Sadomasochism in Sickness and in Health: Competing Claims from Science, Social Science, and Culture
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This article reviews and compares competing depictions of sadomasochism (SM) sexuality, examining portrayals that range from sick to healthy, from normal to abnormal, and from dangerous to healing. The body of this article proceeds in four parts. The first section considers the treatment of SM in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5). The second section addresses debates about the costs, benefits, and scientific validity of the inclusion and definition of SM in the DSM-5. It further highlights how quantitative and qualitative empirical studies of SM practitioners indicate that they fall within normal ranges in psychological and social functioning. The third section examines research on one negative consequence of the inclusion of SM in the DSM: It may interfere with the therapeutic relationship with clients who practice SM or have SM desires by reinforcing broader societal stigma and encouraging diagnostic misuse. The fourth section reviews an emerging body of research that reverses the “SM as pathology” discourse by showing the therapeutic and healing potential of bondage-discipline-dominance-submission-sadism-masochism (BDSM) practice and ethos. Based on this review, the conclusion argues that there is no valid reason to continue identifying SM as a potential mental disorder, and furthermore, there are detrimental effects of its association with pathology in the DSM-5.
KeywordsSadomasochism SM Bondage-discipline-dominance-submission-sadism-masochism BDSM Kink DSM-5 Paraphilias Paraphilic disorders Forensics and sexuality Law and sexuality Societal stigma Diagnostic misuse Healing
Compliance with Ethics Guidelines
Conflict of Interest
Ummni Khan declares she has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by the author.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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