變異的性行為

在20世紀的歷史進程中，性學家引入了生物學、生理學、心理學、社會學、人種學和歷史學等多學科的研究方法，而且他們的研究成果最終迫使精神病學家變得更加地自律。鑒於此，精神病學家數次修改了診斷手冊。例如，當前的性與性別認同障礙的精神病列表中不再包括“戀獸癖”和“同性戀”，而且其它的一些“性副態（paraphilia）”現在正被討論作為刪除的候選對象。一些性治療師甚至要求刪除全部的分類系統。不過，為了現時的教程需要起見，這種討論的細節並不重要，故不作贅述。關鍵在於根本的問題：人類的性行為的一些類型應該被歸類為精神病或精神障礙嗎？如果回答是肯定的，那麼哪一種應該是精神病？而且，對於這樣的分類，標準應該是什麼？對個體和對社會的後果是什麼？對醫學科學的後果是什麼？醫學研究模型提得出最適當的性愛的專業解釋嗎？是否存在其它的、也許更好的研究模型？

美國精神病協會診斷與統計手冊（DSM）

在最近數十年裏，該手冊已經修改過數次；我們期待著進一步的修訂版。最新版本是“帝V”。 左：III。版 - 1987年修訂的。中東：四。文字版 - 1994年修訂版，右：五版2013。

The Diagnostic and Statistical Manual (DSM)
of the American Psychiatric Association.
In the last few decades, the handbook has been revised several times.
The latest edition is “DSM V”.
Left: III. Edition - Revised 1987. Middle: IV. Edition - Text Revision 1994, Right: V. Edition 2013.

Historical Background 4

In the course of the 20th-century, sexologists conducted extensive biological, physiological, psychological, sociological, ethnological, and historical research, and their findings eventually forced the psychiatrists to become more self-critical. As a result, they revised their diagnostic handbooks several times. For example, the current psychiatric list of sexual and gender identity disorders no longer includes “zoophilia” and “homosexuality”, and some other “paraphilias” are now under discussion as candidates for removal. Some therapists even demand the removal of the entire category. For the purpose of the present course, however, the details of this discussion are not important. Essential are the underlying questions: Should certain variations in human sexual behavior be classified as mental illnesses or disorders? If so, which ones? And what should be the criteria for such a classification? What are its consequences for the individual and for society? What are the consequences for medical science? Does a medical model offer the best explanation of erotic specialization? Are there other, and perhaps better, models?