The Diagnostic and Statistical Manual of the American Psychiatric Association (DSM), is the standard reference for defining the criteria for all psychiatric diagnoses. Its influence broadly affects law, child-custody, employment and other social issues. The long awaited revision of the DSM, DSM-IV-TR (DSM, fourth edition, text revision), has just been published. The present paper will critically review whether DSM-IV-TR meets its own goals to "correct factual errors," "to ensure that all of the information is still up-to-date," and "to reflect new information available since the DSM-IV literature reviews were completed in 1992" (p. xxix). Sexual Sadism and Sexual Masochism will be used as case examples to show the confusion these diagnostic criteria have generated. Generic problems with the DSM conceptualization of paraphilias will be highlighted. The problems with the requirement to specify the behavior for each paraphilia diagnosis will be explored. Cross-cultural and trans-historical perspectives will be presented. Alternative conceptualizations and diagnostic language will be suggested. The role of the activist community in changing the DSM will be discussed at length. The impact of the psychiatric diagnoses on discrimination against S/M practitioners will be analyzed. Strategies for the activist to discuss and confront these diagnoses will be highlighted.

The lecture planned is being adapted from a presentation to be given in several venues. These include Society for Sex Therapy and Research (3/22-25/01) in Montreal, The Society for the Scientific Study of Sexuality - Western Region (4/12-15/01) in Newport Beach, The American Association of Sex Educators, Counselors and Therapists (5/2-6/01) in San Francisco, and at the World Congress of Sexology (6/24-28/01) in Paris. I do not have a detailed outline for the lecture at this time, but even if I did it could not be published until the paper is published. The paper will probably be published in a special issue of the Journal of Psychology and Human Sexuality critiquing the sex and gender diagnostic categories in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (2000).

 

Web Questions - Email our Webmaster