Philosophical issues in the paraphilias.
OBJECTIVE
Controversies surrounded the development of paraphilias in the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5. This review examines the philosophical issues that emerge from an analysis of those debates and current literature.


RESULTS
The resolution of controversies in the publication of the DSM 5 drew upon the available evidence, theories of mental disorder, and normative assumptions. The rise of the Internet presents difficult challenges in this field.


CONCLUSIONS
Numerous philosophical assumptions underlie the psychiatric understandings of paraphilias. The focus here is on the nosological issues such as boundary justification for the determinations of normative and nonnormative human sexuality; the importance of not collapsing the distinction between mental disorder and crime, and the relationship between fantasy and action; epistemological questions of perspectivity, reasons-giving, and relationship of communication to truth claims; and sex differences not only in the paraphilias but also in the social context in which sex is formed and given expression.
Department of Philosophy, University of Louisville, Louisville, KY, USA.
Nancy N
NN
Potter
D039721:Diagnostic and Statistical Manual of Mental Disorders; D005084:Exhibitionism / Q000523:psychology; D005201:Fantasy; D005260:Female; D006801:Humans; D007989:Libido; D008297:Male; D057228:Masculinity; D010262:Paraphilic Disorders / Q000175:diagnosis* / Q000523:psychology*; D010684:Philosophy; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology