Editing Paraphilia (section)

=== DSM-5 ===
The [[DSM-5]] adds a distinction between ''paraphilias'' and ''"paraphilic disorders"'', stating that paraphilias do not require or justify psychiatric treatment in themselves, and defining ''paraphilic disorder'' as "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".<ref name="DSM-5, intro"/> The DSM-5 Paraphilias Subworkgroup reached a "consensus that paraphilias are not ''ipso facto'' psychiatric disorders", and proposed "that the DSM-V make a distinction between ''paraphilias'' and paraphilic ''disorders''. One would ''ascertain'' a paraphilia (according to the nature of the urges, fantasies, or behaviors) but ''diagnose'' a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder." The 'Rationale' page of any paraphilia in the electronic DSM-5 draft continues: "This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological. It also eliminates certain logical absurdities in the DSM-IV-TR. In that version, for example, a man cannot be classified as a transvestite—however much he cross-dresses and however sexually exciting that is to him—unless he is unhappy about this activity or impaired by it. This change in viewpoint would be reflected in the diagnostic criteria sets by the addition of the word 'Disorder' to all the paraphilias. Thus, Sexual Sadism would become [[Sexual sadism disorder|Sexual Sadism Disorder]]; Sexual Masochism would become [[Sexual masochism disorder|Sexual Masochism Disorder]], and so on."<ref name="dsm5">{{cite web|url=http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid%3D186|title=302.2 Pedophilia|website=DSM-5|access-date=2012-02-10|url-status=dead|archive-url=https://web.archive.org/web/20100215165810/http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=186|archive-date=15 February 2010}}</ref>

[[Bioethics]] professor [[Alice Dreger]] interpreted these changes as "a subtle way of saying sexual kinks are basically okay – so okay, the sub-work group doesn't actually bother to define paraphilia. But a paraphilic disorder is defined: that's when an atypical sexual interest causes distress or impairment to the individual or harm to others." Interviewed by Dreger, [[Ray Blanchard]], the Chair of the Paraphilias Sub-Work Group, stated, "We tried to go as far as we could in depathologizing mild and harmless paraphilias, while recognizing that severe paraphilias that distress or impair people or cause them to do harm to others are validly regarded as disorders."<ref>Alice Dreger (19 Feb 2010) ''[http://www.thehastingscenter.org/of-kinks-crimes-and-kinds-the-paraphilias-proposal-for-the-dsm-5 Of Kinks, Crimes, and Kinds: The Paraphilias Proposal for the DSM-5]'', [[Hastings Center]]</ref> [[Charles Allen Moser]] stated that this change is not really substantive, as the DSM-IV already acknowledged a difference between paraphilias and non-pathological but unusual sexual interests, a distinction that is virtually identical to what was being proposed for DSM-5, and it is a distinction that, in practice, has often been ignored.<ref>{{cite journal|author=Moser C|year=2010|title=Problems with Ascertainment|journal=Archives of Sexual Behavior|volume=39|issue=6|pages=1225–1227|doi=10.1007/s10508-010-9661-9|pmid=20652734|s2cid=11927813}}</ref> Linguist Andrew Clinton Hinderliter argued that "including some sexual interests—but not others—in the DSM creates a fundamental asymmetry and communicates a negative value judgment against the sexual interests included," and leaves the paraphilias in a situation similar to [[ego-dystonic homosexuality]], which was removed from the DSM because it was no longer recognized as a mental disorder.<ref>{{cite journal|first=Andrew Clinton|last=Hinderliter|author-link=Andrew Clinton Hinderliter|year=2010|title=Defining paraphilia: excluding exclusion|journal=Open Access Journal of Forensic Psychology|volume=2|pages=241–271|url=http://web.me.com/gregdeclue/Site/Volume_2__2010_files/Hinderliter%202010.pdf|access-date=12 November 2010|archive-date=15 October 2011|archive-url=https://web.archive.org/web/20111015022211/http://web.me.com/gregdeclue/Site/Volume_2__2010_files/Hinderliter%202010.pdf|url-status=dead}}</ref>

The [[DSM-5]] has specific listings for eight paraphilic disorders.<ref name="DSM-5, intro"/> These are voyeuristic disorder, exhibitionistic disorder, [[frotteuristic disorder]], sexual masochism disorder, sexual sadism disorder, pedophilic disorder, fetishistic disorder, and [[Transvestic fetishism|transvestic disorder]].<ref name="DSM-5, intro"/> Other paraphilic disorders can be diagnosed under the [[Other Specified Paraphilic Disorder]] or Unspecified Paraphilic Disorder listings, if accompanied by distress or impairment.<ref>{{cite book|title=Diagnostic and Statistical Manual of Mental Disorders|edition=Fifth|chapter=Other Specified Paraphilic Disorder; Unspecified Paraphilic Disorder|editor=American Psychiatric Association|year=2013|publisher=American Psychiatric Publishing|page=705}}</ref>