Wednesday, May 29, 2013

Diversity in Sexual Interests Isn't a Disorder

by Ogi Ogas, Ph.D.

I find myself staring at feet. I like a heel. If she’s wearing clogs, that does something for me. Flip-flops. Sandals. Bare feet are the best. — comedian Jack Black

It's true that many sexual interests which may be present in the population may not necessarily manifest themselves on the Internet. For example, necrophilia — if you like to have sex with corpses this doesn't necessarily mean you will want to look at images of sex with corpses on the Web, or pay to subscribe to a necrophilia website.

Nevertheless, many non-visual sexual interests frequently manifest themselves in online erotic stories (such as interests in incest and male social status), so there's reason to suspect that a necrophiliac might be interested in reading stories about necrophilia, and thus the presence of necrophilia in the population should be partially measurable using online data. But we certainly can't say that the distribution of sexual interests on the Web is a mirror of sexual interests in the population; for example, tactile and olfactory interests may be particularly underrepresented online, even in stories. Nevertheless, we can say that the intense cross-cultural popularity of shemale porn, granny porn, and cheating wife stories reflects a higher frequency of the interest in the heterosexual male population than was ever predicted or imagined by science.

MILFs and DILFs: Fetish or Interest?

Despite the limitations of online data for investigating paraphilias, it's certainly the best empirical data available (far better than surveys of college students, one-off case studies, and surveys of clinical patients). And the data simply does not support the notion of paraphilias representing something atypical, unusual, or disordered. First of all, the mere fact that clinicians, scientists, and the general public all horribly failed to predict which sexual interests were common and which were uncommon should make us wary of any perspective predicated upon typicality. Second, the data demonstrates that a majority of men who seek out online erotic content have at least one salient and enduring sexual interest that is more specific than "women" or "men." In search histories, men tend to search for the same sexual interest over and over, whether it's small breasts, busty Asians, or forced feminization. The vast majority of adult sites that featured paid subscriptions are devoted to specific male sexual interests. Even adult sites that feature a broad spectrum of sexual content, such as tube sites like PornHub and YouPorn, organize content by sexual interest; visitors also search for content almost exclusively by specific sexual interest. (If you're wondering how else such content could be organized, consider the fact that while the male-targeted adult video sites often list more than fifty categories of sexual interests, female-targeted adult video sites often intentionally forego any kind of categorization). The most clicked and highest-rated videos and images on the most popular adult sites usually feature some specific sexual interest (evident in the tags, title, and comments) such as drunk, teen, creampie, etc.

Also, the fact that men are far, far more likely to develop fetishes than women was always a clue that there was some underlying biological predisposition in the male brain towards developing fetishes. (In contrast, female brains are far more likely than male brains to develop objectum sexualis: a romantic, emotional attachment to objects like fences and Ferris wheels; one objectum woman married the Eiffel Tower.) Now, just because there is a gender difference in a biological predisposition doesn't mean that it's natural or healthy — anorexia is indisputably a disorder, even though it's more prevalent in women. But when you have a putative disorder that is fifty or hundred times more prevalent in one gender than another, we must at least consider the possibility that we're looking at design rather than disorder, and a sociocultural label rather than biological reality.

In fact, the evidence strongly suggests that the male sexual brain is designed to imprint upon individual sexual cues. Most of the time, men end up imprinting upon female body parts (namely, breasts, butts, and feet), female body types (young or MILF, skinny or BBW), or reproduction-oriented sexual situations. These all direct men towards intercourse and are a sign of the healthy, natural functioning of the male brain. We also find "paraphilias" as a natural, healthy component of sexual behavior in many birds and mammals, such as male baboons fetishizing female buttocks, male roosters fetishizing red female combs, and female zebrabirds fetishizing colorful male feathers. Our complex, technological society now exposes us to a greater diversity of stimuli than ever before, so it's now much more likely that a man will imprint upon stimuli that are similar to those cues men are biologically predisposed to imprint upon, such as women's shoes (instead of feet), hypnotized women (a variant of submissive women), Japanese anime characters (instead of young, curvy women).

Our sweet and savory taste cues are also natural, but these gustatory mechanisms can lead us to prefer Oreo cheesecake to bananas, or Chicken McNuggets to grilled chicken. Though cheesecake and McNuggets certainly aren't as healthy as bananas and chicken, do such preferences reflect a clinical condition? Should they be classified as a culinary disorder resulting from neural or psychological disturbance? Or are they normal, healthy neural mechanisms getting directed to novel preferences? We might want to tell our McNuggets-loving friend to cut back on their visits to Mickey D's, but would we suggest they needtherapy?

The term "fetish" should be rejected not only because of its suggestion of disorder, but because of its pejorative connotation — the implication that the possessor of a fetish is somehow bizarre, that their sexuality is atypical, strange, outside the norm. In human sexuality textbooks, the term "fetish" invariably shows up in chapters titled "Atypical Sexuality." Similarly, the use of the term "paraphilia" should be discontinued because it implies atypicality and mental disroder (the clinical definition states they are an "obsession with unusual sexual preferences"), when evidence that they reflect psychiatric disorder is clearly absent. We advocate the neutral term "sexual interests." In our book, we also use "sexual cues"--though this term implies a particular theoretical framing of sexual interests (namely, that sexual cues have a specific evolutionary and neural basis).

The DSM and some clinical approaches (such as the Clinical Manual of Sexual Disorders) restrict the label of paraphilia to sexual interests that are distressing to self or dangerous to others, such as pedophilia, frotteurism, and exhibitionism. Though clinicians must certainly intervene and give special attention to sexual interests that motivate illegal behavior, I think it's unhelpful — and logically unjustified — to frame these sexual interests as atypical or reflecting psychiatric disorder. There's clearly no biological reason to believe that an interest in 17-year olds is a paraphilia and an interest in 18-year olds is not, even though one may produce illegal behavior. There's no biological reason to believe that an interest in touching women is a disorder and its illogical to assert that male exhibitionism is a psychiatric illness when we simultaneously believe that female exhibitionism is not. These interests are all bona fide social problems that may pose genuine harm to others — but if we consider these interest to be actual paraphilias, then why shouldn't we consider an interest in MILFs (another age-specific interest) or rubber clothing (another tactile interest) to also be disorders? Should these interests really be listed in the DSM?

Clearly, intervention is required when someone's sexual interest is motivating illegal activity, and perhaps if someone who is distressed by their sexual interests wants their insurance to cover treatment costs, but framing them as mental disorders is fraught with moral hazard. Psychiatry's historical treatment of homosexuality (once considered a paraphilia) remains a chilling precedent. The discomfort we all feel towards "reprogramming" homosexual brains to become heterosexual (not to mention the utter ineffectiveness of such attempts) should make us all hesitant to designate any sexual interest as a paraphilia. We were never able to cure or reprogram homosexuals; other sexual interests show the exact same resistance. We can label an interest as dangerous without labeling it as a disorder.

The terms fetish and paraphilias marginalize and pathologize natural and healthy sexual interests. At the very least, clinical catalogs of paraphilias should be modified to more accurately reflect the true patterns of sexual interests in the population.