Official websites use. Share sensitive information only on official, secure websites. Changes have been proposed based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards. The proposed classification of Paraphilic disorders distinguishes between conditions that are relevant to public health and clinical psychopathology and those that merely reflect private behaviour.
As the revision process advanced, a series of Working Groups in different disorder content areas were also appointed to review available evidence and develop recommendations regarding needed revisions in specific diagnostic groupings 2. Due to the complexity of this context and the need to take a broad perspective in order to develop scientifically and clinically sound recommendations that would facilitate access to health services, the WHO Departments of Mental Health and Substance Abuse and of Reproductive Health and Research have worked together to propose revisions in these areas.
These issues were examined within various settings, including primary care and specialist health care settings, as well as social service and forensic contexts.
Also considered were human rights issues pertinent to diagnostic classification in each of the areas under the Working Group's purview. In addition, a separate grouping of Sexual pain disorders has been proposed. Where possible, categories in the proposed classification of sexual dysfunctions apply to both men and women, emphasizing commonalities in sexual response 12 , 13 e. Men and women exhibit similar central nervous system pathways of activation and deactivation and similar neurotransmitter activity related to sexual desire.
Dynamic alterations of sexual response are similarly modulated and reinforced by behaviour, experience and neuroplasticity. Separate sexual dysfunctions categories for men and women are provided where sex differences are related to distinct clinical presentations e. The proposed guidelines indicate that, in order to be considered a sexual dysfunction, the problem or difficulty should generally: a have been persistent or recurrent over a period of at least several months; b occur frequently, although it may fluctuate in severity; and c be associated with clinically significant distress.
