Politics versus Science

Abstract The authors respond to Robert L. Spitzer's and Paul Jay Fink's discussion of their paper, “DSM-IV-TR and the Paraphilias: An Argument for Removal.” They note that Spitzer and Fink do not dispute their analysis of the problems with the DSM-IV-TR criteria for paraphilias nor do they suggest any solutions to the problems they identified. The authors go on to state the political and media reaction to the unauthorized distribution when their earlier paper was presented at the May 2003 meeting of the American Psychiatric Association (APA). They note that conservative organizations flagrantly misrepresented their statements and intents, the symposium where the paper was presented, and the APA itself. Specifically, it was alleged that the authors were defending pedophilia or at minimum, advocated the decriminalization of child sexual abuse. However, these points were specifically discussed and refuted clearly in the earlier paper. The result of this political conservative misrepresentation was that the focus of the debate shifted; the substance of the original paper, that is, the real flaws in the Paraphilia section, was ignored. The authors suggest that perhaps the main reason for keeping the Paraphilia category in the DSM is public opinion rather than science. This is at odds with the APA claim that the DSM is a dispassionate, scientific document with an empirical basis. The authors feel that all those who are concerned about the scientific basis of psychiatry should be watching these events.