Sexual Healing vs the Hollywood Hype

A number of different twelve-step programs with a focus on sex addiction have been around for over twenty five years, but remain marginal compared to Alcoholics Anonymous—like most of the other spin-off groups other than NA and Al-Anon.

A few months back, Wall Street Journal health editor Melinda Beck wrote a column about sex addiction.  She mentioned that there were twelve-step programs (plural) for sex addicts.  But she was quick to add that they did not generally deserve the bad rap they have been given in television and films, specifically mentioning "Nip/Tuck," "Blades of Glory" and "Choke" as implying that the programs are good places for hook ups.  (Sex addiction: a Sickness or Just an Excuse?  Melinda Beck, Wall Street Journal, September 30, 2008, with alternate site here.)

It was noteworthy to me that there were multiple programs, but none were named specifically.  After some digging, I found that there are indeed a number of programs, but from reviewing their IRS filings, none of them have achieved anything close to the impact of Alcoholics Anonymous or the programs that follow its model, like Narcotics Anonymous and similar programs for Gamblers, Debtors, and Overeaters. 

Of course, the big daddy of all twelve step programs is Alcoholics Anonymous.  Every AA group is a separate organization, but there are three main service organizations that maintain a central office in New York, provides support for groups, and publish the AA literature and a monthly magazie.  The main US office has three organizations, the General Service Board (EIN 23-7282071 Form 990), Alcoholics Anonymous World Services (EIN 13-1679617 Form 990), and Alcoholics Anonymous Grapevine (EIN 13-1871991 Form 990).  The World Services organization has eighty-four employees and the Grapevine fifteen.  Total income of the three organizations is $20.8 million, including the proceeds of $16.7 million in sales and $2 million in income from magazine subscriptions.

In addition, Guidestar lists 122 other organizations with the words Alcoholics Anonymous in their name.  These are mostly local organizations (usually called intergroup associations or intergroups for short) that provide local directories of meetings, operate a local phone hot line, sponsor some outreach to treatment centers and correctional institutions, and coordinate social activities.  In the larger cities, these organizations have paid staff and office space.  In smaller areas they may be entirely volunteer and have nothing but a phone number and a post office box.  I haven't added it all up, but it is entirely possible that the Intergroups taken together might have more income and staff than the three coordinating organizations. 

NA is roughly a third as large as AA. Narcotics Anonymous World Services (EIN 95-3090596 Form 990) reports income of $6,798,622 including $5,720,369 from sales of $8,422,771.  The central organization has a staff of forty-three.  It's notable that the NA central service organization relies almost entirely on sales for its income, while AA relies about half on sales, half on contributions (which mostly come from the groups, not individuals).  In addition, there are 30 or so other groups with Narcotics Anonymous in their names, which appear to be a mix of regional service organizations, some groups, and convention committees. 

Next in size are the Al Anon Family Groups (EIN 13-5636290 Form 990), which are for the families and others who have an alcoholic in their lives.  The central service organization has income of $4,533, 696, including $2,760,325 from sales of $3,685,372.  There is a staff of fifty-five.  There are about 72 other organizations with the Al Anon name, which mostly appear to be local information services. 

To my surprise, the next group in income is Overeaters Anonymous (EIN 23-7016806 Form 990).  This service organization reports income of $1.5 million, including $869,834 from $1,143,701 in sales.  There is a staff of fourteen. But there are fifty-five other organizations, mostly local intergroups. 

After this, the groups get really small.  For Gamblers Anonymous (EIN 95-2273317 Form 990), the report from June, 2005 is the most current available.  It shows income of $314,199, including $105,646 from $294,403 in sales.  There's no staff count on line 90 (a common omission, especially in smaller organizations), but staff expenses of about $147,000 suggests a staff of four or so.  There's only one local service group on Guidestar, in upstate New York.  But the GA web site shows meetings in most states (though you're out of luck in Wyoming).

Debtors Anonymous (EIN 13-3527412 Form 990) shows income of $136,331, including $52,383 from $82,877 in sales.  Staff is listed as five, but staff expense is only about $50,000.  Again, only one local group listed using the DA name, in Southern California.  Again, though, the DA web site can find a meeting in most states (nothing turns up in Wyoming, or even Alabama or Arkansas).

The big contrast with sex groups is that there is serious fragmentation, with a number of groups vying for attention with slightly different approaches to recovery.  (They even refer to themselves as the S programs, since all the big ones start with an S.)  And yet the amount of participation is not very great.  One source reports that in 1998 there were just 35,990 members of various S programs worldwide. 

A big factor in the fragmentation seems to be how the programs approach the issues of homosexuality.  There is a fascinating summary of the differences here, but it is difficult to assess how authoritative it is.  The most of the organizations have Wikipedia articles, but again it's hard to judge how accurate they are. 

Just judging by the size of the central service organization, the largest group appears to be Sex Addicts Anonymous (EIN 41-1675029 Form 990).  Total income $330,487, including proceeds of $83,874 from sales of $190,000.  Number of staff not provided on line 90 as required, but two paid staff are listed as key employees.  Compensation of other staff is $91,888, suggesting that there are three to five other staff. But from the meeting list on the web site, coverage is spotty.  There are no meetings in Boston, for instance, but there are eight in Chicago.  There appear to be dozens of meeting in the greater Los Angeles area, which may account for the popularity of sex addiction groups in television and movies.  SAA seems to be a relatively welcoming group for gays and has a flexible definition of sobriety.

Sexaholics Anonymous (EIN 31-1599955 Form 990) reports total income of just under $200,000 in 2007, with just $48,500 in sales of literature.  There is a staff of two.  SA appears to be the only one of these twelve step groups that does not produce its own literature as a significant source of income.  The organization's web site directs literature requests to another web site.  SA is said to be the strictest of the groups, promoting total abstinence from all sex except with a spouse, specifically the spouse in the marriage of a man and a woman.  As with SAA, the meeting coverage is extensive in Southern California, hit or miss elsewhere.  It is especially difficult to find meetings, because the central meeting directory often just links to an email address. 

Sex and Love Addicts Anonymous (goes by the legal name of Augustine Fellowship) (EIN 04-2768261, Form 990).  The most recent form is from 2003 (somebody has dropped the ball here, both at the organization and the IRS, it appears).  Total income is reported at $284,295, including proceeds of $119,574 on $163,074 sales.  There are five on staff .  With its specific inclusion of relationship addiction, this is the organization with the most female members.  There appear to be active intergroups in some areas but not others (no intergroup in Minneapolis, for instance), but California, again, is extremely well-supported (and in this case there is a meeting in Wyoming). 

Sexual Compulsives Anonymous (EIN 13-3590669, no Form 990 because the group reports income under $25,000).  This groups appears to be mostly for gay men.  Not surprisingly, the meeting list is very spotty, with many links to email addresses rather than meeting locations.

And for Sexual Recovery Anonymous there is no EIN or Form 990 found.  Even the web site lists just a handful of meetings.

It seems possible to me that there are two things holding back the sexual recovery groups: one is the difficulty raised in determining exactly what recovery means (and the consequent fragmentation of the groups) and the other is in the extreme secrecy that some of the groups still find it necessary to practice. 

One intriguing observation in the Wall Street Journal article was that in sex addiction programs the ratio of men to women is generally five to one, while in food addiction programs the ratio is reversed.  I wonder whether the relatively high percentage of women has anything to do with the relatively robust organization and higher level of participation in Overeaters Anonymous compared with the sex addiction programs.  

And it's also quite interesting that the relative success of these programs in Southern California has not, it appears, spawned similar success in the rest of the country.  It could be that Hollywood itself (that is, the relative openness about sex in the entertainment industry) makes a community-based approach to sex addiction recovery possible there and nowhere else. 

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