Defining Paraphilia: Excluding Exclusion

The development of the classification of the paraphilias is considered, with emphasis on justifications for their inclusion in DSM-III in light of the declassification of homosexuality. These justifications are found to be tenuous and do not work for the paraphilias in DSM-III-R because of changes made. Rationale for these changes is discussed based on inquires made to DSM-III-R paraphilias committee members. Changes in DSM-IV and DSM-IV-TR are also discussed. After considering and critiquing more recent arguments for including the paraphilias in the DSM, recommendations are made regarding proposals for DSM-5, whether the paraphilias belong in the DSM, and whether they should be used in SVP commitment