Paraphilias and the Medicalization of Criminal Behavior

'Paraphilia' is the term used by professionals to indicate that a sexual fetish is severe enough to warrant being called a mental health disorder. Even after the release of the fifth edition of the DSM (DSM-5) paraphilias remain controversial. Although philosophers and scientists alike have argued that some paraphilias are just a way to medicalize sexual behavior that is simply abnormal by society's standards, these arguments typically target paraphilias that do not involve immoral or illegal behaviors. To my knowledge, philosophers have largely ignored the 'criminal paraphilias' (like pedophilia) in their arguments. In this paper, I attempt to fill this gap. I argue that the diagnostic criteria for some paraphilic disorders allows for criminal behavior to serve as a sufficient condition for diagnosis, blurring the line between criminal behavior and psychopathology. I argue that such an equivocation is undesirable in at least three ways: it is contrary to the goals of psychiatry; it allows for the rights of individuals being diagnosed to be routinely violated; and it perpetuates mental illness stigma. These objectionable aspects of including criminal behavior as a diagnostic criterion for criminal paraphilias, coupled with the lack of empirical evidence that shows criminal behavior is a legitimate symptom of paraphilic disorders, provide a strong argument in support of removing the criterion. Once removed, there will effectively be no difference between diagnostic criteria for the noncriminal and criminal paraphilias, and philosophers providing critiques of the former group will be pressed to also address the latter.