Classifying sexual disorders: the Diagnostic and Statistical Manual of the American Psychiatric Association

The objectivity of the classification of sexual disorders in the third edition of the Diagnostic and Statistical Manual (DSM-III) of the American Psychiatric Association is explored via a critical examination of the replacement of homosexuality per se by ego-dystonic homosexuality, DSM's working concept of a mental disorder, the notion of a paraphilia, components of sexual identity, and the literature on variant sexual behaviors. It is argued that the same criteria that led to the removal of homosexuality per se as a mental disorder require the removal of all the paraphilias per se, there is no empirical warrant to justify their continued inclusion, and while there is legitimacy for a generalized ego-dystonic category, such ego-dystonias are only incidentally sexual. It is suggested that the present classification of sexual disorders is merely the codification of social mores.