That question is being asked by Ray Blanchard in a letter to the editor (read entire letter here) of the Archives of Sexual Behavior. Blanchard is the former chair of the Paraphilias Subworkgroup of the APA’s DSM V Sexual and Gender Identity Disorders Workgroup. DSM stands for Diagnostic and Statistical Manual of the American Psychiatric Association. The new 5th edition is slated to be released any day now and has attracted much controversy for a variety of reasons.
Generally, there is no more controversial area of the DSM than the section on sexual disorders. Blanchard’s subworkgroup recommended including reference to hebephilia in the section on paraphilias in the new edition. Hebephilia is defined as primary sexual interest in children who are in early puberty (i.e., at Tanner Stages 2 and 3, often corresponding to development between ages 11 and 14). Blanchard begins his letter by noting that “on December 1, 2012, the American Psychiatric Association (APA) announced that its Board of Trustees (BOT) had voted to reject the changes to the diagnostic criteria for pedophilic disorder proposed by the Paraphilias Subworkgroup for DSM-5 and to retain the diagnostic criteria published in DSM-IV-TR [i.e., a sexual preference for prepubertal, i.e., Tanner Stage 1, children, nowadays about age 10 or younger].”
Blanchard believes the proposed change would have allowed more precise diagnosis and research of people who have sexual preferences for early pubescent children but not younger, pre-pubescent children or adults. However, for reasons that are not clear, the APA Board of Trustees did not accept the recommended changes.
The fact that the APA did not make this change raises questions. Blanchard asks if the APA wants to discourage research on hebephilia. Furthermore, Blanchard wonders if the current DSM allows for hebephilia to be diagnosed under the category “other specified paraphilic disorder.” In other words, can clinicians and researchers use the “other” category to give label to individuals with hebephilia. Ultimately, according to Blanchard, the answers to these questions may provide insight into the APA’s stance on normal sexual preferences. He writes
It remains to be seen how the BOT [board of trustees] will respond to these questions when they start to arise in real-life settings, which they will. It seems to me that there are only two possibilities. If the BOT denies that it meant to assert that the sexual preference for children in early puberty is normal, then it has to allow the diagnosis of ‘other specified paraphilic disorder (hebephilia).’ If the BOT, or someone officially speaking on behalf of the BOT or the whole APA, states or testifies that the BOT intended to prohibit the diagnosis of ‘other specified paraphilic disorder (hebephilia),’ then that is tantamount to stating that the APA’s official position is that the sexual preference for early pubertal children is normal.
Elsewhere in his letter, Blanchard states that sexual preference for early pubertal children doesn’t “square with the average layperson’s concept of sexual normalcy and probably does not square with the average clinician’s either.” I agree and believe Blanchard raises some important issues which I hope the APA will address.
Note: On May 16, I asked the APA PR dept for comment on Blanchard’s letter. No response as of today (May 17). I will post anything I get.