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Paraphilias In\ US . Pornography Titles Paraphilias in\ US. Pornography Titles: "Pornography Made Me Do It" (Ted ~~~ndy) Breck Lebegue, MD In 1986, the U.S. Commission on p, ornography reviewed 3,050 separate magazine and book titles sold in ''adults on11 7" pornographic outlets randomly selected in Washington, DC; Baltimore, MD; Mia mi, FL; Philadelphia, PA; New York, NY; and Boston, MA. Of these, 746 titles could be assigned to a DSM Ill-R paraphilia category (513 titles if the category partialism i: s excluded). Incest was listed as a category separately from pedophilia. Thus, 16.t I percent of the titles could be assigned to a paraphilia category (24.4% of all title !s, if partialism is included as a category). Paraphilia distribution is discussed. Sa domasochism was by far the most common paraphilia (49.9%) while incest titles tor nprised 21.4 percent of the perversions. The frequency distribution for the U.S. mate rial is compared with titles reviewed by the Victoria (Australia) State Classification oi ' Publications Board and previously reported by the author. In the last 20 years there have been limiting what may be shown or sold to several extensive government reports on the public. which is beyond the scope of pornography. The 1970 US. Commis- this article. sion on Obscenity and Pornography' de- However, there have been surprisingly scribed the state of the problem in the Few studies in the psychiatric literature United States; the report of the British .omparing what is legally defined as por- Home Office Committee on Obscenity r1 ographic. with that which is clinically and Film Censorship reviewed English dc dined as a paraphiliu. Dietz and pornography in 1 97g2; the report of the El 1ans5 reported in 1982 on the preva- Special Committee on Pornography and 1e1 Ice of paraphilia in pornographic Prostitution reviewed Canadian pornog- co~fer imagery. Although they did not raphy in 1985,3 and in 1986, the U.S. ass1 ign this imagery to specific DSM I11 Department of Justice Attorney Gener- par; nphilia groups. they did find that. of al's Commission on Pornography re- the 1 xraphilic acts portrayed in literature ported their findingse4There is an exten- fron 1 four shops, bondage and domina- sive series of legal cases, defining and tion was by far the most common (16.7 % of all cover pictures). In fact, this Dr. Lebegue is affiliated with the Department of Psy- was tl 'le only scientific article which at- chiatry. University of Utah, 50 North Medical Drive, UT 84 132. tempt, ed to categorize paraphilias that Bull Am Acad Psychiatry Law, Vol. 19, No. 1, 1991 43 Lebegue was available to the 1986 U.S. Commis- total of 2,325 separate magazine titles, 725 sion at the outset of its activities. book titles, and 2,370 film title^.^ In the bibliography of the 1986 Com- mission rep~rt,~there is an excellent re- Method view of recent studies of the effect of I re-viewed the magazine and book pornography on the physiologic and so- titles (N = 3,050) surveyed by the 1986 cial response of normal subjects, as well Attorney General's Commission on por- as on those with a history of paraphilia nogr:aphy and a determination was made or sexual offenses. The commission if a ~~ecognizedDSM 111-R6 act of para- studied the imagery found among mag- phi1 ia was described by the title. A par- azines, books, and films in pornographic aphilia was identified only if the act outlets in Washington, Baltimore, derxribed by the title clearly and explic- Miami, Philadelphia, New York, and it1 y correlated with the diagnostic crite- Boston. ri:a of DSM 111-R. This was relatively The selection procedures included selecting e:asy for some titles, and diffkult for every magazine sold as new merchandise o,thers. A title was assigned to the para- which had one or more photographs on the ~~hiliacategory partialism only if it re- front cover, every fifth book going from left to right and from top to bottom which had one '[erred to a sexual act with one part of or more visual depictions on the front cover. the body of another person; titles listing and every fifth film with one or more photo- more than one body part were excluded graphs on the box front. Duplicate titles were ("asses and ankles"), as were titles that eliminated so that a particular issue of a mag- azine was only coded once. A total of sixteen simply named a single body part, ("big stores were surveyed; the survey resulted in the boobs"). References to school girls were Ta~ble1 U.S. Titles Exc:luding Partialism O/O of Paraphilia Paraphilia No. of Titles O/O of All Titles Titles Exhibitionism Fetishism Frotteurism Pedophilia Sadomasochism Transvestism Voyeurism Telephone scatologia Necrophilia Zoophilia Coprophilia Klismaphilia Urophilia Total paraphilia titles Incest Total perversion titles 51 3 100.0% 16.78% 44 Bull Am Acad Psychiatry Law, Vol. 19, No. 1, 1991 Paraphilias in U.S. Pornography Titles included in the pedophilia category, ref- prepubertal age. These titles were as- erences to adolescent or "young" part- signed to a separate incest category, ners were excluded. which is included as a perversion even Because many titles included refer- though not listed as a DSM 111-R para- ences to both sadism and masochism. philia. they are assigned to a single category, sadomasochism. (It was impossible to distinguish from most of these titles Results whether the fantasied act described in Table 1 presents the frequency distri- the title was sadistic or masochistic). Ti- bution exclusive of partialism, a new and tles which made reference to both a fe- ill-defined paraphilic category. The most tish and sadomasochistic activity were common paraphilia inherent in the titles assigned to the sadomasochism category, reviewed by the commission was sado- as it appeared in these cases that the use masochism, comprising almost 50 per- of the object was for either sadistic or cent of the paraphilic titles and 8.4 per- masochistic purposes. Titles referring to cent of all titles. acts of submission were not included as Incest, although not a DSM 111-R par- a paraphilia. Titles referring to forced aphilia. was second in frequency with gang sex were included in the sadoma- 2 1.4 percent of the perversion titles sochistic category. Titles describing sex- (3.6% of all titles). If combined with ual activity with a daughter were not pedophilia, this category represents one- included in the pedophile category, un- fourth of all paraphilia titles. less the reference was additionally to When partialism is included as a par- Table 2 US. Titles Including Partialism '10 of Paraphilia Paraphilia No. of Titles O/O of All Titles Titles Exhibitionism Fetishism Frotteurism Pedophilia Sado-masochism Transvestism Voyeurism Telephone scatologia Necrophilia Partialism Zoophilia Coprophilia Klismaphilia Urophilia Total paraphilia titles Incest Total perversion titles Bull Am Acad Psychiatry Law, Vol. 19, No. 1, 1991 45 Lebegue aphilia, it is found in 3 1.2 percent of all Discussion titles the Commission surveyed resulting DSM 111-R(6) characterizes a paraphi- in sadomasochism prevalence of 34.3 lia as percent, and incest prevalence of 14.7 percent of perversion titles (Table 2). arousal in response to sexual objects or situa- Although exhibitionism is thought to be tions that are not part of normative arousal/ activity patterns. and that in varying degrees a common paraphilic act, it was present may interfere with the capacity for reciprocal in only a fraction of a percent of the affectionate sexual activity. The essential fea- titles reviewed. No references to frot- ture of disorders in this subclass is recurrent teurism, telephone scatalogia, necrophi- intense sexual urges and sexually arousing fan- tasies generally involving either (1) nonhuman lia, or coprophilia were found in the objects. (2) the suffering or humiliation of titles reviewed by the 1986 U.S. Com- one's self or one's partner. or (3) children or mission. References to klismaphilia nonconsenting persons. The specific paraphi- (enemas) and urophilia represented only lias described here are exhibitionism, fetish- ism, frotteurism, pedophilia. sexual masoch- a fraction of a percent of paraphilia ti- ism, sexual sadism, transvestic fetishism, and tles. voyeurism. Table 3 shows the results of a similar study of 2.173 titles I reviewed in Mel- The residual category, paraphilia bourne. Australia, in 1984 using the NOS, contains acts that do not meet 1980 DSM 111 categories of paraphilia. criteria for any of the specific categories, The prevalence of sadomasochism in the but are nevertheless included as para- 1986 U.S. study was very similar to the philias. All of the listed categories meet Australian study, which found sadoma- the stated definition of a paraphilia, ex- sochism in 47.8 percent in the Paraphilia cept partialism, the exclusive focus on a titles, and 12.4 percent of all titles re- part of the body. Given the high preva- viewed.' lence a focus on body parts in today's society, and the high prevalence (7.6%) Table 3 Australian Titles-1984 Paraphilia No. of Titles O/O of Paraphilia % of All Titles Titles Fetishism Transvestism Zoophilia Pedophilia/incest Exhibitionism Voyeurism Sadomasochism Atypical "Teen/young" sex Total 'Some child titles had a sadistic theme as well. 46 Bull Am Acad Psychiatry Law, Vol. 19, No. 1, 1991 Paraphilias in U.S. Pornography Titles of partialism inherent in the paraphilia from an early age, a pattern of sexual titles reviewed, second only to sadoma- pleasure dependent upon the fantasy, sochism, the inclusion of this category and later the act, of violent domination, as a true paraphilia deserves critical re- humiliation, and even torture and death view before inclusion in DSM IV.
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