Playing doctors and nurses with sex

Psychologist Petra Boyton has written a fantastic piece about the increasing medicalisation of our sexual life as behaviours that were considered personal difficulties are now been re-packaged as disease to be treated by the medical establishment.

Petra focuses on ‘sex addiction’ and ‘female sexual dysfunction’, two concepts that get frequently discussed in the media despite them being seriously questioned as valid disorders by researchers in the field.

Because we’re used to hearing about sex addiction nowadays, criticising it can be difficult. After all doctors are telling us we have it, the media talks about it a lot, and it sounds very serious. To question it surely means denying people have problems or perhaps allowing dangerous health problems to run unchecked? Well, no. We do need to question the idea of medicalising sexual behaviour Рparticularly when ‘treatments’ offered are frequently endorsed by people without adequate training, supervision, or awareness of the wider scientific literature on this issue.

Let’s be clear. Some people do behave in sexually risky ways. They don’t practice safer sex, they cheat on partners, they fail to control impulses or experience sex as a form of compulsive behaviour, or they use sex to make themselves feel better while inside they feel sad, lonely or angry. This is a problem and something that therapy can definitely tackle. But it doesn’t mean people who are acting in this way are ’sick’. Rather than slapping an addiction label on them we need to work with them to identify what is driving problems within their lives or relationships. And we need to get away from the idea that looking at porn, masturbating, enjoying (safer and consensual) sex with multiple partners, having pre marital sex, or being homosexual is a sign of sex addiction.

There’s also a link to an mp3 podcast of an interview with psychologist Leonore Tiefer who discusses problems with the concept of sex addiction, despite its place in popular culture.

I’ve been reading about addiction recently and I’m struck at how poorly the ‘behavioural addictions’ (i.e. non-drug compulsions) actually fit into the addiction model.

A review paper in the latest Behavioural and Brain Sciences aims to identify the core problems and breaks down each type of addiction into the various factors involved.

It includes addiction to cocaine and stimulants, opiates, nicotine, alcohol, caffeine and gambling.

What is most striking is that the authors relate gambling to one gambling-specific vulnerability that is not listed as a factor in any of the other addictions.

In other words, they had to create a mini gambling theory to account for it because it just didn’t fit in any of the other drug-based addiction evidence.

Link to Petra Boyton on medicalising sexual behaviour.
mp3 of interview with Prof Tiefer on the sex addiction con.
Link to BBS review paper on addiction.
Link to PubMed entry for same.

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