How long will health insurers turn a blind eye to porn addiction?

    In recent decades, pornography has reared its ugly head to a point where it has never been easier to access. Some will argue that it offers choice and autonomy, but that is a debate for another time, one this journalist does not wish to address in this article. Like many other habits, watching pornography can eventually lead to addiction. What no one can deny is that, regardless of the age of the internet user, and despite firewalls and other precautionary measures in place, pornography seems to seep into every aspect of people’s virtual world.   For some, it has become more than just casual entertainment though. For certain individuals, pornography has become a compulsion turned addiction. Also, with internet speeds rapidly increasing, an alarming number of people find themselves struggling with porn addiction. The evidence of the latter is mounting, with many a podcaster addressing this topic of late.   Yet, despite its devastating impact on mental health, some major health insurers continue to turn a blind eye. In short, these institutions do not directly acknowledge pornography addiction (from here on out referred to as porn addiction) as a mental health disorder, nor do they cover treatment for those affected. You can compare different health insurance benefits on medicalaid.com   It seems as if one of the main reasons numerous health insurers don’t cover the treatment of porn addiction, would be the lack of diagnosis. According to the manual which serves as benchmark for mental health diagnoses, the Diagnostic and statistical manual of mental disorders (DSM-5), porn addiction has yet to be officially recognised as a disorder. The DSM-5 was compiled by the American psychiatric association, and serves mental health professionals around the globe, including South Africa. According to research, verbatim: “…,sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders,”   There seems to be a light at the end of the tunnel, as there is an ongoing debate among specialists on the subject. Psychiatrists, psychologists and sexologists are in two camps, with some arguing that behavioural addiction, such as porn addiction, should constitute an addiction. The latter obviously includes (possible) diagnosis.   From available information, hypersexuality as a condition, was ultimately left out of the DSM-5 due to insufficient scientific evidence. This state of affairs is why compulsive pornography use has no diagnoses-label to date, and this lack of formal diagnosis is the reason most medical health insurers will not cover treatment.   The sad part is that those struggling, despite coughing up huge amounts for medical coverage, often needs to turn to self-help programmes or private facilities, leaving them to bear the financial burden solo.   The challenges doesn’t stop there. The World Health Organisation’s International Classification of Diseases revision (WHO ICD-11),  further complicate the path to not only medical coverage, but also recognition of the problem. The WHO has introduced Compulsive Sexual Behaviour Disorder (CSBD). CSBD includes behaviours which are intense and repetitive, and which may result in impairment or distress. It is important to note that CSBD’s category falls under Impulse Control Disorders which is not classified as an addiction by WHO ICD-11.   This lack of formal recognition in these key diagnostic manuals all boils down to a significant gap in the framework of numerous medical health insurers’ coverage.   The loophole we found as far as receiving coverage of porn addiction, seems to be when a patient gets diagnosed with recognised mental health conditions such as anxiety or depression. Only in these cases insurers may cover treatment and thus, albeit indirectly, address the compulsive behaviour of porn addiction. As mentioned earlier in this article, this trend has filtered into South Africa’s mainstream health insurance sector.   The profound implications from a purely humane standpoint can therefor arguably be things such as affected individuals struggling with feelings of isolation, helplessness and shame. History has shown that the more we acknowledge and address societal challenges, the less stigma surrounds them. As it stands, families, relationships and overall quality of life of so many victims are being affected on a daily basis due to stigma.   One can only hope that, as more medical professionals and media continues to shine a light on the issue, and as more influencers and celebrities step forward acknowledging the impact of porn addiction, the quicker the understanding of those in key positions will evolve.   For now, and for the foreseeable future, the question remains: How long until the day arrive when major health insurers finally recognise and address porn addiction?   This journalist wants to leave the South Africa’s mainstream health insurers, with this: You needn’t wait for others to take the lead. Stand up and take responsibility. It is time to support the very people who keep you, the medical health insurers, in business. South Africa has the chance to lead the way in addressing the rules around porn addiction and move forward. Inclusive and shame free.   Written by Anchen Coetzee   📌 READ more about Effective Solutions for Porn Addiction