Ask Gloria About BDSM: Should BDSM be classified as a paraphilia?

Hi, Gloria,

Here’s my question for you. I feel like labeling BDSM as a paraphilia does more harm than good. It stigmatizes the lifestyle which leads to stereotypes and inaccurate information.

In Justin Lehmiller’s book, Tell Me What You Want, he surveyed 4,175 Americans about their sexual fantasies and found that BDSM was the second most common fantasy that people had. How can something that almost everyone fantasizes about be considered a paraphilia?

Do you think that BDSM should no longer be considered a paraphilia, given how secretly popular it is?

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Hello, friend,

Not only do I agree, I think the whole concept of paraphilias is based on bad science.

Let’s look at the word paraphilia first.  The first definition to pop up on google is “a condition characterized by abnormal sexual desires, typically involving extreme or dangerous activities.”

The word, paraphilia, comes to us thanks to early 20th-century sex scientists.  Not to disparage a generation of courageous men who forged the foundations of my field, but they drank the kool-aid of Victorian patriarchy.  Their science was distinctly by and for white, middle-class European men.

Their assumptions sprang from a shared belief that male-dominant, missionary position, reproductive sex between man and woman was normal, while everything else — including masturbation, anal sex, oral sex, bisexuality, homosexuality, transgenderism, lesbianism, fetishism and what we call BDSM today — were symptomatic of insanity.

They did not do cross-cultural studies.  They did not have medical data.  They did not have data gathering as we know those methods today. They based their work on anecdotal evidence, like case studies of the troubled people who visited them or the ones they interviewed in psychiatric hospitals.  They shared those case studies to grow a resource all sex scholars could learn from.  If you ever pick up one of their old books you’ll see they’re crammed with Victorian interpretations of unusual sex and fetishes.  I recommend Psychopathia Sexualis (free on Kindle!) by von Krafft-Ebing, the foundational work that’s left a lasting impression on Psychiatry.

There is another huge flaw in the old science.  These doctors relied on case studies of the troubled people who sought help.  They did not see or seem to know any people who were at peace with their kinks or sexual identity.  They, therefore, assumed there was a correlation between mental illness and nonconformist sex.   If a happy submissive woman walked in and said, “I had the greatest time getting tied up last night and the nipple clamps were just CREAMY!” I don’t know what those stuffy dudes would think, but I’m pretty sure it would result in her getting institutionalized and treated for hysteria.

Today’s sex scientist does not jump to conclusions about human sexuality based on “clinical drift,” because we know that a helping professional sees a high concentration of people with problems.  We know that the vast majority of sexually nonconformist people melt into the background of daily life, either finding safe ways to live their truths or choosing to mask their urges and live straight.  There’s no reason to think people were different 200 or 2000 years ago.  Consider Leonardo Da Vinci.  I just know he’d show up at a Gay Leather club and build bomb-ass bondage equipment if he was alive today.

There is genetic evidence and a good bit of hard and soft science proving that people have, yep, you guessed it, always been people!  Wow.  They have always had peoply emotions and peoply sex behaviors.  There’s plenty of weird nonconformist sex in the Bible, including master/slave relationships, intergenerational relationships, even incest.

So ask yourself, why did a privileged white European male clique get to decide what is normal for the whole rest of the world?  Hint: toxic masculinity.  Another hint: patriarchy.  One more:  elitism.

Meanwhile, WHAT THE HELL IS ABNORMAL? Research into sex history has shown us that fetishism, kink, anal, transgenderism, sex-same love, and everything else is as old as human history and therefore older than recorded history.  So as you suggest, if enough people do it, does it cease being “abnormal” and become “oh well, normal enough I guess”?  If a bell curve shows us that most people today identify as bisexual does that mean heterosexuality is now abnormal?  Is it more abnormal if you despise your abnormality or do you have to enjoy your abnormality to quality as abnormal?

Abnormal is a fuzzy concept unless applied to hard data (like “abnormal blood count” or “abnormal temperature”), things we can accurately measure in standardized ways.  In sex, it sounds like prude-speak for “sinful” or “freak-ay!” and “oooh, that makes me uncomfortable.”   Certainly, there is criminal (i.e., nonconsensual) sex, which should be prosecuted. There is BAD sex, which is a damn shame (why aren’t they reading me?).  There is risky sex, which may harm you.  But what is abnormal to one person is normal to another and that’s why the DSM sex labels sound like junk science.

Similarly, what is “extreme”?  What is “dangerous”?  The old scientists believed that anything outside of sex to make babies was dangerous.  Even having a lot of sex with your spouse was viewed as potentially dangerous and extreme.  In their minds, men who enjoyed a buffet of erotic adventures at home were just minutes away from running into the street and ass-raping strangers.   At least that attitude’s changed!  Or has it?

By holding on to standards first established by forensic psychiatrists (notably Krafft-Ebing), today’s psychiatric opinions of sex are as likely to be dead wrong about as often they are to be competent.  I say this based only my own clinical drift, so maybe others have had different experiences.  Half a dozen clients have come to me for second opinions after psychiatrists demoralized them with judgment and labels. Psychiatrists (and the law courts who accept their evaluations) continue like this because the diagnostic governing group for all helping professionals in the US (the APA) allows them and affirms them.

This history of sex in the DSM gives you a snapshot of the grudging evolution of psychiatric attitudes towards accepting diversity in sex.  I admire the work of psychiatrist Thomas Szasz, who advocated for clients to be treated more humanely and for doctors to stop medicalizing behaviors that didn’t fit the politico-religious narrative.

Should BDSM be struck as a paraphilia?  YES.  Will it?  I don’t know!

It’s already been struck from diagnostic manuals in Scandinavia, officially by the World Health Organization and should be struck the world over. Americans would reap the benefit if they made the much needed sexological changes to the DSM in the next revision. No form of consensual, risk-aware, crime-less sex should be considered abnormal.