Being IML - April 2004

John in Liege, Belgium, March 2004
In Liege, Belgium. March 2004
Photo credit: Dave Harris

Looking back at the first 24 men to hold the title, I could see that IML winners were a little bit "unusual" compared to the rest of the population. (Does being IML for a year make you eccentric, or do the judges see a certain kind of madness within the winner? I think we should be told.) However, I had no idea that according to the American Psychiatric Association I could be officially diagnosed as having a mental illness simply for liking SM.

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:

  1. Support your local SM organisations.

  2. Talk about these diagnoses within your local organisations. Too many SM participants (and others who want to participate but do not dare) are affected by the stigma of being interested in SM without realising that this stigma is upheld by the official diagnostic manuals of the APA and the WHO. Spread the word that these diagnoses remain official psychiatric policy and talk about the importance of this issue.

  3. Question SM-negativity that leads parts of the general public, gay community and even some SM community members to assume that SM must be "sick".

  4. Support BDSM civil rights groups such as the National Coalition for Sexual Freedom in the USA and others throughout the world. There is a list of campaigning organisations on my links page. Stay in touch for strategies to fight the APA/ DSM and WHO/ ICD as developments unfold.

  5. Invite the Revise F65 project to give a seminar in your town or city, especially if you can offer to cover their expenses.

  6. The Revise F65 project would like to build a network of supporters all over the world, including as many mental health professionals and national psychiatric organisations as possible. This is the same process as when homosexuality was taken away as a mental disorder, first by several countries and their national psychiatric organisations, followed by the WHO itself. (They are not looking to lobby the WHO directly at the moment.) The Project is also looking for donations and website support.

  7. You can access two articles written by Dr Charles Moser and Dr Peggy Kleinplatz online. (The web server cannot cope with a lot of traffic so you may need to try more than once.) The first explains why Transvestitic Fetishism should be removed from the DSM. It was published in "The New Jersey Psychologist" in 2002. The second article argues that the entire Paraphilia section should be removed from the DSM.

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. (

Thanks for your support.

Hugs and bruises,

John Pendal
International Mr Leather 2003

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