The Diagnostic Manual and Technologies of Psychiatry

  • Jacinthe FloreEmail author


This chapter historicises the discursive expansion in the classifications and interpretations of “sexual dysfunctions” in contemporary US psychiatry in the late twentieth and early twenty-first centuries. It examines how the turn of the psychiatric gaze towards amounts, degrees and appetites in the Diagnostic and Statistical Manual of Mental Disorders harnesses a range of techniques that, in addition to pathologising the patient, invite her to develop greater awareness of their sexual self. The patient is actively encouraged to use the manual as well as information gathered during the therapeutic process as techniques for managing their sexual imbalances. This chapter thus aims to produce a genealogy of the turn of the psychiatric gaze towards the medicalisation of sexual appetite in the last two decades of the twentieth century, and, in doing so, to approach the development of the diagnostic manual as a technical object both for professional diagnosis and for the care of the self.


  1. American Psychiatric Association. 1952. Diagnostic and Statistical Manual of Mental Disorders. 1st ed. Washington, DC: American Psychiatric Association.Google Scholar
  2. ———. 1968. Diagnostic and Statistical Manual of Mental Disorders. 2nd ed. Washington, DC: American Psychiatric Association.Google Scholar
  3. ———. 1980. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association.Google Scholar
  4. ———. 1987. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Revised. Washington, DC: American Psychiatric Association.Google Scholar
  5. ———. 1994. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association.Google Scholar
  6. ———. 2013. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
  7. Bayer, Ronald. 1987 [1981]. Homosexuality and American Psychiatry: The Politics of Diagnosis. Princeton: Princeton University Press.Google Scholar
  8. Bowker, Geoffrey C., and Susan Leigh Star. 1999. Sorting Things Out: Classification and Its Consequences. Cambridge, MA: MIT Press.Google Scholar
  9. Bronski, Michael. 2011. A Queer History of the United States: ReVisioning American History. Boston: Beacon Press.Google Scholar
  10. Brookey, Robert Alan. 2002. Reinventing the Male Homosexual: The Rhetoric and Power of the Gay Gene. Bloomington, IN: Bloomington University Press.Google Scholar
  11. Clayton, Anita H., R.T. Segraves, D. Bakish, D. Goldmeier, J. Tignol, R.H. van Lunsen, R.E. Nappi, et al. 2010. Cutoff Score for the Inventory-Female for Diagnosis of Hypoactive Sexual Desire Disorder. Journal of Women’s Health 19 (12): 2191–2195.CrossRefGoogle Scholar
  12. Cooper, Rachel. 2004. What’s Wrong with the DSM? History of Psychiatry 15 (1): 5–25.CrossRefGoogle Scholar
  13. ———. 2007. Psychiatry and the Philosophy of Science. Montreal and Kingston: McGill-Queen’s University Press.Google Scholar
  14. Corona, G., E.A. Jannini, and M. Maggi. 2006. Review: Inventories for Male and Female Sexual Dysfunctions. International Journal of Impotence Research 18 (3): 236–250.CrossRefGoogle Scholar
  15. Decker, Hannah S. 2013. The Making of the DSM-III: A Diagnostic Manual’s Conquest of American Psychiatry. Oxford: Oxford University Press.Google Scholar
  16. D’Emilio, John, and Estelle B. Freedman. 2012 [1988]. Intimate Matters: A History of Sexuality in America, 3rd ed. New York: Harper & Row.Google Scholar
  17. Downing, Lisa. 2015. Heteronormativity and Repronormativity in Sexological ‘Perversion Theory’ and the DSM-5’s ‘Paraphilic Disorder. Archives of Sexual Behavior 44 (5): 1139–1145.CrossRefGoogle Scholar
  18. Drescher, Jack. 2010. Queer Diagnoses: Parallels and Contrasts in the History of Homosexuality, Gender Variance, and the Diagnostic and Statistical Manual. Archives of Sexual Behavior 39 (2): 427–460.CrossRefGoogle Scholar
  19. ———. 2012. The Removal of Homosexuality from the DSM: Its Impact on Today’s Marriage Equality Debate. Journal of Gay & Lesbian Mental Health 16 (2): 124–135.CrossRefGoogle Scholar
  20. Foucault, Michel. 1978. The Will to Knowledge: The History of Sexuality, Volume 1. Trans. Robert Hurley. London: Penguin Books.Google Scholar
  21. ———. 1985. The Use of Pleasure: History of Sexuality, Volume 2. Trans. Robert Hurley. New York: Vintage Books.Google Scholar
  22. ———. 1986. The Care of the Self: The History of Sexuality, Volume 3. Trans. Robert Hurley. New York: Vintage Books.Google Scholar
  23. ———. 1988. Technologies of the Self. In Technologies of the Self: A Seminar with Michel Foucault, eds. Luther H. Martin, Huck Gutman, and Patrick H. Hutton, 16–49. Amherst: University of Massachusetts Press.Google Scholar
  24. ———. 1997. Subjectivity and Truth. In Ethics: Essential Works of Foucault, 1954–1984, Volume 1, ed. Paul Rabinow, 87–92. London: Penguin Books.Google Scholar
  25. Frances, Allen. 2013. Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life. New York: William Morrow.Google Scholar
  26. Giami, Alain. 2015. Between DSM and ICD: Paraphilias and the Transformation of Sexual Norms. Archives of Sexual Behavior 44 (5): 1127–1138.CrossRefGoogle Scholar
  27. Harsh, Veronica, Elizabeth Lloyd McGarvey, and Anita H. Clayton. 2008. Physician Attitudes Regarding Hypoactive Sexual Desire Disorder in a Primary Care Clinic. Journal of Sexual Medicine 5: 640–645.CrossRefGoogle Scholar
  28. Houts, Arthur C. 2000. Fifty Years of Psychiatric Nomenclature: Reflections on the 1943 War Department Technical Bulletin, Medical 203. Journal of Clinical Psychology 56 (7): 935–967.CrossRefGoogle Scholar
  29. Irvine, Janice. 2005. Disorders of Desire: Sex and Gender in Modern American Sexology. Philadelphia: Temple University Press.Google Scholar
  30. Kaplan, Helen Singer. 1979. Disorders of Desire and Other Concepts and Techniques in Sex Therapy. New York: Simon & Schuster.Google Scholar
  31. Kaplan, Arline. 2009. DSM-V Controversies. Psychiatric Times 26 (1): 5–10.Google Scholar
  32. Keane, Helen. 2004. Disorders of Desire: Addiction and Problems of Intimacy. Journal of Medical Humanities 25 (3): 189–204.CrossRefGoogle Scholar
  33. Kirk, Stuart A., and Herb Kutchins. 1992. The Selling of the DSM: The Rhetoric of Science in Psychiatry. New Brunswick: Transaction.Google Scholar
  34. Klerman, Gerald L., George E. Vaillant, Robert L. Spitzer, and Robert Michels. 1984. A Debate on DSM-III: The Advantages of DSM-III. American Journal of Psychiatry 141 (4): 539–553.CrossRefGoogle Scholar
  35. LeVay, Simon. 2010. Gay, Straight and the Reason Why. Oxford: Oxford University Press.Google Scholar
  36. Lief, Harold. 1977. Inhibited Sexual Desire. Medical Aspects of Human Sexuality 7: 94–95.Google Scholar
  37. Masters, William H., and Virginia E. Johnson. 1970. Human Sexual Inadequacy. Boston: Little, Brown & Company.Google Scholar
  38. ———. 1994. Heterosexuality. New York: Harper Collins.Google Scholar
  39. Maxmen, Jerrold S. 1985. The New Psychiatry: How Modern Psychiatrists Think about Their Patients, Theories, Diagnoses, Drugs, Psychotherapies, Power, Training, Families and Private Lives. New York: William Morrow & Company.Google Scholar
  40. Mayes, Rick, and Allan V. Horwitz. 2005. DSM-III and the Revolution in the Classification of Mental Illness. Journal of the History of Behavioral Sciences 41 (3): 249–275.CrossRefGoogle Scholar
  41. Mol, Annemarie. 2002. The Body Multiple: Ontology in Medical Practice. Durham and London: Duke University Press.CrossRefGoogle Scholar
  42. Paras, Eric. 2006. Foucault 2.0: Beyond Power and Knowledge. New York: Other Press.Google Scholar
  43. Rose, Nikolas. 1989. Governing the Soul: The Shaping of the Private Self. London and New York: Routledge.Google Scholar
  44. ———. 1998. Inventing Our Selves: Psychology, Power, and Personhood. Cambridge: Cambridge University Press.Google Scholar
  45. ———. 2007. The Politics of Life Itself: Biomedicine, Power, Subjectivity in the Twenty-First Century. Princeton: Princeton University Press.CrossRefGoogle Scholar
  46. ———. 2019. Our Psychiatric Future: The Politics of Mental Health. Cambridge: Polity.Google Scholar
  47. Sabshin, Melvin. 1990. Turning Points in Twentieth Century Psychiatry. American Journal of Psychiatry 147 (10): 1267–1274.CrossRefGoogle Scholar
  48. Schover, Leslie R., Jerry M. Friedman, Stephen J. Weiler, Julia R. Heiman, and Joseph LoPiccolo. 1982. Multiaxial Problem-Oriented System for Sexual Dysfunctions. Archives of General Psychiatry 39: 614–619.CrossRefGoogle Scholar
  49. Segal, Lynne. 1994. Straight Sex: Rethinking the Politics of Pleasure. Berkeley: University of California Press.Google Scholar
  50. Shorter, Edward. 2005. Historical Dictionary of Psychiatry. Oxford: Oxford University Press.Google Scholar
  51. Singh, Ilina, and Nikolas Rose. 2009. Biomarkers in Psychiatry. Nature 460: 202–207.CrossRefGoogle Scholar
  52. Spitzer, Robert L., and Janet B.W. Williams. 1983. The Revision of the DSM-III. Psychiatric Annals 13 (10): 808–811.CrossRefGoogle Scholar
  53. Tiefer, Leonore. 2004. Sex Is Not a Natural Act and Other Essays. New York: Westview Press.Google Scholar
  54. Weeks, Jeffrey. 2015. Beyond the Categories. Archives of Sexual Behavior 44 (5): 1091–1097.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2020

Authors and Affiliations

  1. 1.Royal Melbourne Institute of TechnologyMelbourneAustralia

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