By Lisanne Ophoff
Staff Writer
A few months ago, the fifth edition of the Diagnostic Statistical Manual of Mental Disorders was published. When I looked at the changes that had been made, I noticed something that got me thinking (actually, I noticed several things but I’m not writing an article about all of them). What was formerly known as a paraphilia has now been divided into paraphilic disorder and paraphilia.
The DSM-IV-TR said: “The essential features of a Paraphilia are recurrent, 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 nonconsenting persons that occur over a period of at least 6 months (Criterion A).” For some of the paraphilia’s, the diagnosis could be made if somebody had acted on their urges or if they had caused distress, for others the diagnosis could only be made if the urges had caused distress.
In the DSM-V, a distinction between paraphilia and paraphilic disorder has been made. Paraphilia is now defined as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners.” A new term has been introduced, that of the paraphilic disorder. “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. 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.”
This definition of a paraphilic disorder seems to be in line with the rest of the DSM, and it sounds quite logical. However, it does seem a bit peculiar to me that a paraphilia is only a paraphilic disorder if it causes distress or if someone acts on it. For all mental disorders, the diagnosis can only be made if it has caused distress or harm. And for most mental disorders, this seems logical. With paraphilic disorders, however, this may not be the wisest solution. A substantial amount of sex offenders deny that there is anything wrong with them. For them, the paraphilia does not cause distress, so before they committed an offense, they did not suffer from a paraphilic disorder. The difference between paraphilia and paraphilic disorder is whether or not someone acts on their paraphilia. To me, this seems scary. If paraphilic disorders indeed are treatable mental disorders, paraphilias should be treatable as well. And in this case, treating paraphilia could prevent the paraphilia from turning into a paraphilic disorder and it could prevent sex offenses.
Another thing is that the definition of a paraphilia seems to have become even more culture-dependent. Not too long ago, it was very common for men to marry a girl who was not “physically mature”. Now, such a man would be considered as having paraphilic disorder.
Even more recent, homophilia was one of the paraphilias. The taboo on it was at least as big as the one we now have on paedophilia.
We need to start distinguishing between mental disorders and socially unacceptable behavior. And if we decide paraphilias are mental disorders, we might even need to try and accept them. If they are just socially unacceptable behaviors or “sexual preferences”, we should start looking critically at society. We should not judge people, or even diagnose them, just because their sexual preferences bother us. And society causing “distress”, because somebody feels like there is something wrong with him or her because of his or her sexual preferences should not be a reality. Just because somebody is not part of the majority, does not mean he does not function properly.
Lisanne Ophoff, Class of 2016, is a Cognitive Science and Biomedical Science major from Zwolle, The Netherlands.
