Editing Paraphilia (section)

==Definition==
To date there is no broad [[scientific consensus]] for definitive boundaries between what are considered "unconventional sexual interests", [[Kink (sexuality)|kinks]], [[Sexual fetishism|fetishes]], and paraphilias.<ref>{{Cite journal|last=Joyal|first=Christian C.|date=20 June 2014|title=How Anomalous Are Paraphilic Interests?|journal=[[Archives of Sexual Behavior]]|location=New York City|publisher=[[Springer Science + Business Media]]|volume=43|issue=7|pages=1241–1243|doi=10.1007/s10508-014-0325-z|issn=0004-0002|pmid=24948423|s2cid=34973560}}</ref><ref>{{Cite journal|last1=Joyal|first1=Christian C.|last2=Cossette|first2=Amélie|last3=Lapierre|first3=Vanessa|year=2015|title=What Exactly is an Unusual Sexual Fantasy?|journal=[[The Journal of Sexual Medicine]]|location=Amsterdam, Netherlands|publisher=[[Elsevier]]|volume=12|issue=2|pages=328–340|doi=10.1111/jsm.12734|pmid=25359122}}</ref> As such, these terms are often used loosely and interchangeably, especially in common parlance.

===History of paraphilic terminology===
Many terms have been used to describe atypical sexual interests, and there remains debate regarding technical accuracy and perceptions of stigma.<ref name="wiederman2003">{{cite journal|first=Milan|last=Weiderman|date=2003|title=Paraphilia and Fetishism|journal=[[The Family Journal]]|publisher=[[SAGE Publications]]|location=Thousand Oaks, California|volume=11|issue=3|pages=315–321|doi=10.1177/1066480703252663|s2cid=146788566}}</ref><ref name="bullough1995">{{cite book|first=Vern L.|last=Bullough|author-link=Vern Bullough|date=1995|url=http://www2.hu-berlin.de/sexology/GESUND/ARCHIV/LIBRO.HTM|title=Science in the Bedroom: A History of Sex Research|page=281|publisher=[[Basic Books]]|location=New York City|isbn=978-0-465-07259-0|url-status=dead|archive-url=https://web.archive.org/web/20061022080700/http://www2.hu-berlin.de/sexology/GESUND/ARCHIV/LIBRO.HTM|archive-date=22 October 2006|accessdate=5 October 2010}}</ref><ref name="moser2001">{{cite book|last=Moser|first=Charles Allen|authorlink=Charles Allen Moser|date=2001|chapter=Critiques of conventional models of sex therapy|editor-first=Peggy J.|editor-last=Kleinplatz|editor-link=Peggy J. Kleinplatz|title=New directions in sex therapy: innovations and alternatives|publisher=[[Taylor & Francis|Psychology Press]]|location=London, England|isbn=978-0-87630-967-4}}</ref><ref name="mccammon2004">{{cite book|last1=McCammon|first1=Susan|last2=Knox|first2=David|last3=Schacht|first3=Caroline|date=2004|title=Choices in sexuality|page=476|publisher=Atomic Dog Publishing|location=Mason, Ohio|isbn=978-1-59260-050-2}}</ref> Money described paraphilia as "a sexuoerotic embellishment of, or alternative to the official, ideological norm."<ref name="money1990">{{cite book|last=Money|first=John|author-link=John Money|date=1990|title=Gay, Straight, and In-Between: The Sexology of Erotic Orientation|publisher=[[Oxford University Press]]|location=Oxford, England|isbn=978-0-19-506331-8|pages=[https://archive.org/details/gaystraightinbet0000mone/page/139 139]}}</ref> Psychiatrist [[Glen Gabbard]] writes that despite efforts by Wilhelm Stekel and John Money, "the term ''paraphilia'' remains pejorative in most circumstances."<ref name="gabbard2007">{{cite book|last=Gabbard|first=Glen O.|author-link=Glen O. Gabbard|date=2007|title=Gabbard's Treatments of Psychiatric Disorders|publisher=American Psychiatric Press|location=Philadelphia, Pennsylvania|page=581|isbn=978-1-58562-216-0}}</ref>

In the late 19th century, psychologists and psychiatrists started to categorize various paraphilias as they wanted a more descriptive system than the legal and religious constructs of [[sodomy]],<ref name="dailey1989">{{cite book |last=Dailey |first=Dennis M. |title=The Sexually Unusual: Guide to Understanding and Helping |date=1989 |publisher=[[Haworth Press]] |isbn=978-1-4179-3834-6 |location=Philadelphia, Pennsylvania |pages=15–16}}</ref> as well as [[perversion]].<ref name="purcell2006">{{cite book |last1=Purcell |first1=Catherine E. |title=The psychology of lust murder: paraphilia, sexual killing, and serial homicide |last2=Arrigo |first2=Bruce A. |date=2006 |publisher=[[Academic Press]] |isbn=978-0-12-370510-5 |location=Cambridge, Massachusetts |page=16}}</ref> In 1914, [[Albert Eulenburg]] observed a commonality across the paraphilias, using the terminology of his time writing, "All the forms of sexual perversion ... have one thing in common: their roots reach down into the matrix of natural and normal sex life; there they are somehow closely connected with the feelings and expressions of our physiological erotism. They are ... hyperbolic intensifications, distortions, monstrous fruits of certain partial and secondary expressions of this erotism which is considered 'normal' or at least within the limits of healthy sex feeling."<ref>[[Albert Eulenburg|Eulenburg]] (1914). ''Ueber sexualle Perversionen. Ztschr. f. Sexualwissenschaft''. Vol. I, No. 8. Translated by [[Wilhelm Stekel|Stekel, Wilhelm]] (1940). ''Sexual Aberrations: The Phenomena of Fetishism in rRelation to Sex''. New York: Liveright, p. 4. {{OCLC|795528}}.</ref>

Before the introduction of the term ''paraphilia'' in the DSM-III (1980), the term ''sexual deviation'' was used to refer to paraphilias in the first two editions of the manual.<ref>Laws & O'Donohue, p. 384</ref> In 1981, an article published in ''[[American Journal of Psychiatry]]'' described paraphilia as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving" the following:<ref name="AJP">{{cite journal|last1=Spitzer|first1=Robert L.|author-link=Robert Spitzer (psychiatrist)|title=The diagnostic status of homosexuality in DSM-III: A reformulation of the issues|journal=[[The American Journal of Psychiatry]]|publisher=[[American Psychiatric Association]]|location=Philadelphia, Pennsylvania|volume=138|issue=2|pages=210–215|date=February 1981|pmid=7457641|doi=10.1176/ajp.138.2.210}}</ref>
* [[Object sexuality|Non-human objects]]
* [[BDSM|The suffering or humiliation of oneself or one's partner]]
* [[Pedophilia|Prepubescent children]]
* Non-consenting persons

===Definition of typical versus atypical interests===
Clinical literature contains reports of many paraphilias, only some of which receive their own entries in the diagnostic taxonomies of the [[American Psychiatric Association]] or the [[World Health Organization]].<ref>{{cite web |title="Axis I. Clinical Disorders, most V-Codes and conditions that need Clinical attention". Retrieved: 23 November, 2007 |url=http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp |url-status=dead |archive-url=https://web.archive.org/web/20101219132536/http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp |archive-date=19 December 2010 |access-date=2013-03-14 |publisher=Psyweb.com }}</ref><ref>World Health Organization, International Statistical Classification of Diseases and Related Health Problems, (2007), [https://www.who.int/classifications/apps/icd/icd10online/ Chapter V, Block F65; Disorders of sexual preference.] Retrieved 2007-11-29.</ref> There is disagreement regarding which sexual interests should be deemed paraphilic disorders versus normal variants of sexual interest.<ref>[http://www.dsmivtr.org/2-3changes.cfm Summary of Practice-Relevant Changes to the DSM-IV-TR] {{webarchive|url=https://web.archive.org/web/20080511220758/http://www.dsmivtr.org/2-3changes.cfm|date=11 May 2008}} from [http://www.dsmivtr.org/ Diagnostic and Statistical Manual of Mental Disorders (DSM)] {{webarchive|url=https://web.archive.org/web/20080517004926/http://www.dsmivtr.org/|date=17 May 2008}}</ref> The DSM-IV-TR also acknowledges that the diagnosis and classification of paraphilias across cultures or religions "is complicated by the fact that what is considered deviant in one cultural setting may be more acceptable in another setting".<ref name="auto">American Psychiatric Association. (2000). ''Diagnostic and statistical manual of mental disorders'' (4th ed., text rev.). Washington, DC: Author.</ref> Some argue that [[cultural relativism]] is important to consider when discussing paraphilias, because there is wide variance concerning what is sexually acceptable across cultures.<ref>{{cite journal |last1=Bhugra |first1=Dinesh |last2=Popelyuk |first2=Dmitri |last3=McMullen |first3=Isabel |date=30 March 2010 |title=Paraphilias Across Cultures: Contexts and Controversies |journal=[[Journal of Sex Research]] |location=London, England |publisher=[[Routledge]] |volume=2 |issue=47 |pages=242–256 |doi=10.1080/00224491003699833 |pmid=20358463 |s2cid=40452769}}</ref> [[Consensual]] adult activities and [[adult entertainment]] involving [[sexual roleplay]], novel, superficial, or trivial aspects of [[sexual fetishism]], or incorporating the use of [[sex toys]] are not necessarily paraphilic.<ref name="auto" />

=== Criticism of common definitions ===
There is scientific and political controversy regarding the continued inclusion of sex-related diagnoses such as the paraphilias in the DSM, due to the stigma of being classified as a mental illness.<ref>{{Cite journal |last1=Kleinplatz |first1=Peggy J. |url=https://books.google.com/books?id=gcZDghztlpMC&pg=PA135 |title=Politics versus science: An addendum and response to Drs. Spitzer and Fink |last2=Moser |first2=Charles |journal=[[Journal of Psychology and Human Sexuality]] |publisher=[[Taylor & Francis]] |year=2005 |isbn=978-0-7890-3214-0 |volume=17 |location=London, England |pages=135–139 |doi=10.1300/J056v17n03_09 |issue=3/4 |authorlink2=Charles Allen Moser |s2cid=142960356|url-access=subscription }}</ref> Some groups, seeking greater understanding and acceptance of [[sexual diversity]], have lobbied for changes to the legal and medical status of unusual sexual interests and practices. [[Charles Allen Moser]], a physician and advocate for sexual minorities, has argued that the diagnoses should be eliminated from diagnostic manuals.<ref name="moser2005">{{Cite journal |last1=Moser |first1=Charles Allen |last2=Kleinplatz |first2=Peggy J. |year=2005 |title=DSM-IV-TR and the Paraphilias: An argument for removal |journal=[[Journal of Psychology and Human Sexuality]] |location=London, England |publisher=[[Taylor & Francis]] |volume=17 |issue=3/4 |pages=91–109 |doi=10.1300/j056v17n03_05 |s2cid=7221862 |authorlink1=Charles Allen Moser}}</ref> [[Ray Blanchard]] stated that the current definition of paraphilia in the DSM done by concatenation (i.e. by listing a set of paraphilias) and that defining the term by exclusion (anything that is not normophilic) is preferable.<ref>{{Cite journal |last=Moser |first=Charles |date=2011 |title=Yet Another Paraphilia Definition Fails |url=http://link.springer.com/10.1007/s10508-010-9717-x |journal=Archives of Sexual Behavior |language=en |volume=40 |issue=3 |pages=483–485 |doi=10.1007/s10508-010-9717-x |pmid=21210203 |issn=0004-0002|url-access=subscription }}</ref>

===Inclusion and subsequent exclusion of homosexuality===
[[Homosexuality]], now widely accepted as a variant of human sexuality, was at one time discussed as a sexual deviation.<ref name="hutchinson">{{cite journal|last=Hutchinson|first=Gerald E.|author-link=Gerald Hutchinson|date=1959|title=A speculative consideration of certain possible forms of sexual selection in man|journal=[[American Naturalist]]|publisher=[[University of Chicago Press]]|location=Chicago, Illinois|volume=93|issue=869|pages=81–91|doi=10.1086/282059|s2cid=86617336}}</ref> [[Sigmund Freud]] and subsequent [[psychoanalytic]] thinkers considered homosexuality and paraphilias to result from [[psychosexual]] non-normative relations to the [[Oedipal complex]],<ref name="lacan">Lacan, Jacques. Le Séminaire. Livre IV. La relation d'objet, 1956–57. Ed. Jacques-Alain Miller. Paris: Seuil, 1991. p. 201</ref><ref name="Karpman1951">{{cite journal|last1=Karpman|first1=Benjamin|title=The sexual psychopath|journal=[[Journal of the American Medical Association]]|publisher=[[American Medical Association]]|location=Chicago, Illinois|volume=146|issue=8|pages=721–726|date=23 June 1951|pmid=14832048|doi=10.1001/jama.1951.03670080029008}}</ref> although not in the antecedent version of the 'Three Essays on Sexual Theory' where paraphilias are considered as stemming from an original polymorphous perversity.<ref>{{Cite journal|last=Freud|first=Sigmund|date=1971|title=Three essays on the theory of sexuality (1905). Summary|url=http://dx.doi.org/10.1037/e417472005-189|access-date=2023-06-30|website=PsycEXTRA Dataset|doi=10.1037/e417472005-189|url-access=subscription}}</ref> As such, the term ''sexual perversion'' or the [[epithet]] ''pervert'' have historically referred to [[gay]] men, as well as other [[non-heterosexual]]s (people who fall outside the perceived norms of sexual orientation).<ref name="hutchinson"/><ref name="lacan"/><ref name="kafka1996">{{cite journal|last=Kafka|first=Martin P.|author-link=Martin Kafka|year=1996|title=Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders|journal=[[Psychiatric Times]]|publisher=MJH Associates|location=New York City|volume=13|issue=6}}</ref><ref name="Cantor2012">{{cite journal|last1=Cantor|first1=James M.|author-link=James M. Cantor|title=Is Homosexuality a Paraphilia? The Evidence for and Against|journal=[[Archives of Sexual Behavior]]|publisher=[[Springer Science + Business Media]]|location=New York City|volume=41|issue=1|pages=237–247|date=February 2012|pmid=22282324|pmc=3310132|doi=10.1007/s10508-012-9900-3}}</ref>

By the mid-20th century, mental health practitioners began formalizing "deviant sexuality" classifications into categories. Originally coded as 000-x63, homosexuality was the top of the classification list (Code 302.0) until the [[American Psychiatric Association]] removed homosexuality from the DSM in 1973. [[Martin Kafka]] writes, "Sexual disorders once considered paraphilias (e.g., homosexuality) are now regarded as variants of normal sexuality."<ref name="kafka1996"/>

A 2012 literature study by clinical psychologist [[James Cantor]], when comparing homosexuality with paraphilias, found that both share "the features of onset and course (both homosexuality and paraphilia being life-long), but they appear to differ on sex ratio, [[fraternal birth order]], [[handedness]], [[IQ]] and [[Constructive developmental framework#The cognitive profile of a person|cognitive profile]], and [[neuroanatomy]]." The research then concluded that the data seemed to suggest paraphilias and homosexuality as two distinct categories but regarded the conclusion as "quite tentative" given the current limited understanding of paraphilias.<ref name=Cantor2012/>