Thursday, 7 May 2009

You've got to be Crazy Baby

Well, you've gotta be crazy, baby to want a guy like me.
Yeah, you've gotta be out of your mind - crazy.

- Icehouse

From Feministing on the proposed changes to the "Psychiatrist's Bible" - the DSM:
First, Blanchard is proposing a significant expansion of the DSM's definition of "paraphilia" to include:

"any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners."

Blanchard's proposals can be found in his presentation "Paraphilias vs. Paraphilic Disorders, Pedophilia vs. Pedo- And Hebephilia, and Autogynephilic vs. Fetishistic Transvestism" given at the Annual Meeting of the Society for Sex Therapy and Research (SSTAR), April 3, 2009, Arlington, Virginia.

To continue from Feministing:
The first concern here is the term "phenotypically normal" (meaning "normal" with regards to observable anatomical or behavioral traits). Thus, according to this definition, attraction to any person deemed by sex researchers to be "abnormal" or "atypical" could conceivably be diagnosed as paraphilic. So, do you happen to be attracted to, or in a relationship with, someone who is differently-abled or differently-sized? Or someone who is gender-variant in some way? Well congratulations, you may now be diagnosed with a paraphilia!


Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions. This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.

Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia. In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilias.

So, do you and your partner occasionally role-play or talk dirty to one another over the phone? Or engage in arousing play that is not intended to necessarily lead to "doing the deed"? Do you masturbate? Do you get a sexual charge from wearing a particularly sexy outfit or performing any act that falls outside of "genital stimulation or preparatory fondling"? Well, then congratulations, you can be diagnosed with a paraphilia!
This is all true, but things are not quite as bad as they seem - at least from Blanchard's viewpoint. You see, according to him, typical males over 18 have a paraphilia. Pedophilia, to be exact. From his presentation:
..typical men show a slight but non-zero penile response to prepubescent girls when tested phallometrically.
He means by using the plethysmograph, a device that measures bloodflow in the genitalia, and from that it is assumed that there's a correlation with thought. Which is probably true, but the correlation is weak and unreliable, and anyone who has had significant surgical reconstruction in that area should only be compared to others who have had reconstruction, not the standard model, unless some calibration work is done. I know of no work that has been done to find such calibration. But no matter.

So a "paraphilia" is not a Mental Illness per se. Good luck in getting courts to understand that in custody cases by the way, or in trying to pass legislation. Unless this is really well emphasised in the DSM-V, it will be radically misused. Perverted, even. Blanchard seems to be as oblivious to that as he is to the legal effects of his hypotheses about trans people.

So what does make a paraphilia into a "mental illness"?
The next question is equally or more important than the general definition of paraphilia. That is, are all paraphilias ipso facto psychiatric disorders? Our subgroup is taking the position that they are not. We are proposing that the DSM-V make a distinction between paraphilias and paraphilic disorders.

In this formulation, only problematic paraphilias would be called paraphilic disorders. To underscore that point, we propose to use the verb ascertain when talking about paraphilias and the verb diagnose when talking about paraphilic disorders.
So you would not be diagnosed with a paraphilia for being sexually attracted to say, me - someone not phenotypically normal. You would be ascertained to be paraphiliac instead.

As I said, the Best of British Luck getting a Judge or Jury to understand the difference in a custody case.

You would only be diagnosed with a paraphiliac disorder if it would cause distress or impairment to you or others. For example, if your boss disapproved of intersexed people and fired you for being attracted to one.

Well, you've gotta be crazy, baby to want a gal like me.
Yeah, you've gotta be out of your mind - crazy.

And you be diagnosed insane too, if you found a gal like me sexually attractive. Or just wanted to hold hands, rather than scr... have intercourse.


Battybattybats said...


I watched the movie Kinsey the other day. And sure there are plenty of issues with some of his methodology...

but their definitions seem seriously to be trying to roll back things to the pre-Kinsey 50's!

With the sole, single, solitary, isolated example of homosexuality.

Which seems clearly special-pleading because of the gay folk in the group.

lauredhel said...

Doesn't that also pathologise masturbation?

Any idea whether this clown has any sway, or whether he's considered a crank in the field?

animeg said...

Yea...just because one guy says it doesn't mean it'll go in.

Zoe Brain said...

His colleague at CAMH is the chair of the committee.

He's possibly the single most powerful voice there.

See the previous post on the subject of what they're doing with Transsexuality.

And yes, it does pathologise masturbation. It also gives rapists a backdoor to plead an insanity defence.

Anonymous said...

If these kinds of changes do go into the dsm and we have at-your-fingertip access to peoples' information on medical databases, social security databases, national security databases, how difficult would it be for all these newly defined crazies to be identified and... is knocking at the door...they've got my arms...ammmmmmmzith...

E said...

These definitions look suspiciously like they could have been written by the pope himself.

bonze said...

Zoe: "It also gives rapists a backdoor to plead an insanity defence."

Actually not... under the M'Naghten rule which applies in most US states, the defendant must "not know the nature and quality of the act or not know that it was wrong". Having a DSM diagnosis is necessary but not sufficient, and Antisocial Personality Disorder (sociopathy/psychopathy) and paraphilias do not qualify.

Here in New York state the government is now categorizing sex offenders at the time of their release from prison and institutionalizing those they deem to be dangerous...

Anonymous Woman said...


As far as the insanity plea goes, it may not work but it will still cause havoc yet to be imagined. Allow a slight thread derail to make a point.

It reminds me of a case in Idaho where a man was not convicted of a hate crime for pushing a young woman into a camp fire (and giving her severe burns) after calling making a 'Jews burn' joke.

The reason? She wasn't actually Jewish. He just thought she was.

So now in Idaho will victims of racial hate crimes have their ethnicity challenged in court and then have to prove it?

Labeling everything a type of paraphilia will cause similiar legal havoc. Watch and see.

Zoe Brain said...

Bonze - now there's a distinction between a Paraphilia and a Paraphiliac Disorder, the rules may change there.

And a general remark:

It's not enough that I be stigmatised as being either a gay sex maniac or a mentally ill pervert: now anyone who finds me attractive is stigmatised as being mentally ill too.

I genuinely don't think this was Zucker and Blanchard's intent. They just don't realise what they're doing, nor how this will affect us. Or maybe they just don't care. As far as they're concerned, there's nothing actually wrong with being a gay sex maniac or a mentally ill pervert (as they've repeatedly said in the past), so why should anyone else think there is?

It's easy to interpret their proposals in the worst possible light. I'm sure they don't mean them to be. I'm equally sure though that most people outside their Ivory towers will interpret them in that way. That's based on actual experience in the past, not a hypothetical fear.

Blanchard has repeatedly and categorically supported SRS as the appropriate treatment for gay sex maniacs and mentally ill perverts. He just doesn't see that the voting public may not agree there. Or maybe he does... I won't try to second-guess him.

sumptos devil s advocate said...

Zoe Brain,

Care to join a discussion on the web site of my local newspaper?

Look for posts by janiesavon

Anonymous said...

Zoe, are you prepared to be threatened by these people? I mean, if they were willing to threaten Prof. Conway...and your writing is likely to catch fire on the internet here, if it hasn't already. You have a lot of oomph to your writing, you know. I just don't want anything bad to happen to you.

Zoe Brain said...

SAD - I was going to pass on that one - there's little point when you're comment no #300 and something.

But I cut'n'pasted a reply.

Nica - Jurisdiction would be a nightmare. Blogger is hosted in the US, I'm in Australia, and Zucker's in Canada. The costs of initiating litigation would be immense. Just serving notices on the responsible parties would be nigh impossible.

I also have access to the postgrad legal service at the ANU, and the ANU Law School would love to take on such a case.

ELN said...

I have not read his work, but it seems like this could be just an incredibly poor way of explaining what he's trying to accomplish.

Is it possible he means this:
Precopulatory actions cover just about any type of foreplay, including role-playing, etc., so long as the role playing is not the sole object of arousal/sexual satisfaction; so long as intercourse is the preferred outcome. And by preferred, this would also mean masturbation to thoughts of this foreplay, so long as it is understood that the most preferable end to the fantasy would be intercourse, is also normal. (He seems to forget that people, including children, often stimulate themselves just because they feel good...)

Similarly, interest in a phenotypically abnormal person is also okay, so long as it is not interest BECAUSE of that abnormality. It's okay to desire a transsexual so long as it is not just because you find transsexuality arousing. (One must assume the main reason he doesn't include gays in his redefinition is because that within the confines of the psychiatric field, that battle has been fought and lost by people of his thinking.)

What I recall about fetishes is that people fixate on shoes or amputations or what have you so it becomes the primary sexual goal/object, in place of sex itself.

Furthermore, assuming he's fairly closeminded and ignorant of the historical flux of beauty standards, you can at least hypothesize where he's coming from on the phenotypically normal statement. He probably meant that while being a normal, virile-looking male or a woman who looks healthy and well suited for childbearing is an evolutionary cue that should arouse sexual interest, sexual interest in a physical aspect that does not indicate reproductive fitness (such as being an emaciated bleached out model with no hips or ass, for example) is abnormal.

Within this context, I think it's possible to see that he wasn't intending to pathologize damn near everyone who masturbates or finds a rescue scenario stimulating. (Sorry if I'm not explaining myself well; I'm pretty tired.)

Either way, individuals who are, *ahem*, fixated on rigid interpretations of normality irritate me. And you damn well better get the wording correct if you want to change the DSM's/psychological and psychiatric profession's/legal system's entire interpretation of normal sexuality. Regardless, I find the idea that enough people would take this guy seriously laughable. His statement is imprecise, illogical (assuming he really thinks homosexuality is normal), and careless.

Zoe Brain said...

ELN - without extensive evidence to the contrary, your explanation is by far the most plausible and sensible one. It's one I would in general adopt, dismissing the more extreme interpretations as mere hysteria.

Unfortunately.... such extensive evidence exists.

Please search my blog using the key "Blanchard". Or look here.

Emy L. Nosti said...

(Okay, it looked like I double-posted so I deleted the first...anyway...)

Yikes. One could make a career of pathologizing HIS motives. (My next theory is he was intentionally vague to mislead unsuspecting folks like myself.) Hopefully the APA will recognize him for what he is.

On the bright side, I'm pleased to find myself mistaken rather in the company of hysterics :)