“Pornography addiction” is not a diagnosis
As research continues into the nature of the problem people experience with viewing pornography, one thing has become clear: anti-porn zealots are depending on a science-illiterate public. Continual claims that “sex addiction” or “porn addiction” were added to the International Classification of Disorders are false. According to the World Health Organization that publishes the manual, “we don’t feel that the evidence is there yet”.
Most scientists practice model testing. Model testing refers to the idea that we propose an explanation of how variables relate over time to ultimately result in someone saying “I have a problem with my pornography viewing”.
Many models have been proposed to explain why someone may believe that they have a problem with pornography. These models include religious conservatism, high sexual motivation, impulsivity, and so on. As you might have guessed from the names, many of the models are not pathological at all! The model that has been most consistently rejected?
Addiction.
“Although the term ‘sex addiction’ has been taken up by the popular media, the Working Group concludes that available evidence did not support this conceptualization.” — World Health Organization
An “addiction” model of pornography viewing makes the most, and most stringent, prediction of all the models of pornography viewing. For example, the addiction model is the only model that suggests those affected should have a withdrawal syndrome when they stop viewing pornography. Data show withdrawal symptoms do not occur.
The ICD-11 has not been adopted in the United States of America. Since the ICD is used in a variety of countries, it is strongly influenced by cultural norms that often conflict. Perhaps nowhere was this more obvious than the ICD including “homosexuality” as a pathology, then not removing it until 1990. This shameful note in the ICD history made clear that the ICD is influenced by conservative sexual values. Of course, one could argue that the nature of any diagnostic system reflects the values of society. Some of the societies that help formulate the ICD have outlawed sodomy and homosexuality.
The manual used to diagnose mental illnesses in the United States is the Diagnostic and Statistical Manual (DSM). The DSM requires evidence for a diagnosis to be included, unlike the ICD that takes “draft” diagnoses. The DSM does not contain any independent pathology of frequent sexual behavior.
Anti-porn activists were enraged by this outcome and continued to claim that “sex addiction” was now a diagnosis in the USA. “Addiction” and “compulsivity” are completely different. Neither diagnosis is used in the USA. This example is a pornography addiction “coach” who fundraises on various platforms. He also claims abstaining from porn will “lead to a greater penis size when its flaccid”. (It does not.)
Correcting such health disinformation is a full time job. Scientists are required to do “science dissemination” as a part of our jobs, but that is usually in the form of publishing scientific papers and giving scientific talks.
Some sources of disinformation benefit financially by then claiming to treat this non-existent diagnosis. Other sources are religious groups who want to pass legislation outlawing sexual behaviors that they believe are sinful.
With bank rolls like that, it is surprising the lies about “sex addiction” being in the ICD have not gotten even more traction than they have.
