Sex is a biological, evolutionary, and instinctual drive. There is wide variation in the nature and frequency of individuals’ sexual thoughts, fantasies, impulses and behaviors; therefore, it is very challenging to identify where to draw the line between normal variation and pathology. Sex addiction, which is not currently listed in the DSM-5-TR as a diagnosis, remains one of the most controversial topics in psychiatry. Sex addiction can sometimes be diagnosed as part of another mental health condition, such as Other Specified Disruptive, Impulse-Control, and Conduct Disorder in DSM-5. The diagnosis is only appropriate when the individual experiences intense, repetitive sexual impulses that are perceived as uncontrollable, leading to repetitive sexual behavior and results in marked functional, social, and personal impairment.