Disposition and Treatment of Paraphilia in Non-western Cultures

An ongoing discovery of personal sexuality is central to human experience. Determinants of sexual interests and preferences are likely set early, if not from the very beginning, but are also reinforced through an assortment of life encounters. At the same time, societal pressures to conform to what is determined by the majority to be normal and abnormal shape the acceptability (sex positivity) or non-acceptability (sex negativity) of personal interests and preferences. Nowhere is this more the case than with paraphilias—desires and behaviors deemed by social entities to be peculiar, deviant, or aberrant. Conceptual changes beginning with the American Psychiatric Association’s (APA) 2013 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) with respect to the diagnosis and treatment of paraphilias more clearly distinguish between so-called atypical sexual interests and actual mental disorders. An overall paucity of research data into paraphilias, both controlled and anecdotal, limits the generalizability of Western notions of variant sexual behavior to non-Western societies. Because little scientific information has been published addressing alternative sexualities—given differences in cultural understandings, religious and legal prohibitions, and reluctance to report sexual deviations—this chapter necessarily addresses paraphilias from a more generalized point of view, with references to non-Western studies whenever possible. Future cross-cultural research into this important topic is highly encouraged.