Institute for Sex Research and Forensic Psychiatry, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sci Rep. 2018 Feb 27;8(1):3715. doi: 10.1038/s41598-018-22108-z.
The psychiatric classification of "normal" versus disordered sexual behavior has been a subject of some dispute. Although atypical sexual interests have been viewed traditionally as typically male, epidemiological data indicate its presence in both genders. We examined how gender and sexual orientation influence whether or not atypical sexual behavior is classified as a mental disorder. Mental health professionals (N = 546) were presented with five case vignettes where subjects exhibit paraphilic behaviors; one case with psychotic symptoms served as the control condition. For each vignette we randomly changed the described subject's gender (male/female), sexual orientation (homosexual/heterosexual), and presented diagnostic criteria (fulfilled/ambiguous). Female subjects were significantly less pathologized and overall more stigmatized in terms of exhibitionistic, frotteuristic, sexual sadistic and pedophilic behavior. On the other hand, female sexual behavior that fulfilled diagnostic criteria for masochistic disorder was more pathologized. Our results demonstrate that nosologically irrelevant factors, which may be related to different sexual norms for men and women, affect clinicians' decisions regarding atypical sexuality.
“正常”与“异常”性行为的精神科分类一直存在一些争议。尽管非典型性兴趣传统上被视为男性特有的，但流行病学数据表明其在两性中均存在。我们研究了性别和性取向如何影响非典型性行为是否被归类为精神障碍。精神卫生专业人员（N=546）被提供了五个案例描述，其中描述了一些具有性癖好的案例；一个有精神病症状的案例作为对照条件。对于每个案例，我们随机改变了所描述的受试者的性别（男/女）、性取向（同性恋/异性恋）和呈现的诊断标准（满足/模糊）。在暴露癖、摩擦癖、性施虐癖和恋童癖行为方面，女性受试者的病理化程度明显较低，整体上受到的污名化程度也较低。另一方面，满足受虐障碍诊断标准的女性性行为被更多地病理化。我们的结果表明，与男性和女性不同的性规范相关的非病理相关因素会影响临床医生对非典型性的判断。
