Conclusion

The human capacity to eroticize is vast and the boundary between normal and abnormal diffuses. When sexual interests are conceptualized on a continuum rather than as rigid categories, many sexually healthy adults recognize nonpro-blematic but "beyond the usual" aspects of their own erotic preferences. Diagnos-tis is uncomplicated toward the far end of the continuum, where sexual interests are exclusive, or nearly so, and where either others are harmed or suffering is apparent as a result of the interest. Complexity and ambiguity characterize clinical scenarios where the interest is nonexclusive, no one has been harmed, and where, while suffering may be present, it has profound contextual or relational dimensions that make distinctions between the pathological and the incompatible less clear. The accessibility, via the world wide web, of sexual stimuli ranging from the traditional and acceptable to the bizarre and abhorrent, has, in one short decade, brought human sexuality into a spotlight that illuminates, embarrassingly, the lack of empirically based knowledge regarding the nature and causes of human sexual interest and behavior. The implications of this cultural phenomenon for the para-philias are profound. Never before has the mandate been greater to conduct rigorous scientific inquiry to define the line between sexual recreation and sexual pathology, to develop an empirically based and clinically useful taxonomy, to identify specific etiological mechanisms, and to identify those treatments, both biological and psychological, that offer the most efficacious results.

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