Erwin J. Haeberle

“Paraphilia” -  A Prescientific Concept
Some comments on a current debate


In my days as a university professor I used to tell my students that the history of sexology is, to a large extent, a history of ideas and, in many cases, a history of foolish ideas.

One can demonstrate this, for example, by looking at the “scientific” and professional terms used at different times for various sexual behaviors. The most obvious case in point: Some of the terminology introduced by our sexological pioneers is now widely considered obsolete. When we try to find out why this change has occurred, we learn that it is not simply due to scientific progress. We also discover and have to understand a rarely discussed underlying fact of cultural history: Scientific endeavors can be, and often are, subject to non-scientific influences  -  religion, social taboos, civil and criminal laws, partisan politics, intellectual fads and fashions, lobbying by powerful interest groups, research funding opportunities, health insurance policies, the print media, film and television, the internet, and many, many more.

Looking back, one can make one preliminary general observation: In our Western secular societies, the non-scientific  influences have, in one way or another, reinforced two large cultural trends - the criminalization and the medicalization of human sexual behavior. Both of these trends have their own fascinating histories, but this is not the place to delve into them. Let it suffice to say that, over the years, there have also been corresponding counter-trends, i.e. efforts to de-criminalize and de-medicalize. As for the latter effort, psychiatrists have been found on both sides of the issue: Sometimes they have been veritable “missionaries of medicalization”, enlarging their manuals by adding new diagnoses, at other times they have supported the counter-trend and reduced their number. On the whole, however, the tendency has been toward reduction: Today, the diagnoses are fewer, more specific, and more precise. In any case, all of these ideological battles, professional power struggles, minority liberation movements, technological innovations, the present electronic revolution, and other non-scientific influences have played a role in shaping our ideas about human sexuality, and they have also left their traces in our professional terminology - directly or indirectly, for good or for ill.

At the present time, in preparation of a new edition of the Diagnostic and Statistical Manual (DSM V) of the American Psychiatric Association (APA), the old term “paraphilia” has, rather belatedly, become subject to critical examination and vigorous debate.

 Actually, to any critical observer with a background in philology and philosophy the term has always appeared moralistic and thus prescientific on its face. Thus, for scholars outside the field of sexology, it has always been hard to understand why “paraphilia” has not been discarded years ago along with other ideological, imprecise  or misleading terms such as “perversion”, “deviation”, “premature ejaculation”,”coitus interruptus”, “sexual surrogate”, “birth control”, “opposite sex”, and the like. For details, click here.

However, with a few notable exceptions, sexologists, especially those who are also physicians and psychiatrists, have never been very sensitive to the nuances of language or to the origins and precise meaning of a word. Most of them, like many other specialists, have little interest in etymology and semantics. Once a professional jargon has been widely accepted, they usually cling to it, no matter how often it has been proven to be impractical, illogical, nonsensical, or plain wrong. In this respect, even some radical sexologists are curiously conservative.

Turning now to the subject at hand:
Traditionally, psychiatrists have defined a “paraphilia” simply as a “sexual disorder”, adding that it involves “deviant” or “abnormal” behavior. However, in the meantime, some colleagues are becoming uncomfortable with such vague and loose definitions. Therefore, they also criticize the present Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA). For future editions, they try to introduce some distinctions and clarifications in the hope of making the term more acceptable and useful.

A typical “progressive”, “enlightened” example can be found in a recent textbook:

A paraphila is  a “powerful and persistent sexual interest other than in copulatory or precopulatory behavior with phenotypically normal, consenting adult human partners.”(1)


For me, this definition raises a number of questions: How powerful is powerful? How persistent must the persistence be in order to qualify? And what kind of copulation is supposed to follow the “precopulatory behavior”? Only coitus? What about anal intercourse? Do oral intercourse and manual intercourse (mutual masturbation) qualify? Apparently not, because I have been told that “preparatory fondling is OK, if it leads to coitus and anal intercourse, but it is paraphilic if it leads to oral intercourse or mutual masturbation”. This leaves me puzzled: Why should anal intercourse be more “correct” than oral intercourse and mutual masturbation? The logic of this escapes me.

And why this emphasis on copulation as the ultimate goal of sexual activity and its only valid justification?  After all, we know that sex therapists often advise aging couples to “explore non-coital forms of lovemaking” when erection and lubrication problems make vaginal intercourse difficult. Are such therapists encouraging paraphilic behavior? Are they luring their clients into dark sexual side alleys and away from the one and only shining path to erotic fulfillment? Do the clients really need potency pills and artificial lubricants so they can copulate and thus find a “true love” that psychiatrists can approve of?.

On a more mundane level: The above textbook definition also makes paraphilias out of consensual exhibitionism of a sort that is becoming increasingly popular today: Watching each other masturbate over long distances per PC cam. This way, “voyeurs” and “exhibitionsts” can please each other, either as a result of their own direct personal initiative or through larger “amateur” web sites. Indeed, one may very well wonder whether, with the new electronic means of communication, the old stereotypes of  “peeping Toms” and “flashers” will have much of a future. After all, it is likely that more and more “ordinary” people will take advantage of the internet where they can expose themselves and watch others with little effort, no risk of being arrested, and at practically no cost to themselves. An urge to do so seems more common than previously suspected, because the large number of such videos online suggests that both demand and supply are considerable and may be growing.

 Actually, many internet users don’t even need the excitement of interaction, but are content with looking at the many freely accessible porno videos as aids to solitary masturbation. This seems increasingly common among male teenagers, but also among older males, single or married. Does anyone seriously propose that all of them are paraphiliacs? Some psychiatrist might answer that, no, this activity is not necessarily paraphilic as long as it is not exclusive and remains a mere substitute for a desired, but unavailable actual copulation. However, I am not convinced by such hair-splitting arguments. After all, who is going to be the ultimate arbiter here? Who can determine what is substituting for what, and what is temporary and exclusive and why? To me, any claim to certainty in this matter looks like professional arrogance and deliberate blindness -  a refusal to see the whole spectrum of today’s sexual realities.

And what about internet prostitution? Here the participants can see and perhaps also hear but never touch each other. In other words: There is no chance for any kind of actual copulation. It has therefore been argued that internet prostitution is also paraphilic. This does not make sense to me, because it is just a new version of a very old business. By the way, does the concept of paraphilia apply here to both the prostitute and the customer?  For details, click here and here.

Moreover:
The textbook definition speaks of copulation with “a phenotypically normal adult”. This raises two questions:

1. What is phenotypically normal? Is someone paraphilic, because he falls in love with (i.e. feels an intense and persistent sexual interest in) someone who has all symptoms of Turner or Klinefelter syndrome?  Or are these desired partners phenotypically normal? If they are, what about PAIS or CAIS?  Where exactly do you draw the line? Was the wife of the philosopher Moses Mendelssohn paraphilic, because she fell in love with a hunchback?

2. What exactly is meant by the word adult? Anyone over 18? Over 21? After all, legal adulthood is reached at different ages in different countries. Does anyone want to establish a special psychiatric adulthood that applies everywhere to every person at all times? If so, what age should one choose? 

Was the Roman emperor Hadrian paraphilic, because he felt an intense and persistent sexual interest in the 16 year-old Antinous who, as it happens, died at age 20 and thus never reached adulthood? Or did he? Did male adulthood in imperial Rome already begin at age 16? Or even earlier? (2)  In that case, was Hadrian’s infatuation never paraphilic at all? Or should one retroactively postulate a difference between legal and bio-psychological adulthood even in ancient times? If so, was Hadrian perhaps a paraphiliac for the first 2 years of the relationship, but not for the last 2 years? How relevant is all of this anyway, and to whom? Why should anyone care? Why should we need a psychiatric label for one of the greatest love stories of all time?

 

Hadrian (76-138) and his beloved Antinous (110-130).

And what about Shakespeare’s Romeo and Juliet who felt an intense and persistent sexual interest in each other and never reached adulthood? (OK, I guess this one doesn’t count, because both were presumably of roughly the same age.) But let’s consider another teenage couple - Romulo (18) and Jeanette (13). Romulo could, of course, very well face criminal charges (“statutory rape”). In the present context, however, something else is more relevant: Since he is five years older and, according to many, an adult, some would consider his feelings paraphilic and call him a “hebephile“ (from Gr. hebe: young).This is a fancy new term for people (mostly men) who feel sexually attracted to the young around the age of puberty and shortly thereafter (13-16 years). According to most writers, the objects of such adult desire can be teenagers of both sexes, but others restrict the term to the desire for young males. In this latter case, they may also call it “ephebophilia” (from Gr. ephebos: adolescent), but sometimes both terms are used interchangeably or with still other meanings. At this time, the usage is not firm. (3)

For a comment, let us skip here the obvious, well-worn example of ancient Greek “paiderastia” and simply state: No ancient classical text, including the Bible, has ever found the attraction of adults to sexually maturing or mature youths to be odd, rare, or otherwise remarkable in any way. At that age, most of the young had passed their initiation rites and had been accepted as full members of their communities (example: Bar and Bat Mitzvah). Indeed, throughout most of human history, millions of adult men have married young teenage brides. Hebephiles - and thus paraphilicas - all?

In the 18th century, the German professor Georg Christoph Lichtenberg was still able to live openly with a 13-year-old girl in the small provincial town of Göttingen (she died five years later at the age of 18, never reaching adulthood). (4)  Should his neighbors have called him a „hebephile“? Should we do so today? To what purpose?

Georg Christoph Lichtenberg (1742-1799)

In Lichtenberg‘s lifetime, Mozart wrote his operas „Le Nozze di Figaro“ and „Don Giovanni“. In the first of these, based on a popular play, the page Cherubino is just reaching puberty (he must be assumed to be between 13-15 years old). He pursues every female in sight with confessions of love, including a married countess, the wife of his employer. This sub-plot greatly amused the audience at the time and still does today whenever the opera is performed. (5) Here it is clearly the young adolescent who takes the sexual initiative. Even before his voice change, he desires an adult woman. Should we therefore call him paraphilic?

And what about Don Giovanni in Mozart’s opera? He chases every skirt he sees, but, according to his servant Leporello, who is keeping a list of his master’s exploits, “sua passion predominante è la giovin principiante”. For 18th-century opera lovers this revelation hardly came as a shock or even as a surprise. Quite the contrary: For them, it confirmed that the Don’s behavior, while aggressive, excessive and perhaps compulsive, was “normal” in at least one respect - the choice of his erotic victims. In spite of his many unattractive traits, this was something with which the males in the audience could always identify. Apart from this “typical” male sexual orientation, however, Mozart and da Ponte have created here an enigmatic, complex stage figure. Alternately charming and ruthless, a well-mannered egotist and courageous nihilist, Don Giovanni has, over two centuries, inspired many different interpretations. But do we really understand his character (and the thus whole opera) better, if we now also call him a hebephile?

Now many psychiatrists might argue that they would not use the term “hebephile” for Don Giovanni and for every one of the millions of men who, in the past, married young teenage brides. After all, they usually continued their sexual relationships as the brides reached adulthood and even middle age, and many of the men also copulated with mature women (According to Leporello, Don Giovanni bedded many hundreds of females in many countries, in Spain alone 1003. It stands to reason that the majority of them must have been adults). Therefore, the psychiatrists might say, one cannot conclude that these men had an overwhelming preference for teenage girls. Some may have had such a preference, but one can no longer be sure. Anyway, there was no way, even at the time, to distinguish a “hebephile” from all the others, because “everyone was doing it”, and most men probably did not do it for paraphilic reasons, but simply because it was a traditional custom.

An interesting argument, but one that raises a number of new questions: When a whole society observes the custom of having adult men marrying teenage brides, what sense is there in speaking of hebephilia and hebephiles at all? Which criteria could be used to distinguish them from the other men? And why would one try to do that in the first place? What practical purpose could it possibly serve?

But back to Shakespeare‘s tragedy: We know that the Elizabethan theater did not have actresses and that Juliet – like all other female roles – was played by a  boy actor“, i.e. by a boy before his voice change, probably between the ages of 12-15.  This gave the plays a special fascination, indeed an erotic allure no longer permitted today when the new word “hebephilia” has become a handy term of accusation and condemnation. And let’s not forget that Shakespeare and his theater had serious competition in the very popular „children’s companies“, consisting entirely of boys. Chosen for their handsome looks, they performed major dramatic works by important authors. Obviously, their audiences enjoyed the androgynous charm of these boys, which combined the last traces of childhood “innocence” with the first signs of an incipient sexual maturation. Seeing this unique, transitory blending of traits recaptured on the stage, had a special appeal for the spectators. Before their very eyes, this all-too-fleeting phase of their own physical and psychological transition from childhood to adolescence sprung back to life, regardless of the content of the play. It was something that no adult actor could match.

The drama of „Romeo and Juliet“, of course, offered an additional attraction, because the actor playing Romeo was, in all probability, only slightly older than the one playing Juliet. In the love scenes, therefore, one saw two tender youngsters of the same sex interacting – one before and the other after the voice change. (If, for some internal company reason, the role of Romeo was given to a more mature adolescent or even an adult, this did not change Shakespeare’s intentions in writing the play.)

Anyway, we can safely assume that the homoerotic overtones of these scenes were well appreciated by the audience. Indeed, Shakespeare knew how to use this and similar effects for the success of his theatrical enterprise. A good example is his comedy „As you like it“, which deliberately plays with sexual ambiguities: The girl Rosalind, played by a boy actor, pretends to be a boy named Ganymede. In a courtship scene, this „boy“ is then asked to pretend that he is a girl. In response, and still wearing his male costume, “he” changes his hitherto “masculine” demeanor by quickly adopting clearly “feminine” gestures. As a result, s/he is passionately wooed as the supposedly “original” female. But for the boy acting the part, even this “original femaleness” was never more than a pretense in the first place. Thus, to the delight of the audience, the whole love scene operates simultaneously on several oscillating levels: A boy plays a girl who plays a boy who plays a girl. This kind of erotic sophistication cannot be recreated today, no matter how good our modern actresses are.

The commercial success of this sexually ambiguous „double character“ Rosalind/Ganymede prompted Shakespeare to repeat it in his comedy „Twelfth Night“. Here, a „boy actor“ plays the girl Viola, who adopts the role of a boy named Cesario, who soon becomes the love object of a woman. (6) In short, Shakespeare deliberately used the physical charms of boy actors for artistic purposes, and these were well appreciated by his audiences.  Does this make all of them hebephiles?
As this example shows, sexual interests can very well be shaped by cultural influences, and by the way, the name Ganymede in the first-mentioned comedy was a deliberate hint at an underlying meaning of the role, and Shakespeare’s audiences did understand this hint: In ancient Greek mythology, Ganymede was “the most beautiful of all youths”, beloved and abducted by Zeus, who desired his constant presence and therefore made him his cup bearer. Does this mean that Zeus was a “hebephile”?  

A historical look at another “paraphilia” may be useful here - foot fetishism. As we all know, imperial China, for over 1000 years, had a tradition of crippling female feet. This so-called foot-binding is said to have had an erotic component: Small feet made a woman sexually more desirable. Indeed, her “lotus feet” were supposed to provoke and heighten male arousal. Whether this was actually true and, if so, for how many men, will now forever remain a subject of speculation. Only one thing is certain: In the case of imperial China, it makes no sense at all to speak of “foot fetishism” as a paraphilia and to distinguish “foot fetishists” as a special group from of the rest of the population. The belief in the erotic attraction of artificially produced small female feet was so deeply embedded in Chinese culture, that such a distinction would have been considered not only pointless, but absurd. For details, please, click here.

“Lotus-Shoes”

The Chinese erotic ideal was a small, crippled female foot of ca. 3 inches in length, the so-called Lotus foot.
Slightly longer feet were called ”Silver-Lotus“ (4 inches), and, if still longer, “Iron-Lotus”.
The erotic fascination extended to the respective shoes.
From the left: 1. Porcelain wine cups, length: 3 inches, Qing Dynasty. 2. and 3. Silken “Lotus shoes”.
4. Photo of a crippled foot. 
All courtesy of the China Sex Museum, Tongli

these also determine the moral evaluation of such interests. It goes without saying that cultural factors are also operating in our Western world today, although they are very different from those in imperial China.  Indeed, these factors now shape our perception of adult sexual interest in teenagers as „hebephilia”, an utterly inappropriate reaction to love objects that are now “forbidden”. In this respect, our distant forebears had very different attitudes, but, in the meantime, our culture has changed. An awareness of this change is essential to a proper understanding of the issue. It should warn us to be very cautious, when we try to formulate „objective“ criteria for the evaluation of human sexual behavior. This does not mean that psychiatrists could not and should not intervene in certain concrete situations. However, they will be able to do so more effectively if they refrain from sweeping claims and absolute pronouncements based on unacknowledged moral convictions.

This brings us to the term “paraphilia” itself: It is, and will always remain, prescientific - a negative value judgment, not an objective description of facts. Psychiatrists do not do themselves any favors by adopting such moralistic terms. If they want respect in the future, they’d better look for new, more neutral expressions. I don’t mean to be picky or negative. I just think that my esteemed colleagues, careful and serious as they are and driven by the noblest motives, are fighting a lost cause as long as they cling to this outdated term.

If I may quote myself from my Critical Dictionary:

paraphilia. (gr. "next to" & "love", i.e. second-class love) …a term now preferred over the older "perversion", "aberration" and "deviation" which have fallen into disfavor as too harsh and ideological. However, the new term does not really represent any intellectual progress, since it also assumes and implies the existence of a "real", "true","natural", and "correct" love (philia) which has sisters of minor rank standing next, behind, or below it, just as the paramedical personnel stands behind or below the "real" doctor. Scientifically speaking, this is an unwarranted assumption. Professionals in any field should clearly and openly state the reasons for their disapproval in each individual case. These reasons will prove convincing in some cases, but in other cases they may very well turn out to be no more than prejudices.

In other words: Anyone who uses a term like “paraphilia” thereby indirectly claims to know what is right and wrong in human sexual behavior. The same is true of the word “disorder”. Again, the speaker claims to know the one and only correct order. Such a claim may make some sense when one talks about the human body and its functions, although, as the cases of indeterminate physical sex remind us, even here the term can be controversial. For example, some well-meaning physicians have, in reference to intersexuality, introduced the term “Disorders of Sex Development (DSD)”. Not surprisingly, this did not sit well with the intersexuals who felt denigrated by such a pejorative characterization. Therefore, they have, in direct response, suggested the less judgmental expression “Differences of Sex Development (also DSD).

Some Historical Notes

1. From sin to sickness

In the 4th century A.D. the Roman emperor Constantine I (“the Great”) converted to Christianity on his deathbed, and, under his successors, it became the official state religion.   As a consequence, even the furthest reaches of the state eventually adopted the Christian doctrine of human sexual behavior. This doctrine combined older Jewish traditions with certain ascetic “pagan” philosophies und survived the decline and fall of the Roman Empire. Indeed, it dominated not only Europe, but the entire Western world and its colonies until well into the Modern Age.

Constantine I (ca. 280-337)
first Christian Roman emperor

In the Christian view, sexual activity was justified only for the purpose of procreation. All forms of sexual behavior that did not serve this goal were sinful. Some of them, like oral or anal intercourse or sexual contact between men or with animals, were considered so offensive and outrageous that, for many centuries, they were severely punished as “crimes against nature.” It was not until ca. 200 years ago that some European countries began to remove religious influences from their penal codes. Little by little, the secular state stopped paying attention to the old sexual „abominations“. As long as no one was hurt, the police and the courts no longer tried to intervene.

Where the law retreated, medicine soon moved in and took its place. The emerging, ambitious profession of psychiatry transformed the old sins and vices into diseases, and thus the old „abominations“ were reborn as „sexual psychopathologies”. Indeed, the psychiatrists even continued to use the old religious vocabulary and spoke of „perversions“, „aberrations“ and „deviations“. In both Catholic and Protestant doctrine, these terms had referred to „false“ beliefs, but now they meant „false“ sexual behaviors. Thus, the former heretics turned into modern patients. Instead of punishment, they needed therapy.

Carl Westphal (1833-1890)
invented the illness homosexuality

A prime example of this development is the psychiatric illness „homosexuality“, invented in 1869 at the Berlin medical school Charité by the „modern“ psychiatrist Carl Westphal. The university‘s conservative „establishment“ (Rudolf Virchow and his colleagues) had, in the same year, refused to recognize sexual contact between males as a medical problem, but the new “progressives” like Westphal, and especially von Krafft-Ebing, soon convinced themselves that the “contrary sexual feeling” was a proper subject for their fast expanding  specialty. As a result, for over a century, the Western, Christian world subjected „homosexuals“ to medical treatment until, in 1973, American psychiatrists finally removed the diagnosis from their official handbook (DSM III).

The belatedly „enlightened“ authors realized that their claim of being scientific could not be reconciled with silently implied value judgments. Thus, over time, other moralistic diagnoses of „deviance“ were also removed from the handbook (for example human sexual contact with animals, in the Christian tradition condemned as “sodomy”). Instead, psychiatrists now tried to become more „objective“, to avoid the old, discredited religious terms, and to develop a neutral, purely descriptive terminology.

Friedrich Salomon Krauss (1859 -1938),
 an Austrian ethnologist, coined the term „paraphilia“.

2. From „perversion“ to „paraphilia“
When the sexological pioneer Friedrich S. Krauss proposed the seemingly unobjectionable term „paraphilia” (Gr. para: next to, and philia: love), it was eventually adopted by psychiatrists as the perfect solution to their terminological problems. However, upon closer examination, the term offers no improvement. A paraphilia is, per definitionem, a second-class love. The term implies that there is such a thing as a “true”, “real”, “correct”, and “natural” love (philia), and that next to it or behind it there are other loves of inferior rank, just as the paramedical personnel stands behind and below the “real doctor”. However, such a silent assumption is arbitrary and unscientific. Those who use the term „paraphilia“ thereby indirectly continue to claim that they know the „true“ meaning and purpose of sexual behavior and therefore possess the authority to correct it, if it does not conform to their ideal. They are ideologues, although they may not realize it.

Indeed, when average citizens search the internet for the term „paraphilia“, they find  definitions that fail the most basic tests of objectivity. The wording is usually unspecific and vague or even tautological. For example, some authors offer definitions like these: “Paraphilia is the experience of intense sexual arousal to atypical objects, situations, or individuals” or Paraphilias, or sexual deviations, are defined as unusual fantasies, urges, or behaviours that are recurrent and sexually arousing” . The key terms here are “atypical”, “unusual. In other words, the authors claim to know what is “typical” or “usual” in human sexual behavior. But how do they know this? After all, many human activities are “atypical” or “unusual” without indicating a psychological disturbance, such as mountain climbing in the Himalayas, a bicycle tour around the world, entering a monastery, breeding orchids, or collecting porcelain thimbles. And sexual behavior does not allow for such healthy idiosyncrasies? Why not?  Another definition of paraphilia states that it is “a condition, in either men or women, of compulsive responsivity and obligatory dependence on an unusual  or personally or socially unacceptable external stimulus or internal fantasy for sexual arousal or orgasm”.  This author does not seem to realize that what is “socially acceptable” varies with the societies in question, i.e. with time and place. Still other definitions are meaningless, empty phrases, for example the assertion that a paraphilia is “any abnormal sexual attraction”. (What a “normal” attraction could be is left to silent assumptions.) And then there is this triple tautology: “Paraphilias are a variety of complex psychiatric disorders which are manifest as deviant sexual behaviour” .  (7) In other words: Paraphilias are disorders expressed in deviant behavior. This is like saying that an extramarital affair amounts to cheating on the spouse and is therefore manifest as adultery.

In all of the above cases we are dealing with something that critics have called “psychiatric bullshit”. (8) There is no way around it: The word “paraphilia” is just as ideological and prescientific as the traditional religious terms it was meant to replace. It expresses a negative value judgment; it does not describe an objective fact. Psychiatrists undermine their own cause when they use such moralizing terms.  Furthermore: Many people remember the time when psychiatrists considered solitary masturbation and homosexual behavior to be symptoms of psychopathology, i.e. sexual disorders. Indeed, the Catholic Church is still upholding part of this tradition when it declares in its current catechism that "homosexual acts are intrinsically disordered”. In support of this opinion, the authors cite the doctrine of Natural Law. For a discussion of this doctrine, click here.

To us modern sexologists, however, it should be clear by now that the Natural Law doctrine has no place in science. It should therefore be equally clear that the term “disorder” is no longer acceptable when it comes to something as complex as human sexual behavior. Scientists should leave such moral certainty (better: dogmatism) to the religious authorities.

In conclusion: We in sexology should, once and for all, get rid of the moralistic, prescientific terms “paraphilia” and “disorder”. Instead, we should worry about behaviors that cause distress or impairment in the individuals concerned or/and cause harm to others. Here, we should seek (and I’m sure we will find) morally neutral, purely descriptive terms, which, in the end, will strengthen, not weaken, the authority of psychiatrists and others who might be asked for interventions.

Perhaps something like “erotic interests that may profit from or require therapy”, or “sexual urges that demand control or intervention“. I am not a classicist, but one of our colleagues who is fluid in Greek and Latin could probably come up with a new, appealing Greek or Latin term that does not prejudge the issues before one even looks at them! If this new, appropriate term sounds both erudite and snazzy enough, it will be accepted by the psychiatric profession. Then everybody will be happy, and the present useless, endless, and often acrimonious debate will come to a harmonious end.

Amended  Nov. 2016  EJH

Notes

(1) The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR); American Psychiatric Association, 2000 defines ‘‘paraphilias,’’. as “conditions which …are characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations…’’ (p. 535).

(2) In ancient Rome, male adolescents at the ages of  15-16 years were allowed to wear the toga as a sign of their adulthood. On the other hand, they did not reach the full maturity of citizens (plena maturitas) until the age of 25. Robert Kastenbaum (ed.), Encyclopedia of Adult Development, Oryx Press, Phoenix AZ 1993, p.31

(3) The British pediatrician James M. Tanner  (1920- 2010) was the first to propose a measurement of human sexual development, the now so-called  Tanner Scale  or Tanner Stages. Using this scale, Ray Blanchard and his colleagues - see above (3) – suggest the following age groups for their definitions:

Pedophilia (prepubescent children on Tanner -Stage 1.  Age generally 10 or younger),
Hebephilia (children in early puberty on Tanner-Stage 2 and 3. Age generally  11 - 14),
Ephebophilia (adolescents on Tanner Stage  4. Age generally  15 and 16),
Teleiophilia (adults on Tanner Stage  5, between physical maturity and decline),
Gerontophilia (old people).

(4) A few years ago, the story was turned into a novel:  Gert Hofmann, Die kleine Stechardin, 1994, engl: Lichtenberg and the Little Flower Girl, 2004

(5) Die “trouser role” of Cherubino is written for a soprano/mezzo , i.e. for someone before the voice change. If Mozart had intended to portray an adolescent after the voice change, he would have written the part for a light tenor, such as required for the role of Pedrillo in the „Abduction from the Seraglio“. In any case, the play on which the opera is based, clearly demands an actor at the beginning of puberty. Most importantly, a „trouser role“ played by a woman creates a similar - if opposite - effect  of the kind already used by Shakespeare (see above in my text  As you like it“). In one of the scenes of Mozart‘s opera, Cherubino is dressed in women’s clothes: A female plays a male who plays a female. By the way: The play on which Mozart’s „Figaro“ is based was the second in a trilogy written by Beaumarchais: „Le barbier de Seville“, „Le mariage de Figaro“ and „La mère coupable“.The first of the three comedies was turned into an opera twice, first by Giovanni Paisiello (1782) and again by Gioachino Rossini (1816): „Il barbiere di Siviglia“.) There is no operatic  version of the third play, but it reveals that, at some later time, Cherubino had impregnated the countess.

The effect of Cherubino’s „trouser role“ was later recreated on a grander scale by Hugo von Hofmannsthal and Richard Strauss for the male title role of their opera „Der Rosenkavalier“, which had its premiére in Dresden 1911. Here, the 17-year-old, androgynous count Rofrano, sung and played by a woman, is dressed in women’s clothes for a key scene in Act I and again for most of Act III (a female playing a male playing a female). As the curtain rises, he is seen lying in bed with the married princess Werdenberg (the “Marschallin”). Just before - with the curtain still closed - Strauss’ short orchestral introduction had very drastically illustrated their coitus in “in real time” – from the young man’s erection and penetration and his all-too hasty coital movements to his ejaculation, clearly and very noticeably made audible by the orchestra. This music, reflecting Strauss’ perhaps somewhat crude Bavarian humor, is both funny and witty, because the actual coitus lasts only 1 minute and 10 seconds. Then follows a last loving embrace, and the remaining 2 minutes describe the young count’s blissful exhaustion after his orgasm. Thus, even before the actual opera begins, and by strictly musical means, the composer signals the sexual inadequacy and inexperience of his youthful hero. This, in turn, casts an interesting light on the following action. Unfortunately, most opera directors today do not listen to the introductory “lovemaking” music, which seamlessly continues as the curtain rises. Thus, they fail to notice or do not understand the musical joke. Some of them may also be tone deaf or too prudish to understand it. (The censors in the first Berlin performance did understand it and demanded changes.) Thus, these incompetent directors promptly ruin the opening scene. (When we first see him, still lying in bed, Rofrano should not wear trousers, because he is still cuddling with the princess and had no time to put them on. If you faithfully follow the music and the text, he cannot wear anything but a long shirt with (apparently) nothing underneath, but covering his private parts. 

(6) Similar roles for “boy actors” in Shakespeare’s plays are:  Sylvia (Two Gentlemen of Verona) as well as Portia, Nerissa and Jessica (The Merchant of Venice) and Imogen (Cymbeline).

(7) From Encyclo.Co. UK, all quotes found here: http://www.encyclo.co.uk/meaning-of-Paraphilia

(8)  Niall McLaren, Psychiatry as Bullshit, in: Ethical Human Psychology and Psychiatry, Volume 18, Number 1, 2016, pp. 48 – 57. See also the seminal book by Harry Frankfurt, On Bullshit. Princeton, N.J.: 2005.