Dear Stephen,

I just found out that my boyfriend has been cheating on me, even though we’ve had what I thought was a non-open (that means closed!) relationship. I’m pretty upset about it…just the fact that he stepped out once was hard to hear, and then I found out that he’s also very into porn, and has been with lots of different guys over the course of our relationship. I don’t know if we’re going to make it, but I’m also really concerned about him and wonder if he needs an intervention or something. Is he a sex addict?

–Concerned and Upset

Dear Concerned,

I can’t tell you what’s going on with your boyfriend himself, since I haven’t met him, much less assessed what’s going on with him, but I can tell you my thoughts on sex addiction. First, you should know that the jury is still out on the question of whether “sex addiction” is a useful and ethical way to describe a person’s sexual problem. You are likely to find therapists and other medical professionals in your community who use the disease model of addiction to describe a person’s out-of-control sexual behaviors and habits, but you’ll also find therapists like me who won’t go that far. (For what it’s worth, the primary diagnostic manual in the field of psychiatry, psychology, and psychotherapy–the DSM–is not considering “sex addiction” as an additional disorder in its next edition. There is simply not enough consensus about this in the field to warrant its inclusion in the official listing of ‘disorders.’)

There are problems with using a disease/addiction model when talking about a person’s sexuality. Unlike external substances like alcohol and drugs, sex is something that is fully integrated into our physical being. It’s a fundamental dimension of human sensation, human relationships, and human experience. It’s how we propogate the species, and it’s simply a major part of a natural human life on earth. If your boyfriend were thinking about joining a celibate religious order, he might want to discern with his superiors whether he truly wants to live a life in which his sexual behavior is highly constrained. But–and I think it’s safe to guess that he’s not interested in that!–outside of a context like that, his use of the addiction model to change his sexual behavior will have its limits. Unlike an alcoholic, your boyfriend would be striving for a sex life in which sex happens–perhaps on a daily basis–but happens in a context that is, in his own opinion, life-giving and healthy.

Having said that, the addiction model offers wisdom up to a point … wisdom that a person who believes s/he has sexual-behavior problems might like to know. For example, it might be helpful for that person to identify triggers of problematic behavior, or social contexts where it’s more likely to happen; and it may be a good idea to identify friends or companions who can help that person make healthier choices. These are tactics that lots of addicts use to maintain sobriety. But one doesn’t have to say, “I am a sexual addict,” to build a new sex life that is more in keeping with what they want.

You may have noticed that I’ve shifted the focus off your boyfriend and onto a general, non-specific person. That’s because, as interesting as your question is, I’m guessing it’s not the best question for you to ask right now. Your boyfriend is behaving in ways that upset you. Your boyfriend has done things that have harmed you emotionally. And–this is important!–your boyfriend has potentially put you at physical risk if the two of you have had sex while he was having sex with other people. Are you sure that both of you have been tested for sexually-transmitted infections? These questions are more worthy of your attention right now than your boyfriend’s need for a sexual treatment plan.

Take good care of yourself, ask your own questions first, and I think that whatever your boyfriend chooses to do, you’ll be in a better position.

–Stephen

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Dear Stephen,

My daughter has a friend, let’s call her/him Kelly, and Kelly keeps telling my daughter that s/he is a boy. Kelly wears clothes that look like boy’s clothes, and has a haircut that makes her look boyish. My daughter accepts without question that Kelly is a boy. I like to think of myself as liberal and progressive, so I don’t want to overreact to this, and I actually smile when I think about my daughter being so accepting. But what should I do? When we talk about Kelly, should I refer to Kelly as “he” like my daughter does? Should I talk to the teacher, or Kelly’s parents, to see what I should do?

–Open-Minded Mom Who Worries About Stuff

Dear Open,

I smiled too when you told me about your daughter’s easy acceptance of Kelly’s gender-bending behaviors. And it’s nice of you to be concerned, to wonder what you should do about this problem…if it’s a problem. Here’s what I would do. First and foremost, or if all else fails, simply do nothing. It could be that Kelly is just experimenting with gender for one reason or another. Maybe her parents have liberated themselves from rigid gender roles and are deliberately trying to encourage their child to freely shape her own identity. They might be even more progressive than you! Whatever the case, it’s really not your affair.

But your own daughter is a different story. If you’re uncomfortable referring to Kelly as “he,” you could practice avoiding pronouns while allowing your daughter to say “he” and “him” all she wants. Or you could just go along with it. Kids try on lots of roles; as I’m sure you know, their identities are in flux. Trust your instinct that tells you not to pathologize Kelly and give your daughter lots of freedom to accept Kelly exactly as Kelly is. And, if you’re really interested or concerned about all of this, you could take this opportunity to talk with your daughter about gender. What’s a ‘girl’? What’s a ‘boy’? Your daughter will learn (whether you want her to or not!) that some people define gender only on the basis of sexual plumbing, but many others see gender as the complex, mysterious, and never-totally-understood phenomenon that it truly is.

Finally, you could learn more about the topic if you like. The link below might be a good book for you to learn more about sexuality and childhood.

Kelly is lucky that he has such a great friend in your daughter, and in you!

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