Journal of Sex & Marital Therapy, 27:113–116, 2001 Copyright © 2001 Brunner-Routledge 0092-623X/01 $12.00 + .00 113 Address correspondence to Yitzchak M. Binik, Department of Psychology, McGill University, 1205 Dr. Penfield Ave., Montreal, QB, Canada, H2A 1B1. E-mail: binik@ego.psycho. mcgill.ca COMMENTARY The Sexual Pain Disorders: A Desexualized Approach YITZCHAK M. BINIK, CAROLINE F. PUKALL, and ELKE D. REISSING Department of Psychology, McGill University and Royal Victoria Hospital, Montreal, Canada SAMIR KHALIFÉ Department of Obstetrics and Gynecology, Faculty of Medicine, McGill University, Montreal, Canada A new look at Diagnostic and Statistical Manual of Mental Disorders’ (DSM- IV; American Psychiatric Association, 1994) dated view of sexuality and sexual dysfunction is long overdue. The report of the recent consensus conference (Basson et al., 2000) is an important first step, and some of the proposed changes represent significant progress. Unfortunately, little has changed with respect to the sexual pain disorders, and the one proposed change totally misses the mark. We will divide our comments into theoretical, clinical, and empirical problems. The most important problems are theoretical. The concept of sexual pain makes little sense because it implies that there is a special type of pain that is sexual in nature. Dyspareunia and vaginismus are the only “pains” in the DSM that are outside of pain disorder; thus, we have two types of pain problems, sexual and all the rest. This dichotomy does not seem reasonable. In essence, the consensus report adheres to the DSM view of classifying genital pain by the activity with which it interferes—intercourse. This is un- usual, since almost all chronic pain syndromes typically, albeit crudely, are identified by the body region that they affect. Although such crude anatomi- cal classifications typically are supplemented by associated pain characteris- tics and mechanisms (Mersky & Bogduk, 1994), it seems highly unlikely that there is a unique kind of pain that only interferes with intercourse or associ- ated activities. There are, in fact, other pain problems such as “tennis elbow” and “writer’s cramp” that are colloquially identified by the problem with which they interfere. No one, however, would seriously suggest that these should