Sexual Compulsivity: Issues and Challenges

Abstract

Throughout society, individuals have attempted to understand the sexual behaviors of others and themselves that they perceive to be "out of control" or "compulsive." These sexual behaviors and their characteristics have been called by many different names, with the most common being nymphomania, hypersexuality, sexual compulsivity, sexual addiction, and sexual impulsivity. These terms are used interchangeably by some professionals who work in the sexuality field, and often one's choice of a term reflects his or her personal beliefs and professional training. These terms are also used in different ways, depending on whether one is describing a psychological characteristic of an individual (i.e., someone is a "sex addict" or a "sexually compulsive person") or describing a particular behavior (i.e., some believe that excessive use of the Internet for sexual purposes is an example of a "sexually compulsive behavior"). That different terms are used to describe the phenomenon of a person being sexually "out of control" or that a behavior is "sexually compulsive" is also the result of the fact that there remains a great deal of debate as to whether the phenomenon of sexual compulsivity truly exists, and if it does, how it is measured. For consistency throughout this chapter, we will use the label "sexual compulsivity" to refer to behaviors and their characteristics that some people perceive to be problematic. A range of sexual behaviors have been considered to be indicative of sexual compulsivity, such as excessive masturbation, having high numbers of sexual partners, excessive use of the Internet for sexual purposes (sexual chatting online, viewing sexually explicit videos, etc.), and looking for sex or having sexual interactions in public spaces (often called "cruising" or "dogging"), among others. However, the problem with any of these behaviors, either alone or in combination, being indicative of sexual compulsivity is that there are no established criteria for distinguishing among behaviors that are a normal part of one's sexual repertoire and when these behaviors have become excessive. In the beginning of this chapter, we give a brief description of the history and meaning of sexual compulsivity. But regardless of the lack of consensus on the meaning of sexual compulsivity, and on how to assess it and treat it, researchers have devoted a significant amount of energy into studying it and trying to understand how it is related to sexual health issues. Following the section on the history of sexual compulsivity, in this chapter we will present three examples of this type of work from our own research. Three specific lines of research are presented, including work that has focused on sexual compulsivity and its associations with continued high-risk sexual behaviors among those living with HIV, work exploring the extent to which sexual compulsivity is an issue among young adults, and research that looked into sexual compulsivity among individuals who seek sexual interactions in public places, known as cruising (which is perhaps one of the issues that is often cited as being a clear example of out-of-control sexual behavior).