The World Health Organisation (WHO) produces an International Classification of Diseases and Associated Health Problems (ICD). This is a diagnostic manual for the medical profession, internationally, and it also has a lot of impact on people making laws and social policy in countries around the world. 

Recently, a new version of the ICD was released, that, for the first time, dropped bdsm, fetishism and transvestism from its list of “paraphilic disorders”. The word “paraphilic” essentially means “it’s sexual but they’re doing it wrong.” 

Background

Why the change? There’s been pressure on WHO from assorted advocacy groups representing LGBTQ people, and bdsm activists, to get their ICD changed, so it doesn’t enable and encourage legal discrimination against people in any of those categories. So WHO knew they should take a look at the issue. 

But what made the change possible, or inevitable, was the research. Most of the “bdsm, fetishism and transvestism is bad” came from religious and other prejudice against people who are different, and that side of it had no intellectual content at all.

Really, Freud just wanted to look like Hemingway

A lot of the “theory” that supported the view that bdsm, in particular, but also fetishism and transvestism, were bad came from the Freudian tradition, for reasons I explained in my previous post. 

It’s not that the Freudians of today are especially likely to be bigots, or that people who aren’t Freudians now take Freudian writing very seriously. However, for historical reasons the vast bulk of academic writing on bdsm, at least until around 2004, was Freudian and hostile to bdsm in particular.

Naturally, a committee reviewing that literature may not take any one essay seriously, but they have to note that the majority academic stance has been one of hostility to sexual “deviance”.  

The Australian nation-wide studies

But more recent research was starting to contradict that view. There are studies showing that men who took part in bdsm were less likely to accept “rape myths” than men who weren’t into bdsm, for example. 

Australians are much like the rest of the world. Except that they get their orgies and their sports events confused.

But the single most important piece of research was from Australia: The Australian Study of Sexual Health and Attitudes. That’s because they didn’t do qualitative research, or get your sample from a small bdsm community.

That kind of research is valuable if your goal is to increase understanding, but it doesn’t have much political impact. 

The Australian surveys in 2002 and 2014 were nation-wide random sampling surveys, each with a sample size of 20,000 people. There was simply no room for making any suggestion of selection bias. The surveys found that about 5% of the population, or 1 in 20 people, had taken part in bdsm, or bdsm-lite bedroom games like “teacher and naughty schoolgirl”, in the last year. 

When the survey result were analysed to compare the people who said they’d taken part in bdsm with the people who hadn’t, every single prediction based on the Freudian “explanation” of bdsm went crashing down in flames. 

People who’d taken part in bdsm in the last year (from here on I’m going to call them “bdsm people”, or “us”) were no more likely to have spent any time in prison. Their education and income level was simply normal, no better or worse than average. Their reported enjoyment of sex was slightly higher than average. (They were probably reporting that enjoyment accurately, because they did tend to have sex slightly more often than average.)

In other news, bdsm people were no more likely than the rest of the population to have been sexually coerced, either in the last year, or ever in their life, including when under-age. (There goes the “bdsm is caused by childhood sexual abuse” theory.) 

Respectable couple. Payin their taxes and lovin their bdsm

So bdsm people were as healthy, as sane, as optimistic, and so on, as the rest of the population. We’re upstanding citizens. We don’t commit crimes, or wind up in hospital, any more than the rest of the population.

Only two differences emerged: we tended to skew slightly younger than the population who hadn’t done bdsm in the last year, and we were noticeably randier. 

(The 2013 survey came up with essentially the same result.) 

So there is simply no factual basis, or social interest, in treating bdsm as a disease or disorder.

It simply wasn’t a sustainable position, intellectually, economically or politically. Once there was political pressure on it, and research, it had to change.

There hasn’t been a similar study that’s asked about fetishism or transvestism. But that Australian research project shifted the WHO committee more than anything else.

Couldn’t find a pic of Freud pulling something out of his arse. But have you noticed that guys with cigars tend to look like assholes?

It had been demonstrated that virtually the entire academic literature on sexual “problems” was essentially bullshit, utterly discredited by empirical research, and based largely on ideas that Freud had (excuse the slightly Freudian expression) pulled out of his arse.  

So the WHO committee had both the political will and the intellectual weaponry to make the change and stand by it. 

Notes

I have a contact who’s in contact with the people reviewing the World Health Organisation’s (WHO) International Classification of Diseases and Associated Health Problems (ICD).

This account is drawn from what that person told me, with some other sources.

There’s one more post about this to come.