Sexual Compulsivity or Sexual Entitlement?

Dr. Minwalla

Dr. Minwalla


The Vanishing Point Newsletter

February 2024 Issue

The Institute for Sexual Health, Inc.

© Omar Minwalla, Psy.D., 2023-2024, All rights reserved

More Than Just Lack of Control?
The Role of Sexual Entitlement in Understanding
Problematic Sexual Behaviors

Omar Minwalla, Psy.D.

The Institute for Sexual Health (ISH), Los Angeles

This article first reviews current concepts of compulsive sexual behavior, which focus on the problem of lack of control. It then introduces the concept of sexual entitlement and its role in problematic sexual behaviors. Despite considerable social science research that shows a connection between sexual entitlement and sexual violence, the integration of sexual entitlement within the framework of compulsive sexual behavior remains overlooked. This gap is evident in the traditional and contemporary methods used by treatment professionals for conceptualizing, diagnosing, and treating such behaviors. To bridge this divide, the term compulsive-entitled sexuality (CES) is introduced and discussed. This dual- concept diagnosis brings to light not only the aspects of impulse control and compulsivity but also, and with equal importance, the role of sexual entitlement – particularly masculine sexual entitlement – as a critical etiological factor driving infidelity and problematic sexual behavior. A discussion on treatment implications and reasons behind this oversight, particularly within the context of gender-based violence and the constructs of masculinity, offers insights into the systemic and cultural underpinnings that contribute to this complex issue.

Public Significance Statement
Increasing awareness of the role of sexual entitlement in the assessment, diagnoses, and treatment of compulsive and deceptive sexuality empowers professionals to deliver care that not only addresses the surface-level sexual behaviors or instances of infidelity, but also delves into the underlying psychology of sexual entitlement. This dual-focused approach allows for more comprehensive and effective treatment strategies.

Keywords: infidelity, compulsive sexual behavior, sex addiction, sexual entitlement, masculinity

Current Understandings of Compulsive Sexual Behavior
Over the past several decades there has been an ongoing debate in the clinical field on how to best classify, understand, diagnose, and provide treatment for patients seeking help for sexual behaviors that are causing life problems or distress. According to Coleman et al. (2018), the “diagnostic and conceptualization of obsessive, compulsive, impulsive, and driven sexual behavior is controversial, and its terminology has varied over time and across conceptualizations (out-of-control sexual behavior, compulsive sexual behavior, sexual addiction, etc.)” (p. 125). The following section provides a synopsis of traditional and current definitions for understanding compulsive sexual behavior (i.e., a lack of control over engaging in sexual behaviors that cause significant negative life consequences). 

  1. Compulsive Sexual Behavior Disorder (CSBD). Compulsive sexual behavior disorder (CSBD) refers to a disorder where the person lacks control over or is not able to resist engaging in sexual behaviors despite negative consequences (Kraus S.W., et. al., 2018). CSBD is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behaviors over an extended period (e.g., 6 months or more) that cause marked distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning. The CSBD pattern is manifested in one or more of the following:
    1. Engagement in repetitive sexual activities that become a central focus of the person’s life, to the point of neglecting health and personal care or other interests, activities, and responsibilities
    2. The person has made numerous unsuccessful efforts to control or significantly reduce the repetitive sexual behavior(s)
    3. The person continues to engage in repetitive sexual behavior(s) despite adverse consequences (e.g., repeated relationship disruption, occupational consequences, negative impact on health).
    4. The person continues to engage in repetitive sexual behavior(s) even when he/she derives little or no satisfaction from it

  2. Sex Addiction (SA). The sex addiction model conceptualizes repetitive sexual behaviors that cause significant negative life consequences as an addiction – a brain disease similar to a chemical or substance addiction. SA is characterized by:
    1. A lack of control and compulsivity of sexual behavior(s)
    2. Continuation of engagement in sexual behavior(s) despite negative consequences
    3. Preoccupation/obsession

  3. Out of Control Sexual Behavior (OCSB). Out of control sexual behavior (OCSB) is another conceptualization of the issue of control and sexual behaviors (Braun-Harvey, 2016). OCSB is defined as a sexual health problem in which consensual sexual urges, thoughts, or behaviors feel out of control. Unlike a clinical disorder, OCSB is framed as a behavioral problem that is within the normal range of sexual expression. It is considered to be a sexual health behavior problem rather than a process addiction or psychosexual disorder.

A Single Concept of Sexual Compulsivity or a “Lack of Control” Problem. Important distinctions exist and remain in the ongoing professional debate on how to conceptualize the essential problems among individuals who engage in sexual behaviors despite negative consequences. However, each of the terms described above (CSBD, SA, and OCSB) all focus on the same basic issue: lack of control. In other words, despite some subtle yet important differences, these models share a common focus: they aim to understand, diagnose, and treat the sole issue of behavioral control. This approach unites them in their single-concept diagnosis perspective concerning problematic sexual behavior.

Sexual compulsivity is a “lack of control” problem, and sexual entitlement is an, “I don’t want to control” problem. One is an impulse control issue, and the other an unhealthy psychology and belief system.

The Psychology of Entitlement
Entitlement is a belief system or mindset that guides our thoughts and behaviors based on the conviction that we deserve certain things. This concept isn’t inherently negative; in fact, a sense of entitlement can be healthy and necessary, fostering self-respect and ensuring we advocate for what we deserve in a way that benefits our well-being. As a natural component of our psychological makeup, everyone possesses some degree of healthy entitlement, which plays a crucial role in our overall survival and adaptation.

Unhealthy entitlement, however, reflects a mindset where individuals feel they’re owed certain privileges or outcomes at the expense of others’ rights and well-being. This belief propels actions that disregard the potential harm or detriment to others, placing personal desires and perceived rights above the respect and consideration due to fellow human beings. When we act on this sense of entitlement, ignoring the negative consequences on others, it morphs into a harmful and toxic trait. Unhealthy entitlement, therefore, is not just a belief, but a driver of behavior that elevates self-interest above the collective good, revealing itself in actions that undervalue the importance of empathy and mutual respect. It is a psychology, a belief system, of prioritization of self over harm to human beings.

Exploring the Roots of Unhealthy Entitlement
Unhealthy entitlement is cultivated through two main pathways that twist the concept of deservingness into something problematic and harmful. These pathways are known as socialized entitlement and victimized (or revenge) entitlement.

  1. Socialized Entitlement: Socialized entitlement results from a wide variety of social influences—culture, race, ethnicity, and the subtle yet persistent messages from society about power and privilege. Over time, these factors intertwine to foster a sense of entitlement that, left unchecked, can lead to actions that disregard and even harm others. So, socialization is one source of unhealthy entitlement. 
  2. Entitlement Born from Victimization: Experiencing or perceiving victimization can sow seeds of resentment, anger, and a deep sense of injustice. This emotional turmoil can feel entirely justified, fueling a desire for revenge that doesn’t necessarily register as harmful or violent to the individual. It’s this blend of justified anger and rationalization that cultivates a dangerous form of entitlement—one that feels entitled to retaliate, often in ways that harm or violate the rights and well-being of others, sometimes manifesting as aggressive or even violent acts. So, victimization is another source of unhealthy entitlement.

Understanding Different Types of Unhealthy Entitlement
Distorted beliefs about deservingness, particularly around gender and sexuality, can lead to behaviors that harm and disrespect others. In this section, we unravel the nuances of male entitlement, male sexual entitlement, and sexual entitlement, revealing the impact of these unhealthy mindsets on individuals and society.

  1. Sexual Entitlement. Sexual entitlement focuses on the idea that one’s own sexual satisfaction is paramount, regardless of its impact on others. It’s a toxic viewpoint that places personal, sexual, or relational gratification above the rights, feelings, and well-being of others, leading to behaviors that can deeply harm and disrespect those involved.
  2. Male Entitlement. Male entitlement is the belief that simply being male grants one special rights and privileges, especially those tied to societal constructs of power and masculinity. It’s a mindset that assumes certain benefits are a given due to one’s gender, often at the expense of others.
  3. Male Sexual Entitlement. Male sexual entitlement is a more specific and troubling manifestation of entitlement. This concept revolves around the notion that men are inherently owed sexual encounters because of their gender. It’s rooted in outdated and harmful beliefs about male sexuality, assuming it to be an unstoppable force that women are expected to satisfy (Hill & Fischer, 2001). This perspective not only devalues women, but also overlooks the complexity and individuality of male desires and needs.

Sexual Entitlement is Part of Male Socialization
The journey from boyhood to manhood is often navigated through the intricate landscapes of hegemonic masculinity, where sexual entitlement emerges as a critical, yet troubling, milestone. This process instills in males a sense of prerogative over sexual deserving based on being a guy, blurring the lines related to harming others. Such deeply ingrained beliefs lead to a spectrum of adverse outcomes, including sexual violence and assault, underscored by a significant body of research linking sexual entitlement to sexually aggressive behaviors (Bouffard, 2010; Hill & Fischer, 2001; Parkinson, 2016). Beyond the overt acts of violence, male sexual entitlement also drives infidelity and other problematic sexual and intimate behaviors, which are often cloaked in a veil of normalcy that obscures their inherently abusive nature. Society’s tacit endorsement of male sexual adventures, celebrated as badges of masculinity, overlooks the psychological damage and manipulation at play. This normalization process effectively gaslights the very notion of abuse, disguising the exploitation embedded within. The mischaracterization of these behaviors as mere lapses in impulse control fails to confront the real issue: a pervasive entitlement that operates behind the scenes, orchestrating a hidden sexual narrative at the detriment of close relationships and family dynamics. The veil of secrecy not only perpetuates this cycle but also lays bare the full extent of sexual entitlement’s grip on personal and societal norms. Boys and men are groomed to engage in deceptive sexuality, and not see the abuse at all, but instead see it as a normal part of masculinity, that actually increases masculine status and esteem.

Illuminating the Role of Sexual Entitlement in Sex Addiction, Compulsivity, and Infidelity
For years, the academic and clinical worlds have wrestled with the nuances of compulsive sexual behaviors and infidelity, aiming to distill these complex phenomena into comprehensible terms. Despite rigorous debate and thoughtful analysis, a critical element often remains in the shadows: the profound influence of sexual entitlement. This concept, well-documented within the realm of social sciences, draws a direct line to a spectrum of sexual misconduct, from offenses and violence to assault and abuse. Notably, risk assessment tools for sex offenders and educational programs on sexual violence acknowledge sexual entitlement, especially its male-centric form, as a pivotal factor in perpetuating harm. In addition, there is a significant body of research on campus rape and rape awareness curricula that educate on the topic of sexual entitlement, particularly male sexual entitlement.

The point here is that sexual entitlement plays a significant role in various forms of problem sexuality, particularly sexual violence, and sexual harm. However, when we attempt to understand sexual compulsive behaviors, there is a surprising blind spot – a remarkable and conspicuous lack of recognition of sexual entitlement. The role of sexual entitlement is a gigantic elephant in the room, which remains paradoxically invisible, shrouded in normalization and ubiquity. This significant blind spot persists despite decades of fervent discussion, leaving a gap in our understanding of problematic sexual behaviors. As noted above, the prevailing single-concept narrative often simplifies these actions to an issue of lack of control, ignoring the potential role of an entitlement mentality or psychology problem. A person who is engaging in repetitive problematic sexual behaviors, despite significant negative consequences, may be doing so because of sexual entitlement (not compulsivity or lack of control). We simply do not see clearly yet that deceptive sexuality relies upon and is an ongoing system of intentionally withholding life-altering information and gaslighting, which is an ongoing covert psychological operation of dishonesty, a deceptive system…not simply isolated incidents of sexual behaviors or an illicit relationship.  This system of dishonesty and deception is driven by a psychology of sexual entitlement.

The Distinction Between Sexual Compulsivity and Sexual Entitlement
Sexual compulsivity is an impulse control problem (similar to an addiction), and sexual entitlement is an unhealthy mindset, a psychology, or a belief system. These two concepts are quite distinct. Sexual compulsivity is governed by the challenges of managing behavior, grappling with eroded willpower, and overcoming habitual actions. Sexual entitlement involves a deeply ingrained belief that one’s desires hold precedence, regardless of the collateral damage to human beings and relationships. Sexual compulsivity is “a lack of control” problem, and sexual entitlement is an “I don’t want to control” problem. One is an impulse control issue, and the other represents an unhealthy psychology and belief system.

The distinction between these two is not merely academic; it carries profound implications for treatment approaches. Addressing addiction or behavioral control issues diverges sharply from tackling the entitlement mindset, particularly male socialization. Understanding the difference between the two terms also illuminates the nuanced nature of these issues, emphasizing the need for tailored interventions that address the underlying psychology of entitlement alongside the mechanics of compulsivity.

Compulsive-Entitled Sexuality (CES)
Sexual compulsivity and sexual entitlement are two pivotal concepts that create a dual-concept or understanding of these types of issues. This insight leads us to introduce a more comprehensive term: Compulsive-Entitled Sexuality, or CES. CES refers to the lack of control over specific sexual behaviors in combination with a psychology of sexual entitlement. CES recognizes that sexual compulsivity and sexual entitlement can (and often do) coexist as co-occurring disorders. Through this perspective, we can see that problematic sexual behaviors that have typically been labeled as addictive or compulsive are also caused by sexual entitlement – a belief system of “deserving or being owed.” Sexual compulsivity and sexual entitlement are different, have different etiologies and root causes, and, as such, the treatment for each requires tailored approaches. This dual-concept of CES (versus the traditional single-concept models), provides professionals and society as a whole a deeper and more nuanced understanding of the behaviors and underlying motivations associated with problematic sexual behaviors, paving the way for more effective assessment, diagnosis, treatment, support, and understanding


1 Bouffard, L. A. (2010). Exploring the utility of entitlement in understanding sexual aggression. Journal of Criminal Justice, 38(5), 870-879.

2 Braun-Harvey, D. & Vigorito, M. A. (2016). Treating Out of Control Sexual Behavior: Rethinking Sex Addiction. Springer Publishing Company.

3 Coleman, E., Dickenson, J. A., Girard, A., Rider, G. N., Candelario-Pérez, L. E., Becker-Warner, R., Kovic, A. G., & Munns, R. (2018). An integrative biopsychosocial and sex positive model of understanding and treatment of impulsive/compulsive sexual behavior. Sexual Addiction & Compulsivity, 25(2-3), 125–152.

4 Hill, M. S. & Fischer, A. R. (2001). Does entitlement mediate the link between masculinity and rape-related variables? Journal of Counseling Psychology, 48(1), 39–50.

5 Kraus SW, Krueger RB, Briken P, First MB, Stein DJ, Kaplan MS, Voon V, Abdo CHN, Grant JE, Atalla E, Reed GM. Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry. 2018 Feb;17(1):109-110.doi: 10.1002/wps.20499. PMID: 29352554; PMCID: PMC5775124.

6 Parkinson, D. (2016). Intimate partner sexual violence perpetrators and entitlement. In L. McOrmond-Plummer, J.Y. Levy-Peck, & P. Easteal (Eds.), Perpetrators of intimate partner sexual violence (pp. 72-82). Routledge.

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Trish Haight, LMFT

Licensed Psychotherapist

Trish Haight, LMFT is a certified Deceptive Sexuality and Trauma Therapist (DSTT), a specialization in deceptive sexuality and trauma (DST), offered by The Institute for Sexual Health (ISH).Trish is a leading professional voice in Deceptive Sexuality and Trauma Treatment (DSTT) and is an Adjunct Professor and Faculty Member of The Institute for Sexual Health (ISH), and currently teaches Level 2 and 3 of the DSTT Professional Training along with Dr. Omar Minwalla, Licensed Psychologist and Clinical Sexologist. Trish formally trained directly under Dr. Omar Minwalla and was an instrumental part of Dr. Minwalla’s original core clinical treatment team at The Institute for Sexual Health from 2009 – 2015, which is referred to as Dr. Minwalla’s, Sacred Clinical Incubator, giving birth to both DSTT and IVTT, Intentional Vibe Trauma Treatment. IVTT is a treatment for systemic abuse, injustice, and complex trauma, and relevant in particular to survivor-based communities.

Dr. Omar Minwalla, Psy.D.

Licensed Psychologist & Clinical Sexologist

Dr. Omar Minwalla is a Licensed Psychologist and Clinical Sexologist trained at the University of Minnesota Medical School. Dr. Minwalla has spent 20 years as a first responder on the front lines of treating infidelity and compulsive sexual behavior. His grounded theory of Deceptive Sexuality and Trauma Treatment (DSTT) not only establishes a new standard of care for the treatment of infidelity, compulsive sexual behavior disorders, and sex addiction, but shines a light on a unique method for the treatment of systemic abuse, injustice and complex trauma, called Intentional Vibe Trauma Treatment (IVTT). Dr. Minwalla is the founder of The Institute for Sexual Health (ISH) which was one of the first and only U.S. treatment centers to challenge the “co-sex addict” model and articulate the systemic abuse associated with infidelity and compulsive sexual behavior disorder.

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