The Complexity and Paradox of Hypersexuality, Part 1

Over 20 years ago when Zahrain and I were receiving marriage guidance from Bishop Brown of  Bronzeville, Chicago who officiated our wedding, he schooled us on three critical issues of focus for sustained happiness in our marriage.  In this brief blog, I will focus on the second (sex), and may discuss the other two in future writings. 

Bishop Brown emphasized that while sex is very important in marriage, it is also critical in other healthy romantic relationships. He advised that a healthy sex life helps to reduce adverse conditions such as stress, depression, and anxiety.  

Although many people perceive Valentine’s Day as the main celebrated season of romantic love (of which sex plays an important role), indeed, the celebration of sex has no special season.   In other words, it is almost always open season for sex. During Valentine’s Day season, discussions about sex may induce happiness, sadness, isolation, togetherness, trauma, release, and a wide range of thoughts and emotions. Concerns will likely be about too little, just enough, or too much sex. Where do you fall, or wish to fall, on this continuum?

Bishop Brown’s main relevant advice to Zahrain and me were to “strive for a healthy balance; avoid too little and avoid too much sex.” The biggest sex-related challenge, he argued, is when one partner wants too much sex, and the other wants too little sex. The second challenge is when one partner wants at least just enough, and the other partner is not willing or able to deliver. In another post, I may discuss techniques for achieving what Bishop Brown referred to as a healthy balance.  

The main point of this post is to identify something that, even in his great wisdom, Bishop Brown seemed to have never thought about, or at least discussed with us. In fact, the issue seems so complex and paradoxical, that even DSM-5 does not seemed to recognize it.

That is, when one person is having too much sex, and too little sex at the same point in their life. 

Sounds confusing? I know, right?

Perhaps this complexity and paradox is part of why the DMS series has so far been unable to include hypersexuality as a disorder and has considered and reconsidered its inclusion in current and past volumes (Kingston et al 2021).

You may ask, what does he mean by a person having too much sex, and too little sex, at the same point in their life? I am referring to instances when a person is hyperactive (seven or more total sexual outlets (TSO) (Kingston, 2018a, 2018b; Montgomery-Graham, 2017; Pullman et al., 2018) with masturbation, but concurrently hypoactive in sexual interest and activities with their romantic partner.

So that’s it for Part 1 of this series.

Have you ever thought of a person being both hyper and hypo active sexually in this manner? How will that be recognized? What may be potential comorbid conditions? What are the ramifications for their romantic relationship? What are the ways that therapists can be alerted to this problem and help clients toward paths to healing? What must clients know about this paradoxical reality?

In subsequent parts of this series, I will focus on definitions and measurements of sexual hyperactivity, its prevalence in the US and other countries, what DSM-5 categories come closest to the diagnosis, and insights for clients and therapists to potentially address this complexity and paradox.

Meanwhile, be thoughtful and heartful about your role in what can be recognized and experienced as healthy sexual balance.

Peter, Masters Level Intern, 2022


Kingston, D, M.E. Olver, E. Levaque, M. L. Sawatsky, M. C. Seto, and M. L. Lalumiere. (2021). “Establishing Canadian metrics for self-report measures used to assess hypersexuality.” Canadian Journal of Human Sexuality. 29 (1) 65-78. 

Kingston , D. A. (2018a). Hypersexuality : Fact or fiction ? Journal of Sexual Medicine, 15(5), 613–615. jsxm.2018.02.015. Medline:29699750

Kingston, D. A. (2018b). Moving forward on hypersexuality. Archives of Sexual Behaviour, 46(8), 2257–2259. https://doi. org/10.1007/s10508-017-1059-5. Medline:28913564

Montgomery-Graham, S. (2017). Conceptualization and assess­ment of hypersexual disorder: A systematic review of the lit­erature. Sexual Medicine Reviews, 5(2), 146–162. https://doi. org/10.1016/j.sxmr.2016.11.001. Medline:28041854

Pullman, L. E., Kingston, D. A., Lalumière, M., Légère, M., Leva- que, E., Renaud, M., & Sawatsky, M. (2018). How much is too much? An examination of total sexual outlet in the general pop­ulation. Presented at the 37th annual convention of the Asso­ciation of the Treatment of Sexual Abusers, Vancouver, British Columbia, Canada.

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