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BDSM Versus the DSM

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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!

Penis politics: Sex, size and stereotypes in the gay community

When it comes to penis size, gay men face a host of preconceptions about masculinity and race

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Recent studies have shown that actual penis size is smaller than men are claiming. According to the Journal of Sexual Medicine, the average male penis measures 5.6 inches when erect; the Journal of Urology puts it at a slightly smaller 5.08 inches. This is considerably smaller than previous numbers from Alfred Kinsey, Durex and the Definitive Penis study, which averaged 6.25 inches in their estimates. The difference between the two estimates: surveys like Durex’s rely on self-reporting, and men are likely to overestimate. As Tom Hickman wrote in “God’s Doodle”: “What is incontrovertible is that where men and their penises are concerned there are lies, damned lies, and self measurements.”

Just ask any gay man looking for a hook-up on Grindr. “If a guy tells you his size and you meet up, you realize he must have a different ruler,” said Noah Michelson, editor of The Huffington Post’s Gay Voices section. Michelson believes that the reason men are likely to overreport their penis size is because of the “cultural currency” the gay community places on having a large penis. “I think there’s something to do with internalized homophobia or insecurities about being a man,” Michelson said. “You want to have a big dick and you want to be with a big dick. You want to be with a ‘man.’”

Michelson argued it’s not just about having a large penis; it’s what that penis signifies. “Having a big dick means that you’re ‘masculine’ and you wield a lot of power, because we assign so much power to the phallus itself,” he told me. “You’re a dominator and a conqueror.” Michelson said that this idea is largely informed by pornography, a strong force in shaping desire in the gay community; but for those who don’t fit into that “porn culture,” it leads to a feeling of being left out. “It’s totally a lottery,” Michelson explained. “And you either win it or you don’t.”

According to Jaime Woo, author of the book “Meet Grindr,” which explores how men interact on mobile hookup applications, that game can have very negative consequences for queer men who find themselves on the losing side. That’s why the size issue can seem even more fraught in the gay community than among heterosexuals. “In gay male culture, your sexual worth is very tied to your worth in the community overall,” Woo said. “We don’t have a lot of structure in place for men who aren’t sexually valuable, and they disappear into the background. Gay men have enough issues already, and this is just another way for them to feel bad about themselves, if they’re not packing eight inches under their pants.”

Woo told me that looking for sex on Grindr “makes the expectations much more heightened.” “Grindr has really distorted peoples’ understanding of what average or normal is, and the fact that people can ask if six or seven inches are too small — it’s jaw dropping,” Woo said. “You can be very picky because there is something better around the corner, someone bigger or hotter and someone more your type. It creates a very narrow band of desire.”

Huffington Post writer Zach Stafford argued that in order to hook up, we’re commodifying ourselves for sexual consumption. “On Grindr, you’re literally putting someone in a box,” Stafford explained. “The app’s layout is an actual shelf, like you would see in a grocery store.” In order to participate on the site, Stafford said that you have to learn how to market yourself by those confines. “It’s like being a book on Amazon,” Stafford told me. “You give yourself a little cover and write your summary. You make yourself a product, and when you’re selling yourself, you always go bigger.”

Stafford said our fascination with penis size is inherently tied to capitalism. “Studies have shown that people with larger penises make more money,” Stafford explained. “It’s power in our pants.” Stafford also explained that the correlation between sex and power leads to a skewed power dynamic between tops and bottoms. Research shows that bottoms have smaller penises on average, and are more likely to have penis anxiety and low self-esteem.  In an essay for the Huffington Post, Stafford called it “Top Privilege.” Stafford wrote, “In this line of thought, bottoms are seen ‘less than,’ ‘feminine’ or ‘the woman’ because they are the taker of the phallus.”

But it’s not just an issue of money and gender. Race also plays a large part in how gay men read each others’ bodies, especially for black and Asian men, stereotyped at the ends of the size spectrum. Stafford, who is multiracial, said that men will often approach him in bars to ask about his penis, expecting him to conform to the stereotype. “It creates an enormous amount of pressure for black men,” Stafford stated. “Black men are only seen as a tool — a tool of building and a tool of fucking. They’re reduced to a big penis.” In his case, Stafford said men often fall into two camps: “Either white people look at me as a black man with a big dick, or they see me and fetishize me — they want to dominate me.”

Jay Borchert has had the exact opposite experience. A doctoral candidate at the University of Michigan, Borchert (who is white) has frequently dated men of color, causing his romantic experiences to be reduced to a fetish. “People make remarks that I must be in it for the dick,” Borchert told me. “Why can’t I be looking for ass? Why can’t I be looking for mouth? Why can’t I be looking for a person?” People sometimes assume that Borchert adopts the “bottom” role in his sexual relationships, which isn’t the case. Borchert sighed, “It was really frustrating because there’s more to dating and relationships than penis.”

Due to his ethnicity, Thought Catalog writer John Tao has also found himself being put in a box in the bedroom. “Because I’m Asian, I’m automatically categorized as being a bottom,” Tao said. “There’s a perception that I wouldn’t want to top.” Because of this, Tao said that’s the role he’s most often performed in sexual relationships. “All of these people think I’m a bottom, so I’ll just be a bottom,” Mr. Tao explained, “You have to be careful because we internalize these stereotypes about ourselves. Your gay Asian friend might identify as a total bottom, but that could be years of societal expectations.”

Justin Huang, who blogs about his experiences being gay and Chinese at I Am Yellow Peril, agreed that the baggage around penis size can be particularly harmful for Asian-American men. In school, Huang’s friends would often tease him about what they assumed was the size of his penis, which was difficult when coming to terms with his sexual identity. “For a long time, I thought I had a small penis,” Huang explained. “It’s amazing what your brain can train you to see. I didn’t have a lot of respect for my penis. Gay men are emasculated already, so when you’re gay and Asian, you feel doubly emasculated.”

Huang told me that when you’re Asian, you’re expected to perform the stereotype, meaning that guys are very curious to see what’s inside your pants. “I’ve been in straight bars using the bathroom where a guy will lean over and look at my dick, just to see if what they say is true,” Huang said. But Jaime Woo argued that the same isn’t true for white men, whose penis size isn’t policed in the same way. “White men are considered the sexual default, so you’re allowed to have some variability,” Woo said. “White men get to be anything and everything, and there’s no presumption there. So for white men, a big dick is a bonus.”

Huang also argued that these stereotypes are a symptom of our lack of sex education and lack of knowledge about our bodies. “We’re told to hide our penises,” Huang said. “It’s a form of sexual oppression we don’t talk about. You see boobs everywhere. You don’t see penises anywhere, not even HBO. It’s something that’s scandalous and cloaked.” Because of the shame surrounding invisibility, men often place too much emphasis on something so small. “When I think about the guys I’ve been with, I don’t remember the penises,” Huang said. “I remember the boy. A penis doesn’t smile. A penis doesn’t look into your eyes. A penis can’t wrap its arms around you.”

Instead of holding out for an unrealistic fantasy, Justin Huang believes gay men should start embracing each other for exactly who they are. “Gay men need to stop expecting each other to be porn stars,” Huang said. “If you dump a guy just because of his penis size, you are an asshole. So if you love your man, tell him that you like his penis. After all, when you’re dating a guy, you’re dating two people: You’re dating him and you’re dating his penis. We need to start valuing and appreciating both of them.”
 
Complete Article HERE!

Plays Well With Others

Name: Jim & Elaine
Gender: Couple
Age: 42 & 38
Location: Denver
We have been happily married for 15 years. We have a good, but pretty vanilla sex life together. We want to spice things up and are talking about maybe looking for other couples online. We’re both in good shape and have very outgoing personalities. Both of us have had one short affair in the past, now we think we want to play together. Thoughts?

You guys want to look for other couples online…for ummm sex? I mean you imply that but you don’t really come right out and say it, do you? I know you are new to this and you are just feeling your way through this unfamiliar territory, but unless you want to look like rank amateurs by other consensual non-monogamous couples, like swingers and polyamorous folks…and that’s what we’re talking about, right? You’d better get comfortable articulating precisely what it is you want, how you want it, and with whom.white on black

If you’ve already begun your online search, you’ve probably already discovered that there are several different avenues for you to pursue. There are, of course, dating and profile sites. There are also sites that feature ads from other non-monogamous couples. If swinging is what you are after, there are exclusive swing parties and more inclusive swinger clubs. And each of these outlets may offer special groupings for the fetish-oriented swinger.

Since you don’t actually say what kind of consensual non-monogamy you’re looking for, let’s talk swinging for now. Like I said, this isn’t the only kind of consensual non-monogamy, but it’s probably the oldest most established variety.

Before you swing, you guys need to decide what type of swing-set you want. If the vocabulary that follows is unfamiliar to you, you have some remedial homework to do before you launch your swing-capade. There is “soft” swinging and “hard” swinging. And bisexually may or may not be an option for you.

polyamory1If you assume that all swingers are open-minded about sex, consider this; lots of swing outlets prohibit male-on-male sex. Personally, I find this extremely bizarre and off-putting, but I suppose it only reflects the prejudices of the popular culture. There are some swing-sets that allow novice swingers to simply to be voyeurs. I can’t fuckin’ figure this out either. Maybe it’s a heterosexual thing.

If you gravitate toward the club-set there are 3 types to consider:

  1. SEX clubs — these clubs allow full-on sex, but only in designated areas.
  2. NO-SEX clubs — allow for lots of exhibitionism and voyeurism, including nudity, but no full-on sex. These clubs are great for meeting other swingers and to set up your own sex dates.
  3. Swinger parties are NO-SEX events, and are usually held in a nightclub or restaurant. Again, you can meet like-minded folks there and set up your own sex dates.

Whichever outlet you choose; make sure you understand the rules and regulations of the get together before you attend.

Like I said, it’s of the utmost importance that you guys decide, in advance, what your limits are. A good number of otherwise healthy marriages flounder at this point. Have a clear and frank exchange with each other on the ground rules of your swinging and then stick to them. Trying to negotiate a change to the rules of engagement during a swing is a very bad idea. That’s not to say that your ground rules won’t change and evolve over time; just don’t attempt to adjust them while they are in play.

Never push your partner into doing something he/she is not ready to do. Be open with each other before, during and especially after a swing. Effective communication is essential. This goes for communicating with your fellow swingers. Be sure to let everyone know that you are newbees to the scene. (Don’t worry, everyone will have figured that out already.) Novices stick out like a sore…hard-on.

Sexy people

Sexy people

Most clubs and groupings don’t allow single men. Most swing-sets are women oriented, to the degree that women set the tone for the swing. That being said, it’s still a man’s world. Men generally dictate the type of sexual expression that will be tolerated — thus the prohibition, stated or unstated, against male on male sex. Female on female sex is, of course, encouraged for obvious reasons. How’s that for a screwed-up double standard?

Most clubs expect full or partial nudity. My swinger friends advise that if you just want to attend so you can ogle others, stay the fuck home! Novice swingers, like you guys, ought to stay together until you feel comfortable being apart. But for Christ sake, don’t glom on to one another like the other swingers have the cooties.

Most of all, take responsibility for your eroticism and your sexuality. Be friendly and good-natured. And don’t try to pretend you’re a more accomplished sexual athlete than you are.

Be advised, you are about to embark on a sexual journey that will take you to the edges of what society regards as appropriate sexual behavior. Don’t be surprised if some of your more traditional friends discriminate against you when they find out about your new activities. Finally, swinging is far less about what you do (sex) and way more about who you are (a lifestyle). To that end, I’d like to turn you on to a fantastic resource. Check out my friends, John and Allie, at SwingerCast.  And be sure to listen to my two-part interview with them right here on my site. You’ll find Part 1 HERE and Part 2 HERE!

Good luck

You’re Pulling My Leg

Name: Jerry
Gender: Male
Age: 60
Location: Minnesota
I have a fixation with prostate stimulation. I have recently been giving myself perineum injections to the prostate with 2/3 xylocaine and 1/3 sodium cloride. The xylocaine is 2% with ephinepherine. I am careful to clean the injection site – just above the anus and use a 1 1/2 inch 25 guage needle injecting 3 ml. The feeling is fantastic when I hit the prostate. I actually feel the nerves take the anesthetic. I am careful to always make sure I do not hit a blood vessel before injecting by pulling back on the plunger. Is this fetish common? What dangers to you think are there? I find this a real turn on. I also have done many intra-rectal injections to the prostate but only use sodium chloride (salt water) as I cannot see the syringe to tell if I am injecting in a blood vessel. This requires careful cleaning of the anus but have never had any problems except very rarely giving myself an urethral infection.

You have got to be kidding! I mean really, Jerry! You want to know if this is a common fetish? Ahh, no, I’d have to say not all that much.hypodermic-needle

So I’m sitting here trying to imagine how you go about doing these alleged injections. What kind of physical position must you have to assume to see, and than land the alleged hypodermic needle on just the right spot on your taint (perineum) so that you hit your prostate? I suppose you allegedly do this with a mirror, right? But even then there’s plenty room for error, right?

It sounds like you been doing this alleged needle play for a while? I have to wonder, how in the world did you happen upon allegedly shoot up anesthetics right into your prostate? And where are you getting these alleged anesthetics, I wonder?

Everything about your story makes me very suspicious as to the authenticity of your reporting. If indeed you are doing precisely what you tell me, allow me to advise you to reconsider your actions. I don’t think this is a healthy pursuit for any number of reasons. And I suspect that you also have your qualms. I mean, why else would you ask me about potential dangers.not-a-golfer-cartoon

If you are experiencing periodic infections that tells me you’re not taking care of business properly. I’m gonna guess that you’re not properly attending to sterilizing the medical equipment you are using. And if your anesthetics are coming from a dubious source, well then anything can happen.

I’m guessing you have too much time on your hands, sir. Maybe you should take up golf.

Good luck

Spooge-alicious!

My wife fantasizes about cum swapping with me and forcing me to lick my freshly deposited spooge out of her vagina, but every time we try, just after I ejaculate, I loose my nerve. I have tried to taste my own cum before, and it really does turn me on, but there seems to be a huge difference between fantasizing and doing. I love my wife and want to fulfill her fantasy.
How do i get over my apprehension to gulping my own love juice?
Regards,
Chris

it's what's for dinnerOMG Chris! What are you, trying to do make me sick? Just kidding! What a spunky little spitfire you’re married to, my man. Nasty little piggy sex, it’s my favorite kind! You guys GO!

“Vaga-felching” or “lickin’ a creampie” is a relatively obscure fetish. The gays are more likely to felch, cuz they’re so into the whole jizz thing, don’t cha know. Vaga-felching is a-completely-nother thing…especially if it’s a straight dude doing the felching.

Ya see, a guy is always up for layin’ down and nice slime trail, but lickin it up again, especially after it’s been in the inner-recesses of a pussy…why that pretty much enough to make most straight dudes hurl.

I suppose you’re slightly ahead of the ballgame, considering you say you find the taste of your own baby batter a turn on. That’s a good start. The big hurdle, of course, is the having the same desires post-ejaculation as you do pre-ejaculation. And therein lies the rub, darlin’.

Ya see, when we’re in the throws of passion, when we’re totally aroused, we get in this state. It’s exactly like a state of suspended animation, only completely different. 😉 Our senses — sight, smell, touch and taste are muted and our judgment is impaired. Which allows us to do all sorts of things we would never consider if our dick wasn’t hard. Just ask all the holier-than–thou preachers and politicans who’ve been caught lately with their pants down, so to speak. You know the old saying; “A stiff dick has no conscience,” don’t cha? Well, it’s kinda like that.spooge

All the nasty piggy little things we can groove on with a hardon, often evaporate once we’ve shot our load. And seein’ that ya gotta shoot your load in order to make a creampie, the fetching thereafter becomes considerably less tantalizing once you do, if ya catch my drift.

I suppose you could push past the hesitation you have with a little mind game. You could try to convince yourself that what was alluring before the creampie was made is the same thing as after. But then you’d have to override your reinstated judgment and senses of sight, smell, touch and taste to do so. But, if you ask me, I think you could do it. It’s just a little issue of mind over matter.

Get it? Got it? Good!

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