Most practitioners of family law have had to make judgments concerning their clients on what is considered to be sexually abnormal behavior. This is an extremely difficult task since issues such as frequency, level of interest, object of interest have changed sometimes radically over time and among subcultures.

In our own culture, we have changed our views on homosexuality, masturbation, and oral sex. Our male rock stars have worn skirts and our actresses smoke cigars. Assessments of abnormality are so tinged by personal values and personal biases that objective assessment of abnormal is almost impossible. One individual’s fetish is another’s object of disgust.

In a provocative chapter by Charles Moser in the book, New Directions in Sex Therapy, edited by Peggy J. Kleinplatz, he argues that one should abandon entirely the use of the conventional diagnostic system manual when defining sexual abnormality. Instead of focusing on the object of sexual desire, or even the behavior itself, we should assess on the consequences or effects of that behavior on the adult. Thus, atypical sexual behaviors aren’t inherently “sick” or maladjusted. People would be diagnosed as sexually disordered only if their fantasies, urges, or behavior are unacceptable to themselves and cause clinically significant disturbance in their social, occupational, or personal life.

As an example, if sado-masochistic rituals are enjoyed by consenting partners, they are not considered to be sexually impaired. “Sexual acts” such as rape or pedophilia which are legally and humanely unacceptable, but not, according to the Moser, sexual disorders. The implication is that neither of the two examples should be “treated”. The sado-masochistic couple are doing normal behavior according to their needs. The rapist and pedophiliac should be prosecuted, not treated.