Revise F65! The ICD-10 paraphilia diagnoses

In Norwegian


The relevant sections in “F65 Disorders of sexual preference”:


In the ICD-10 the Sexual deviation category is called Disorders of Sexual Preference (DSP) and given the code F65.

“Disorders of Sexual Preference, Includes: paraphilias,

Excludes: problems associated with sexual orientation”

“Diagnostic Criteria for Research”, characterize these disorders by the following general criteria:

G1. The individual experiences recurrent sexual urges and fantasies involving unusual objects or activities.

G2. The individual either acts on the urges or is markedly distressed by them.

G3. The preference has been present for at least 6 months.
F65.0 Fetishism

Reliance on some non-living object as a stimulus for sexual arousal and sexual gratification. Many fetishes are extensions of the human body, such as articles of clothing or footware [sic]. Other common examples are characterized by some particular texture such as rubber, plastic, or leather. Fetish objects vary in their importance to the individual: in some cases they serve simply to enhance sexual excitement achieved in ordinary ways (e.g. having the partner wear a particular garment).

Diagnostic guidelines. Fetishism should be diagnosed only if the fetish is the most important source of sexual stimulation or essential for satisfactory sexual response.

Fetishistic fantasies are common, but they do not amount to a disorder unless they lead to rituals that are so compelling and unacceptable as to interfere with sexual intercourse and cause the individual distress.

Fetishism is limited almost exclusively to males.

F65.1 Fetishistic transvestism

The wearing of clothes of the opposite sex principally to obtain sexual excitement.

Diagnostic guidelines. This disorder is to be distinguished from simple fetishism inn that the fetishistic articles of clothing are not only worn, but worn also to create the appearance of a person of the opposite sex. Usually more than one article is worn and often a complete outfit, plus wig and makeup. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. A history of fetishistic transvestism is commonly reported as an earlier phase by transsexuals and probably represents a stage in the development of transsexualism in such cases.

Includes: transvestic fetishism

F65.5 Sadomasochism

A preference for sexual activity that involves bondage or the infliction of pain or humiliation. If the individual prefers to be the recipient of such stimulation this is called masochism; if the provider, sadism. Often an individual obtains sexual excitement from both sadistic and masochistic activities.

Mild degrees of sadomasochistic stimulation are commonly used to enhance otherwise normal sexual activity. This category should be used only if sadomasochistic activity is the most important source of stimulation or if necessary for sexual gratification.

Sexual sadism is sometimes difficult to distinguish from cruelty in sexual situations or anger unrelated to eroticism. Where violence is necessary for erotic arousal, the diagnosis can be clearly established.

Includes: masochism sadism

F65.6 Multiple disorders of sexual preference

Sometimes more than one disorder of sexual preference occurs in one person an none has clear precedence. The most common combination is fetishism, transvestism, and sadomasochism.

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