The Atlantic
by MERISSA NATHAN GERSON
Asking your partner to tie you to the bedpost, telling them to slap you hard in the throes of lovemaking, dressing like a woman if you are a man, admitting a fetish for feet: Just a few years ago, any of these acts could be used against you in family court.
This was the case until 2010, when the American Psychiatric Association announced that it would be changing the diagnostic codes for BDSM, fetishism, and transvestic fetishism (a variant of cross-dressing) in the next edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), published in 2013. The new definitions marked a distinction between behavior—for example, playing rough—and actual pathology. Consenting adults were no longer deemed mentally ill for choosing sexual behavior outside the mainstream.
The change was the result of a massive effort from the National Coalition for Sexual Freedom (NCSF), an advocacy group founded in 1997 “to advance the rights of and advocate for consenting adults in the BDSM-Leather-Fetish, Swing, and Polyamory Communities.” At the time, these types of sexual behavior, by virtue of their inclusion in the DSM, were considered markers of mental illness—and, as a result, were heavily stigmatized, often with legal repercussions. In family court, an interest in BDSM was used as justification to remove people’s children from their custody.
“A sexual sadist practices on non-consenting people,” explains NCSF founder Susan Wright, while “someone who is kinky is having consensual enthusiastically desired sex.” The problem with the earlier DSM: It didn’t draw a distinction between the two. A 1998 survey from the NCSF found that “36 percent of S&M practitioners have been victims of harassment, and 30 percent have been victims of discrimination.” As a result, the organization’s website says, “24 percent [have lost] a job or a contract, 17 percent [have lost] a promotion, and 3 percent [have lost] custody of a child.”
“We were seeing the DSM used as a weapon,” says Race Bannon, an NCSF Board Member and the creator of Kink-Aware Professionals, a roster of safe and non-judgmental healthcare professionals for the BDSM and kink community. (The list is now maintained by the NCSF.) “Fifty Shades [of Grey] had not come along,” says Bannon, an early activist in the campaign to change the DSM. “[Kink] was still this dark and secret thing people did.”
Since its first edition was published in 1952, the DSM has often posed a problem for anyone whose sexual preferences fell outside the mainstream. Homosexuality, for example, was considered a mental illness—a “sociopathic personality disturbance”—until the APA changed the language in 1973. More broadly, the DSM section on paraphilias (a blanket term for any kind of unusual sexual interest), then termed “sexual deviations,” attempted to codify all sexual preferences considered harmful to the self or others—a line that, as one can imagine, is tricky in the BDSM community.
The effort to de-classify kink as a psychiatric disorder began in 1980s Los Angeles with Bannon and his then-partner, Guy Baldwin, a therapist who worked mostly with the gay and alternative sexualities communities. Bannon, a self-described “community organizer, activist, writer, and advocate” moved to Los Angeles in 1980 and soon became close with Baldwin through their mutual involvement as open participants in and advocates for the kink community. “I’m fairly confident that I was the first licensed mental-health practitioner anywhere who was out about being a practicing sadomasochist,” Baldwin says.
The pair was spurred to action after the 1987 edition of the DSM-III-R, which introduced the concept of paraphilias, changed the classifications for BDSM and kink from “sexual deviation” to actual disorders defined by two diagnostic criteria. To be considered a mental illness, the first qualification was: ‘‘Over a period of at least six months, recurrent, intense sexual urges and sexually arousing fantasies involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.’’ The second: ‘‘The person has acted on these urges, or is markedly distressed by them.’’
“1987 was a bad shift,” Wright recalls. “Anyone who was [voluntarily] humiliated, beaten, bound, or any other alternate sexual expression was considered mentally ill.”
With the new language, Baldwin says, he quickly realized that laws regarding alternative sexual behavior would continue to be problematic “as long as the psychiatric community defines these behaviors as pathological.” …