![]() ![]() Furthermore, debate is ongoing about where this behavioral pattern fits into the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV), and how it should be classified and conceptualized. 1 It can take many forms, and although it may seem obvious to diagnose, standardized criteria have yet to be developed. This term has been used synonymously with others, such as compulsive sexual behaviors, hypersexuality, and excessive sexual desire disorder. For some, though, this increase in availability has uncovered an inability to control sexual impulses resulting in continued engagement in these behaviors despite the creation of negative consequences-otherwise known as sexual addiction. Together, these cultural changes have increased the acceptability and availability of sexual rewards. ![]() Strengthening their presence and availability is the internet, which has created an information portal for these services through online dating services, classified ads, and discussion boards for those in pursuit of sexual gratification. Escort services, massage parlors, and street prostitution continue to be available in every major city in the US. Inside them, the degree of physical contact has also increased, as compared to a generation ago, to the point where the boundaries of what constitutes sexual intercourse are blurred. Strip clubs have evolved from backroom cabarets into large multimillion dollar nightclubs and are present in virtually every state in the US. The adult entertainment industry generates close to $4 billion per year and its acceptability in society is reflected in the mainstreaming of its products into traditional retail stores and the portrayal of its actors and actresses as role models and celebrities. Sales and rental of adult movies through DVDs and pay-per-view services allow access to sex anywhere and at any time. Digital media offers portability, access, and visually explicit depictions of sexual acts in high-definition that leave nothing to the imagination. Internet pornography has become a billion-dollar industry, stretching the limits of the imagination. In many ways, sexual expression has become a form of accepted entertainment similar to gambling, attending sporting events, or watching movies. Sex has become part of mainstream culture as reflected through the explicit coverage of sexual behaviors in the media, movies, newspapers, and magazines. ![]() Sexuality in the United States has never been more socially acceptable. ![]()
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