Under the title “Disorders of Sexual Preference” (paraphilia; Greek. παραφιλία from pará, “apart,” “beside,” and philía, “friendship,” “love”; English, paraphilic disorders; ICD-10-GM F 65.-), the ICD-10-GM directory lists diagnoses in which sexual stimulation is experienced primarily through unusual sexual acts or fantasies involving unusual objects or activities. Sexual preference describes what makes a person sexually aroused. Sex ratio: sexual preference disorders occur predominantly in males. The following explanations are strictly based on the definitions of the ICD-10-GM directory. Sexual preference disorder includes:
- Fetishism (ICD-10-GM F 65.0): use of dead objects as stimuli for sexual arousal and gratification.
- Fetishistic transvestitism (ICD-10-GM F 65.1): to achieve sexual arousal wants clothes of the opposite sex worn; thus giving the appearance that it is a person of the opposite sex.
- Exhibitionism (ICD-10-GM F 65.2): the recurrent or persistent tendency to expose one’s genitals in public in front of mostly opposite-sex strangers without inviting or desiring closer contact.
- Voyeurism (ICD-10-GM F 65.3): recurrent or persistent urge to watch other people engage in sexual activity or intimate activities, such as undressing, without the knowledge of the person being watched.
- Pedophilia (ICD-10-GM F 65.4): sexual preference for children, boys or girls, or children of either sex, usually in prepuberty or early puberty.
- Sadomasochism (ICD-10-GM F 65.5): sexual activities involving the infliction of pain, humiliation, or bondage are preferred.
- Masochism: when the individual suffers this type of stimulation.
- Sadism: when someone inflicts pain, humiliation or bondage on another.
- Multiple sexual preference disorder (ICD-10-GM F 65.6): presence of multiple abnormal sexual preferences without one being prominent. The most common combination is fetishism, transvestitism and sadomasochism.
- Other disorders of sexual preference (ICD-10-GM F 65.6): eg.
- Obscene telephone calls,
- Rubbing/pressing one’s body against other people for sexual stimulation in crowds (= frotteurism),
- Sexual acts on animals (= zoophilia),
- Strangulation and use of anoxia (lack of oxygen) to increase sexual arousal,
- Sexual preference directed at corpses (= necrophilia).
- U. v. m.
Sexual preference disorder must be “at least six months of recurrent and intense sexually arousing fantasies, sexual needs or behaviors” that cause significant distress or dysfunction. Other forms of sexual preference:
- Asexuality: no desire for sexual interaction.
- Pansexuality (prefix “pan” comes from Greek and means “all”; synonym: omnisexuality; anthrosexuality): sexual orientation in which persons do not make a preselection in their desire according to sex or gender identity* ; can apply to people of all gender identities, ie. in addition to the binary sexes man and woman – from bi- or homosexual women and men – also feel sexual or romantic feelings for any other gender identities (eg, about transsexual people to hermaphrodites / individuals of a kind with male and female gender expression (intersexuals, hermaphrodites)).
- Bisexuality (actually “ambisexuality”, after the Latin prefix bi- for “two”): sexual orientation or inclination to be emotionally and/or sexually attracted to two sexes.
- Homosexuality: sexual orientation in which sexual desire is predominantly directed toward persons of the same sex: women with women (lesbians) and men with men (gays).Demographic surveys for homosexuality vary from 2-6%; 1.5-2 percent lesbian women and up to 3.5-4 percent gay men. Note: Homosexuality was removed from the DSM-III-R in 1987 and from the ICD-10 in 1991.Since then, homosexuality has been considered normal.
* Gender identity: “a person’s subjective sense of themselves as a man or a woman (or in between).”
Gender identity disorders:
- Transgender (Latin trans “beyond”, “beyond” and English gender “social sex”) refers to people whose gender identity does not match or does not fully match the sex registered after birth based on external characteristics or who reject a binary assignment (man or woman). Depending on the positional classification, one speaks of transgender persons with female (transwoman) as well as male (transman) gender identities and all forms of identity (non-binary gender identities) in between. Note: transgender is independent of sexual orientation, i.e. it can be heterosexual, homosexual, bisexual or asexual.
- Transsexualism or transsexuals (from Latin trans “across, beyond”, and sexus “sex[es]”; ICD-10-GM F 64): People with the desire “to live and be recognized as members of the opposite sex”; incomplete identification of a person with the sex assigned to him by others according to sexual characteristics.
- Transvestitism while maintaining both sex roles (Latin trans “over”, vestire “dress”; ICD-10-GM F 64): wearing the clothing of another sex; regardless of sexual orientation.
- The desire for permanent sex reassignment or surgical correction does not exist; the change of clothes is not accompanied by sexual arousal.Gender identity disorder in adolescence or adulthood, non-transsexual type.
The following are the definitions of LGBT and transgender in this context:
- LGBT (also GLBT, LGBTI, LGBTQ+), an abbreviation coming from the English language for Lesbian, Gay, Bisexual and Transgender, describes a community whose commonality is heteronormativity. That is, a worldview in which heterosexuality is the social norm.
Comorbidities (concomitant disorders) in sexual preference disorders [Guidelines: 1]: addiction and anxiety disorders (up to 80%); affective disorders (severe (major depression) up to 30%, mild up to 60%); psychoorganic impairment and schizophrenic psychosis (up to 5%); obsessive-compulsive disorder (up to 10%); attention deficit hyperactivity disorder (ADHD; Engl. Attention deficit hyperactivity disorder (ADHD): paraphilic patients or sex offenders have a history of frequent attention deficit hyperactivity syndromes in childhood and adolescence, sometimes even in adulthood; personality disorders.
