In Liege, Belgium. March 2004
Photo credit: Dave Harris
The American Psychiatric Association has a list of mental illnesses called the Diagnostic and Statistical Manual of Mental Disorders (DSM). Homosexuality was removed from the DSM in 1973, but it still contains a section on paraphilias which includes Sexual Sadism, Sexual Masochism, Fetishism, Transvestic Fetishism, Voyeurism, Frotteurism, Exhibitionism and Paedophilia.
Obviously there are some restrictions before you can be diagnosed as a Sexual Sadist or Sexual Masochist. You have to have had intense, arousing SM fantasies for at least 6 months, which narrows down the group of people who could receive a diagnosis ... hardly at all. The SM fantasies also need to have caused you marked distress or interpersonal difficulty. But if you lose your job because someone tells your boss that you like SM, then it can be said that SM has caused you marked distress or interpersonal difficulty! Another symptom psychiatrists are recommended to look out for is when your fantasies involve a non-consenting person. But how can your SM partner give their consent if they have also been diagnosed as having a mental illness?
Those of you who live outside North American may think you have nothing to worry about. Unfortunately the World Health Organisation (WHO) has an International Classification of Diseases (ICD) which includes Fetishism, Transvestism and Sadomasochism as a psychiatric diagnoses. So if you live in the rest of the world and like SM, watch out, you too could be diagnosed as having a mental illness.
Does any of this really matter? Surely anyone who enjoys SM and wants psychiatric treatment would look for a kink-friendly therapist?
Unfortunately the law and the psychiatric profession work hand in hand. If an SM player ends up in court fighting for custody of their children, as a victim of rape or abuse, or defending themselves against allegations of assault following a consensual scene, then it is not going to help when the court asks for a psychiatric evaluation and the SM player is given a positive diagnosis of mental illness. We can stop the courts from using this against us if we can persuade the psychiatric professions to remove SM from their lists of diseases.
Some people argue that SM should stay listed as a possible diagnosis because "it's not right for everyone" or "it causes some people problems". Well I know some people who work in jobs that are not right for them or that cause them depression, but we don't classify the profession they work in as a potential mental illness. Instead we recommend that the person gets another job.
The good news is that there are people campaigning for change.
The Revise F65 project in Norway is lobbying to remove Fetishism, Transvestism and Sadomasochism as psychiatric diagnoses from the International and national Classifications of Diseases published by the WHO. On the other side of the Atlantic two academics, Dr Peggy Kleinplatz and Dr Charles Moser, are writing scholarly papers arguing that the entire paraphilias section should be removed from the American Psychiatric Association's DSM. (They say that they would like the entire section removed because some paraphilias, like paedophilia, should be treated as serious crimes and having them listed as mental illnesses helps paedophiles obtain more lenient sentences in court.)
Here are some things that you can do to help:
MAY 2018 UPDATE: The Revise F-65 Project have achieved their goal! The World Health Organisation has announced that fetish and BDSM will be removed from their list of diseases. (https://revisef65.net/)
Thanks for your support.
Hugs and bruises,
International Mr Leather 2003