Though sex addiction remains excluded from the American Psychiatric Association’s catalog of mental and behavioral disorders, the concept has gained substantial prominence in American approaches to problematic sexual behaviors. Though it is commonly believed that sex addiction remains a niche, “pop” form of treatment and diagnosis, it has crept substantially into American legal and forensic cases and is gaining disturbing levels of credibility.
In 2015, this writer, with two co-authors, published the first ever review of forensic applications of sex addiction. An exhaustive review of hundreds of legal records was conducted. Though it has been suggested that there is little likelihood of the sex addiction or related hypersexual disorder concepts being misused in legal settings, this review found a volume of evidence suggesting that our legal system should undertake thoughtful consideration of this issue. Further, sexuality therapists and mental health professionals who use these concepts are at risk of damaging their own credibility, and incurring legal liability under charges of malpractice and insurance billing practices.
This review found that use of sex addiction in US legal proceedings clustered into four general areas of the law:
Administrative Law, including licensing and certification of professionals such as healthcare providers and lawyers.
Civil Law, addressing lawsuits for damages;
Family Law, including divorce proceedings and child custody issues;
Criminal Law, including both trials for criminal responsibility and guilt, as well as legal proceedings related to sex offender registration.
Administrative Law: According to one study, nearly half (48%) of the non-substance addictions reported by state bar associations involved claims of sex addiction. In many of these cases, licensing bodies ordered professionals into mandated sex addiction treatment programs, as a term of the individuals maintaining their license and livelihood. Examples of these include:
Civil Law: Claims of sex addiction were identified in many different types of civil law cases, where the sex addiction concept was used in numerous different manners related to alleged damages. In contrast to other areas of law the concept of sex addiction appears to have gained little traction in civil law proceedings.
Family Law: In matters of family law, involving marital disputes, divorce proceedings, and child custody battles, claims of sex addiction are often used to paint one partner as hopelessly disturbed and aggressive. Claims of sex addiction are often invoked related to issues of sexual incompatibility. Family lawyers have identified the concept of sex addiction as an important issue to consider in marital disputes involving sex or porn.
Criminal Law: Testimony related to claims of sex addiction appear in numerous aspects of criminal law. In trial, claims of sex addiction are sometimes presented to mitigate guilt or responsibility. In sentencing, sex addiction diagnosis or treatment is sometimes offered to attempt to reduce punishment or decrease fears of recidivism. United States Sentencing Guidelines recommends consideration an individual’s ability to control their behavior. Some defendants have successfully presented claims of behavioral addiction to support assertion that they had diminished control at times of offense.
Criminal defense attorneys sometimes explicitly identify “sex addiction” as a potential defense for sexual charges, particularly in cases of child pornography. One attorney’s website (accessed during creation of the original article and since changed) listed out several possible defenses against charges of child pornography, and includes “sex addiction” amongst them: “Addiction — Although not a true defense, if you can offer psychological testimony that you are addicted to the material and show the appropriate remorse, you could persuade the judge to give you a lenient sentence and undergo counseling as a condition.”
Even though claims of sex addiction fail to meet legal standards of expert testimony, it appears that most claims of sex addiction go unchallenged in court. Though different courts and attorneys give the idea of sex addiction different degrees of credibility, it’s clear that the idea of sex addiction has become embedded in legal proceedings, to our detriment. Claims of sex addiction are confused with the issues related to sex offenses. Individuals who have committed sexual crimes are sent to sex addiction treatment, a modality with no evidence for effectiveness. When sex offenders are mislabeled as sex addicts, the public may be put at increased risk, and justice may not be served.
Overwhelmingly, cases involving claims of sex addiction involve males. It is especially noteworthy that claims of sex addiction in administrative law and licensing/certification cases were exclusively made regarding professional, educated and often successful males. Issues of male sexual privilege may need to be considered, before excusing or explaining these cases as related to a currently unaccepted mental health diagnosis.
Allen Frances, MD., Psychology Today blogger, testified in one California civil commitment case, and asserted that “Compulsive sexuality is ‘an incompetent diagnosis in a forensic case,’ and a psychologist who would offer such a diagnosis as an expert opinion should not be taken seriously.” It is clear in this review that experts who testify on the concept of sex addiction are rarely, if ever, acknowledging that this concept is, at best, an “experimental treatment” given the consistent rejection as a formal diagnosis for the past thirty years. Further, those professionals who treat and bill for services under this concept may be engaging in unethical behavior by failing to inform their patients of the limits of the diagnosis. Billing insurance companies for sex addiction treatment services occurs, and is likely to be regarded as “upcoding” by insurance investigators.
It is important that the role of “sex addiction” in legal proceedings be critically examined. Because “sex addiction” is often accepted and endorsed in the general media, and because attorneys are mostly concerned with the outcome of cases, it’s understandable that attorneys introduce this concept to serve their cases and clients. It’s essential that mental health professionals, forensic psychologists and psychiatrists, sex offender therapists and sexologists, all endeavor to educate the courts about these questions and concerns, when “sex addiction” claims or labels are presented in court.Further, even those who believe in the concept of sex addiction are likely to shudder at the ongoing misuse of this concept in the legal system.
Where professional licensing boards are involved, it seems appropriate and judicious for these groups to make decisions about both impairment and treatment, upon the most current, accurate empirical and medical evidence available. Accurate, ethical testimony based upon the most current medical diagnostic framework and research preserves judicial effectiveness, the credibility of clinical testimony, protects victims and ensures that individuals are held responsible for their behaviors, and offered the most current and effective treatments.
Details of the above cases and examples are available in the source article. Though this article focused on US law, there are numerous examples of similar issues playing out in other jurisdictions.
*Disclosure: David Ley has provided testimony in legal cases involving claims of sex addiction.
**Acknowledgments to co-authors of the original paper: Julie Brovko and Rory Reid.