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There has been some confusion in recent questions about the term paraphilia. In most questions and answers, including my own, paraphilias have been seen as disorders that might require treatment.

But are paraphilias disorders?

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2 Answers 2

The DSM-5 does not list all paraphilia as a disorder! According to the DSM-5,

The term paraphilia denotes any intense and persistent sexual interest other than sexual interest in genital stimulationor preparatory fondling with phenotypically normal, physically mature, consenting human partners.

What the DSM-5 does list are paraphilic disorders:

A paraphilic disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia b itself does not necessarily justify or require clinical intervention.

In the diagnostic criteria set for each of the listed paraphilic disorders, Criterion A specifies the qualitative nature of the paraphilia (e.g., an erotic focus on children or on exposing the genitals to strangers), and Criterion B specifies the negative consequences of the paraphilia (e.g. distress, impairment, or harm to others). In keeping with the distinction between paraphilias and paraphilic disorders, the term diagnosis should be reserved for individuals who meet both Criteria A and B.

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Thanks, this is a useful reference. I hope you are linking to it from the relevant question. –  Artem Kaznatcheev Jan 31 at 17:55

Paraphilia and paraphilia disorder were basically synonymous before DSM 5. It was up to individual clinicians to determine the level of dysfunction caused by the abnormal behaviour as it still is today. DSM 5 only specifically outlines non-distressing consensual abnormal behaviour as determined by a psychologist as non disorderly. (Paraphilia can be subconsciously distressing in the same method anger can be dangerous if internalized) Indeed no amount of consent is going to make a frequent paraphilia psychologically normal but it is ok.

One would ascertain a paraphilia (according to the nature of the urges, fantasies, or behaviors) but diagnose a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder." The 'Rationale' page of any paraphilia in the electronic DSM-5 draft continues: "This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological.

Bioethics professor Alice Dreger interpreted these changes as "a subtle way of saying sexual kinks are basically okay – so okay, the sub-work group doesn’t actually bother to define paraphilia. But a paraphilic disorder is defined: that’s when an atypical sexual interest causes distress or impairment to the individual or harm to others." Interviewed by Dreger, Ray Blanchard, the Chair of the Paraphilias Sub-Work Group, explained: "We tried to go as far as we could in depathologizing mild and harmless paraphilias, while recognizing that severe paraphilias that distress or impair people or cause them to do harm to others are validly regarded as disorders."

-wikipedia

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And with this change, DSM-5 reflects a change in common morality. Which shows that clinical diagnoses are not absolute, but depend on the cultural context which defines "normality" and what deviates from it. E.g. aggression was a necessary trait to survive as a stone age hunter (maybe), but today it is seen as disruptive and warrants treatment. It also shows that one must use contemporary definitions to diagnose and discuss a disorder. –  what Feb 1 at 6:50
    
@what no that is not the case; the citations i give are very clear –  caseyr547 Feb 1 at 6:51

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