World Health Organization position on "sex addiction"

The World Health Organization (WHO) is responsible for drafting the International Classification of Disorders. Currently, WHO has proposed ICD-11. It has not yet been adopted in the United States of American (USA), and there currently is no timeline for adoption in the USA. The ICD-11 proposed a new diagnosis that has not yet been tested by any scientific study, such as for its reliability, called “Compulsive Sexual Behavior Disorder”.

We contacted Dr. Geoffrey Reed, the head of this section for the WHO, and asked him whether this included “sex addiction”. He responded on July 12, 2018. We received permission to circulate his response.

Regarding the term ‘sex addiction’.  We have never liked this term and have never used it ourselves. 

But what does that mean, exactly? Dr. Reed continued:

 ’Sex addiction’ had been listed as a synonym, only to indicate that this was terminology that sometimes might be used, not that we were endorsing it.  However, the presence of the index term seemed to be interpreted by some as indicating that it was okay to refer to it that way.  This was not our intention and classification and professional coders would know that, but obviously there was a risk of misinterpretation.  This was not a message we wanted to be sending.  We do not consider that there is sufficient evidence to conceptualize this as an addiction, as I have said (e.g., per the Kraus et al article, which you know).  So, after some internal discussion, I asked that the index term be removed, which it subsequently was. 

Dr. Reed verified that WHO intentionally rejected the “addiction” diagnosis due to lack of evidence, as they had published. But does WHO think it is acceptable to just call it “addiction” out of convenience or to communicate?

I have asked the WHO Media Office to specifically avoid using the ‘addiction’ terms and to point out to journalists that we are not using it when they use it in their questions.

For completeness, I am attaching the recent brief piece from World Psychiatry, which you have also seen. This piece also addresses this issue, though less explicitly than does the 2014 Grant et al. paper.

In summary, WHO did not include “sex addiction” in the ICD-11, they did not intend for it to be referred to in that way, and they took steps to try to prohibit people from referring to the diagnosis inaccurately.