, Volume 39, Issue 6, pp 1231-1233
Date: 13 Jul 2010

What’s Wrong With Sex?

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Several psychiatrists and psychologists have recently made important criticisms of specific diagnostic innovations proposed by the DSM-5’s Sexual and Gender Identity Disorders Work Group (DeClue, 2009; Frances, 2010; Green, 2010; O’Donohue, 2010). As a historian and philosopher of science, my goal here is more general: I want to show that what this Work Group is trying to accomplish undermines the definitions of “paraphilia” and “mental disorder” that have been operative since the DSM-III. If the revisions proposed by the Work Group are implemented, the DSM-5 will be closer to the DSM-I and DSM-II than to their successors. In order to understand why this is so, we need first to take a short historical detour and to look at how “mental disorder” and “paraphilias” have traditionally been defined. Only then will we be in a position to grasp the magnitude of what the DSM-5 is trying to accomplish.

As is well known, the DSM-I (American Psychiatric Association, 1952) and DSM-II (American Psyc