Revising the DSM V


“Consensual adult activities …that may involve some aspects of sexual role-play, novel, superficial or trivial aspects of sexual fetishism….. are not automatically or by default, inherently psychopathological or paraphilial in nature… and quite conversely, can serve to pique, or excite, the arousal phase of the human sexual response cycle in manners that can enhance fertility and procreation.” This is the wording of the DSM-IV TR, the test revised publication for the Diagnostic and Statistical Manual of Mental Disorders. It is a hopeful step in the right direction for the goal of removing alternative sexual practices such as fetishes, the paraphilias, from the list of disorders.

Paraphilias are defined by DSM-IV-TR as “intense sexually arousing fantasies, sexual urges or behaviors generally involving (1) nonhuman objects, (2) the suffering or humiliation of oneself or one’s partner, or (3) children or other non-consenting persons that occur over a period of months which “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning”. DSM-IV-TR describes 8 specific disorders of this type: exhibitionism, fetishism,, frotteurism, pedophilia, sexual masochism, sexual sadism, voyeurism, and transvestic fetishism, and a vague last category of: not otherwise specified (NOS).

The bottom line for decisions outlined in the DSM, much like those in the legal cases hinge on the concept of consent. Within the BDSM community the notion of consent and mutual information is considered necessary and extremely important; the situations where these ‘disorders’ occur often involves a lack of consent and communication, resulting in someone getting hurt. Unfortunately, the difference between consensual SM and non-consensual abuse is currently decided by individual doctors, and whatever biases and personal, moral or political views they may have. Without a clearer distinction between “paraphilia” and consensual SM, doctors, much like lawmakers, are free to diagnose with those prejudices and not necessarily the mental state or nature of the relationship between otherwise consenting adults.

The NCSF and the ITCR have joined together to present scientific research to the American Psychiatric Association for review in the process of releasing the DSM V, due out in May 2012. This effort is supported by several scientists and practicing doctors across the world- and most importantly by the research. The position of the NCSF and the ITCR is that because the data so clearly distinguishes between harmful behaviors and that of ‘safe, sane consensual’ ones practiced by the BDSM community, that the “paraphilias” of the DSM-IV are expressions of political opinions and not scientific ones.

With many research studies supporting the position of the NCSF and ITCR, it is hopeful that these and other changes will be made to the social climate in which we live.

The relationship between medicine and politics can clearly be seen in the law. Medical standards are used to decide the ability of someone to stand trial, raise children, run for public office, and in many other ways to lead free lives. While not completely independent (the law and medicine influence one another) recent cases such as the Supreme Court ruling on Lawrence v. Texas found that it is un- constitutional to have laws that rule on moral grounds. The attitude of doctors/DSM is therefore the last large obstacle to climb in an ongoing battle for equal rights under the law and equal access to medical care, without discrimination.

The wording of the DSM-TR-IV opens a hopeful door in its opinion that some ‘fetishistic behaviors aid in fertility’. While limited, and not a green light acceptance of alternative sexualities, this is historically the first step in a successful procedure:: when alternatives are practiced within the bonds of traditional married couples, like birth control and sodomy, we then gain equality by claiming equal status, as with the Gay rights movement.

-Klawdya Rothschild

First published in the NCSF 2008 Fall Notes Newsletter, WHICH YOU WOULD HAVE RECEIVED IF YOUR MEMBERSHIP WAS CURRENT- hmmmmmn  hmmmmmn?   That’s what I thought!  Go here: JOIN

~ by Klawdya Rothschild on November 11, 2008.

One Response to “Revising the DSM V”

  1. well they always seem to have some weird thigns in the DSM in general that can be really considered regualr behavior except by nitpickers i knwo the original dsm 1 and dsm 2 actually had homosexuality as a illness that they could commit you to an asylum or sanitorium for. I meen the books are written by usaully peopel whove bene inthe profession forever and are stuck up and rich in the first place.

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