1. Problems with the DSM-IV Definition of Sexual Paraphilia: Criterion A: (1) Lumps together disparate categories of sexual behaviour when there is no evidence that these behaviours are related. (2) Fails to distinguish between consensual sexual activity and non-consensual activity. (3) Fails to distinguish between sexual activity with inanimate objects versus animals

2. (4)Fails to distinguish between fantasies versus behaviour. In particular, there is no distinction between fantasies involving non-consensual sexual activity versus behaviour involving non-consensual sexual activity - reinforces the notion that someone with an unusual sexual fantasy is automatically impaired in their ability to negotiate the difference between fantasy and reality - the underlying assumption is that unusual sexual fantasy takes over our lives, shuts down ability to make intelligent decisions and threatens our relationships and our jobs

3. (5)Assumes children are always non-consenting sexual partners (6) Provides no consistent guidelines with regards to who counts as a “child” (7) Lack of clarity regarding whether sexual arousal in response to “an atypical focus involving humans (self or other)” is a paraphilia (e.g., sexual arousal in response to non-covert viewing of partner engaging in sexual activity)

4. Criterion B: (1) Unusual sexual urges, or fantasies, or behaviour, may not cause clinically significant distress or impairment, yet they may be considered paraphilias by many clinicians, nonetheless. (2)Opens up the possibility that paraphiliac sexual behaviours aid the individual in functioning (i.e., if they function to reduce stress)

5. - The ambiguity inherent in much of the DSM-IV’s treatment of sexual paraphilias opens it up to the cultural biases of the moment - Homosexuality was considered a sexual paraphilia up until 1980 when it was officially removed from the DSM (DSM-III). - Clinicians developed theories about homosexuality based on homophobia and bad scientific practice that reflected and reinforced societal notions of homosexuals as neurotic, compulsive and narcissistic.

6. -The DSM-IV’s treatment of sexual paraphilias is entirely conceptualized from the perspective of Euro-American society - As such, the manner in which Euro-American society conceptualizes sexuality is characterized as “normal” and mentally healthy -There is no recognition that sexual activity is conceptualized and enacted differently in non-Euro- American societies

7. - There is a lack of recognition that what counts as acceptable sexual activity vary within cultures - There tends to be more tolerance for unusual sexual activities in large urban environments compared to elsewhere - There is a lack of recognition that what counts as acceptable sexual activity varies historically -What is considered mentally healthy in the present, might have been a sign of mental illness in the past

8. - Variation in unusual sexual activities across time and space suggests that these behaviours are universally indicative of mental disorders, but rather are conceptualized as mental disorders by particular (sub)cultures at particular moments in time.

9. - The DSM-IV’s treatment reinforces the notion that there is such a thing as “normal” sexual behaviour - Two ways of thinking about sexual behaviour: (1)Means (2)Ranges - When we think about sexual activity in terms of means, deviations from the mean tend to be thought of as “abnormal”

10. - Abnormal behaviours are problematic and demand solutions that will render the individual “normal” - When we think about sexual behaviour in terms of ranges, atypical consensual sexual behaviours are no longer problematic because they are not seen as deviating from a norm

11. - The DSM-IV encourage diagnosis of sexual paraphilias based the content of sexual fantasy, as opposed to the individual’s relationship to their fantasy Turkey Man Sexual Fantasy