Those who hoped to see sexual fetishes removed completely from the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of psychiatry published by the American Psychiatric Association, will likely be disappointed when the new edition is released in May. The DSM-V will probably still mention certain sexual predilections, reported LiveScience, but they won't necessarily be labelled as mental illnesses.
The DSM currently defines "unusual" sexual turn-ons as paraphilias. Paraphilias include everything from foot fetishes, S&M and erotic eating to exhibitionism and pedophilia. These paraphilias are considered harmless unless the person experiencing them feels distressed about their preferences or if their unusual sexual practices are harmful to others. "Simply put, the DSM V will say that happy kinksters don’t have a mental disorder. But unhappy kinksters do," wrote Slate's Jillian Keenan.
It appears that the DSM-V will further formalize this idea and separate paraphilias from paraphilic disorders. This means that a benign fetish like being turned on by feet or enjoying some consensual bondage play would be considered a paraphilia, while having a sexual obsession with underage children would be considered a paraphilic disorder. LiveScience also reported that the definition of paraphilia may be made more specific in the DSM-V. The proposed definition is: "any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting human partners between the ages of physical maturity and physical decline."
Some see this definition as problematic since the list of paraphilia are so far-reaching and includes things like Gynanadromorphophilia (attraction to trans women) and Fat Fetishism (attraction to fat people). Feministing's Julia Serano expressed her frustration with the DSM's list of paraphilias in 2009, claiming that it stigmatized transgender people and people with non-thin bodies:
This [definition of paraphilia] reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It’s bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.
Another common complaint about the DSM's paraphilia comes from the Trans community, specifically with regards to the inclusion of Transvestic Disorder, defined as "excessive sexual or erotic interest in cross-dressing."
"Despite its best efforts, the DSM still allows existing sexual stigmas and social norms to define whether a sexual practice is 'healthy,'" wrote Keenan in Slate, summing up the problems that arise when it comes to psychologists defining sexual health. "That’s why social conventions can’t dictate 'health' -- that must be determined by clear and compelling medical evidence."
The DSM has undergone significant changes over the last 50 years in how it defines healthy and unhealthy sex and sexuality. Homosexuality was considered a mental disorder until 1973 and it wasn't until 1986 that feeling distressed about one's homosexuality was fully dropped from the manual.
Do you think that sexual fetishes should be in the DSM at all? Let us know in the comments!