變異的性行為

這個不斷膨脹的“性副態（paraphilia）”的一覽表終於被證明連精神病學家也感到不滿意，因而他們開始縮減和修訂它。這樣的修訂似乎在將來也會繼續下去。在修訂期間，大家始終有一個共識，那就是應該區分兩類性欲變異行為（erotic variation）[1]：

① 不傷害他人和只是偶爾為之或罕見的性欲變異行為。只要這些性欲變異行為保持私密性和不招惹公眾對他們過度的關注，最好得到社會的忽略或容忍。如果相反，社會可根據情況適度地做出反應。對於有各自特點的性伴雙方來說，有一個簡單的規則：如果這樣的性欲變異行為穩定或至少不損害雙方的關係，就沒有什麼問題。但是，如果它導致爭執和分歧，性伴雙方可能必須分開並尋找更合適的性伴。

② 對他人造成一些具體傷害或對所涉及的個人正帶來麻煩的性欲變異行為（例如，因為性欲變異行為是強迫的）。根據這樣的情形，一些專業人員的照護可能有助於問題的解決甚或是必須的。這種照護可能是精神病治療或其它的醫學治療，不過可能也是某種非醫學的心理諮詢服務。如果違反了法律，某種形式的法律強制措施可能是需要啟動的：逮捕和起訴，可能需要懲罰。在一些案例，這種懲罰可能不得不加強或隨之被強制性的治療。在非常罕見的案例，罪犯可能必須被託付給精神病收容所多年甚或在那裏度過餘生。在其它的罕見案例，他可能被確定不為他的犯罪行為負責，並可能在不受懲罰之下委託他人對其進行監護。

在本教程裏，此處所涉及的這些問題的複雜性不允許我們做深入的討論。不過，在以下的簡要闡述的內容裏，我們至少能提供這兩種性欲變異行為的一些例子。

Historical Background 6: A Practical Distinction

The ever-expanding lists of “paraphilias” eventually proved unsatisfactory even to psychiatrists, and thus they began to shorten and revise it. Such revisions are likely to continue in the future. In the meantime, there is already a general consensus that one should distinguish between two kinds of erotic variations:

1. Erotic variations that do not harm others and are simply odd or rare. These are best ignored or tolerated by society as long as they remain private and do not call undue public attention to themselves. If they do, the appropriate social reaction depends on the circumstances. For individual couples, there is a simple rule: If such a variation stabilizes or at least does not impair the relationship, there is no problem. However, if it causes disagreement and disharmony, the couple may have to separate and look for more suitable partners.

2. Erotic variations that cause some concrete harm to another person or are troubling to the individual concerned (for example, because they are compulsive). Depending on the case, some professional attention may be helpful or even required. This may be some psychiatric or other medical treatment, but it may also be some form of non-medical psychological counseling. If the law has been broken, some form of law enforcement may be called for: Arrest and trial, possibly punishment. In some cases, the punishment may have to be augmented or followed by therapy. In very rare cases, the offender may have to be committed to a psychiatric institution for many years or even for the rest of his life. In other rare cases, he may be found not responsible for his criminal actions and may be so committed without punishment.

The complexity of the issues involved here does not allow us a thorough discussion in this course. However, in the following brief sections, we can provide at least some examples of both kinds of erotic variations.