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Introduction to Sexual Disorders

Kathryn Patricelli, MA

This Sexual Disorders topic center contains information about paraphilias (more commonly known as sexual perversions or deviancies). If you are interested in sexual desire or arousal disorders, as well as information about healthy sexuality throughout the lifespan, the proper terms for that would be Sexuality and Sexual Problems.

living roomWith the publication of the DSM-5, this family of disorders has been renamed Paraphilic Disorders and all the disorders in this group require the presence of a paraphilia. A paraphilia involves intense and persistent sexual interest (recurrent fantasies, urges or behaviors of a sexual nature) that center around children, non-humans (animals, objects, materials), or harming others or one's self during sexual activity. Sometimes this sexual interest focuses on the person's own erotic/sexual activities while in other cases, it focuses on the target of the person's sexual interest.

In order to be diagnosed with one of these disorders, the paraphilia also needs to be causing significant distress or impairment, or involve personal harm or risk of harm to others. You can have a paraphilia, but not have a paraphilic disorder. It is only when it causes impairment, harm or the risk of harm that it become a clinical diagnosis.

This category of disorders includes:

There is also a diagnostic category for Other Specified Paraphilic Disorder. This is used when symptoms of a paraphilic disorder are present and cause significant distress or impairment, but do not meet full criteria for any of the other disorders. This classification is used when the clinician is listing the specific reason that the symptoms do not meet the full disorder criteria. Examples include chronic preoccupation with making obscene telephone calls or relating sexually to only a part of another's body, dead people, feces and urine, animals, etcetera.

Unspecified Paraphilic Disorder is used when symptoms cause significant distress or impairment, but do not meet full criteria for any of the other disorders, and the clinician does not wish to specify the reason that criteria are not met. This also includes situations when there is not enough information available for the clinician to make a specific diagnosis.

Paraphilic Disorders are disorders of deviant sexuality. Because they are so often associated with abusive sexual practices that create real victims, many people tend to regard persons who display sexual deviancies as monsters. Further, many people tend to assume that all sexual deviants are equally awful and disgusting. Neither of these statements are accurate. While they are ultimately responsible for their choices (including those that harm other people), should be punished and, thereafter, closely monitored to prevent further abusive practices, even people with pedophiliac disorder or sexual sadism are legitimately suffering from mental, emotional and spiritual disturbance and should be able to participate in treatment. There are also forms of sexual deviancy such as Transvestic Disorder and Fetishistic Disorder that harm no one and that do not deserve to be thought of in the same breath as the other more extreme cases.

On a final note, we should point out one mode of sexuality which is definitively not listed here, and that is Homosexuality and Bisexuality. Although historically listed as sexual deviancies, homosexuality and bisexuality has been recognized as completely normal variants of human sexuality for many years now. However, just because being gay isn't a sexual deviancy or disorder, doesn't mean that it doesn't come with its own set of stressful issues.