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Paraphilias: The Pathologic Side of Sex

Reproduction through the sexual act allows the constant renewal of the genetic heritage.

Reproduction through the sexual act allows the constant renewal of the genetic heritage.

Life on Earth appeared between 4.4 and 3.7 billion years ago, and for a very long time, reproduction was asexual. Only with the advent of complex multicellular organisms did individuals differentiate into male and female. Evolution has favored reproduction through the sexual act because it allows the constant renewal of the genetic heritage.

This article will discuss the difference between sex and human sexuality, with particular references to:

  • its evolutionary aspects,
  • its manifestations that are considered normal,
  • its psychopathological aspects (definition and description of paraphilias) according to the DSM-5,
  • how the classification of paraphilias has changed with the progress of psychiatry, and
  • the social impact of paraphilias.

Table of Contents

  1. Sex: An Evolutionary Strategy
  2. The DSM: The Uniquely Recognized Reference Text in Psychiatry
  3. The Paraphilias
  4. The Classification of Paraphilias: An Ongoing Process
  5. Paraphilias in the Society

1. Sex: An Evolutionary Strategy

Sexual genders represent the fundamental stage in the development of the ecosystems that have followed one another in the biological eras up to today.

Sex is the set of acts aimed exclusively at reproduction, while sexuality is the set of psychological aspects related to sex and can be observed solely in the human species.

In summary, sex is related to biology, while sexuality is to the intellectual dimension.

The Various Aspects of Sexuality

Sexuality is one of the most powerful vital impulses humans can experience, comparable only to the instinct for self-preservation that we share with all living creatures.

There is a substantial difference between male and female heterosexuality:

  • For the male, it is important to reproduce as much as possible.
  • For the female, the essential thing is to select the most suitable mate to procreate.

Homosexuality is hypothesized as a tool chosen by evolution to contain the number of individuals.

Defining Normal Sexuality

An expression of normal sexuality can be defined as any behavior that does not involve:

  • violence,
  • coercion, or
  • repression

toward the occasional or habitual partner.

Consensuality between physically and psychologically healthy and sexually mature individuals is fundamental to considering human sexuality normal.

Violence, coercion, and repression never represent normal sexuality.

Violence, coercion, and repression never represent normal sexuality.

2. The DSM: The Uniquely Recognized Reference Text in Psychiatry

The DSM (Diagnostic and Statistical Manual of Mental Disorders) has been published by the American Psychiatric Association in five editions:

  • DSM-I (1952)
  • DSM-II (1968)
  • DSM-III (1980)
  • DSM III-R (1987)
  • DSM-IV (1994)
  • DSM-5 (2013)

The latest version refers to the "International Classification of Diseases and Related Health Problems" of the World Health Organization (WHO).

Today this publication is a reference to diagnose pathologies and disorders in the psychiatric field with universal criteria. Thanks to this, an Italian patient with the same symptoms as a Russian or American one receives the same diagnosis in Italy, Russia, the US, or any other country, as long as he consults an up-to-date and trained psychiatrist.

The progress of psychiatry has determined that some disorders considered pathologies in the past are now better defined and treated.

3. The Paraphilias

The term "paraphilia" comes from the union of the Greek words παρά (pará) = "near," and φιλία (filía) = "love," and was created by the DSM-IV to define sexual arousal. The person affected is well aware of his condition and cannot live his sexuality except through disturbed and disturbing behaviors.

Below are some examples of common paraphilias:

  1. Sadism: The behavior of those who have the impulse to inflict suffering on other people. This paraphilia can occur equally in both heterosexual and homosexual people and leads to behaviors that are always seriously harmful to the victims if implemented.
  2. Sexual exhibitionism: The behavior of those who have the impulse to show genitals in public for a period exceeding six months. It can be limited to a desire confined to fantasies or evolve into concrete delinquent behaviors that represent the step from disorder to full-blown pathology.
  3. Sexual fetishism: The behavior of those who present, for a period exceeding six months, the impulse of achieving sexual arousal in the exclusive presence of particular objects. It is generally considered a compulsive disorder of a sexual nature and can degenerate into delinquent behavior to the detriment of people or things.
  4. Frotteurism: The behavior of those who manifest, for a period exceeding six months, the need to rub against a non-consenting person. If committed, this behavior is now considered sexual assault.
  5. Pedophilia: The behavior of those who present, for a period exceeding six months, sexual desire for children under the age of 13 or underage subjects who do not show physical characteristics typical of adults and can be directed both toward males and females or simultaneously. This paraphilia can occur equally in both heterosexual and homosexual people and leads to behaviors that are always seriously harmful to the victims if implemented.
  6. Masochism: The behavior of those who present, for a period exceeding six months, fantasies, impulses, and concrete behaviors aimed at obtaining psycho-physical humiliation.
  7. Cross-dressing: The behavior of those who present, for a period exceeding six months, the tendency to cross-dress as a person belonging to the opposite sex, to be distinguished from the condition of transsexualism.
  8. Voyeurism: It occurs when the subject presents, for a period greater than or equal to six months, the impulse and desire to observe people in sexual attitudes, unaware of being watched.
  9. Transvestism: It falls within the paraphilias but is considered on the sidelines of sexual identity disorder.
Voyeurism consists of the impulse to watch other people engage in sexual activities.

Voyeurism consists of the impulse to watch other people engage in sexual activities.

4. The Classification of Paraphilias: An Ongoing Process

The DSM-IV begins to differentiate paraphilias based on the obsessive-compulsive aspect toward behaviors or situations not directly connected to the reproductive purposes typical of traditional sex. In the absence of this element, such sexual practices are considered only unusual, without necessarily implying that they are "wrong" or "sick."

The term "paraphilia" was introduced to replace, with a more rigorous scientific classification, the old definition of sexual perversions or deviations, which once included homosexuality and other forms of sexuality.

The DSM-5 confirms the cornerstone that distinguishes paraphilias from other expressions of sexuality: the link between paraphilic behavior and sexual activity; without the former, the latter is impossible.

5. Paraphilias in Society

In psychiatry, all paraphilias have in common the conception and implementation of certain rituals or behaviors essential to achieve sexual arousal.

In a social context, the parameters for evaluating paraphilias are entirely different in relation to eras and cultures. If fetishism, for example, does not determine or rarely determines socially unacceptable behavior, everything changes when we speak of pedophilia or sadism.

Anything that involves violence, oppression, and physical or psychological damage is condemned in almost all modern cultures and punished at the judicial level, even if deeply rooted ancestral taboos impede or significantly hinder an open dialogue and an appropriate emotional education of human sexuality.

References

  1. American Psychiatric Association. (2017). Diagnostic and statistical manual of mental disorders: Dsm-5.
  2. Italian National Institute of Geophysics and Volcanology. (2020, July 4). Quando La Vita Comparve Sulla Terra. Retrieved December 29, 2022.
  3. Elenco Completo Parafilie - Perversioni. Psicologo. (2020, November 5). Retrieved December 29, 2022.
  4. Barba, M. (2016, May 23). Teorie Biologiche e genetiche sull'omosessualità. OggiScienza. Retrieved December 29, 2022.
  5. Ruberti, E. (2020, October 9). Sesso E Sessualità: Biologia e Sviluppo Antropologico. Il Progresso Magazine. Retrieved December 29, 2022.

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2022 Giovanna Rezzoagli Ganci