BDSM and Fetishism: Finally off the “Sick List”

By Tess Joseph

Consensual sexual practices should not be medicalized. In fact, the medicalization of consensual sexual practices and sexual identities is an affront to human rights and sexual liberation, one that echoes a disturbing history that includes the categorization of “homosexuality” as a mental disorder until 1973. Classifying consensual sexual practices as illnesses has long been a project of classifying—or rather, demonizing—people.  

A landmark decision on June 18, 2018 by the World Health Organization (WHO) intends to put an end to the deeply harmful legacy of the medicalization of sexual practices. Following the Nordic countries’ adaptation of the Norwegian model, the WHO has removed consenting sexual practices from the International Classification of Diseases in ICD-11. Perhaps most notably, the WHO has taken BDSM and fetishism off their “sick list.” Rather than render these sex practices as illnesses, the WHO recognizes them as iterations of the fundamental human right to freely express one’s sexuality.

As a sexual freedom organization, the Woodhull Freedom Foundation applauds the WHO for their decision and its profound implications for human rights and sexual liberation movements. Still, we seek something beyond the changes the WHO has enacted.

While removing the (scientifically unfounded) diagnoses may in turn remove a significant amount of stigma, we recognize that much of the stigmatization and judgement of the BDSM and fetish communities is not just contained in WHO documents—it is pervasive in popular culture. The problematic portrayal of BDSM in the Fifty Shades of Grey books and movies is emblematic of popular culture’s misrepresentation of these communities, of its failure to show that these of communities center and honor consent, communication, and pleasure . And no, the people in these communities are not “ill” by way of expressing their sexuality.

The WHO has made an important step forward, and it serves as a reminder for all of us to keep making progress. In order to do so, we also need to remind ourselves of the history of medicalization. And we need to recognize when medicalization becomes a tool of demonization, when stigmatization becomes a tool of discrimination. As change-makers in the sexual liberation movement, we need to commit ourselves to challenging the medicalization and/or misrepresentation of not just BDSM and fetishism, but all consensual sexual practices.

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