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BDSM Versus the DSM

A history of the fight that got kink de-classified as mental illness

A history of the fight that got kink de-classified as mental illness

By Merissa Nathan Gerson

Asking your partner to tie you to the bedpost, telling them to slap you hard in the throes of lovemaking, dressing like a woman if you are a man, admitting a fetish for feet: Just a few years ago, any of these acts could be used against you in family court.

This was the case until 2010, when the American Psychiatric Association announced that it would be changing the diagnostic codes for BDSM, fetishism, and transvestic fetishism (a variant of cross-dressing) in the next edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 2013. The new definitions marked a distinction between behavior—for example, playing rough—and actual pathology. Consenting adults were no longer deemed mentally ill for choosing sexual behavior outside the mainstream.

The change was the result of a massive effort from the National Coalition for Sexual Freedom (NCSF), an advocacy group founded in 1997 “to advance the rights of and advocate for consenting adults in the BDSM-Leather-Fetish, Swing, and Polyamory Communities.” At the time, these types of sexual behavior, by virtue of their inclusion in the DSM, were considered markers of mental illness—and, as a result, were heavily stigmatized, often with legal repercussions. In family court, an interest in BDSM was used as justification to remove people’s children from their custody.

“We were seeing the DSM used as a weapon,” says Race Bannon, an NCSF Board Member and the creator of Kink-Aware Professionals, a roster of safe and non-judgmental healthcare professionals for the BDSM and kink community. (The list is now maintained by the NCSF.) “Fifty Shades [of Grey] had not come along,” says Bannon, an early activist in the campaign to change the DSM. “[Kink] was still this dark and secret thing people did.”

Since its first edition was published in 1952, the DSM has often posed a problem for anyone whose sexual preferences fell outside the mainstream. Homosexuality, for example, was considered a mental illness—a “sociopathic personality disturbance”—until the APA changed the language in 1973. More broadly, the DSM section on paraphilias (a blanket term for any kind of unusual sexual interest), then termed “sexual deviations,” attempted to codify all sexual preferences considered harmful to the self or others—a line that, as one can imagine, is tricky in the BDSM community.

The effort to de-classify kink as a psychiatric disorder began in 1980s Los Angeles with Bannon and his then-partner, Guy Baldwin, a therapist who worked mostly with the gay and alternative sexualities communities. Bannon, a self-described “community organizer, activist, writer, and advocate” moved to Los Angeles in 1980 and soon became close with Baldwin through their mutual involvement as open participants in and advocates for the kink community. “I’m fairly confident that I was the first licensed mental-health practitioner anywhere who was out about being a practicing sadomasochist,” Baldwin says.

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The pair was spurred to action after the 1987 edition of the DSM-III-R, which introduced the concept of paraphilias, changed the classifications for BDSM and kink from “sexual deviation” to actual disorders defined by two diagnostic criteria. To be considered a mental illness, the first qualification was: ‘‘Over a period of at least six months, recurrent, intense sexual urges and sexually arousing fantasies involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.’’ The second: ‘‘The person has acted on these urges, or is markedly distressed by them.’’

“1987 was a bad shift,” Wright recalls. “Anyone who was [voluntarily] humiliated, beaten, bound, or any other alternate sexual expression was considered mentally ill.”

With the new language, Baldwin says, he quickly realized that laws regarding alternative sexual behavior would continue to be problematic “as long as the psychiatric community defines these behaviors as pathological.”

“I knew there were therapists around the world diagnosing practicing consensual sadomasochists with mental illness,” he says.

At the time that the new DSM was published, Baldwin and Bannon were planning to attend the 1987 march on Washington, D.C., in support of gay rights; after the new criteria came out, they decided to host a panel discussion for mental-health professionals in the State Department auditorium, where they announced the launch of what would come to be known as “The DSM Revision Project.”

“We asked how many people in the room were mental-health professionals,” Baldwin says, and “two-thirds of the people in the room raised their hands. And we said, ‘The way this needs to happen is, licensed mental-health practitioners need to write the DSM committee that reviews the language of the DSM concerned with paraphilias.’”

Around 40 or 50 people left the session with the information needed to write the letters. “We did not know exactly what would result,” Bannon recalls. “We did not think we would see dramatic changes suddenly.”

They didn’t—but the changes they did see were positive. The next edition of the DSM, published in 1994, added that to be considered part of a mental illness, “fantasies, sexual urges, or behaviors” must “cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

“This was a definite improvement from the DSM-III-R,” says Wright, who later took over leadership of the DSM Revision Project from Bannon and Baldwin.

“These criteria gave [health professionals] wiggle room to say, ‘They have issues, but it is not about their kink. For the vast majority, it is just the way they have sex,’” Bannon explains. “Rather than saying, ‘Because you are into this method of sexuality, you are sick,’ [they could say], ‘Pathologically, if this impacts your life negatively, then you have a problem.’”

But the new language in the 1994 DSM also allowed for wiggle room of a different kind: The threshold of “significant distress” was often loosely interpreted, with the social stigma of kink, rather than kink itself, causing the negative impact on people’s lives. Workplace discrimination and violence were on the rise, according to a 2008 NCSF survey, and people were still being declared unfit parents as a result of their sexual preferences: Eighty of the 100 people who turned to the NCSF for legal assistance in custody battles from 1997-2010 lost their cases.

A few years after the 1994 DSM was published, Wright decided it was time to fight for another revision. When she founded the organization in 1997, the NCSF’s goal was a change to the APA’s diagnostic codes that separated the behavior (e.g., “he likes to restrict his breathing during sex”) from the diagnosis (e.g., “his desire to restrict his breath means that he must be mentally ill”). The next DSM, the group argued, should split the paraphilias from the paraphilic disorders, so that simply enjoying consensual BDSM would not be considered indicative of an illness.

Their efforts were largely ignored by the APA until early 2009, when Wright attended a panel discussion at New York City’s Philosophy Center on why people practice BDSM. Among the panelists was psychiatrist Richard Krueger, whose expertise included the diagnosis and treatment of paraphilias and sexual disorders.

During the meeting, Wright says, “I brought up the point that the DSM manual caused harm to BDSM people because it perpetuated the stigma that we were mentally ill. [Krueger] heard me and said that was not what they intended with the DSM.” Krueger, it turned out, was on the APA’s paraphilias committee, and following the meeting opened up an email dialogue between Wright and the other committee members, in which Wright provided documentation about the violence and discrimination kinky people experienced. “I credited that to the DSM,” she says. “Courts used it. Therapists used it. And it was being misinterpreted.”

Over the next year, “I sent him information, he gave it to the group, they asked questions, and I responded. It was very productive,” Wright recalls. “We [the NCSF] felt we were heard, we were listened to—and they took [our arguments] into account when they changed the wording” of the DSM in 2010.

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Another major factor in the NCSF’s favor was a paper, co-written by sexual-medicine physician Charles Moser and sexologist Peggy J. Kleinplatz and published in 2006 in the Journal of Psychology and Human Sexuality, titled “DSM IV-TR and the Paraphilias: An Argument for Removal.” According to Wright, the paper, which “summed up opinions of mental-health professionals who thought you shouldn’t include sexual activity in the DSM,” played a significant role in the paraphilia committee’s eventual shift in language.

In February 2010 the proposed change was made public—clarifying, Wright says, that “the mental illness [depends on] how it is expressed, not the behavior itself.” The new guidelines drew a clear difference, in other words, between people expressing a healthy range of human sexuality (for example, a couple that likes to experiment, consensually, with whips, chains, and dungeons) and sadists who wish others genuine harm (for example, tying and whipping someone in a basement without their consent).

The DSM-5 was released in May 2013, its contents marking a victory for the NCSF, Bannon, and Baldwin. The final language states: “A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not necessarily justify or require clinical intervention.”

“Now we are seeing a sharp drop in people having their children removed from their custody,” Wright explains. Since the change, according to the NCSF, less than 10 percent of people who sought the organization’s help in custody cases have had their children removed, and the number of discrimination cases has dropped from more than 600 in 2002 to 500 in 2010 to around 200 over the last year.

“The APA basically came out and said, ‘These people are mentally healthy,’” Wright says. “‘It’s had a direct impact on society.”

Complete Article HERE!

Beginning Sex Play — Tips and Techniques

I most frequent hear from your average Dick and Jane, (or Dick and Dick, or Jane and Jane) who want to spice up their sex life. When they write to me they inevitably describe the kind of sex they’re currently having. And almost universally that description makes this grown man cry. Jeez, the boredom. How can they stand it? It’s a wonder any of them are having sex at all.

big funWhat’s with all the humdrum, run of the mill, we’ve always done it that way mentality? Are ya’ll afraid that if you add a little something new to your sex chore from time to time that the sky will fall? Holy cow!

Today’s tutorial is yet another attempt to motivate you to get off your butts and make something interesting happen in the sex department. We’ll begin today with what was once called foreplay.

First off, I hate the word “foreplay” because it suggests that all the really great sex play activities out there are only a lead up to a single — more important activity — that is fucking. It also implies that ya’ll can dispense with the one in order to hurry up and get to the other. And that, sex fans, is always a huge mistake.

From now on I want you to banish “foreplay” from your vocabulary. Instead let’s start using “Beginning Sex Play.” It says it all. It says it’s at the beginning, but there’s no suggestion that anything in particular must follow.amazing sex secrets

I’m of the mind that we’d all be better served if we thought of sex play as a continuum of pleasure with a beginning, middle and an end. If you ask me, our sex play ought mirror our sexual response cycles — arousal, plateau, orgasm and resolution. That way we’re less likely to overburden one particular activity at the expense of all the others. Get it? Got it? Good!

Experienced sex fans agree; the best sexual encounters include an extended period of sensual play at the beginning of most all sex play. This brings increased pleasure to both partners, and will make whatever else that might follow more satisfying. Just remember, beginning sex play can be a meal in itself.

Beginning sex play brings spice to the encounter because it gets our motors started. Even all you major sex athletes out there, who are perpetually primed for sex, will benefit from more beginning sex play. It will help cool your jets and make the encounter last longer than a firecracker. And I know that you know what I mean!

erotic talkIn our hectic rush-around-world, beginning sex play is particularly important. It helps us transition from the daily cares and woes to the realm of sensual pleasures. The workaholics among us need more time to become fully aroused. Our minds are still filled with the junk of the day, and not yet ready to give or receive pleasure. And pleasuring and being pleasured, I might add, takes a big attitude shift from that of the rest of the day. In fact, if you’re gonna try and approach sex and pleasure with the same mindset as you have on the job or with the kids, give it up now and be done with it. You’ll only walk away from the encounter disappointed.

Beginning sex play primes us for maximum pleasure. Us men folk will have the time we need to come to full erection and the women folk will have the time they need to properly lubricate. (By the way, this is called the arousal stage in our sexual response cycle).

When we stop thinking of beginning sex play as “foreplay” we realize there is no such thing as spending too much time giving and getting pleasure. If beginning sex play evolves into full-on fucking — SWELL. Both partners will be fully aroused and fucking will flow naturally and effortlessly from the pleasure enjoyed at the beginning of sex play.

Beginning sex play can include everything from chocolate and whipped cream to whips and chains. But let’s not get too far ahead of our selves. Let’s start at the beginning of beginning sex play, shall we? beginner's guide

Most people miss out on the pleasure of undressing with and for their partners. Stripping out of, or being helped out of our daily wear and into something sexy or nothing at all can be very arousing. It’s also a visual signal that we’re shifting out of our work-a-day world and entering the realm of sensuality. Stripping is an art form, ya know. We could all learn a lesson or two from the folks who do this for a living, but more about this in THIS tutorial.

Creating the right sex environment is important too. Make sure the room is warm. Proper lighting and music will surely add to the mood. Scents are also important. More and more people are incorporating erotica into their sex play — reading a sexy story together or enjoying some hot porn will make the encounter memorable.

Most women complain that their partners don’t kiss long enough and rush the kissing to get at their pussy. Guys, what the fuck? You want pussy? Use your mouth to maximum advantage kiss and nibble all over everything. Literally devour your partner with your mouth. Believe me, if you do this right, by the time you get to her pussy she’s gonna want to give it up big time.

Hanky Spanky Gift SetBeginning sex play is the perfect time for setting the mood for all that might follow. It’s a time for sharing fantasies, role-playing, dirty talk or some full body massage. Always have some nice lotion available then use your hands, forearms, feet and elbows to knead your partner’s muscles and naughty bits.

Certain areas on the body are more hot-wired than others. It’s your job to find each and every one your partner has. As you massage vary your strokes and touch to stimulate your partner. Roll your fingertips across his or her nipples and behind his or her ears as you kiss him and tease her with your tongue.

If you’re doin things right, your partner will be moaning with pleasure. If she or he starts getting impatient it’s time to bring out the restraints. There’s nothing like some hot erotic bondage to punctuate the beginning sex play.

While your darling is subdued and possibly blindfolded, crank things up a notch. Add different sensations and stimuli, a warm chocolate sauce followed by ice cream. A fur mitt followed by a Loofah. Introduce some sex toys — a vibrator, tit clamps, or an anal simulator.

Don’t forget to check in with your partner from time to time. Ask for some feedback and direction. Do you like this? Or do you like this better? If you presume that you know what your partner likes simply because he or she liked it before, that, my friend, is a recipe for boredom and the dreaded bed death. If words fail you, SHOW your partner what you want. Then encourage your partner to do the same.002

Beginning sex play is not about pressing the right buttons in the right order. It is about understanding what makes your partner tick and supplying and applying those things to their greatest sensual advantage. There are many ways to give your partner extreme pleasure, and it all begins in your brain. Beginning sex play is as much of an art form as it is a necessity. Finally, the basic premise behind all of this is that the great lover is one that gives pleasure because it is its own reward, not a means to getting something else.

Good luck

What A Drag

Here’s something unusual. Just last month we heard from Roxie, a crossdresser at a crossroads. Today, another crossdresser. That’s what’s so unusual, two in one month. Maybe it’s something in the stars. Anyway, our fabulous friend here has a bit of the ennui.

Name: Mariah
Gender: Male
Age: 23
Location: Brewster NY
I have been doing a lot of crossdressing secretly and I have no idea how to stop. Its been going on for quite a number of years and I am not sure exactly what I should do. I enjoy a lot of other things that I won’t mention. I guess my question is how long does it take to get over this?

Mariah darling, I’m confused. You’ve been secretly crossdressing for a number of years and now you want to stop? Why? Sounds to me like you’re still into it. A lot!

crossdressingAnd then you tantalize me with; “I enjoy a lot of other things that I won’t mention.” What’s up with that?

So ok, you’re a kinky little transvestite; is that such a big deal? Crossdressing is a relatively innocuous fetish, as far as fetishes go. And if you’ve been doing it for years, albeit secretly, I’d guess you have your fetish under control. It doesn’t sound like it’s messin’ with or spillin’ over into the rest of your life. So again, my question is, why stop?

If you’re just bored with it, which doesn’t sound like the case; why not simply pack up your frilly knickers and dancer heels and drop them off at the Goodwill? If you don’t have women’s clothing around the house, you won’t be able to crossdress. So that part is relatively simple.

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Georgina

However, getting over a fetish is not so easy as ridding yourself of your frocks. There’s probably a psychological and an erotic hook in your crossdressing, as there is for most folks who do drag. After all, this is what makes the whole exercise a turn on and so much fun. You can learn to wean yourself off this activity, if you really, really want to. But again my question is: why?

If you feel your crossdressing is screwin’, up your life, or contaminating your relationships; well, that’s another thing. But you don’t say that. Maybe you just need some assistance in understanding what’s going on with you and some support from others like you. And that, my dear Mariah, is very easy to come by. First, let me direct you to a couple of brilliant podcast interviews I’ve done with two amazing crossdressers — first, Debra Christina Darling. (You’ll find Part 1 of that conversation HERE and Part 2 HERE!)   Then there’s the toast of the Emerald City, Sylvia O’Stayformore. (You’ll find Part 1 of that conversation HERE and Part 2 HERE!).  Or just use the the search function in the sidebar to your right, type in either of those names, and PRESTO! Faster than you can say Lane Bryant, you be taken to their podcast postings.

These interviews are chock full of information about crossdressing; the dos and don’t as well as the whys. I’ve also supplied a short list of online resources for crossdressers, drag queens, and transgender folk.

Good luck

A cock in a frock with his marriage nearly on the rocks

Name: Roxy
Gender:
Age: 37
Location: SF Bay Area
Dear Dr. Dick, I am slowly but inexorably marching to my wits end over my current dilemma. I’m a part time TV married to a wonderful girl who I find very satisfying emotionally, mentally and physically. So what’s the problem, you’re asking? The problem is that before we got married I had several sexual encounters with men (yes, with me dressed and made up as a girl). Some of which were quite thrilling, and now I find that I am yearning to get all dressed up and find a male partner who will satisfy the girl side of my psyche sexually. I don’t want to cheat on my wife (with whom I’ve talked about marital fidelity…if I cheated and she found out, her line is that our sex life would be over), but I feel the compulsion to act getting stronger all the time… what should I do?
Sincerely, Distraught in downtown

Before I respond to you, Roxy, I want to make sure my audience knows what we’re talking about.

transvestiteFolks, Roxie here is identifying himself as a part-time TV. That, of course, has nothing to do with the box in your living room on which you watch The Brady Bunch reruns. TV in this context means transvestite, or better still, crossdresser. Which is literally the practice of crossdressing; wearing the clothing of another sex. Which as we all know, or should know, must not to be confused with a TS, which means transsexual, or better still, transgender. (Here’s a tip:  the terms transsexual and transvestite are outmoded because they are heavily pathologized, as medically or psychologically abnormal.) A transgender person is someone who self-identifies as a gender other than the one she/he was assigned at birth. I hope we’re all down with that now.

Now back to you, Roxy. It seems to me that you’re really overreaching here. Desires are wonderful things. We just better know the difference between a desire and reality. I encourage you to think twice about realizing this particular desire of yours if it means upending your relationship. Seems to me your long-suffering wife’s feelings deserves more than the casual consideration you seem to afford them.

Most TVs I know would give their left falsie for a partner as understanding and accommodating as your wife. And look at you, contemplating fucking this up by skipping out on her just so you can get all gussied up so you can find a dude to pound the bejesus out of you to satisfy the girly side of your psyche.TV01

I never advocate the cheating option. But I know how compelling sexual fantasies can be. On the other hand, maybe some kind of additional accommodation could be made with your wife. Maybe she’d be up for a 3-way.

I know this marvelously kinky woman, Abby, who pimps out her beautiful straight boyfriend to totally hot gay men they meet at the best gay nightclubs. She does this just so she can watch the straight BF get pounded. I hasten to add that the beautiful straight BF is a willing participant in this unusual ménage. Curiously enough, he’d never think of doing this on his own. For him, the turn on is not the part where other guys fuck him; although that is pleasurable. It’s the pleasing and being dominated by his kinky girlfriend that turns his crank. So when Abby snaps her finger, you know for certain that Ty will soon be buggered senseless while she’ll get a great show. Now that’s devotion. And while this is not for everyone, it sure as hell works for them.

RHPSWill your little woman go for something like this, Roxy? Who knows! One thing for sure, you’ll never know unless you ask. Here’s a tip. To sell this whole ménage thing to the wifie, I encourage you to play up how HOT it will be for her. How much fun she’ll have watching and possibly even directing her pansy-ass husband take it up the bung-hole. How it’s gonna blow her mind, and shake up your traditional sex roles and really spice things up in the boudoir. With a sales pitch like that she might just give it a whirl.

I don’t envy your dilemma, Roxy, but I think something interesting could come of this just as long as you’re upfront about it with your wife. If ya don’t, you’ll soon be a cock in a frock with his marriage on the rocks.

Good luck

A little bit of this, a little bit of that

Name: Jake
Gender: Male
Age: 16
Location: NM
Can u get more guys to tell about mutual masturbation stories? And how I can get my friends (both straight) to do it with me?

OK, I’ll ask my audience to send us stories about their mutual masturbation experiences.wanking

Hey guys, and guys and gals, here’s what I want you to do. Send me stories about your mutual masturbation experiences. You can post your stories in the comments section of this posting, or use the Got A Sex Question form in the sidebar to the right. If we get some good ones, I’ll put them up on my site.

As to asking your straight friends to jerk-off with you, well, that’s another issue all together. Most young men won’t even acknowledge that they pull their pud. Most ostensibly straight men wouldn’t consider choking the chicken in front of a gay guy, or even with a gay guy, because they think that’s…well gay. Maybe your friends are more open-minded about such things, but I won’t hold my breath.

However, if you think there is a chance they’d consider such a thing. Why not just come out and ask. “Hey guys, I’m hosting a circle jerk at my house on Wednesday afternoon after school. If you’re lookin for a good time all you have to do is show up, drop trou and spring a boner. We’ll all be handing our own meat, so it’s just for the ritual. Prizes for the biggest load and the guy who shoots the furthest.”

See, if ya make it a sport; they may cum.

Here’s a curious exchange I had with a fellow named Dennis.

Hi, thanks for taking the time to answer me. My new girlfriend is 49, sexually active, but has never given oral sex to a male. She was married 6 years to a man who had sex with her. He liked to dress in women’s heels and clothing but never asked his wife for oral sex. They had sex and he gave her oral. Could there be a reason why he didn’t ask for oral for himself? Could he have been cheating with men to get what the wife did not do?Submissive-Crossdressing

Thank you very much; I’m very concerned. Also my girlfriend has never jerked a man off including her husband. I’m concerned why is this? Dennis

Can’t see why you’re concerned at all, Dennis. Some men, your GF’s former husband for example, aren’t all that interested in getting a blowjob or even a hand job. He probably was a submissive and was way more interested crossdressing and pleasuring his wife than getting pleasured (blowjob or hand job) himself.

There’s no reason to think he cheated on his wife with other men either. He’s just a sub. Not a particularly difficult concept to grasp, right?

Then Dennis writes back to say: I’m concerned because I’m having trouble with her touching me and giving me oral sex. Is this normal? I’ve never encountered this. Thanks Dennis

Maybe, just maybe, she just doesn’t want to blow you. Maybe she doesn’t like the whole idea. Lots of women don’t like giving BJs. And you pestering her for something she’s not interested in doling out, is only gonna make matters worse.

Have you talked to her about it? If not, that’s the way to go.

I don’t think I have anything more to offer you besides the suggestion that you and your GF might want to consult a sex therapist. You might find that there are a lot of things that you and she need to understand about one another before you invest too much more into this relationship.

Good luck