Innovations, reviews and proposals on the DSM-5: The case of sexual dysfunctions, gender dysphoria and paraphilic disorders

Abstract

Human behaviours have different meanings depending on the historical moment and context. In this article, we analyse the way in which psychiatric nosology is structured in texts such as the DSM-5 by studying the category of sexual behaviours. The very design of these diagnostic manuals, in terms of their notion of health, disease, mental health and mental disorders, in short, what is normal and what is pathological, shows that they are far from objective tools, and are very much influenced by certain elements of power.Each new diagnosis, or even the removal of existing diagnoses and the recomposition of the different diagnostic criteria, particularly in the field of sexual behaviour, represents a particular view of individual and collective human life, and constitutes an attempt to control human sexuality by medicalising behaviours and bringing to bear moral, religious and even legal considerations.Categories such as gender dysphoria, paraphilia or paraphilic disorders are examples of how the limits imposed on biomedical perspectives, in addition to being incomplete and imprecise, violate the individual and social construction of sexual behaviour and the very notion of mental health, and are evidence of the ongoing difficulties and controversies involved in drawing up psychiatric classifications.