Yet Another Paraphilia Definition Fails

Abstract

Historically, it has been difficult to define paraphilias in a consistent manner or distinguish paraphilias from non-paraphilic or normophilic sexual interests (see Blanchard, 2009a; Moser & Kleinplatz, 2005). As part of the American Psychiatric Association’s (APA) process of revising the Diagnostic and Statistical Manual of Mental Disorders (DSM), Blanchard (2010a), the chair of the DSM-5 Paraphilias subworkgroup (PSWG), has proposed a new paraphilia definition: ‘‘A paraphilia is any powerful and persistent sexual interest other than sexual interest in copulatory or precopulatory behavior with phenotypicallynormal, consentingadulthumanpartners’’ (p. 367). Blanchard (2009a) acknowledges that his paraphilia ‘‘definition is not watertight’’and it already has attracted serious criticism (see Haeberle, 2010; Hinderliter, 2010; Singy, 2010). The current analysis will critique three components of Blanchard’s proposed definition (sexual interest in copulatory or precopulatory behavior, phenotypically normal, and consenting adult human partners) to determine if the definition is internally consistent andreliably distinguishes individualswith a paraphilia from individuals with normophilia. Blanchard (2009a) believes his definition ‘‘is better than no real definition,’’but that remains to be seen. According to Blanchard (2009a), the current DSM paraphilia definition (APA, 2000) is a definition by concatenation (a list of things that are paraphilias), but he believes a definition by exclusion (everything that is not normophilic) is preferable. The change is not substantive as normophilia (formerly a definitionofexclusion)nowbecomesadefinitionofconcatenation (a list of acceptable activities). Nevertheless, it seems odd to define a paraphilia on the basis of what it is not, rather than by the commonalities among the different paraphilias. Most definitions are statements of what things are, not what things are excluded or lists of things to be included. Blanchard (2009a) purposefully left ‘‘intact the distinction betweennormativeandnon-normativesexualbehavior,’’implying that these categories are meaningful. Blanchard (2010b; see alsoBlanchardetal.,2009)definesaparaphiliabyrelativeascertainment (the interest in paraphilic stimuli is greater than the interest in normophilic stimuli) rather than absolute ascertainment (the interest is intense). Using relative ascertainment confirms that one cannot be both paraphilic and normophilic; the greater interest would classify the individual as paraphilic or normophilic. Blanchard (2010a) then contradicts himself when he asserts that once ascertained with a paraphilia, the individual should retain that label, even if the powerful and persistent paraphilic sexual interest dissipates. Logically, the relative dissipation of the paraphilic and augmentation of the normophilic interests should re-categorize the individual as normophilic. The first aspect of Blanchard’s paraphilia definition is the ‘‘sexual interest incopulatoryorprecopulatorybehavior.’’Obviously, most normophilic individuals do not desire or respond sexually to all adults. Ascertaining if someone is more aroused by the coitus or their partner’s physique, attitude, attributes, etc. seems fruitless and hopelessly convoluted. I can see no other way to interpret sexual interest in copulatory or precopulatory behavior, except to conclude that coitus (between phenotypically normal consenting adults) is normophilic. Otherwise, a powerful and persistent preference for blonde (or Asian or petite) coital partners is a paraphilia. If a relative lack of sexual interest in brunettes as potential coital partners indicates a C. Moser (&) Department of Sexual Medicine, Institute for Advanced Study of Human Sexuality, 45 Castro Street, #125, San Francisco, CA 94114, USA e-mail: docx2@ix.netcom.com 1 Another version of this definition exists (Blanchard, 2009a, 2009b), but I do not believe the changes substantially alter any of my comments.