English Sexual politics

How to remove SM and Fetish diagnoses

Introduction to workshops held at SM Pride August 2nd in London, August 24th in Manchester (one for women and one general) and August 28th in London 2003.

Founded in Norway –
Serving the world

About us and the ReviseF65 group

My name is Svein Skeid (picture right). I have been working in the field of SM human rights for two decades. I am Gay Person of the Year in Norway 2003, and have a special membership of Scandinavian Leather Men Oslo (SLM). Today, I represent the ReviseF65 group, whose aim is to remove SM and Fetish diagnoses from the the International Classification of Diseases (ICD) published by the World Health Organization (WHO).

Eric Barstad (picture below) is a female to unisexual leather/SM/rubber transgender person. Eric is the President of the lesbian/gay SM/Fetish group Smia-Oslo and a member of the ReviseF65 committee and SLM-Oslo).

We will talk about what our project group is all about: why it was established and which diagnoses are to be removed. We will also tell you about why these diagnoses need to be abolished and how to remove them.

SM Pride: I have traveled from Norway to this festival because I always have wanted to attend SM Pride and the SM Pride March which started in 1992, the year before the Spanner Verdict which made some SM play illegal in the UK.

Europride: We have traveled from Norway to Manchester, not only because of this year‘s Europride, but also because this is the very town where the Spanner Case startet in 1987. As you possibly know, the 1993 Spanner Verdict made some SM play illegal in the UK.

In the 1990’s members of our group campaigned and set about fund-raising to help the gay defendants in the Spanner Case (a total of £2000 was raised). We gained support of several dozen Norwegian political organizations, including women‘s rights groups and trade unions, not to mention the unanimous backing of the Lesbian and Gay movement.

Take a look at our Spanner website (unfortunately only in Norwegian).

In our view, the ReviseF65 work is a logical follow-up of the Spanner campaign. Even if the Spanner fight is not won yet and Spanner Trust still have a long way to go, the ReviseF65 group considers it necessary to start the long-term national and international project to get rid of discriminatory SM diagnoses. We understand that the Spanner Trust trustees are of the same opinion.

And as we shall see, there is similarities between the law and psychiatric diagnoses.

Even though the diagnoses of Fetishism, Transvestism and Sadomasochism are rarely applied, the stigma attached to them is used to justify various forms of harassment of these sexual minorities.

Fetishism, transvestism and sadomasochism are still considered mental illnesses by the World Health Organization (WHO) and most countries, despite the fact that US psychiatrists revised their DSM manual nine years ago and Denmark in 1995 was the first European country to totally remove the diagnosis of Sadomasochism.

The ReviseF65 project concerns both gays, straights and transgender people. Therefore the group consists of Leather/SM/Fetish men and women who represent organizations of Leather and SM gays, lesbians, bi- and heterosexuals, as well as professionals in sexology, psychology and psychiatry.

The name “F65” is a chapter in the International Classification of Diseases (ICD) describing the so called “Paraphilias”, earlier called “perversions”. It also contains other paraphilias. Obviously, we are only rallying for the SM and Fetish diagnoses that concern consenting adults.

Why do we want to abolish these diagnoses?

The Revise F65 project group is of the opinion that stigmatizing minorities by considering their sexual orientation as a psychiatric condition is as disrespectful as if you discriminate against people because of their race, ethnicity or religion.

The stigma attached to these diagnoses is used to justify harassment. The ReviseF65 group can document that people are losing their jobs, the custody of their children etc., because of their SM-love, lifestyle and self-expression.

Sadomasochists as prosecution witnesses face similar difficulties in credibility as heterosexual women. In law courts, murderers and rapists are acquitted despite confessing to their crime. The only reason why is that the victim is a masochist. Several courts have done this because of the diagnoses.

Because people are considered “sick” or “perverted”, the victim is placed beyond the protection of the law. This is some of the same “illiberal nonsense” as in the Spanner case. Because you are a “pervert” your consent place you beyond the protection of the British law.

Lack of legal security for SM-ers

Leitner v. State (1983) 631 So. 2d 278-9. The “sadomasochist” is often seen as having given up h/er rights to protection from violence or abuse. It is clear that homosexual men as prosecution witnesses face similar difficulties in credibility as heterosexual women. In August of 1993, an appellate court released a man convicted of murder because the murder victim had written a long sadomasochistic sexual fantasy in his journal and the trial court had refused this journal entry as evidence at trial. The fantasy is reproduced for the delight of the court in its entirety in the published case. The unspoken implication here is that a man who fantasizes about homosexual sadomasochism has somehow consented to a brutal murder: “The journal excerpt was essential to the appellant’s defense. It suggested Craven may have desired to be involved, and may have been involved in voluntary sadomasochist sex when he was killed. If he suffered from these desires, then he might have sought out an amenable partner”[20] who eventually killed him. (That wasn’t very “amenable” of the partner if you ask me). Again, the law has constituted the sadomasochist as an always-already willing victim, even to the point of death.[21] This opinion also highlights the idea of “voluntary sadomasochistic sex” as a “desire” that one “suffers from,” a common thread in much of this discourse. The official status of “perverse” desire is thus situated as a medical and psychiatric condition that places those “afflicted” beyond the protection of the law and unworthy of inclusion in “civilized” society.

The US National Coalition for Sexual Freedom and the Leather Leadership Conference documents that between one-third and one-half of the leather/SM population suffer discrimination, violence or persecution because of their sexual orientation and identity. As with other forms of assault, women are the chief sufferers, losing their jobs, or even their children, because of their SM love, lifestyle and self-expression.

In fact, staying in the closet doesn’t protect people – only one-third of those who suffered violence or discrimination reported that they are “out”. The other two-thirds were minding their own business and keeping their mouths shut when they were either harassed or discriminated against.

A lot of people fear loss of child custody, losing their job or the possibility of harming family relations because of their SM orientation.

A Norwegian example: 

In 1997, a 42–year-old woman in Eastern Norway let herself be pressured by her own lawyer to give up the custody of her two daughters after a divorce. The lawyer considered that the woman had a poor legal case because SM is defined as a psychiatric illness in Norway. This happened after her ex-husband got hold of the woman’s holiday photographs which showed her interest in SM – sado-masochism. He passed the photographs on to his lawyer. The children were also informed about the woman’s orientation. Today, the woman lives 250 English miles away from her children, but has partially regained contact with them after many years without contact.
Source: SMil-bladet, no. 2, 2002. The whole case is described in more detail at (unfortunately currently only in Norwegian). 

Once more we see the the law and the psychiatry walk hand in hand, as was the case concerning homosexuality in earlier days.

Possible strategies to remove the SM/fetish diagnoses

We have in recent years seen three strategies used to remove SM and Fetish diagnoses.

1) Political actions directed towards the government and the health administration. This was the strategy used when Denmark withdrew SM from their national list of psychiatric diagnoses in 1995. It was a political decision resulting from a single letter from a SM organization. Maybe the chairman of the SM group “The Black Society” had an “easy match”, because the Health Minister of that time – Yvonne Herløv Andersen – was a liberal lesbian lady. we also know that there has been a serious debate about sadomasochism in Denmark for decades.

2) The second strategy is coordinated action from kink-friendly mental health professionals towards the board that is responsible for decision-making concerning the diagnoses. This is what happened when the American Psychiatric Association, APA, considerably revised their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. SM and Fetishism is now considered to be a healthy form of sexual expression in the US, as long as it does not impair the daily functioning of the subject, according to the latest edition of DSM-IV.

According to DSM-IV, SM and Fetishism only becomes a diagnosable dysfunction when urges, fantasies or behaviors “cause clinically significant distress or impairment in social, occupational or other important areas of functioning.” In addition APA clearly indicate that “a paraphilia must be distinguished from the non-pathological use of sexual fantasies, behavior or objects as a stimulus for sexual excitement.”

3) In the ReviseF65 group we have discussed which strategy to choose for some time. My visit to Europride in Cologne last summer was a great help as it gave me the opportunity to discuss strategy with German SM activists.
You could say that we have chosen the slow and labour-demanding way: building up support from federations of mental health professionals. Last winter, we received important support from both the Norwegian Association of Gay and Lesbian Physicians and the Norwegian Society for Clinical Sexology. Next year, we hope to be able to receive support from the Organization of Psychiatrists in Norway. In this way, we will build a professional foundation for an initiative by the health authorities to remove the diagnoses.

On an international level, we have for several years tried to stimulate the building-up of a growing international activist and professional network that shares our goals.

The more countries that abolish their national SM and Fetish diagnoses, the bigger the possibility that the World Health Organization will follow suit.

We have also gained support from other organisations in Europe. So far we have got support from the International Lesbian and Gay Association (ILGA Europe), and the European Confederation of Motorcycle Clubs (ECMC).

This third “hard way” strategy is much like the one used by the lesbian and gay movement to get rid of homosexuality as a diagnosis (this was in fact in the same F65 chapter as the SM diagnosis is now).

Professional articles

The support we have obtained this far, is not least due to systematic professional work from the mental health specialists in the ReviseF65 committee. An article by psychologist Odd Reiersøl can be found at So far, this article has been translated by other webpages to German, Portuguese, Spanish, Italian and Russian, in addition to English and Norwegian. Another article, written by Reiersøl and I, will be published in a SM edition of the American publication “The Journal of Homosexuality”. A third article addressed to psychiatrists, written by our project psychiatrist Reidar Kjaer, will also soon be accessible to the public in a scientic magazine.

Last June, Kjaer was a speaker at a symposium on the SM/fetish diagnoses at the International Psychiatric Conference in Vienna, Austria, which was arranged by the World Psychiatric Association. A first step can be that the WHO will change the ICD diagnoses in a similar way that happened in the US in 1994 when DSM-IV was established.


In spite of several attempts, we have not been able to carry out research projects as yet. We wanted to find out whether SM/fetish people have a higher degree of psychopathology than the rest of the population. Unfortunately, the efforts were aborted, due to collaboration difficulties and lack of support from the educational and political institutions approached.

But no, evidence has so far showed that there is any more severe psychopathology to be found in the persons that can be labeled with any of these three diagnoses.

Results from a research project by Connolly et al 2003, among a group with bondage and sadomasochistic interests (BDSM) showed that “no evidence was found to support the notion that major disorders–including depression, anxiety, mania/bipolarity, and obsessive-compulsivity–are more prevalent among members of the BDSM community than among members of the general population. Indeed, if anything, our findings suggested that members of the BDSM community are less likely than others to present with major disorders.”

They also “found no support for the view that BDSM players present greater-than-average levels of psychological sadism or masochism. Clearly, then, earlier assumptions that severe psychopathology underlies all BDSM erotic play were not supported”.
Ref. (Connolly et al. in press)

How can we co-operate?

The purpose of this introduction has been to get individuals, SM groups and kink-friendly mental health professionals in the UK involved in the network-building efforts to reach the goal of getting the diagnoses repealed. We think that specific strategies should be determined at the local and national level, depending on the professional and political situation in your own country. The support and work of leather men and women, SM community-leaders and kinky organizations are crucial to reaching this goal. The initiative of individuals is always to be welcomed. Even more effective can be the formation of local and national working groups, which are able to approach the professionals in question.

Is there any possibility that UK activists can rally against this diagnoses even though some forms of SM is still illegal in the UK?

Is it possible that medical and judicial suppression of SM people are two aspects of the same case? That legal thinking to some extent is grounded on psychiatry, and that psychiatric thinking to some extent is grounded on the judicial situation?

Is it possible that the removal of SM diagnoses could make it easier to legalize SM in Great Britain?

Is it possible for British SM human rights activists to collaborate with the ReviseF65 group?

To be informed and have your voice heard – you can join our e-mail discussion group at

Svein Skeid