People talk about sex addiction like it’s a thing. Every so often, I offer my opinions – opinions which evolve.

Here is where I stand today.

First, a couple of objective, indisputable facts:

1) “Sex addiction” is not a psychiatric diagnosis. Nor is any other “behavioral addiction,” such as gambling, overeating, spending, or what have you. (I’m not saying that it’s not a real malady – I’m saying that, in the DSM-V, the current guide to psychiatric diagnosis in the United States, it is not an approved diagnosis.)

2) When people speak of “sex addiction,” they are speaking of many different things. There is not any one ailment that is universally agreed to constitute “sex addiction.”

3) A sex addict is someone who disapproves of her or his own desires and behaviors. That same person, freed not of the behaviors but of the judgment, would be no more a sex addict than the same person, freed of the behaviors themselves. And, in the same vein…

4) One person’s healthy sexuality is another’s sex addiction – the range of human sexual desire and behavior is so great as to render almost anything healthy (or pathological) in the eyes of some or other observer. In my time in twelve-step groups, I encountered people who “suffered from same-sex attraction,” and considered themselves addicts. In my time out of those groups/rooms, I have met incredibly promiscuous people who did not experience their sexuality as problematic.

5) There is no “treatment” for “sex addiction” that has demonstrated any significant positive results. Regardless of what anyone tells you. There is no evidentiary basis for the efficacy of 12-step programs, or inpatient programs, or anything….

And now, a couple of opinions:

1) The word “addiction” obscures more than it reveals, conjuring images of junkies, of people ruled by their bodily appetites for poisons.

2) There are unquestionably people who experience their sexual behaviors as existing beyond their control. I have been one of them.

3) There is a neuro-chemical sense in which it is possible to develop a relationship to the stimulation provided by sex structurally similar to that provided by addictive drugs.

4) The “first step” of the twelve steps – “I am powerless over sex and my life has become unmanageable” – unquestionably describes the experience of many people when it comes to sex. For those of us unfortunate enough for that to be true, we definitely need help. (And for me, simply reading the first step was enormously empowering.)

5) The whole “sex addiction” debate is unfortunate, at best. The bottom line is that when our notion of who we wish we were comes into conflict with who we actually are (what we desire, what we do), we suffer. This is not a suffering unique to (sex) addiction – it is in fact the root of much human suffering.

If you are one of those unlucky people (as I have been) whose sexual desires conflict with your ideal notion of yourself, if you are someone who has developed the habit of using sex to medicate your emotions, there is hope. The hope doesn’t lie in finding some “cure.”

It lies in understanding yourself, your motivations, your behaviors. And accepting yourself.