Mental health professionals’ pathologization of compulsive sexual behavior: Does clients’ gender and sexual orientation matter?

It has recently been proposed that compulsive sexual behavior disorder should be included in the 11th version of the International Statistical Classification of Diseases and Related Health Problems. Concerns have been repeatedly expressed regarding the overpathologizing of sexual behaviors and the potential for false-positive results in clinical practice. Empirical evidence indicates that stereotypes related to gender and sexual orientation might influence therapists’ assessments of clients. Those stereotypes are likely to be associated with different levels of pathologization and stigmatization of high levels of sexual interest and behavior. The aim of this study was to explore the possible connections between clients’ gender and sexual orientation and mental health professionals’ (MHP) pathologization of compulsive sexual behavior. A sample of MHPs (N = 546) were presented with a case vignette describing a client with compulsive sexual behavior. The information on the client varied by gender (male or female), sexual orientation (homosexual or heterosexual), and clinical condition (ambiguous diagnostic criteria and fulfilled compulsive sexual behavior disorder diagnostic criteria). After reading the vignette, the MHPs rated the client’s mental health status and gave an opinion about causation (psychological vs. biological etiology) and stigmatization indicators (blaming the affected individual for their problems, desire for social distance, perception of dangerousness). The MHPs showed significantly fewer tendencies to pathologize when the client was a homosexual woman or man independent of their clinical condition. Mediation analyses revealed that the biological etiological model partly mediated the effects of reduced pathologization in homosexual clients. These results indicate that clinical decisions relating to compulsive sexual behavior are influenced by nosologically irrelevant beliefs about the biological causation of sexual behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved)