One of the most highly debated issues in the field of human sexuality is sex addiction, sometimes more formally called sexual addiction or hypersexuality. The idea is simple: The American Psychiatric Association (APA) defines sex addiction as "recurrent and intense sexual fantasies, sexual urges, and sexual behavior," known in more common circles as "he can't keep his pants up." The definition of this label leaves little to the imagination, however our perceptions of the guy with an iPhone full of hookups isn't enough to cement the behavior as an actual medical condition.

Since 2012, The American Psychiatric Association (APA) has considered including sex addiction in its coveted Diagnostic and Statistical Manual of Mental Disorders (DSM), the accepted standard of all things perceived medically screwy in our brains. However, the APA says progress on giving male sex addicts a stamp of disorderly approval is "being recommended for further study." In other words, the governing body of psych isn't convinced that sex addiction is actually a medical disorder or just some horny chap's excuse.

So what's the holdup? Opinions versus scientific evidence has many in a sea saw of theories and opinions as hotly debated and unresolved as nature versus nurture. With a social behavior such as sex it's hard to determine the actual motives of the participants. There are too many factors in play.

The APA has a six month rule. Behaviors that are medically consistent among patients can be classified as an addiction. But does that include a guy out to have a good time after a breakup or a someone who has a higher than average drive?

Clinical psychologist Dr. David J. Ley, the author of The Myth of Sex Addiction (2012) says we should put the breaks on the medical mumbo jumbo and recognize this thing called "sex addiction" for what it is. Like the X-File's Mulder, Ley writes that we want to believe sex addiction is real, but it's just not true:

"The public is inundated with the labels of sex addiction inappropriately and unethically applied to public figures involved in sex scandals... But, the reality is that sex addiction is NOT a valid diagnosis, is not accepted by the American medical, psychiatric or psychological communities and associations. There are many treatment centers and sex addictionologists who will take your money to treat sex addiction, but there is NO scientific evidence that their treatment works, or is worth your money."

Ley is keen on taking your money, however, to present what he says is the other side of the argument over sex addiction. But is Ley off base with his idea of our American obsession with pathologizing the sexual behavior of men?

Ley isn't alone.

"I often hear gay men dismiss the whole idea of sexual addiction as simply a bigoted ploy to further marginalize gay men and their sexual behavior," psychologist Joe Kort wrote in a review of Robert Weiss's bookCruise Control: Understanding Sex Addiction in Gay Men.

Still, Kort doesn't deny the plausibility of sexual addiction, using Weiss's claim that sex addiction is the opposite of what "healthy sexuality is not about—namely obsession, compulsion, trance-like-states, and repeated poor judgment for one’s physical, emotional and legal safety."

Kort says sexual addiction leaves the sufferer feeling lonely and ashamed, disconnected and isolated—the exact reverse of what healthy sexual expression will provide.

In the debate over sex addiction it's common for those that agree with the diagnosis to see the male as sufferer, while opposing camps like Ley view the male's impulses as hardly something to pity him over. The one thing they all agree on is there are guys out there that are having a lot of sex—in some eyes at an unnatural frequency and in others with locker room boasting swagger.

There is no clear line to draw in this penile version of the insanity defense. Sex addiction may not see its heyday in the DSM (and thankfully so) since human relationships are subjective, even those that begin and end in 45 minutes. And as long as some men are willing to throw it out there to dodge a tight situation, those that feel senses of shame as Kort describes won't be taken seriously.

As the APA says, much more research is needed before any of us can tuck away this issue. Myth, circumstance, habit or disorder, the issue of sex addiction will continue to stand tall inside and out of the bedroom and therapist's office.