Kink, Fetish, Paraphilia, Paraphilic Disorder: The Distinctions That Actually Matter

Foundations of Sexology and Kink Psychology

Estimated reading time: 18 minutes

Reader promise: This article explains the precise clinical and cultural differences between kink, fetish, paraphilia, and paraphilic disorder. It draws on verified psychological research and current diagnostic criteria to show why these distinctions matter, why they are so routinely confused, and why getting them right is essential for practitioners, professionals, and anyone trying to understand their own desires with honesty and accuracy.

The Word You Choose Changes Everything

Language is never innocent. When a person describes their intense attraction to leather as a disorder, they are saying something very different from when they describe it as a kink, even if the attraction itself is identical. One framing reaches for a prescription pad. The other reaches for a glass of wine and a good conversation. The question of which framing is accurate is not merely a matter of personal preference or political generosity. It is a question with a precise, researchable answer grounded in clinical psychology, diagnostic criteria, and decades of sexology research. And the answer, as it turns out, is far more liberating than most people expect.

The four terms that cause most of the confusion in public discourse about sexuality are kink, fetish, paraphilia, and paraphilic disorder. They are frequently used as if they mean the same thing, or as if each is simply a more clinical or more extreme version of the last. They are not. Each term describes something specific, and the differences between them have direct consequences for how people understand themselves, how clinicians treat their patients, how courts have prosecuted consenting adults, and how much unnecessary suffering gets produced by misdiagnosis and social stigma. This article explains each term clearly, uses the most current clinical frameworks to draw the distinctions precisely, and makes the case that understanding these words properly is the foundation of any serious education in sexuality, whether you are a curious beginner, an experienced practitioner of Bondage, Discipline, Dominance, Submission, Sadism, and Masochism (BDSM), a therapist, a researcher, or simply someone trying to make sense of their own inner world.

What Kink Means

Kink is not a clinical term. It does not appear in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) as a category of disorder, nor does it appear in the International Classification of Diseases, Eleventh Revision (ICD-11) as a diagnostic entity. Kink is a colloquial term, originating in English slang and adopted enthusiastically by practitioners and communities to describe sexual interests, practices, and relationship dynamics that fall outside conventional or socially dominant sexual scripts. The word carries none of the pathologising weight of older clinical vocabulary, and that lightness is deliberate. For the people who use it to describe themselves, kink is simply part of who they are.

In practical usage, kink covers an enormous range of activities and interests. It includes power exchange dynamics, impact play, sensory play, role-play, bondage, protocol-based relationships, financial domination, pet play, erotic humiliation, and hundreds of specific practices and interests that share one characteristic: they are non-normative in the sense that they exist outside the sexual mainstream, but they are consensual, adult, and pursued for pleasure, connection, creative expression, or psychological fulfilment. The word is used both as a noun and as an adjective. A person may describe themselves as kinky, or they may say they are into kink. Neither phrasing implies disorder. Neither phrasing requires clinical intervention. Kink is, in the language of modern sexology, a form of sexual diversity rather than a symptom of sexual pathology.

It is worth noting that what counts as kinky is culturally and historically contingent. Oral sex was once classified as a perversion in several Western medical systems. Homosexuality was listed as a mental disorder in the DSM until 1973. The boundary between normative and non-normative sexuality is not fixed; it shifts across time, culture, and politics. Kink communities are keenly aware of this history, which is one of the reasons many practitioners resist clinical labels with considerable intellectual energy, and with considerable justification.

What Fetish Means

The word fetish has two distinct lives: one cultural, one clinical. In everyday usage, fetish is used loosely to describe any strong or intense sexual interest, particularly one focused on an object, a specific body part, or a scenario. Someone might describe their collection of latex garments as a fetish wardrobe, or say they have a thing for red hair and call it a fetish. In these everyday uses, the word simply means an intense attraction or preference. There is nothing clinically meaningful about this usage, and it is widely understood in that spirit. However, it is not the same as the clinical definition, and the difference matters considerably for how people understand themselves and how professionals respond to them.

In clinical sexology, a fetish involves a strong or exclusive sexual arousal connected to a non-living object, a specific non-genital body part, or a particular material. The key distinction from general sexual interest lies in the degree of focus and, in some formulations, the element of necessity. A person who finds latex aesthetically and erotically appealing has a preference. A person for whom latex is a required element in sexual arousal, without which arousal is absent or significantly reduced, is describing something closer to what clinicians mean by a fetish. The line between preference and fetish is not always sharp, and many leading sexologists, including Charles Moser and Peggy Kleinplatz, have questioned whether the clinical delineation is as useful or as scientifically rigorous as it is often assumed to be.

The critical point is this: having a fetish does not mean having a disorder. The fetish becomes a clinical concern only when it causes significant distress to the person who has it, causes significant functional impairment in daily life, or involves non-consenting others. A person who enjoys foot fetishism in consensual adult contexts, who does not feel distressed by it, and whose life functions well across work, relationships, and personal wellbeing is simply a person with a sexual preference. They are not disordered. They do not need therapy unless they want it for their own reasons. The clinical literature, and the diagnostic frameworks that govern clinical practice, are clear on this point.

What Paraphilia Means

Paraphilia is a clinical term with a specific meaning in the DSM-5-TR. The American Psychiatric Association (2022) defines a paraphilia as an intense and persistent sexual interest other than genital stimulation or preparatory fondling with normal, physically mature, and consenting human partners. This definition is worth examining with care, because it contains both useful precision and genuinely awkward language. The word normal in particular has attracted substantial criticism from sexologists who rightly note that it implies a fixed and socially agreed standard of sexuality that does not, in practice, exist. Moser and Kleinplatz (2020) argued in the Annual Review of Clinical Psychology that the construct of paraphilias is poorly conceived and may have outlived its usefulness precisely because the boundary between normophilic and paraphilic interests is arbitrary and culturally variable rather than scientifically grounded.

Setting aside those important debates for a moment, the working definition from the DSM-5-TR tells us three things about what a paraphilia is. First, the interest must be intense and persistent, meaning it is not merely occasional curiosity or context-specific fantasy but a stable, recurring feature of a person’s sexuality. Second, the target of the interest is atypical in the sense that it falls outside conventional focus on adult, consenting, human sexual partners. Third, and most importantly, having a paraphilia is not the same as having a disorder. The DSM-5-TR states this explicitly: most people with atypical sexual interests do not have a mental disorder (American Psychiatric Association, 2022). A paraphilia is a description of a sexual interest pattern. It is not a diagnosis, and it should not be treated as one.

The category of paraphilias covers a wide range of interests, including arousal focused on specific materials or objects, on wearing clothing typically associated with another gender, on observing others in intimate situations, on exposing oneself, and on giving or receiving pain or humiliation. The presence of these interests in a person’s psychology is what the term paraphilia describes. Whether those interests have become a clinical problem is an entirely separate question, and it is the question addressed by the next, and most important, distinction on this page.

What Paraphilic Disorder Means

A paraphilic disorder, in the framework of the DSM-5-TR, is a paraphilia that is causing serious problems. Specifically, it requires that the person meets two criteria. The first criterion, Criterion A, establishes that the paraphilic interest is present and describes the nature of the atypical sexual arousal pattern. The second criterion, Criterion B, is what transforms a paraphilia into a clinical disorder, and it can be satisfied in either of two ways. Either the person has acted on their urges with a non-consenting person, causing harm or distress to that person, or the person themselves is experiencing clinically significant distress or functional impairment as a direct result of their paraphilic interest. Both criteria must be met for a formal diagnosis of a paraphilic disorder to be appropriate (American Psychiatric Association, 2022).

This two-criterion structure is significant, because it means that a person can have a strong, persistent, lifelong paraphilic interest, can practise it consensually with adult partners, can feel entirely comfortable and fulfilled by it, and can function perfectly well in every area of their life, and that person does not have a paraphilic disorder. They have a paraphilia. The distinction is not merely semantic. It has consequences for whether a person is stigmatised, pathologised, referred to treatment they do not need, or, in some legal contexts, placed on registers designed for people who cause harm. The DSM-5-TR lists eight specific paraphilic disorders: exhibitionistic disorder, fetishistic disorder, frotteuristic disorder, pedophilic disorder, sexual masochism disorder, sexual sadism disorder, transvestic disorder, and voyeuristic disorder. In each case, the disorder label applies only when Criterion B is satisfied. The interest alone is not enough.

The ICD-11 takes a similar approach but uses somewhat different language and structure. The ICD-11 classifies paraphilic disorders as patterns of sexual arousal that involve non-consenting persons or that cause clinically significant distress or impairment in the individual. Importantly, the ICD-11 also reflects a broader movement in international clinical thinking toward distinguishing sexual diversity from dysfunction or disorder. Clinicians should be aware that the DSM-5-TR and the ICD-11 do not map onto each other perfectly, and that which framework a clinician uses in a given jurisdiction can affect diagnosis, treatment recommendations, and, in some cases, legal outcomes for the people involved.

Why These Distinctions Matter in Practice

These are not merely academic distinctions. They have real effects on real people’s lives. A therapist who does not understand that kink is not the same as a paraphilia, and that a paraphilia is not the same as a paraphilic disorder, may inadvertently pathologise clients for whom no pathologising is clinically justified. A judge who does not understand that consenting adults can legally and ethically engage in sadomasochistic practice may conflate that practice with criminal assault, as has happened repeatedly in British and American legal history. A person who has been told by a poorly informed doctor or counsellor that their fetish is a mental illness may carry unnecessary shame, avoid disclosure in future relationships, or seek treatment for something that does not require it and may not benefit from it.

The field of sexology has produced clear evidence that the pathologising of consensual kink and fetish interests causes genuine harm. The stigma attached to BDSM has been studied, and its effects documented. Kolmes, Stock, and Moser (2006) found evidence of bias in psychotherapy with BDSM clients, with some clinicians attributing unrelated presenting problems to the clients’ BDSM involvement. Practitioners who sought therapy for anxiety, depression, relationship difficulties, or work stress sometimes found their kink identity treated as the presenting problem regardless of what they had actually come to discuss. This is not good clinical practice. It is what happens when clinicians conflate kink with disorder without examining the evidence, the criteria, or their own assumptions.

Understanding these distinctions is equally important for the people who hold these interests themselves. The experience of believing that one’s sexuality is pathological is distressing in ways that the sexuality itself often is not. Many people report spending years convinced that their fetish or kink interest meant something was wrong with them, when the evidence does not support that conclusion. Clarifying these distinctions is, among other things, a harm reduction exercise. When people understand where the clinical line actually falls, they can assess their own situation accurately and seek support if and when support is genuinely warranted, rather than out of shame or internalised stigma inherited from frameworks that were never as scientifically grounded as they claimed to be.

What the Research Actually Shows

The empirical literature on BDSM practitioners and psychological wellbeing does not support the assumption that kink is a symptom of damage, dysfunction, or traumatic history. One of the most methodologically important studies in this field was conducted by Richters, de Visser, Rissel, Grulich, and Smith (2008), who used a nationally representative sample of 19,307 Australian adults to examine the psychological and psychosocial characteristics of people who had engaged in BDSM activities. The study directly tested the hypothesis that BDSM is practised predominantly by people with histories of sexual coercion, sexual difficulties, or psychological problems. The findings did not support that hypothesis. The researchers concluded that BDSM is, for most participants, simply a sexual interest or subculture, and not a pathological symptom of past abuse or difficulty with conventional sexuality. This is not a community sample recruited from a kink website. It is a national survey drawn from the general population, which makes it considerably more robust than studies relying on self-selected BDSM communities.

More recently, Lecuona and colleagues (2024), working with a Spanish sample of 1,884 participants, replicated and extended earlier findings on the psychological characteristics of BDSM practitioners. Comparing practitioners with non-practitioners, the study found that BDSM practitioners showed higher levels of secure attachment, higher conscientiousness, higher openness to experience, and higher overall wellbeing. They showed lower levels of insecure attachment, lower rejection sensitivity, and lower neuroticism. These are not the psychological markers of a disordered population. They are, by any standard psychometric reading, the markers of a relatively well-functioning one. The study title, Not Twisted, Just Kinky, captures both its findings and its deliberate refusal to treat kink as synonymous with psychological damage.

It is also important to acknowledge that the research picture is not entirely one-sided, and intellectual honesty requires saying so. A 2025 study by Selic and Jug, using a smaller sample of 318 participants, found associations between childhood sexual abuse and certain dimensions of BDSM involvement, particularly submissiveness. This is a legitimate finding and should not be dismissed. However, it must be interpreted carefully. Association is not causation. Many people with histories of trauma do not engage in BDSM, and many people who engage in BDSM have no significant trauma history. The evidence across the broader literature does not support the conclusion that BDSM is caused by trauma, or that a traumatic antecedent is necessary for kink interest to develop. These are complex relationships requiring nuanced investigation, not simplistic assertion in either direction. The weight of the evidence, taken as a whole, supports the view that consensual adult BDSM and kink practice is not itself a marker of psychological disorder.

A Brief History of These Classifications

Understanding where these clinical categories came from helps explain why they remain contested, and why contested they should be. The pathologising of non-normative sexual interests in Western medicine has a long and, in retrospect, frequently embarrassing history. Richard von Krafft-Ebing’s Psychopathia Sexualis, published in 1886, catalogued what he called sexual perversions and treated them as symptoms of degeneracy, nervous disorder, or moral failure. His work shaped clinical thinking for decades and created a template in which unusual sexual interests were, by definition, problems requiring diagnosis and treatment. Freudian psychoanalysis reinforced this pathological framework with different theoretical machinery: fetishes and perversions became evidence of developmental arrest, unresolved anxiety, and failures of normal psychosexual development. These frameworks were not grounded in rigorous empirical research. They were speculative theories presented with enormous authority and accepted as scientific truth by clinicians who treated patients accordingly.

The formal classification of sexual disorders in psychiatric manuals began with the first edition of the DSM in 1952, and the categories evolved through subsequent editions, often driven by cultural and political factors as much as by clinical evidence. Homosexuality was listed as a mental disorder until 1973, when it was removed following sustained advocacy, activist pressure, and a growing body of evidence that gay and lesbian people showed no characteristic psychopathology related to their sexual orientation. The removal of homosexuality set a precedent for how the relationship between diagnostic manuals and social norms could and should be reexamined, and it opened intellectual space for subsequent challenges to the pathologising of other forms of sexual diversity.

The transition from the fourth to the fifth edition of the DSM brought meaningful conceptual progress. The DSM-5, published in 2013 and updated in the 2022 text revision, formally clarified the distinction between paraphilia and paraphilic disorder, making explicit what should always have been the case: that atypical sexual interests are not inherently disorders. Moser and Kleinplatz (2005) had argued for the removal of paraphilias from the DSM entirely, on the grounds that the category did not meet the DSM’s own standards for inclusion as a mental disorder. While their position was not fully adopted, the paraphilia/paraphilic disorder distinction in the current framework reflects a meaningful and welcome step toward depathologising sexual diversity in the clinical mainstream.

Myths and Misconceptions

Myth: Having a fetish means you have a mental illness.
Reality: Having a fetish means you have a sexual interest with a specific focus. A fetish only becomes a clinical concern, specifically fetishistic disorder, when it causes clinically significant distress, functional impairment, or involves harm to a non-consenting person. The American Psychiatric Association (2022) states explicitly that most people with atypical sexual interests do not have a mental disorder.
Myth: BDSM practitioners are psychologically damaged or have a history of trauma.
Reality: The most methodologically rigorous studies do not support this. The nationally representative Australian study by Richters and colleagues (2008) and the 2024 replication study by Lecuona and colleagues both found that BDSM practitioners do not show predicted patterns of dysfunction or coercion history. In several respects, practitioners showed more favourable psychological profiles than non-practitioners.
Myth: Kink and paraphilia mean the same thing.
Reality: Kink is a colloquial term with no clinical definition, covering a broad range of non-normative but consensual sexual interests. Paraphilia is a clinical term referring specifically to intense and persistent atypical sexual interests as defined by the DSM-5-TR. A person who enjoys light bondage as an occasional part of their consensual sex life may not have a paraphilic interest in any clinically meaningful sense at all.
Myth: Paraphilia and paraphilic disorder are the same category.
Reality: They are distinct categories with a critical difference. A paraphilia describes an atypical sexual interest. A paraphilic disorder is that same interest combined with clinically significant distress, functional impairment, or non-consensual behaviour. Without the consequences described in Criterion B, there is no disorder diagnosis, regardless of how unusual or intense the interest may be.
Myth: If something appears in the DSM, it is universally agreed to be a mental disorder.
Reality: The DSM itself distinguishes between paraphilias and paraphilic disorders to prevent precisely this conflation. The DSM is a clinical instrument shaped by both science and cultural context, with a documented history of including categories that were later removed or revised as research improved and social understanding evolved. Moser and Kleinplatz (2020) noted that there is no universally accepted definition of paraphilia even within the manual that uses the term as a foundational concept.
Myth: Kinky people should see a therapist to address their interests.
Reality: Kinky people should see a therapist if they choose to, for any reason they choose, with the same autonomy that anyone brings to seeking support. The presence of kink interest does not create a clinical indication for therapeutic change. Kink-aware therapists and professional bodies including the American Association of Sexuality Educators, Counselors and Therapists (AASECT) take the position that kink and BDSM are expressions of sexual diversity and are not inherently appropriate targets for therapeutic intervention.

How Stigma Harms People

The conflation of kink with disorder has measurable psychological costs, and they fall primarily on people who have done nothing wrong. People who internalise the belief that their sexual interests are symptomatic of illness experience what researchers describe as internalised stigma: a form of psychological distress produced not by the interest itself but by the shame attached to it through social, religious, and clinical frameworks. The minority stress model, developed in Lesbian, Gay, Bisexual, Trans, Queer, and plus (LGBTQ+) psychology and applicable to other stigmatised groups, describes how chronic exposure to stigma and the expectation of rejection creates specific psychological burdens including concealment, hypervigilance, and exhausting self-monitoring. People who are kinky and who live in environments where their interests are treated as shameful or disordered carry this burden even when nothing about their actual practice causes any harm to themselves or anyone else.

The clinical consequences of this stigma are not trivial. People with kink interests have reported avoiding medical consultations for fear of judgment, concealing relevant information from health providers, delaying or avoiding therapy for entirely unrelated problems, and experiencing significant distress not because of their sexuality but because of the fear of how that sexuality will be interpreted. Kolmes, Stock, and Moser (2006) documented instances in which therapists pathologised clients’ BDSM interests without clinical justification, attributed unrelated presenting problems to BDSM involvement, and attempted to change sexual interests that were not the source of the client’s difficulty and had not been identified as such by the client. This is not an acceptable clinical standard, and it reflects the practical consequences of the theoretical confusion this article is attempting to address.

There is also a subtler harm, most acute for younger people coming to understand their own sexuality. When individuals encounter the vocabulary of disorder before they encounter the vocabulary of diversity, the framing shapes how they understand themselves at a formative moment. A person who discovers that their erotic imagination includes power exchange dynamics or a specific fetish and who searches for information may encounter clinical language that places their experience inside a category of pathology before they ever find the more accurate framing: that they have a sexual interest shared by many consenting adults worldwide, that it does not indicate something is wrong with them, and that they have every right to understand it on its own terms.

What Professionals Need to Understand

For psychologists, psychotherapists, counsellors, sexologists, general practitioners, nurses, social workers, and any professional who may encounter clients or patients with kink or BDSM interests, several principles follow directly from the evidence and clinical frameworks described in this article. The first is that kink and BDSM are not inherently indicative of psychological disorder and should not be treated as such. A client who discloses BDSM interests deserves the same non-pathologising professional response as a client who discloses any other form of consensual adult sexuality. The second principle is that if a client is experiencing genuine distress related to their kink interests, the clinician’s first task is to explore the source of that distress carefully, because the source may be internalised stigma, shame imposed by family or religion, relationship conflict, or genuinely compulsive and distressing behaviour, and these are very different clinical situations requiring very different responses.

The distinction between distress caused by an interest itself and distress caused by social stigma about that interest is clinically crucial and frequently missed. A person who is distressed because their community, religion, or family has told them their desires are shameful is not experiencing the kind of distress that constitutes a paraphilic disorder. They are experiencing the consequences of stigma. The appropriate clinical response in that situation is not to treat the sexuality but to address the internalised shame and its sources. This requires clinical knowledge, honest self-reflection about one’s own assumptions regarding normative sexuality, and, ideally, specific training in working with sexual diversity.

Professional bodies have begun to formalise this understanding. The International Institute of Clinical Sexology offers a 120-hour Kink Aware Therapy specialisation for graduate-level clinicians. The Sexual Health Alliance provides a Kink Informed Certification programme accredited by the American Association of Sexuality Educators, Counselors and Therapists. These programmes exist because the gap between what standard clinical training covers and what clients who are kinky actually need from their professionals is real, documented, and consequential. Clinicians who regularly encounter this population and wish to serve them well should seek appropriate training rather than assuming that general therapeutic competence is sufficient.

Reader Reflection

Before moving to the practical takeaways, consider the role that language has played in your own understanding of desire. If you have ever described a sexual interest as weird, wrong, or probably a sign of something, it is worth asking honestly where that assessment came from. Was it based on evidence of harm, distress, or dysfunction? Or was it based on the assumption that non-normative equals pathological, that unusual equals dangerous, or that intensity of interest is itself something to be suspicious of? These assumptions are worth examining with the same rigour one would bring to any other belief about the self. The vocabulary of psychology is powerful. Used precisely, it illuminates. Used carelessly, it can produce exactly the kind of distress it claims to address. What language have you been using, and does the evidence actually support it?

Practical Takeaways

Kink, fetish, paraphilia, and paraphilic disorder are not the same thing. Using them interchangeably creates confusion with real consequences for self-understanding, clinical practice, and legal outcomes. Use the precise term that fits the situation.
The presence of a kink or fetish interest does not constitute a disorder. Under both the DSM-5-TR and the ICD-11, a clinical disorder requires distress, functional impairment, or harm to a non-consenting person. Interest alone does not meet that threshold, regardless of how intense or unusual the interest is.
The research does not support the assumption that BDSM practitioners are psychologically damaged. Nationally representative and large-sample studies consistently find that practitioners show comparable or more favourable psychological profiles than non-practitioners. This is the evidence base from which clinicians and educators should work.
Stigma causes genuine harm, independent of the interest itself. Internalised stigma, clinical pathologising without justification, and socially imposed shame produce measurable psychological costs. Reducing stigma is a harm reduction goal, not merely a political or ideological position.
Professionals working with kinky or BDSM-practising clients should seek specific training. General clinical competence is not sufficient for working well with sexual diversity. Kink-aware and kink-informed training programmes exist, are professionally accredited, and are worth pursuing for any practitioner who regularly encounters this population.
If you are experiencing genuine distress related to your sexuality, that distress deserves proper attention. The first and most important question to ask is where the distress originates: from the interest itself, or from the way the world has responded to it. The answer determines what kind of support is actually useful.

Conclusion

Centuries of clinical thinking about sex have left behind a residue of vocabulary that continues to shape how people think about desire, even when the thinking that produced that vocabulary has long since been revised or abandoned. The word perversion no longer appears in mainstream clinical frameworks, but its spirit persists in the casual conflation of kink with disorder, in the assumption that unusual equals pathological, and in the persistence of shame where the evidence would justify curiosity instead. The distinctions between kink, fetish, paraphilia, and paraphilic disorder are not bureaucratic niceties. They are the difference between seeing human sexuality with accuracy or through a distorting lens inherited from the nineteenth century and dressed up in the language of science.

The current clinical frameworks, for all their imperfections and ongoing debates, represent real and hard-won progress. The DSM-5-TR’s explicit statement that most people with atypical sexual interests do not have a mental disorder is not a throwaway footnote. It is a clinically and scientifically grounded position that should inform how practitioners are treated by professionals, how clients are counselled in therapy, and how curious people understand their own inner lives. BDSM practitioners are not damaged. People with fetishes are not disordered unless their experience meets a specific and demanding clinical threshold. Kinky people are not patients in need of fixing. They are a diverse, largely well-functioning population whose interests deserve the same intellectual seriousness, clinical accuracy, and freedom from unwarranted shame as any other dimension of human sexuality.

That is the foundation this website is built on. Everything else follows from it.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). American Psychiatric Association Publishing.
Kolmes, K., Stock, W., and Moser, C. (2006). Investigating bias in psychotherapy with BDSM clients. Journal of Homosexuality, 50(2-3), 301-324.
Lecuona, O., Martinez-Barajas, O., Gimeno-Martin, A., Hernansaiz, A., Carrillo-Molina, C., Alcolea-Cantero, R., Rodriguez-Carvajal, R., and de Rivas, S. (2024). Not twisted, just kinky: Replication and structural invariance of attachment, personality, and well-being among BDSM practitioners. Journal of Homosexuality, 72(6), 1079-1108. https://doi.org/10.1080/00918369.2024.2364891
Moser, C. and Kleinplatz, P.J. (2005). DSM-IV-TR and the paraphilias: An argument for removal. Journal of Psychology and Human Sexuality, 17(3-4), 91-109.
Moser, C. and Kleinplatz, P.J. (2020). Conceptualization, history, and future of the paraphilias. Annual Review of Clinical Psychology, 16, 379-399. https://doi.org/10.1146/annurev-clinpsy-050718-095548
Richters, J., de Visser, R.O., Rissel, C.E., Grulich, A.E., and Smith, A.M.A. (2008). Demographic and psychosocial features of participants in bondage and discipline, “sadomasochism” or dominance and submission (BDSM): Data from a national survey. Journal of Sexual Medicine, 5(7), 1660-1668. https://doi.org/10.1111/j.1743-6109.2008.00795.x
Selic, M. and Jug, V. (2025). Childhood sexual abuse, adult attachment styles, and involvement in BDSM practices in adult intimate relationships. Behavioral Sciences, 15(6), 813. https://doi.org/10.3390/bs15060813
World Health Organisation. (2022). International Classification of Diseases, Eleventh Revision (ICD-11). World Health Organisation. https://icd.who.int/