The Paraphilias: Classification
Richard D. McAnulty
Defining sexual deviance is a difficult task. The erotic fantasies and behaviors that presumably constitute sexual deviance are relative since they vary over time within a given culture as well as across cultures. Sexual behavior is considered deviant or pathological when a large or influential segment of society disapproves of it because it violates explicit or implicit social norms about "normal" sexuality. Thus, with rare exceptions (such as sexual homicide), no sexual behavior is deviant in an absolute sense.
As Wakefield ( 1992) persuasively noted, all diagnostic labels entail value judgments: The observer chooses to attend to some phenomena while disregarding others. Wakefield proposed a formulation of disorders as "harmful dysfunctions." To qualify as a disorder, the condition in question must represent a dysfunction and must be viewed as harmful or undesirable by society. According to Wakefield, "a disorder exists when the failure of a person's internal mechanisms to perform their functions as designed by nature impinges harmfully on the person's well-being as defined by social values and meanings" (p. 373). In the case of homosexuality, no dysfunction has been identified, but the history of psychiatric classifications is replete with attempts to categorize homosexuality as harmful (as a sexual deviation).
The changing sociopolitical views of homosexuality have been paralleled by changes in the psychiatric nomenclature, as illustrated by the removal of the