Learn what an expert certified sex therapist thinks about “sex addiction”
Sexuality is a central part of human experience—but when sexual behavior feels confusing, distressing, or out of control, people often turn to the internet or therapy searching for answers. For decades, the dominant explanation for such behavior has been the concept of “sex addiction.” But what if that model causes more harm than good?
In a recent interview hosted by Michelle Melville-Kashon of the Sexual Health Alliance (SHA), licensed marriage and family therapist and certified sex therapist Michael Vigorito dives deep into why the traditional sex addiction model fails many clients—and what a more compassionate, accurate, and clinically effective alternative looks like.
Michael, co-author of Treating Out of Control Sexual Behavior: Rethinking Sex Addiction, offers a compelling critique of the moral, stigmatizing narratives that often shape treatment approaches. Drawing from his clinical roots in HIV mental health care and his ongoing work training clinicians, Michael shares why a shift is urgently needed—and how we can build a more inclusive, informed model for understanding problematic sexual behavior.
Why the “Sex Addiction” Model Is Flawed
The term “sex addiction” has long been used to describe behaviors like compulsive pornography use, infidelity, or engaging in sex despite negative consequences. While the label can seem useful for organizing experiences, Michael Vigorito warns that it often leads to oversimplification and stigmatization.
“The sex addiction label pathologizes people’s identities and experiences,” he explains. “It implies moral failure or disease without understanding the context.”
Michael notes that many clients who believe they are “addicted to sex” are actually struggling with shame, trauma, identity conflict, or emotional dysregulation. Applying a one-size-fits-all addiction label can obscure more relevant clinical factors, such as psychiatric comorbidities, substance use, relational dysfunction, or cultural messaging about sexuality.
Shame: The Hidden Force Behind Out-of-Control Sexual Behavior
One of the most powerful themes Michael addresses is shame—especially for clients from marginalized communities. Early in his career, working with HIV-affected populations, he saw how gay and bisexual men were often labeled as sex addicts when their sexual behavior was, in fact, shaped by unresolved shame around identity.
Shame doesn’t just hurt—it fractures the self. Clients hide parts of who they are, creating internal tension and preventing healthy integration of sexuality. Michael’s therapeutic approach seeks to decouple shame from sexual behavior, helping clients build a more positive, authentic self-concept.
A Certified Sex Therapist’s Perspective: Slowing Down, Getting Curious
What makes Michael’s approach stand out is his deep clinical curiosity. As a certified sex therapist, he encourages practitioners to slow down and avoid rushing to conclusions when clients report “out of control” sexual behavior.
Instead of simply accepting a sex addiction diagnosis at face value, he recommends:
Exploring the client’s emotional landscape
Understanding relational dynamics
Assessing psychiatric or substance use factors
Situating behavior in the context of identity, trauma, and values
This nuanced perspective leads to better outcomes—and greater client trust. It also reinforces SHA’s belief that sexual health must be integrated into routine behavioral health care, not treated as a specialty concern or afterthought.
Beyond Morality: Debunking Outdated Beliefs About Desire
Many people struggle with misconceptions about what healthy sexual desire “should” look like. Michael calls attention to one particularly harmful myth: that desire must always be spontaneous and equal in a relationship.
This rigid belief system can cause distress and pathologize perfectly normal variations in desire—especially in long-term relationships. Clinicians, he argues, must update their understanding of sexual health, embracing more inclusive and realistic frameworks.
Ask a Certified Sex Therapist About Sex Addiction
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That it’s a disease rooted in moral weakness or lack of control. That kind of framing does real harm. In reality, people are often dealing with complex psychological and relational issues. Labeling them as “addicts” adds shame rather than insight.
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Many LGBTQ+ clients grow up receiving messages that their sexuality is wrong or dangerous. When they struggle with sexual behavior, they often internalize those messages and assume they must be addicted. This compounds stigma and can lead to misdiagnosis.
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With curiosity. Instead of agreeing or disagreeing, ask: “What makes you think that?” “What’s going on in your life?” “How do you feel about your behavior?” That exploration often reveals deeper issues that need care and compassion, not just a label.
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Certified sex therapists are trained to hold space for complexity without judgment. We’re equipped to talk openly about sex, assess context, and offer evidence-based strategies rooted in sexual health—not shame.
Ready to Rethink Sex Addiction?
If you’re a clinician looking to better support clients with complex sexual behavior concerns, Certified Sex Therapist Michael Vigorito leads SHA’s advanced certification in Problem Sexual Behavior—a training designed to move beyond outdated models and toward inclusive, evidence-informed care.
This program offers:
A deep dive into treating Out of Control Sexual Behavior (OCSB)
Skills for conducting comprehensive assessments
Tools to address shame and promote integration
Consultation with experts like Michael Vigorito and Dr. David Ley
Attend “Rethinking Sex Addiction: Treatment and Techniques for OCSB”
Join us for our upcoming online event, “Rethinking Sex Addiction: Treatment and Techniques for OCSB,” where Michael and other leading experts will share innovative approaches to this evolving area of clinical care.
Whether you’re a seasoned therapist or just beginning to explore sex therapy, this event will expand your perspective, challenge your assumptions, and equip you with better tools for helping clients.
It’s time for certified sex therapists to rethink “Sex Addiction"
Michael Vigorito’s approach to understanding and treating sexual behavior difficulties is a welcome shift from the reductive and often harmful sex addiction framework. As a certified sex therapist, his insights remind us that sexuality is never just about behavior—it’s about identity, emotion, connection, and context.
By slowing down, asking better questions, and treating sexual health as a core aspect of well-being, clinicians can offer more effective, affirming care. Whether you're a sexual health professional or someone exploring your own relationship with sexuality, we invite you to engage with this growing movement to rethink sex addiction—and replace shame with understanding.
Want to become an in-demand sexual health professional? Learn more about becoming certified with SHA!
