Patologisering af non-reproduktive seksuelle praksisser aktuelt og historisk

Resumé

The article provides a critical commentary on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-V, from 2013. It traces the historical reasons behind the fact that sexual preferences are included as mental disorders in the psychiatric manual, even if many of them are empirically neither generally associated with impairment or harmful to anyone else. This holds true for fetishism, masochism and consensual sadism among others, and the article pays special attention “sadism” and “masochism, which as “clinical” terms are constituted from the names of literary authors. Second it close reads the descriptions in DSM-V to show that there are several reasons why these descriptions become pathologizing and stigmatizing despite explicit intentions to be the opposite. These include erosions of the distinction between paraphilia and paraphilic disorder – a distinction on which the very possibility of diagnosis is established. Furthermore, the handbook does not make the non-consensual, the impairing or the harmful, the over-riding principle but instead the sexual preference in and of itself. The article shows how deeply affected the conceptions of the real-world preferences are by the events and characters in the fiction of these authors, and how hierarchical disparity and power exchange are typically more central to the preferences than pain with which they have been so closely linked.