioral patterns that are often seen as symptoms of sex addiction could make a clinical sexologist think of many other possible diagnoses. For example, a person who has affairs outside the marriage can easily be diagnosed as sex addict. However, if the clinician learns more about the patient, it could turn out that this sexual behavior reflects an existential dilemma – for example, the person is in his or her fifties having a routine marriage and reflecting on his or her future. To make his point clearer Klein gives some examples of behaviors that were labeled as sexological diseases in the past: libertine, masturbator, nymphomaniac, birth-control advocate, frigid and homosexual.