Do Genders Experience Compulsive Sex Differently?

What research says about gender differences in compulsive sexual behavior disorder (CSBD).

Key points

• CSBD affects all genders, with a similar core pattern of symptoms.

• Women face more stigma and have a harder time accessing help or treatment for CSBD.

• Inclusive, gender-sensitive approaches are key to better support and treatment for CSBD.

Man looking out the window

This post was written by Ewelina Kowalewska, Ph.D., researcher at the Centre of Postgraduate Medical Education in Warsaw, Poland, and leading expert on women with compulsive sexual behavior disorder.

Out-of-control sexual behavior, now officially termed compulsive sexual behavior disorder (CSBD) in the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2022), has long been recognized in clinical and everyday life, yet for much of its history, scientific understanding has focused primarily on men. But does CSBD look and feel the same for everyone, regardless of gender?

Meet Jamie: A Story Beyond the Stereotype

Jamie is 30 years old. She first encountered pornography at age 11 and gradually moved on to more extreme content, describing herself as addicted and aroused by pain. She now uses pornography daily, sometimes bingeing for whole days or weekends. Although she prefers high-intensity partnered sex at parties, both activities give her similar feelings of arousal and relief. She experiences cycles of being "decent" and self-destructive. Her lack of control over sex and substances intensified after two assault experiences. The consequences include neglecting work, social withdrawal, family conflicts, sex-related injuries, sexually transmitted infections (STIs), and broken relationships. Despite many failed attempts, she feels she cannot stop it.

How Common Is It?

Jamie’s story highlights that CSBD is about far more than how often someone engages in sexual activity. It’s deeply tied to emotional regulation, the fallout in everyday life, trauma histories, the weight of stigma, and the presence or absence of support systems. This condition can affect women as much as men and gender-diverse individuals, challenging narrow perceptions.

A recent large-scale survey across 42 countries found that 2.42 percent of women screen at high risk for CSBD (Bőthe et al., 2023). However, these figures aren’t fixed—they ebb and flow with cultural attitudes and social contexts. This variability reminds us that CSBD is a widespread concern transcending gender and geography.

Similar Distress, Different Dynamics

Though men and women share key features—a persistent, often distressing failure to control sexual urges leading to negative consequences—the context can differ (Kowalewska et al., 2020; 2024; 2025):

• Sexual behavior patterns: Men tend to report higher pornography consumption and solitary sexual activity (i.e., masturbation) as problematic, while women more often describe emotional turbulence, relational difficulties, and impulsive or risky partnered sex.

  
  

• Motivations and triggers: Men and women can use sex or pornography as an escape from negative emotions, boredom, or stress, but women report greater levels of shame and internalized stigma, sometimes tied to societal attitudes toward female sexuality.

  
  

• Functional impairment: Importantly, for women who meet CSBD criteria, the degree of distress, disruption to daily life, and comorbid mental health issues (including anxiety, depression, and trauma histories) are just as significant as for men, even if the absolute frequency of behaviors is lower.

  
  

• Help-seeking: Women and gender-diverse individuals encounter more barriers to accessing support, from stigma and lack of specialized resources to misdiagnosis or disbelief from professionals.

  
  

Key Similarities: Core Mechanisms

Despite these differences, recent research (Kowalewska et al., 2020; 2024; 2025) shows important overlaps:

• Core mechanisms such as impulsivity, emotional dysregulation, and trauma are consistently identified as robust transdiagnostic risk factors for CSBD across all genders; however, the expression and functional role of these mechanisms appear to differ significantly between genders.

  
  

• Though men are more likely to label themselves as “addicted,” women with CSBD experience equivalent levels of distress and functional impairment.

  
  

• Cross-cultural studies suggest the outcomes (social, occupational, or relationship difficulties) are comparable, emphasizing the need for inclusive prevention and treatment strategies.

The Need for Gender-Sensitive Approaches

When we overlook gender diversity in research and clinical care, we miss crucial diagnoses and leave the needs of women and gender-diverse individuals unmet. To truly help individuals like Jamie—no matter their gender—we need assessment tools that are validated for all, outreach tailored to diverse experiences, and a deeper awareness of the unique barriers people face. Recent advances make it clear: CSBD isn’t just about male sexuality spiraling out of control. It’s a complex, multifaceted condition that demands a nuanced, person-first approach. Only by embracing this complexity can we break down shame and stigma and better support those who live with this condition.

Beáta Bőthe, Ph.D., and Mónika Koós, Ph.D. - blog