变异的性行为

在20世纪的历史进程中，性学家引入了生物学、生理学、心理学、社会学、人种学和历史学等多学科的研究方法，而且他们的研究成果最终迫使精神病学家变得更加地自律。鉴于此，精神病学家数次修改了诊断手册。例如，当前的性与性别认同障碍的精神病列表中不再包括“嗜兽癖”和“同性恋”，而且其他的一些“性副态（paraphilia）”现在正被讨论作为删除的候选对象。某些性治疗师甚至要求删除全部的分类系统。不过，为了现时的教程需要起见，这种讨论的细节并不重要，故不作赘述。关键在于根本的问题：人类的性行为的一些类型应该被归类为精神病或精神障碍吗？如果回答是肯定的，那么哪一种应该是精神病？而且，对于这样的分类，标准应该是什么？对个体和对社会的后果是什么？对医学科学的后果是什么？医学研究模型提得出最适当的性爱的专业解释吗？是否存在着其他的、也许更好的研究模型？

美国精神病协会诊断与统计手册 (DSM)
在最近数十年里，该手册已经修改过数次；我们期待着进一步的修订版。最新版本是“帝V”。 左：III。版 - 1987年修订的。中东：四。 1994年修订版 - 文本，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?