When It Is Not Sex Addiction, But Sexual Diversity
Common challenges couples face when dealing with secret same-sex attraction.
Posted September 11, 2025 | Reviewed by Tyler Woods
In my sex therapy practice, I see a respectable number of couples in heterosexual relationships where the presenting issue is that the male partner has been engaging in sexual behavior with other men and has kept this secret from his girlfriend or wife…until it was no longer secret. Needless to say, by the time these couples come to see me, their relationship is in deep crisis. I would like to address a few of the common issues that these couples face.
As is so often the case with the general public, some of these couples do not know how to discern those mental health providers who are skilled in this work vs. those who are not. In more than one situation, these clients often find me after seeing at least one or two other therapists, where it became clear to them that the therapist was not adequately trained in how to help them. In addition, many couples self-diagnose the male partner as a sex addict. Some of my clients are commonly referred to me from the clients’ individual therapists, who understand these couples need a skilled couples therapist who is trained in couples work and human sexuality .
In more than one scenario, because of the client’s self-diagnosis, a male client’s individual therapist encouraged him to go to 12-step-based meetings for sex addicts; these men had begun doing that. This is upsetting and shocking for several reasons. It must be said that no matter the relationship context, same-sex sexual attraction and same-sex sexual activity are not sex addictions.
Regardless of what certain cultures and communities say, there is nothing intrinsically wrong with a man desiring sex with another man, even when that man is in a heterosexual relationship. Suggesting he go to sex addiction peer support groups pathologizes his sexual attraction to men and provides external validation of his profound shame about that attraction. This ill-considered recommendation can cause psychological harm, adding to an already complex clinical picture. (On a related note, I have written about how my profession has its own shameful history of having a blindspot when it comes to seeing the role morality plays in determining mental health and sexual health and this “suggestion” is a perfect example.)
The suggestion to attend 12-step-based groups borders on oppression. Why? Because when we limit men to only allowing them a sexual expression that fits inside a narrow box, it encourages conformity , denies the normal scientifically proven variation in human sexuality, suppresses individual sexual development, and causes psychological harm. I have written about erotic interests in a past blog, and I encourage you to read it here, as much of what I wrote applies to some of these types of clients.
In addition, keeping secrets from and/or lying to your partner also does not make you an addict. Many, many people keep all kinds of things from their partners and that is not about any addictive process. Just imagine if we called all those people addicts! What exactly are they addicted to—secret-keeping? Eeek. Secret-keeping is typically steeped in shame, not addiction.
When we set aside the sexual issue (same-sex attraction and sex) and the relational issue (secret-keeping) that these male clients have, what is left is a behavioral issue. Speaking more generally now, I believe that when people, and especially clinicians, use the term "sex addiction," what they are really referring to is compulsive behavior combined with an internal conflict plus a lack of insight or self-understanding about their compulsivity.
After almost two decades doing this work, I have seen countless clients make choices that create really complicated sexual lives for them (and their partners) without examining their underlying motivation (s). An urge bubbles up inside them and they feel compelled to act on it. I liken this to an itch needing to be scratched. They also frequently have poor insight, struggle to understand themselves, and have poor language skills to describe what they are experiencing. There can also, but not always, either be a substance use issue and/or undiagnosed mental health issue. When all that combines with compulsivity (which is a strong urge to repeat certain behaviors that appear to have negative consequences), many folks lazily default to using the word “addiction”.
There is an important question for all of us to consider when it comes to situations like these. Instead of labeling the client a “sex addict”, ask yourself what the function of this dysfunction is. In other words, what is the secondary gain? Secondary gain is when a person does something that, on the outside, appears to undermine or sabotage themselves. Yes, that may be happening, and there is also a reason for their behavior. That is the secondary gain. Secondary gain is typically outside of a person’s awareness and they can only see the harm they are causing themselves. This is where Freud was right: there are things we do not know about ourselves yet drive us to act—the unconscious is at work. Secondary gains are often a major component in compulsive behaviors .
The other thing I have noticed in working with clients with compulsive sexuality is their difficulty in understanding certain emotions. These (mostly) male clients are fairly disconnected from their emotions. When I ask these men, “What emotion is coming up for you right now?” they typically answer, “I don’t know.” This can be extremely painful, frightening, and shameful to them. It is often at this moment when the client wants to pivot to “I’m a sex addict” because it redirects them from this experience and because that seems like an easier, and less painful, path forward than doing the hard work of psychotherapy .
It is also worth stating that our culture has what is called "compulsory heterosexuality," meaning that we assume everyone is heterosexual—and also pressure them to be heterosexual—until they tell us they are not. So while you may think that those in the LGBTQ+ community are openly accepted now, many of these men realize, as a result of psychotherapy, that they are not exclusively heterosexual (think Kinsey scale) and come out as queer even after decades in a heterosexual relationship. Not everyone understands their sexual, erotic, or romantic orientation or identity at the onset of (or even before) adolescence . For some, this process is a lifelong unfolding. And we need to have patience and compassion for them and their partners.
So-called sex addiction in men typically involves layers of: sexual and erotic interests that are subjectively taboo; keeping secrets from a partner; compulsivity and impulsivity due to poor self-awareness and self-regulation ; substance abuse ; and other mental (and possibly physical) health issues. Like I said, it is a complex clinical picture that regularly gets oversimplified by many. Folks who struggle with this issue need and deserve skilled clinicians who work from a human-centered model, not a pathology or shame-based model, informed by human sexuality.
To find a therapist near you, visit the Psychology Today Therapy Directory .
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Diane Gleim is an experienced and sex-positive Licensed Marriage and Family Therapist and Certified Sex Therapist.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.