Hinderliter, A. C. (2010). Defining paraphilia: Excluding exclusion. Open Access Journal of Forensic Psychology, 2, 241-272. Defining Paraphilia: Excluding Exclusion Author: Andrew C. Hinderliter Department of Linguistics University of Illinois, Champaign-Urbana, USA Email: andrewc.hinderliter@gmail.com Abstract The development of the classification of the paraphilias is considered, with emphasis on justifications for their inclusion in DSM-III in light of the declassification of homosexual- ity. These justifications are found to be tenuous and do not work for the paraphilias in DSM-III-R because of changes made. Rationale for these changes is discussed based on inquires made to DSM-III-R paraphilias committee members. Changes in DSM-IV and DSM-IV-TR are also discussed. After considering and critiquing more recent argu- ments for including the paraphilias in the DSM, recommendations are made regarding proposals for DSM-5, whether the paraphilias belong in the DSM, and whether they should be used in SVP commitment. Keywords: Paraphilias, DSM-5, SVP Commitment DSM-IV-TR (American Psychiatric Association, 2000b) defines a paraphilia as, “recur- rent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other nonconsenting persons” (p. 566); over at least six months. DSM-IV-TR lists eight paraphilias: exhibitionism, fetishism, frotteurism, pedophilia, sexual maso- chism, sexual sadism, transvestic fetishism, and voyeurism. It also has a not otherwise specified category (NOS) for less common paraphilias. In DSM-II (American Psychiatric Association, 1968), they were called sexual deviations, which is where homosexuality had been listed. Whether the paraphilias should even be in the DSM has been contro- versial, with a number of authors (e.g. Moser and Kleinplatz, 2005; Silverstein, 1984; Suppe, 1984;), arguing that the logic behind the removal of homosexuality should lead to the removal of all of these diagnoses. With the DSM currently being revised, the DSM-5 Paraphilias Subworkgroup has made a number of controversial proposals to expand this group of diagnoses, including a pro- posal to change the definition of paraphilia to be “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners” (Blanchard 2009). Blanchard calls the DSM-IV-TR’s definition of paraphilia a “definition by concatenation”—essen- tially, it is little more than a list. It provides no basis for determining why certain sexual