• DOI:10.1007/s10508-016-0787-2
• Corpus ID: 29031029

“Psychosexual Development Disorders”: Calling and Recalling for Declassification

@article{Janssen2016PsychosexualDD,
  title={“Psychosexual Development Disorders”: Calling and Recalling for Declassification},
  author={Diederik F. Janssen},
  journal={Archives of Sexual Behavior},
  year={2016},
  volume={45},
  pages={1601-1604}
}

• Diederik F. Janssen
• Published 8 July 2016
• Psychology
• Archives of Sexual Behavior

‘‘Psychological and Behavioural Disorders Associated with Sexual Development and Orientation’’are the broad focus of ICD-10’s rubric F66 (WHO, 1992/2004/2016, pp. 221–222). F66’s organizing concept, undefined and unreferenced but invoked in the rubric’s begging‘‘Other’’ (F66.8) and‘‘Unspecified’’(F66.9) items, is thatof‘‘PsychosexualDevelopmentDisorder.’’Thisseemstorefermostlytothefirstof threesubsumeditems, namely‘‘Sexual Maturation Disorder’’(F66.0), much less readily, however, to‘‘EgodystonicSexualOrientation’’(F66.1)and‘‘Sexual Relationship Disorder’’(F66.2). Taken together, mentioned items aremadetorefer toproblemsattributedinclusivelyto‘‘variationsof sexualdevelopmentororientation’’inanhistoricaltimeframe,anda global context, where ‘‘[s]exual orientation alone is not to be regardedasadisorder’’(p.221)but itsuncertaintyor‘‘ego-dystony’’ apparently is. F66 has seemed contrived predominantly when it comes to homosexual orientation or preference and its pre-adult correlates. According to the WHO, ‘‘Sexual Maturation Disorder’’ entails distressing‘‘uncertainty about [one’s] gender identity or sexual orientation’’which wouldoccurmostly in‘‘adolescents who arenot certain whether they are homosexual, heterosexual, or bisexual inorientation’’(1992/2004/2016,p.221;however, thechapter in which F6X categories appear is called‘‘Disorders of Adult Personality and Behaviour’’). Attracting little research after a quarter of a century (nil results for‘‘sexual maturation disorder’’on PubMed in May 2016, for instance), Cochranet al. (2014)called for F66’s declassification in anticipation of ICD-11 (due out 2018), arguing that it invitespathologizationofLGBTQ—especiallyquestioningbutarguablyalso‘‘gender-queer’’—youth(apossibility previously noted, e.g., by Platzer, 2006, p. 111). Curiously lumped together, the three diagnoses indeed appear embarrassing tracesoftheWesternpsychiatricization,thenprogressivedepsychiatricization, of homosexuality (Drescher, 2015). Moreover, international nuances in their respective formulation are suggestive of enduringlocalsensitivitiesconcerninghomosexuality(SouthKorea: Yi,inChoi&Yi,2004,p.948;China:Wu,2003).TheChineseSocietyofPsychiatry’s2001andcurrentChineseClassificationofMental Disorders Third Revision (CCMD-3), styled after ICD-10 and DSM-IV, still retains‘‘Ego-Dystonic Homosexuality and Bisexuality’’(but not pedophilia) among its‘‘Disorders of Sexual Preference’’(Wei, 2013). The ICD-11 Beta Draft (accessed March 1, 2016) does not yet list F66. The intertwined DSM and ICD edifices have a history of retaining dubious categories regarding gender variance and sexual orientation (Drescher, 2010). The implicit verdict of ‘‘psychosexual immaturity’’seems to be key to this history. The ICD-9 interestingly defined its rubric 302.6‘‘Disorders of Psychosexual Identity’’as involving‘‘[b]ehaviour occurring in preadolescents of immature psychosexuality which is similar to that shown in the [adult] sexual deviations described under transvestism and transsexualism’’(WHO, 1977, vol. 1, p. 179). However, F66’s conceptual underpinnings pertain to the wider historical gambit of‘‘sexual deviation.’’For example, ICD-9 also curiously tied‘‘sexual immaturity, e.g., frigidity and over-responsiveness tostimuli’’to‘‘hystericalpersonalitydisorder’’(p.428).‘‘Sexual Maturation Disorder’’has also, if sporadically, been named in reference to juvenile sex offenders against younger minors, in whichcaseitwouldprovideanalternativetothehereclearlyproblematic diagnosis of pedophilia (Aebi, Plattner, Ernest, Kaszynski,&Bessler,2014,p.385),orperhaps, inDSM-5andlikelyICD11 terms,‘‘pedophilic disorder.’’The proposed alternative is clearly no less problematic. A prefatory note to F66 invites a specification of a‘‘prepubertal sexual orientation’’if such would prove tobe‘‘problematic for the individual.’’InvocationofF66inadolescent sex offender contexts would shift the arguable crux of the diag& Diederik F. Janssen [e-mail]