English Seksualpolitikk

Fetish and SM diagnoses deleted in Sweden

Fetishism and Sadomasochism no longer diseases in Sweden

Inspired by Revise F65, Fetishism and Sadomasochism, along with four other sexual behaviours, were repealed from Sweden’s official list of medical diagnoses January 1, 2009.

By Svein Skeid

November 17, 2008, the Swedish National Board of Health and Welfare (Socialstyrelsen) announced that six diagnoses of sexual behaviours will be deleted from Sweden’s national version of ICD diagnoses. The six diagnoses include sadomasochism, fetishism, transvestism, fetishistic transvestitism, multiple disorders of sexual preferences and gender identity disorder in youth.

Except for gender identity disorder in youth, these are  the same diagnoses that Revise F65 recommend to remove from ICD, the International Classification of Diseases.

The first seed

According to RFSU secretary Wiktor Södersten, the very first seed was sowed at the RFSU congress in 2005, when he talked with the present RFSU coordinator and educator Helene Delilah about the Norwegian Revise F65 web pages.

November 23, 2006 Mika Nielsen wrote an article in the biggest gay and lesbian Swedish newspaper QX. She encouraged the Swedish sexual political movement to follow the example of the Revise F65 pioneer group and start the work to remove transvestism and BDSM-diagnoses from the ICD-10.

A working group was established after the model of Revise F65 with members from Swedish gay, lesbian and heterosexual fetish and SM groups (Club Sade, LASH, Club Sunrise, Dekadance and RFSL). Mika Nielsen wrote a new article in “Ottar”, the newspaper of RFSU (the Swedish Association for Sexual Education). Once again she referred to the Norwegian Revise F65 efforts.

The RFSU winter congress in 2007 decided to work for education about fetishism and BDSM and to work for abolishment of the same diagnoses as is on the agenda of Revise F65. However, the Swedish Lesbian and Gay Organization RFSL was not willing to support this agenda in the same way as the Norwegian LGBT Association, LLH (FRI) does.

July 29, 2008. During Europride in Stockholm, the Revise F65 leader Svein Skeid had talks with RFSU, participated in panel discussions and gave a presentation about the Revise F65 work. We gave them our memory stick with all relevant political health arguments and scientific evidence.

Four weeks later, August 27, 2008, referring to the cooperation with Revise F65, RFSU sent a formal letter demanding the removal of fetishism and sadomasochism from the National Board of Health and Welfare (Socialstyrelsen) registry of diseases.

Health political arguments

Agency head Lars-Erik Holm’s (picture) arguments for the Swedish revision announced November 17, 2008, were word by word concurrent with the health political premises of Revise F65.

The Swedish revision was done because these psychiatric diagnoses “may contribute to preserve and reinforce prejudices in society, which in turn increases the risk of social stigmatizing of individuals”.

“The abolition of  the diagnosis of homosexuality 30 years ago gave the group self confidence because they no longer had a psychiatric stigma. We hope that the current revision will give a similar result.”

“These diagnoses are rooted in a time when everything other than the heterosexual missionary position were seen as sexual perversions. The changes emphasize that these behaviours are not illnesses in and of themselves, nor are they something perverse. It is very important for these individual that the society acknowledge them as equal members of society“, said Lars-Erik Holm, Director General of the Swedish National Board of Health and Welfare.

In line with recommendations from Revise F65, other F65 diagnoses like transsexualism and pedophilia will remain as diagnoses and not be removed at a later stage. “Transsexualism needs to be left to carry out gender reassignment in health care, and pedophilia is a criminal act that harms others”, according to Lars-Erik Holm.

Victory for Revise F65

In a press release immediately after the Swedish announcement November 17, 2008, the Revise F65 leader Svein Skeid characterized the decision as a victory for the fetish/SM population and for the Revise F65 strategy to motivate other countries to remove their national versions of the ICD SM/fetish diagnoses.

Revise F65 is happy to have succeeded with that strategy. Now we hope to bring about the same changes in Norway and in the World Health Organization, WHO.

The BDSM Organization SMil November 18, 2008, sent a letter to the The Ministry of Health and Care Services asking him to remove the fetish and SM diagnoses in Norway. In an answer December 19, 2008 the Ministry of Health and Care Services said they had given the Directorate of Health the responsibility of taking a decision in the case.

Positive Norwegian reactions

So far, Norwegian health authorities have responded positively to the Swedish decision.

According to Nettavisen, the head of the Norwegian Directorate of Health (Helsedirektoratet), Bjørn-Inge Larsen (picture), said: “There is no basis, neither within today’s social norms nor within health political thinking, for labeling several of these phenomena as illnesses”.

Senior adviser in the Directorate of Health, Arild Johan Myrberg, was also “very positive to the idea of removing the SM diagnoses in Norway”. – This is not a very relevant diagnosis and has to do with past times view of sexuality. Norway wants to follow up the professional development and looks forward to cleaning up this matter. The future objective is that the World Health Organization removes SM from their list of classifications, but this will possibly take some years, he said.

Also the prominent Norwegian sexologist and psychologist Thore Langfeldt (picture) supported the Swedish decision.

February 2, 2009, psychologist Odd Reiersøl and the Revise F65 leader Svein Skeid had a short meeting at the office of the Norwegian Directorate of Health where we delivered a memorandum with health political and professional arguments for why the SM and fetish diagnoses should be removed from the Norwegian ICD-edition.

At a meeting with the Revise F65 committee and the Norwegian Directorate of Health May 11, 2009, Senior adviser Arild Johan Myrberg informed that a decision to repeal Norwegian fetish and SM diagnoses can be announced fall 2009 with the intention to bring the decision into force January 1, 2010.

Denmark repealed the dual-role transvestism diagnosis and the SM diagnosis respectively August 19, 1994 and May 1, 1995. The American Psychiatric Association considerably revised the criterion for SM and fetish diagnoses in 1994.