Question explored with the scientific record
Is anal sex an addition?
The short version: the retrieved evidence does not study whether anal sex itself is addictive; it studies compulsive sexual behavior (CSB) as a broader condition, and anal sex appears in these studies only as one sexual practice among many.
The records you received are about compulsive sexual behavior, hypersexual disorder, and related topics like chemsex (drug use combined with sex) [2]. None of them set out to test whether anal sex specifically has addictive properties. One study on Belgian gay men found that 59% of those who had receptive anal sex reported some degree of pain, but it was studying pain, not addiction [5]. Another large Danish survey found that 92% of men who have sex with men had anal sex in the past year, with HIV-positive men reporting a mean of 17 anal sex partners versus 8 for HIV-negative men [6]. That is a behavioral pattern, not evidence of addiction to the act itself.
What the literature does show is that compulsive sexual behavior exists as a recognized condition, with proposed diagnostic criteria [1] and treatments including naltrexone [4]. Childhood trauma and sexual narcissism are linked to higher hypersexual behavior scores [3]. But none of this tells you whether anal sex is more or less likely to become compulsive than any other sexual practice. The question of whether the act itself has a unique addictive potential—through nerve density, pain-reward pathways, or any other mechanism—is simply not addressed in these records.
My call: the evidence does not support the claim that anal sex is an addiction. The broader category of compulsive sexual behavior is documented, but this specific question has not been studied. Confidence: low—not because the answer is no, but because the evidence does not reach the question.
Sources used 6
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Sexual Disorders Not Otherwise Specified: Compulsive, Addictive, or Impulsive?
A narrative review that discusses compulsive, addictive, and impulsive sexual disorders, argues for recognizing hypersexual disorder as a DSM category, proposes diagnostic criteria, and surveys overlaps with OCD and impulse-control disorders along with treatment considerations a…
DOI: 10.1017/s1092852900012670 -
Chemsex as a Diagnostic Challenge: Toward Recognition in ICD-12 and Integrated Treatment Approaches—A Narrative Review
A narrative review arguing that chemsex constitutes a mixed addiction (substance use with compulsive sexual behavior), synthesizing its origins, substances, epidemiology, diagnostic challenges, and integrated treatment approaches including CBT and digital technologies (AI/mobile…
DOI: 10.3390/jcm14176275 -
A Study on Childhood Trauma and Sexual Narcissism in Individuals with Compulsive Sexual Behavior Receiving Counseling
Childhood trauma is linked to higher sexual narcissism and hypersexual behavior, with sexual narcissism mediating the trauma–hypersexuality link in adults seeking counseling for compulsive sexual behavior.
DOI: 10.1007/s10508-025-03137-y -
Treatment of compulsive sexual behaviour with naltrexone and serotonin reuptake inhibitors: two case studies
This study presents two case reports demonstrating the successful treatment of compulsive sexual behavior (CSB) using naltrexone, suggesting its potential efficacy in reducing urges and improving psychosocial functioning in affected individuals.
DOI: 10.1097/00004850-200207000-00008 -
The Gay Men Sex Studies: Anodyspareunia Among Belgian Gay Men
This study investigates the prevalence and predictors of anodyspareunia (anal pain) among Belgian men who have sex with men (MSM), revealing that 59% of participants who engaged in receptive anal sex experienced some degree of pain, with various factors influencing its occurrenc…
DOI: 10.1002/sm2.6 -
HIV and risk behaviour among men who have sex with men in Denmark – the 2006 Sex Life Survey
Among Danish men who have sex with men in 2006, 33% reported unsafe sex in the past year, with the number of anal sex partners and HIV status being the strongest predictors despite high HIV-risk awareness.
DOI: 10.2807/ese.13.48.19050-en