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According to the American Psychiatric Association, a paraphilia is a type of mental disorder diagnosed by any unusual sexual behavior, which includes preferences of a nonhuman object for sexual arousal, engaging in repetitive sexual activity with humans involving real or simulated suffering or humiliation, engaging with partners based off their appearance including age, femininity (or lack thereof) and ethnicity, or repetitive sexual activity with nonconsenting partners. The third edition of the Diagnostic and Statistical Manual of Mental Disorders introduced the word "paraphilia" and noted, "In other classifications these disorders are referred to as Sexual Deviations. The term Paraphilia is preferred because it correctly emphasizes that the deviation (para) lies in that to which the person is attracted (philia)".

In February 2011, Allen Frances and Michael B. First, Chair of the DSM-IV Task Force and its Editor of Text and Criteria, respectively, published an "insider's parsing of the intended meanings" of the first three sentences of the DSM section on paraphilias and stressed that the underlying principle governing inclusion in this category is that a person's focus of sexual arousal be considered deviant, bizarre, and unusual. Thus, if a sexual preference, fantasy, urge, or behavior were to be deemed characteristic of normal people or not inherently deviant, then the sexual arousal or conduct would not be considered evidence of a paraphilia.[1]


Homosexuality was in the first edition of the DSM as a sexual deviation. Liberal influences have continued to erode the APA ever since then.


Ego-dystonic homosexuality coded as mental disorder.

In DSM-III-R, it was moved to "sexual disorder not otherwise specified", which could include "persistent and marked distress about one's sexual orientation."


Sexual sadism, sexual masochism, voyeurism, exhibitionism, and transsexuality were all listed and defined in this version of the DSM. They are also remarkably absent from the DSM-5 (the most current version). Liberalism, while not (entirely) a sexual disease, has contributed to this change.

The DSM-5

The current indeces for paraphilias are as follows.[2]

The following specifier applies to Paraphiliac Disorders when indicated:
Specify if: In a controlled environment. In full remission
302.82 (F65.3) Voyeuristic Disorder (686)
302.4 (F65.2) Exhibitionistic Disorder (689)
Specify whether: Sexually aroused by exposing genitals to prepubertal children. Sexually aroused by exposing genitals to physically mature individuals. Sexually aroused by exposing genitals to prepubertal children and to physically mature individuals
302.89 (F65.81) Frotteuristic Disorder(691)
302.83 (F65.51) Sexual Masochism Disorder (694)
Specify if: With asphyxiophilia
302.84 (F65.52) Sexual Sadism Disorder (695)
302.2 (F65.4) Pedophilic Disorder (697)
Specify whether: Exclusive type. Nonexclusive type Specify if: Sexually attracted to males. Sexually attracted to females. Sexually attracted to both Specify if: Limited to incest
302.81 (F65.0) Fetishistic Disorder (700)
Specify: Body part(s). Nonliving object(s). Other
302.3 (F65.1) Transvestic Disorder (702)
Specify if: With fetishism. With autogynephilia
302.89 (F65.89) Other Specified Paraphilic Disorder (705)
302.9 (F65.9) Unspecified Paraphilic Disorder (705)


  1. Frances, Allen and First, Michael B. (February 2011). "Hebephilia Is Not a Mental Disorder in DSM-IV-TR and Should Not Become One in DSM-5". J Am Acad Psychiatry Law 39 (1): 78–85. 
  2. American Psychiatric Association. (2013). Paraphiliac Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).

See also