“Hypersexual Disorder” came very close to being added to the DSM-V, the controversial fifth edition of the standard psychiatric diagnostic manual, released earlier this year. That is the official term for what's sometimes referred to as "sex addiction."
Though it may not be officially recognized as a disorder, hypersexuality or sex addiction—call it what you will—is typically portrayed in the realm of men. The disparity is striking and important. Fictional sex addicts, like those seen on the show Desperate Housewives, and in the recent films Shame and Thanks for Sharing, are almost always men. So it is perhaps not surprising that research about sex addiction among women is scarce.
One of the only studies focusing specifically on female sex addicts was published just last year, and it has some surprising findings: For one, exposure to pornography as a child was a stronger predictor of hypersexual behavior than sexual abuse as a child. Prior to that, the one study that did include women (from 2003, which compared rates of sex addiction among males and females on a college campus) actually found that nearly twice as many women as men fell into the "needing further evaluation" and "at-risk" categories. But you won’t have any trouble finding research on female hypoactive sexual desire, also known as "low sex drive," which is neatly consistent with societal norms about sex: that men want it all the time and women never do.
It seems as if the sexual double standard and stigma around female sexuality are spilling over onto science. This has created an enormous blind spot in the research on sex addiction, so almost all of the research has been conducted with men, while female sex addicts have largely been ignored—except by the clinicians who’ve been treating them for decades. Linda Hudson is a licensed professional counselor and former president of the Society for the Advancement of Sexual Health who has been working with female sex addicts for more than 20 years. She and several other female therapists recently published the first book offering a targeted treatment for therapists working with female sex addicts called Making Advances: A Comprehensive Guide for Treating Female Sex and Love Addicts.
"I know it is hard to believe that there hasn’t been much research on this, but we only very recently developed the standard of care for female sex addicts, even though we have been treating them for more than 20 years," she says. Although mental health clinicians began using the Sexual Addiction Screening Tool (SAST) in 1988, researchers didn’t develop a version that satisfactorily assess sex addiction in females until 2010. The double standard also extends to treatment facilities, according to Elizabeth Edge, a certified sex addiction therapist in Atlanta who’s been working with sex addicts since 2003. She says she initially worked only with men who were struggling with sexual compulsivity “because the atmosphere where I worked mirrored society’s belief that women don’t have a problem with sex,” though she does see things starting to shift with the younger generations. For one thing, with the proliferation of porn, clinicians are realizing that more women are “visually wired” (highly responsive to erotic images), which was previously thought to be a characteristic exclusive to men.
Edge offers the following definitions of sex addiction: “Patrick Carnes, the founder and leader in the field, says that sex addiction is ‘a pathological relationship with a mood altering experience.’ Kelly McDaniel, a sex addiction therapist who wrote an important book for women called Ready to Heal, defines ‘sex and love addiction as a disease of loneliness, fueled by shame and despair. It is a compulsion to use romance, people, and sexuality to feel alive.’”
Sex addicts are hooked not just on the act itself, which often is actually a small part of the addiction, but all the aspects surrounding it—the planning, fantasizing, anticipation, excitement, relief, even the shame, guilt, and continual re-commitments to “do better.” That’s why it’s considered a process addiction; each phase of the cycle elicits neurochemical and emotional rewards that can be as compelling as other addictions. Hudson adds, “The components of any addiction include: compulsive pattern of use, loss of control, continued use in the face of negative consequences.” Many people hear sex addiction and, understandably, imagine it to mean addiction to intercourse itself, so they have a hard time believing sex addiction is even a real thing, let alone thinking of it as something women might struggle with.
“There is a huge cultural stigma with sex addiction in general and specifically as it relates to women,” Edge says. “Men are respected if they have a lot of sex or many sexual partners—this is not the same for women,” so there tends to be more shame around female sex addiction. When women do seek help, they’re often too ashamed to identify their problem as sex addiction, or may not even realize that’s what the problem is, usually calling it “love addiction” or “relationship addiction” instead. While these other types of process addictions often co-occur with sex addiction, those labels are sometimes inaccurate to describe a woman’s actual experience. Edge says that, at least initially, labels aren’t important as long as a woman has recognized that her life has become unmanageable and is ready to get help.