Paraphilia

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Paraphilia (in Greek para παρά = beside and -philia φιλία = friendship, having the meaning of love) is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her. A paraphilia involves sexual arousal and gratification towards sexual behavior that is atypical and extreme.[1] The term was coined by Wilhelm Stekel in the 1920s.[2] Controversial sexologist John Money later popularized the term as a nonpejorative designation for unusual sexual interests.[3][4][5][6] He described paraphilia as "a sexuoerotic embellishment of, or alternative to the official, ideological norm."[7]

In the late 19th century, psychologists and psychiatrists started to categorize various paraphilias as they wanted a more descriptive system than the legal and religious constructs of sodomy[8] and perversion.[9] Before the introduction of the term paraphilia in the DSM-III (1980), the term sexual deviation was used to refer to paraphilias in the first two editions of the manual.[10] American Journal of Psychiatry[11] describes paraphilia as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving:

The view of paraphilias as disorders is not universal. Some groups seeking greater understanding and acceptance of sexual diversity have lobbied for changes to the legal and medical status of unusual sexual interests and practices. Charles Allen Moser, a physician and advocate for sexual minorities, has argued that the diagnoses should be eliminated from diagnostic manuals.[13] Psychiatrist Glen Gabbard writes that despite efforts by Stekel and Money, "the term paraphilia remains pejorative in most circumstances." [14]

In the current version of the DSM (DSM-IV-TR), a paraphilia is not diagnosable as a psychiatric disorder unless it causes distress to the individual or harm to others. The DSM-5 draft adds a terminology distinction between the two cases, stating that "paraphilias are not ipso facto psychiatric disorders", and defining paraphilic disorder as "a paraphilia that causes distress or impairment to the individual or harm to others".[15]

In the United States, following a series of landmark cases in the US Supreme Court, persons diagnosed with paraphlias and a history of anti-social behavior, particularly pedophilia (Kansas v. Hendricks, 1997) and exhibitionism (Kansas v. Crane, 2002), can be held indefinitely in civil confinement under various state legislation generically known as SVP laws[16][17] and the federal Adam Walsh Act (United States v. Comstock, 2010).[18][19]

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