The American Psychiatric Association depathologized sadism, masochism, cross-dressing and fetishes in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) in 2013.
The DSM-5 defines paraphilia as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling.” A paraphilic disorder is a “paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others.” (DSM-5, pp. 685-686)
“A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not necessarily justify or require clinical intervention.” (DSM-5, p. 686)
The revised DSM is helping to change the way society views kinky people. For example, In all 41 child custody cases in 2012 in which NCSF provided the proposed DSM-5 criteria, the BDSM evidence was set aside and child custody was determined on its own merits.
In contrast, NCSF’s success rate in 2006 was approximately 20% when it came to refuting the false contention that a parent is unfit because they are kinky.
EXAMPLES OF THE REVISED LANGUAGE IN THE DSM-5
“Such individuals openly acknowledge intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors. … In contrast, if they declare no distress, exemplified by anxiety, obsessions, guilt, or shame, about these paraphilic impulses, and are not hampered by them in pursuing other personal goals, they could be ascertained as having masochistic sexual interest but should not be diagnosed with sexual masochism disorder.” (DSM-5, p. 694)
“In Australia, it has been estimated that 2.2% of males and 1.3% of females have been involved in bondage and discipline, sadomasochism, or dominance and submission in the past 12 months.” (DSM-5 p. 694)
“The majority of individuals who are active in community networks that practice sadistic and masochistic behaviors do not express any dissatisfaction with their sexual interests, and their behavior would not meet DSM-5 criteria for sexual sadism disorder.” (DSM-5, p. 697)
“Depending on the criteria for sexual sadism, prevalence varies widely, from 2% to 30%.” (DSM-5, p. 696)
“Many individuals who self-identify as fetishist practitioners do not necessarily report clinical impairment in association with their fetish-associated behaviors. Such individuals could be considered as having a fetish but not fetishistic disorder.” (DSM-5, p. 701)
“For example, an individual whose sexual partner either shares or can successfully incorporate his interest in caressing, smelling, or licking feet or toes as an important element of foreplay would not be diagnosed with fetishistic disorder; nor would an individual who prefers, and is not distressed or impaired by, solitary sexual behavior associated with wearing rubber garments or leather boots.” (DSM-5, p. 702)
“The diagnosis of transvestic disorder does not apply to all individuals who dress as the opposite sex, even those who do so habitually.” (DSM-5, p. 703)
“Fewer than 3% of males report having ever been sexually aroused by dressing in women’s attire. The percentage of individuals who have cross-dressed with sexual arousal more than once or a few times in their lifetimes would be even lower.” (DSM-5, p. 703)
Feature image: vintage pinup by Gil Elvgren
• NCSF – The DSM-5 Says Kink is OK!
• The Atlantic – BDSM Versus the DSM
• Fearless Press – DSM Revisions: The Impact on BDSM
• Heather Sheaffer – Sexual Masochism Disorder
• Psychology Today – Taking the DSM out of BDSM
• B.E.S.T. Slave Training – The New DSM-5 and slave training and Sadomasochism
The National Coalition for Sexual Freedom (NCSF) was formed in 1997. The goal was to fight for sexual freedom and privacy rights for all adults who engage in safe, sane and consensual behavior. Today, NCSF has over 50 Coalition Partners. As an advocacy organization, one of NCSF’s strategies has been to educate the media about issues facing the SM-Leather-Fetish, swing and polyamory communities and NCSF’s Incident Reporting and Response helps hundreds of individuals, groups and businesses when they face persecution because of their involvement with BDSM, swinging or polyamory by providing people with advice, documentation to assist their efforts, and help with strategy and tactics. If you are in the US, please consider providing support by becoming an individual member of NCSF, volunteering to join the NCSF staff, making a donation to NCSF, or encouraging your group to become a Coalition Partner of NCSF.
NCSF’s DSM Revision Project ran from 2008-2013, when the DSM-5 was published by the American Psychiatric Association. The APA responded to the underserved population of BDSM practitioners and clarified that healthy adults who engage in kinky sexual behavior are not considered to have a mental disorder.