That’s the central question the Paraphilias Sub-Work Group of the American Psychiatric Association has had to face as they’ve developed proposed revisions for the DSM-5. Pity those given the task of trying to figure out how, when, and why to medicalize or de-medicalize everything from asexuality to zoophilia (the latter being the sexual interest known to less progressive types as bestiality).
Looming over the whole task is the ugly history of the pathologizing of homosexuality. As I teach my students every year, it took until 1973 for the American Psychiatric Association to stop officially categorizing all forms of homosexuality as mental disorders. And that official demedicalization happened not because a happy and spontaneous consensus emerged that the science supported the change, but because gay psychiatrists understandably had had enough.
Nowadays, you can find self-appointed representatives of every sexual interest who will try to align their history with homosexuality, because, like the gay psychiatrists of the early 1970s, they want out of the DSM. The bondage folks, the zoophiles – even the pedophiles want out. At least the vocal ones do. They’ll tell you that, like gay men and lesbians, they never should have been in the book in the first place.
I would have been watching the progress of the Paraphilias Sub-Work Group regardless; as an historian of sexuality, I’m professionally fascinated to see where it will all go. But as it turns out, I’ve had something of a ringside seat, because my friend Ray Blanchard has been serving as the chair of the sub-work group.