Why do people question if sex addiction is real?

There are two main factors that raise questions of sex addiction being authentic. The first  being, there is not a “legitimized” diagnosis for sexual addiction.  This causes some mental health practitioners to question its validity. This situation leaves the possibility that those who are suffering will not be diagnosed or treated for their disease—a disease that can be fatal.

The diagnostic criteria most commonly used by those who treat sexual addiction are similar to those applied to chemical dependence. They include:
Loss of Control. Clear behaviors that go further than intended, such as having unprotected sex, meeting someone as opposed to just talking to them online, and having sex in dangerous conditions, such as with a coworker in the office storage area during business hours.

Compulsive Behaviors. A pattern of out-of-control behaviors over time, such as masturbating to the point of injury.

Efforts to Stop. Failed attempts to stop the behaviors, such as broken promises to self or others, or bargaining with oneself (e.g., “I will only flirt with someone at the bar instead of having sex”).

Losses. Significant losses due to engaging in behaviors related to acting out sexually (e.g., sacrificing hobbies, commitments, and financial, career, and family obligations; not meeting deadlines; or forgetting special occasions).
Preoccupation. Obsessing about behaviors, leaving the addict disengaged or disconnected from the present moment. This allows for emotional numbing but will never provide or promote personal intimacy or connection with others.
Progression. The need to make the behavior more intense, frequent, or risky. Like an alcoholic, the sex addict will reach a threshold or plateau that needs to be amplified in order to maintain the desired high.

Continued Behavior despite Negative Consequences. The inability to stop a behavior that creates problems, including legal, physical, financial, or relational problems. The addict is usually in a great deal of denial as to the extent to which his addiction has permeated his life.

Withdrawal. Stopping behavior causes physical and/or emotional discomfort or distress, including mood swings, depression, irritability, headaches, nausea, dissociation, interrupted sleep patterns, anxiety, or intrusive thoughts.

The second factor impacting the legitimacy of this disorder is that sex addiction is a process addiction.  Unlike chemical dependency the individual does not have to ingest anything in order to get high.  The high comes from the thoughts, anticipation, planning and implementation of the behavior.  I like to compare this to eating your favorite food.  Let’s say that is chocolate.  When you actively think about eating chocolate notice what happens in your body.  You might be feeling pleasure, your awareness is heightened, and your mood has lifted.  The reason is because just thinking about chocolate has released chemicals in the pleasure center of the brain that cause euphoria.  Those chemicals can include, seratonin, adrenaline and dopamine.  These chemicals are powerful and for the sex addict they are like a 24-hour IV drug,  just like a junkie getting a hit of heroin.