MSM and compulsive sexual behaviours

Abstract

This chapter will focus on the treatment of compulsive sexual behaviours with MSM (men who have sex with men). Firstly, it will clarify the diagnostic criteria from the ICD-11 and the updated studies on sexual compulsivity that demonstrate it is not an addiction, discussing a paradigm shift in the conceptualisation of sexual compulsivity, away from the addiction framework. This is particularly pertinent working with MSM as the ‘sex addiction’ narrative is embedded in heteronormativity. Neves argues that working ethically and responsibly with MSM requires adopting a robust sex-positive philosophy and informed by the latest knowledge in sexology to help clients with re-integrating their sexual behaviours with their values and integrity, whilst reducing sexual shame. This chapter will discuss why 12-step programmes are not recommended as they can be harmful, especially with the MSM population. The chapter will explain the three-phase treatment model working with sexual compulsivity, integrating pluralistic knowledge of different modalities, illustrated by case studies.