The World Health Organization implemented Compulsive Sexual Behavior as a disorder in the International Classification of Diseases, version 11, (ICD-11) a change that took effect in 2022. This illness was not included in the previous version, the ICD-10. This compulsion is described as "evidenced by a chronic pattern of inability to control powerful, recurrent sexual impulses or desires resulting in repetitive sexual behavior," which is taken from the official diagnostic handbook.

This is a significant step forward in helping to treat, and relieve the pain, of those who are experiencing the negative consequences of compulsive sexual behavior in their, or their partners, lives. (You can take the Sex Addiction Screening Tool or Problematic Porn Consumption Scale for free here to self-determine your level of risk for compulsive sexual behavior disorder)

According to the World Health Organization (WHO), the following are some of the signs that an individual may be struggling with a kind of sexual compulsion:

1. When a person becomes so preoccupied with their sexual activities that they disregard their own physical, emotional and mental health, personal care as well as their other interests, hobbies, and duties, they are said to have a sexual addiction.

2. A multitude of futile attempts made to considerably cut down on recurrent sexual conduct.

3. Sexual conduct that is repeated over and over again despite their being negative repercussions or there being little to no enjoyment gained from it.

Compulsive Sexual Behavior Disorder is an issue that has the potential to severely limit a person's life, although it is possible that it does not function in the same way as some other addictions do. More study is required to more fully and completely achieve equal footing with other addictions which would land Compulsive Sexual Behavior Disorder in the DSM 5, the diagnostic framework clinicians most look to.

Christian Lindmeier, a communications officer at the WHO headquarters in Geneva, told Business Insider that the inclusion of compulsive sexual disorders in the ICD-11 is meant to help people who might be seeking treatment for sex issues get better care.

However, psychotherapists and counselors are still engaged in a heated discussion over what qualifies as "addiction" outside of the context of substances like alcohol or narcotics that are associated with physical withdrawal symptoms. Further research and funding are needed to show the empirical validity of aligning Compulsive Sexual Behavior Disorder with other addictions. The therapeutic community seeks more detail regarding the telltale signs of tolerance and dependence that activities like drinking and gambling display. I believe that it is simply a matter of time until Sex Addiction and Porn Addiction are included in DSM, particularly as we’ve seen gambling and gaming addictions enter the DSM very recently.

Technical Sidebar: In 2016, Kraus et al. published an article in which they stated that the diagnosis of compulsive sexual behavior was being considered for inclusion in ICD-11 (which it has since been included in), and they observed that the diagnosis of hypersexual disorder was rejected by the American Psychiatric Association (APA) for inclusion in DSM-5. Both of these diagnoses have since been incorporated into the relevant classification systems. It is important to note that diagnoses that could refer to compulsive sexual behavior have been included in the DSM ever since the publication of the DSM-III in 1980, and in the ICD ever since the first addition of a classification that included mental disorders with the publication of the ICD-6 in 1948. Both of these publications date back to the 1940s and 1980s, respectively. The diagnostic of "sexual disorders not otherwise specified" (NOS) (302.9) was added in both the DSM-IV and the DSM-IV-TR. This made it possible to diagnose hypersexual behavior. The word 'pathological sexuality' was included in ICD-6 and -7; however, in ICD-8, the term 'unspecified sexual deviance' was added, which includes 'pathological sexuality NOS.' This category was maintained as 'sexual deviation and disorders, unspecified' in the ICD-9 manual, which was released in 1975 and is used by the vast majority of nations outside of the United States. The term "unspecified psychosexual disorder" was added in ICD-9-CM (clinical modification), which was a version of the diagnostic manual that was prepared only for the United States and adopted there in 1989. The diagnostic code of 302.9 had been assigned to each of these disorders.

The phrase "sexual addiction" is not included in the latest version of the Diagnostic and Statistical Manual of Mental Disorders, generally known as the DSM-5. The DSM-5 is the primary resource used by psychiatrists practicing in the United States. However, the DSM-5 was revised to include gambling as a potentially addictive behavior because of the fact that the cravings that individuals describe for gambling are extremely similar to the physical impulses that they get for narcotics or stimulants.

Sex addiction has a feature of inner struggle, despair and vulnerability. These individuals have repeatedly promised to themselves and their partners that they will never return to their unwanted behavior again. They’ve tried crafting strategies to aid in reducing or eliminating the compulsion. Yet, despite their herculean effort they are still returning to their rituals, their compulsion and staying in the exact same cycle of addiction other types of addicts are experiencing.

Other therapists think that items like technology, sex, and porn may all become addictions, they're simply a different sort without actual withdrawal symptoms.

This inclusion of Compulsive Sexual Behavior Disorder by the World Health Organization is a huge development in our relationship with sex addiction and porn addiction. This shift will likely assist in removing the taboo around the disorder and in doing so will allow millions more to be able to come forward for the help they, and their families, so desperately need.

If you’d like to get help, schedule an initial session with Blair here.

If you’re looking for a book to help you dive deeper in understanding and/or improving negative consequences from compulsive sexual behavior in your life or a loved ones, find my recommended books here.