Sex addiction is a real mental health issue, so let’s talk about barriers to treatment
Too many of us have stories about struggling to access the care we need. Often, health care obstacles are directly tied to medicine’s gender bias, as well as stigmas relating to our race, ethnicity, sexuality, gender identity, age, size, income, and condition. In our series Pain Today, we are highlighting these stories through personal and reported essays, hoping to empower each other to advocate for our health in a way that much of the medical community does not. Here, one of our contributors discusses her experience with sex addiction recovery as a Black woman, specifically.
My boyfriend and I had sex all the time in college. He was my first love and we were young. Depo Provera (the birth control chosen for me by my mother when I was in high school) paved the way for us to be fairly reckless. This was before I became a mother. Before I lost my mother. Before Michelle Obama became the first lady.
During the summer after sophomore year, I was no longer on my mother’s insurance. My days of Depo Provera were over. We kept having sex without protection and ended up pregnant. It’s a tale as old as time.
If you’ve read my work and happen to be great at math, then you know I have only one child who was born long after my coed adventures. That’s right—I had an abortion. That college relationship deteriorated into a flaming dumpster fire and I failed a class that I needed to graduate. For days I would lay in the house. In the bed, on the couch, on the floor. This was before self-care was a trending topic. BlackGirlTherapy.com did not yet exist.
I wish I could say that my first idea to help myself was to attend counseling, but it wasn’t. I broke up with my boyfriend soon after the abortion and dived head first into a coping mechanism—sex with another man. I didn’t stop dating this new guy until he assaulted me on campus while he was tweaking. Being assaulted is never the fault of the victim, but I felt so guilty for putting myself in that position by pursuing a man I knew to be toxic.
My advisor called me in. I knew what she wanted before I got there—she wanted to know why I’d been missing class. Within the first few minutes of our meeting, I was a blubbering mess. It wasn’t just my dysfunctional relationships with men—it was my confusion around my abortion, too. The overwhelming feeling that I might have passed on my one chance to bring life into this world was too much to face alone. My mother—who I told everything—was completely unaware of what I was going through. I lied to her. I lied to myself. And I was about to lie to my advisor, the one person who might actually understand.
“Just tell me what’s wrong.”
I simply couldn’t tell her that, not only was I itching to get right back into bed with the next man who would have me, but I was also deciding whether I deserved to live; at that time, I didn’t yet know if I’d made the right choice for myself. Looking back, she probably wouldn’t have judged me, but I lied: “I had a miscarriage.”
The lie seemed like enough of the truth to justify why I’d missed class. She helped me get extensions from my professors and I promised to go to counseling.
“I simply couldn’t tell her that, not only was I itching to get right back into bed with the next man who would have me, but I was also deciding whether I deserved to live.”
The first therapist I saw was not what I expected. When I walked in, he didn’t get up to greet me. He didn’t smile. He barely looked up from his desk. In my mind, I was expecting to be embraced by a woman who looked like Murphy Brown. Instead, I felt like I was bothering him. This was my first session, so I didn’t know the usual procedure.
“So do you want to talk?”
The answer was yes, but I didn’t feel comfortable talking to him. His labored sigh indicated that my response wasn’t quick enough. I continued, “Me and my boyfriend—”
“Is your boyfriend a student?” he interrupted.
“Um. Yes. Well, we broke up so he isn’t really my boyfriend anymore.”
“Oh, I see. And you’re sad? Depressed?”
“No, I’m not saying I’m depressed.”
“It’s common to break up in college. If you’re feeling sad, hang out with some friends. Take a yoga class. Do things that make you happy. Try not to worry about him so much.”
“It’s not really about him,” I asserted.
“And that’s good. That’s good.”
He hadn’t even asked my name. Despite his salt and pepper, Mr. Rogers-esque look, he wasn’t kind or interested in why I was there. His diagnosis amounted to me being heartbroken. His prescription? Calm down and get over it. What do you get when you combine racial bias, misaligned addiction assessment, and sexism?
You get the statistical fact that misdiagnosis is more common for Black women. In Illinois last year alone, Black women were six times more likely to die from pregnancy-related complications. A lot of these doctors don’t see us—they see a projection of their insecurities and a reflection of their own biases.
It is this perception that made me feel like I couldn’t talk about what I was going through: sex addiction and trauma.
Dr. Angela Neal-Barnett believes anxiety for Black women is more chronic than in other groups because anxious Black women don’t comfortably fit into any of the three boxes attributed to us: strong Black woman, angry Black woman, and Jezebel. These stereotypes have created a barrier to mental health that has only recently started to be acknowledged. Moreover, Tiffany Farmer, an adult attachment and relationship specialist, tells HelloGiggles that “Black people have been left out of addiction conversations—both from the expert side and from the patient/client perspective.”
Farmer adds that “as mental health pertains to Black women, a large misconception is that [we are] stronger somehow. Supposedly, we endure more and require less with regard to self-care and mental wellness. This is so harmful.” I think of my friends, colleagues, and students who have also sought help—many of their mental health concerns have been dismissed, and study after study reveals empirical data to support those experiences.
Thankfully for me, I eventually found Black women mental health professionals who helped me feel like I wasn’t a burden—but it took a while. I wonder how different my healing process would have been if I’d had access to more therapists and counselors who actually believed me when I said something felt wrong. Historically, Black women are not granted the privilege of being depressed. So when I started the work of battling and healing from my sex addiction, I stumbled. I am still stumbling. The misdiagnosis epidemic affects Black women navigating sex addiction, too. Unfortunately, the road to mental wellness can be paved with racism.
“Historically, Black women are not granted the privilege of being depressed. So when I started the work of battling and healing from my sex addiction, I stumbled. I am still stumbling.”
Farmer says, “At the root of many sexual addictions is trauma, and given that most sexual abuse is by someone that the victim knows, the root is also shrouded in secrecy. How can someone truly get to explore themselves, learn, process, heal, and move forward [from sex addiction]…all while having no support because they don’t share their reality fully? …It’s not possible.”
Sexism then impacts Black women’s ability to seek professional help. “Black women owning their sexuality or desires is even less savory and seems to have more of a social consequence than it does for men. This leads to secrecy,” Farmer explains. “Compulsive thoughts and behaviors can develop and grow without any honest feedback from friends and loved ones.”
We have an obligation to ourselves to sit with our pain and deal with our trauma. Trust me, it’s difficult to move forward once you’ve realized that healing involves revisiting your coping strategies (sex) and developing news ones. When I became a mom after college, I’d put my mental health on the back burner so I could be the kind of mother I thought my son deserved. But that meant I’d ask myself what right I had to feel sad and empty when everything in my life was so good. I’d wonder, am I really as good of a person as I think I am? Do I deserve love? Soon, I realized that I had to really work through these questions so that I could prevent a spiral into addictive behaviors. Our trauma can take on a life of its own if left unchecked, so my mental health can’t be on the back burner anymore.
"We have an obligation to ourselves to sit with our pain and deal with our trauma. Trust me, it's difficult to move forward once you've realized that healing involves revisiting your coping strategies (sex) and developing news ones."
When I feel like giving up, I think of the cliche that says if you have a flat tire, you wouldn’t slash the other three. When I hit a wall during my recovery and feel compulsions and anxiety creep up on me, I lean on my new coping strategies. For me, that includes breathing, running, reaching out to someone, going to therapy, writing, and running again.
Recovery work looks different for everyone, but it can be particularly challenging to navigate when it seems that no one believes your pain. Farmer says that, because of this treatment, “we have been taught that our needs and feelings are…just something that [gets] in the way.” I don’t plan to get in my own way—there is joy within healing and beyond it. Mental health does not improve quickly and the day-to-day screenshots of our lives won’t immediately become Instagram-worthy. It will be hard and confusing. Some days, it might not even seem worth the fight. You’re worth that struggle, though. We all are.