In the new proposals for the DSM-V, alternative sexual behavior has been depathologized. The American Psychiatric Association's Paraphilias Subworkgroup's DSM revisions acknowledge that you can be a fetishist, transvestite, sexual sadist or sexual masochist without having a mental disorder.
NCSF has worked very hard with its DSM Revision Project to make sure these changes take place, and will continue to strongly advocate for clear language of what exactly constitutes a mental disorder. Susan Wright liaisoned with the work group and supplied data that NCSF has gathered about the real-world discrimination and persecution that takes place against BDSM-fetish practitioners because of the DSM-IV-TR. The DSM Revision Petition was also extremely useful in generating comment from community members and mental health professionals urging that the current diagnoses be changed.
To see the proposed changes, go to: http://www.dsm5.org/ProposedRevisions/Pages/SexualandGenderIdentityDisorders.aspx
Read the "Rationale" section under each diagnosis to see their thinking on the paraphilias. The work group makes it clear that "non-normative" sexual behavior is practiced by healthy people:
"The first broad change follows from our consensus that paraphilias are not ipso facto psychiatric disorders. We are proposing that the DSM-V make a distinction between paraphilias and paraphilic disorders. A paraphilia by itself would not automatically justify or require psychiatric intervention. A paraphilic disorder is a paraphilia that causes distress or impairment to the individual or harm to others. 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."
"These revisions will affect everything-child custody, job discrimination battles, and even help change the way society views us," says Leigha Fleming, Chairperson and Director of Incident Response. "I think of all the people over the years who have had the DSM used as a tool of discrimination and punishment, and I'm proud of NCSF for continuing the fight to change it. This is the first step towards decriminalization of BDSM, which NCSF is pursuing with our Consent Counts project."
The Paraphilias Subworkgroup is now reconsidering what constitutes "clinically significant distress or impairment in social, occupational, or other important areas of functioning" when determining a mental disorder. The DSM must make it clear that people do suffer distress and impairment because of the societal stigma against alternative sex, but that doesn't mean they are suffering distress that is generated internally.
As part of the development process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are now available for public review and comment
until April. Personal comments about discrimination and persecution are welcome additions to this commentary to continue to urge the work group to differentiate between sexual minorities and sex offenders.
Just as Norway recently joined Sweden and Denmark in removing consensual paraphilias entirely, NCSF continues to urge the complete removal of these paraphilias from the DSM. However like the incremental removal of homosexuality (to egodystonic homosexuality and then finally taken out in 1987) this is an important step for the BDSM-leather-fetish community.
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