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Symposia

Addictive Behaviors

Compulsive Sexual Behavior in Diverse Populations: Garnering Insights Through Mixed Methods Approaches

1 - (SYM 64) Compulsive Sexual Behavior and Minority Stress Among Sexual Minority Men: A Mixed-methods Exploratory Study

Sunday, November 23, 2025
12:04 PM - 12:18 PM CST
Location: Bolden 4, Level 2
Keywords: Addictive Behaviors, Methods, LGBTQ+
Recommended Readings: Jennings, T. L., Gleason, N., Grubbs, J. B., & Kraus, S. W. (2024). Compulsive sexual behavior in LGBTQ individuals and minority stress theory: A literature review and theoretical integration. Current Addiction Reports, 11(2), 256-264.,   Grubbs, J. B., Hoagland, K. C., Lee, B. N., Grant, J. T., Davison, P., Reid, R. C., & Kraus, S. W. (2020). Sexual addiction 25 years on: A systematic and methodological review of empirical literature and an agenda for future research. Clinical psychology review, 82, 101925.,   Borgogna, N. C., Owen, T., Johnson, D., & Kraus, S. W. (2024). No magic pill: A systematic review of the pharmacological treatments for compulsive sexual behavior disorder. The Journal of Sex Research, 61(9), 1328-1341.,   Bőthe, B., Koós, M., Nagy, L., Kraus, S. W., Demetrovics, Z., Potenza, M. N., ... & Vaillancourt-Morel, M. P. (2023). Compulsive sexual behavior disorder in 42 countries: Insights from the International Sex Survey and introduction of standardized assessment tools. Journal of Behavioral Addictions, 12(2), 393-407.,   Gleason, N., Finotelli Jr, I., Miner, M. H., Herbenick, D., & Coleman, E. (2021). Estimated prevalence and demographic correlates of compulsive sexual behavior among gay men in the United States. The journal of sexual medicine, 18(9), 1545-1554.
Abstract Body

Research suggests an association between compulsive sexual behavior (CSB) and LGBQ+ minority stress. This relationship could be etiological (i.e., minority stress causes CSB to develop), due to moral incongruence (i.e., minority stress is associated with homonegative morals that conflict with sexual behavior), or due to measurement error (i.e., measures of CSB erroneously measure minority stress factors unrelated to CSB). The present study utilizes a mixed methods approach to explore these possible pathways.

 

A sample of US gay, bisexual, and other men who have sex with men who reported recent substance use and condomless anal sex were recruited to complete an online survey (N=510) assessing CSB and sexual frequency, and internalized homonegativity (IH). A subsample of survey participants completed qualitative interviews (N=26) involving a cognitive interview with CSB measures.

 

Results of the qualitative interviews provided examples of all three pathways. For the etiological pathway, participants described engaging in CSB to cope with mental health symptoms, though noted coping could be both positive and maladaptive. For the moral incongruence pathway, participants described distress (i.e., guilt and shame) caused by external and internal stigma related to their queer identity and casual sexual behaviors. For the measurement error pathway, researchers noted several examples of CSB measures inaccurately identifying minority stress experiences as CSB. Based on these findings, exploratory mediation analyses were conducted with quantitative survey data to explore the moral incongruence pathway. Results provided evidence for this pathway, indicating participants with elevated IH show a stronger association between frequency of sexual behaviors (condomless anal sex, sending sexual messages/pictures) and CSB.

 

Qualitative results provide nuanced descriptions for all three proposed pathways of the CSB-minority stress relationship, while quantitative results provide evidence for moral incongruence. Future research should use both qualitative and quantitative methods to clarify these pathways and improve the construct validity of CSB measures.