Abbreviation for "buttsex"
dude 1: kenny doesn't like girls
dude 2: rofl he must love btsx
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BTSX is an abbreviation of "Back To Saturn X", which a series of map pack (or WADs) for the video game Doom 2, it's often praised for it's beautiful architecture and visual for a map pack build in a 1994 game engine, but it's also sometimes criticised that the maps are so consistently well done that it felt repetitive.
the phrase can be used to describe a game level or a series of things that's so consistently perfect, it's repetitive and unintuitive.
This game's level had gotten BTSX Syndrome, it's good but ultimately boring.