Fear of forensic misuse was one of the main reasons why "Hypersexual Disorder" was excluded from DSM-5.

The ICD-11 introduction of "Compulsive Sexual Behavior Disorder" revives concerns about forensic misuse.

Courts must distinguish those who cannot control impulses from those who simply choose not to.

This post was written by Johannes Fuß, director of the Institute of Forensic Psychiatry and Sex Research in Essen, Germany. Besides being a researcher, he provides psychiatric expert opinions in court proceedings.

The public sphere has long served as a theater for the intersection of private sexual behavior and public accountability. Over the last two decades, high-profile figures from Tiger Woods to former Congressman Anthony Weiner have navigated the fallout of sexual scandals by framing their actions through the lens of psychological pathology. Woods suggested that his affairs were the result of a compulsive condition rather than a moral lapse, while Weiner used the language of "recovery" to address repeated sexting scandals. These instances initiated a cultural conversation about "sex addiction," but they also raised skepticism regarding whether such labels serve as genuine clinical insights or strategic tools for image restoration.

The stakes shifted even more dramatically during the #MeToo movement, particularly with the case of Harvey Weinstein. When Weinstein reportedly sought treatment for sex addiction following allegations of predatory misconduct, experts and the public alike pushed back, arguing that abusive, coercive acts reflect an abuse of power and a lack of empathy rather than a clinical addiction. These contemporary examples underscore a fundamental tension: the struggle to define where personal responsibility ends and a "mental disorder" begins.

The Conceptual Struggle in Forensic Psychiatry

This conceptual struggle is not new; it has been part of forensic psychiatry since its earliest days. The........

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