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Hebephilia: A Postmortem Dissection

  • Special Section: DSM-5: Classifying Sex
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Abstract

In 2008, the concept of hebephilia, which denotes an erotic preference for “pubescent children,” was suggested by Blanchard and his team for inclusion in the DSM-5 (Blanchard et al., 2009). Four years later, the APA’s Board of Trustees opted for the status quo and rejected that proposal. This essay sheds light on the reason for this rejection. I consider three important questions related to hebephilia: Does hebephilia exist? Is it a disease? And what would have been the social consequences of including it in the DSM? I argue that if Blanchard failed to convince others that hebephilia should be included in the DSM-5, it is not because he focused too much on the first question and was unable to offer a convincing answer to the second one, but because he made the mistake of dismissing the third one as extraneous. The DSM is not intended to be a pure research manual, and a category like hebephilia cannot be evaluated without taking into account its potential forensic impact. In part or in whole, the decision to include a new diagnostic category in the DSM is, and always should be, a political decision.

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Notes

  1. Wakefield’s (1992, 2011) influential “harmful dysfunction” analysis of mental disorder offers an obvious response to Blanchard’s point here, but as far as I know Blanchard never discusses Wakefield’s work.

  2. Let us note in passing that while Blanchard’s proposal to introduce hebephilia was soundly rejected by the BOT, the consent criterion in the DSM-5’s general definition of paraphilia logically validates the category of hebephilia. On this incoherence, see First (2014).

  3. From the DSM-III to the DSM-IV-TR, harm was a necessary requirement for all disorders, not just for the paraphilias. This is no longer the case in the DSM-5, which states in its official definition of mental disorder that “mental disorders are usually associated with” harm (American Psychiatric Association, 2013, p. 20, my italics; see Cooper, 2015).

  4. An article by Cantor (2012), a collaborator of Blanchard, confirms that the main people working on hebephilia have not been personally involved with SVP laws: “Neither I, nor Blanchard, nor Freund, nor Zucker has ever been retained for SVP testimony, either by prosecution or by defense” (p. 61).

  5. There is no reason to doubt the candor of this statement, but one also cannot help but note that it clearly contradicts Blanchard’s own definition of paraphilia, where the legal criterion of consent is what makes hebephilia into a disorder. In this definition it is clinical science that adjusts itself to the law, since its domain of research is carved out by means of a legal criterion. If this criterion changes (for instance, if the legal age of consent is raised or lowered), then the clinical determination of what counts as hebephilia must logically change accordingly.

  6. The chair of this Task Force, Howard Zonana, also participated in the DSM-5 Forensic Review Committee, as did another member of the Task Force, Steven K. Hoge.

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Singy, P. Hebephilia: A Postmortem Dissection. Arch Sex Behav 44, 1109–1116 (2015). https://doi.org/10.1007/s10508-015-0542-0

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