But is sex addiction an appropriate diagnosis for Weinstein and other alleged sexual offenders’ crimes — and is it even a real diagnosis at all? As men continue to point to sex addiction to justify their crimes, experts agree that this course of action isn’t what these men should be doing to address their patterns of abuse.
The diagnosis of “sex addiction” is up for debate
Sex addiction, according to the International Institute of Trauma and Addiction Professionals, is defined as “any sexually-related compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones and one’s work environment.”
The disorder “is when someone repeatedly uses sexual behavior to medicate, so to speak, for things like loneliness, sadness, anger,” John Giugliano, a Philadelphia-based researcher and clinician specializing in “out of control sexual behavior” — his preferred term for sex addiction — said in an interview.
“Just like [with an] alcohol or eating disorder ... the person uses that to feel better,” Giugliano said. “And people keep using that, repeatedly, despite the negative circumstances.”
Giugliano said sex addiction is when a person has an inability to regulate their sexuality and it becomes a problem in their lives, with the end goal of treatment being “healthy sexuality.”
Whether or not sex addiction should actually be classified as a mental disorder has been up for debate. The American Association of Sexuality Educators, Counselors and Therapists declared in a 2016 position paper that it “does not find sufficient empirical evidence to support the classification of sex addiction or porn addiction as a mental health disorder.”
This finding is supported by a 2013 study at UCLA, which found that though other studies have revealed brain activity heightens in drug addicts when they see images of the drug they’re addicted to, a similar test performed using those suffering from “hypersexuality” found their brain activity stayed the same. This suggests, the UCLA researchers noted, that hypersexuality “did not appear to explain brain differences in sexual response any more than simply having a high libido.”
The dispute over sex addiction’s validity are why Giugliano said he prefers the term “out of control sexual behavior,” he said, as when “some people say sex addiction doesn’t exist, what they are actually disputing is the nomenclature, rather than the disorder itself.”
“I don’t quite know when being a selfish, misogynistic jerk became a medical diagnosis, but apparently that is the way that this train is moving.”
For some, however, the nomenclature isn’t the only problem. Clinical psychologist David Ley, author of The Myth of Sex Addiction, does take issue with sex addiction as a disorder, saying in an interview: “These things that get called sex addictions are typically symptoms of other issues. They are symptoms of moral conflicts, they are symptoms of people exerting sexual privilege.”
Citing the fact that most people in sex addiction treatment centers are “white, heterosexual, married men who tend to be religious,” Ley added: “What that means is the sex addiction label has simply become a term or a concept that has been used to excuse people acting on sexual privilege, engaging in selfish, irresponsible behaviors toward others.”
“I don’t quite know when being a selfish, misogynistic jerk became a medical diagnosis, but apparently that is the way that this train is moving,” he said.
Sexual abuse should not be confused with sexual addiction
Whether or not it’s a “real” disorder, however, it’s clear that sex addicts and sexual offenders should not be seen as interchangeable.
“Some sex addicts can become sexual offenders — a small minority, maybe 20% or less — move on, escalate to become something like that,” Giugliano said, “but most do not. And sex offenders are not necessarily sex addicts.”
The main difference, Giugliano cites, is that sex offenders engage in nonconsensual acts, while the behavior of nonabusive sex addicts is legal and consensual.
According to the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering and Tracking at the U.S. Department of Justice, a “combination of factors likely contribute to sexual offending behavior,” including childhood trauma; “cognitive distortions” and problems in interpreting social cues; exposure to sexually aggressive pornography; the inherent imbalance of power between men and women and having “self-interested motives” instead of compassion and empathy.
“These things that get called sex addictions are typically symptoms of other issues. They are symptoms of moral conflicts, they are symptoms of people exerting sexual privilege.”
Whatever the reason, though, alleged sex offenders — such as Weinstein — who purely seek treatment for sex addiction likely won’t address the actual underlying issues at hand.
“We have a long history of powerful, wealthy men getting in trouble for sexual behaviors, and they go to ’sex addiction summer camp’ and contend that that is going to address the issue,” Ley said.
“Because the sex addiction industry has done such a good job at promoting themselves as the answer to these sexual behaviors, there are lots of people — lots of men, predominantly — who have engaged in criminal behaviors that are being sent for sex addiction treatment. And that is a tragedy,” Ley continued. “After 40 years of sex addiction treatment existing, there is still no … peer-reviewed evidence that proves that sex addiction treatment works.”
While Giugliano did contend that sex addiction treatment is successful in cases where the addicts in question are not engaging in nonconsensual sexual abuse, he, too, said he agrees that for Weinstein and other alleged sexual offenders, sex addiction treatment isn’t the right course of action.
“Anybody can use sex addiction as an excuse. ... In this case, I don’t [know] if Weinstein is a sex addict or not. I don’t know his history, prior to the sex offending,” Giugliano said.
How should sex offenders be treated?
So if what Ley has dubbed “sex addict summer camp” isn’t the answer for these powerful men, what is?
Giugliano said that while treatment for sexual offenders is “similar” to sex addiction treatment, the treatment, which is typically focused on “cognitive-behavioral” treatment, requires “more monitoring.”
“Because it’s dangerous behavior, you really need — in some cases — a controlled environment,” Giugliano said.
Studies have shown that such treatment can be effective; the SMART Office at the Department of Justice concluded that “treatment for sex offenders —particularly cognitive-behavioral/relapse prevention approaches — can produce reductions in both sexual and nonsexual recidivism.”
Ley said effective treatment allows “people to understand and acknowledge the cognitive distortions that lead them to feel like they can grab women, you know, and get away with it.”
“Those are the real kind of issues that need to be addressed, but unfortunately in sex addiction treatment, none of that is,” he continued.
Treating alleged serial sexual offenders such as Weinstein, Giugliano said, may even go beyond just treating the sexual abuse itself, as “people can have more than one disorder going on at the same time,” including, for some sexual abusers, sociopathic behavior or anti-social personality disorder.
“So if [Weinstein or other alleged serial abusers] really have this kind of lack of conscience and all the stuff that goes with sociopathy, then it’s really more severe, and usually imprisonment is the necessary way [to deal with it], so that he can be contained and in a safe environment,” Giugliano said.
Beyond how the offenders are personally treated, though, Ley noted that it’s also important to consider how society itself discusses sexuality and the idea of personal responsibility in our relationships.
“Weinstein’s alleged behaviors emerge from a history of very misogynistic, very power-based kinds of social dynamics,” Ley said. The sex addiction concept also emerges from those same patterns.”
“So I think what we really need is we need these conversations to acknowledge that the way we address these issues is through more effective social dialogue around sexuality, around personal responsibility and around relationships.”