title: Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11).
abstract: The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged with reviewing and making recommendations for categories related to sexuality that are contained in the chapter of Mental and Behavioural Disorders in ICD-10 (World Health Organization 1992a). Among these categories was the ICD-10 grouping F65, Disorders of sexual preference, which describes conditions now widely referred to as Paraphilic Disorders. This article reviews the evidence base, rationale, and recommendations for the proposed revisions in this area for ICD-11 and compares them with DSM-5. The WGSDSH recommended that the grouping, Disorders of sexual preference, be renamed to Paraphilic Disorders and be limited to disorders that involve sexual arousal patterns that focus on non-consenting others or are associated with substantial distress or direct risk of injury or death. Consistent with this framework, the WGSDSH also recommended that the ICD-10 categories of Fetishism, Fetishistic Transvestism, and Sadomasochism be removed from the classification and new categories of Coercive Sexual Sadism Disorder, Frotteuristic Disorder, Other Paraphilic Disorder Involving Non-Consenting Individuals, and Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals be added. The WGSDSH's proposals for Paraphilic Disorders in ICD-11 are based on the WHO's role as a global public health agency and the ICD's function as a public health reporting tool.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, USA. rbk1@cumc.columbia.edu.|Department of Psychiatry, New York Presbyterian Hospital, New York, NY, USA. rbk1@cumc.columbia.edu.|Sexual Behavior Clinic, New York State Psychiatric Institute, 1051 Riverside Drive, Unit #45, New York, NY, 10032, USA. rbk1@cumc.columbia.edu.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Krueger
authors.affiliation: Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.|Global Mental Health Program, Columbia University Medical Center, New York, NY, USA.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Reed
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: First
authors.affiliation: Department of Psychiatry and Mental Health, Groote Schur Hospital, University of Cape Town, Observatory, South Africa.
authors.forename: Adele
authors.initials: A
authors.lastname: Marais
authors.affiliation: , Geneva, Switzerland.|Global Health Justice Partnership, Yale Law School, New Haven, CT, USA.
authors.forename: Eszter
authors.initials: E
authors.lastname: Kismodi
authors.affiliation: Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Peer
authors.initials: P
authors.lastname: Briken
mesh_terms: D005329:Fetishism, Psychiatric / Q000145:classification; D006801:Humans; D038801:International Classification of Diseases; D008398:Masochism / Q000145:classification; D010262:Paraphilic Disorders / Q000145:classification*; D012725:Sexual Behavior / Q000145:classification*; D019529:Sexuality; D014190:Transvestism / Q000145:classification
keywords: DSM-5; Disorders of sexual preference; ICD-10; ICD-11; Paraphilias; Paraphilic disorders