[...] One would ascertain a paraphilia (according to the nature of the urges, fantasies, or behaviors) but diagnose a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder." The Rationale page of any paraphilia in the electronic DSM-5 draft continues: "This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological. It also eliminates certain logical absurdities in the DSM-IV-TR. In that version, for example, a man cannot be classified as a transvestite—however much he cross-dresses and however sexually exciting that is to him—unless he is unhappy about this activity or impaired by it. This change in viewpoint would be reflected in the diagnostic criteria sets by the addition of the word Disorder to all the paraphilias. Thus, Sexual Sadism would become Sexual Sadism Disorder; Sexual Masochism would become Sexual Masochism Disorder, and so on. "Bioethics professor Alice Dreger interpreted these changes as "a subtle way of saying sexual kinks are basically okay – so okay, the sub-work group doesnt actually bother to define paraphilia. But a paraphilic disorder is defined: thats when an atypical sexual interest causes distress or impairment to the individual or harm to others."
This likely underrepresentation may also be attributable to a "societal tendency to dismiss the negative impact of sexual relationships between young boys and adult women". Michele Elliott has done extensive research on child sexual abuse committed by females, publishing the book Female Sexual Abuse of Children: The Last Taboo in an attempt to challenge the gender-biased discourse surrounding sex crimes. John Hunsley states that physiological limitations in the study of female sexuality must also be acknowledged when considering research on paraphilias. He states that while a mans sexual arousal can be directly measured from his erection (see penile plethysmograph), a womans sexual arousal cannot be measured as clearly (see vaginal photoplethysmograph), and therefore research concerning female sexuality is rarely as conclusive as research on men. Legal issues
In the United States, since 1990 a significant number of states have passed sexually violent predator laws. Following a series of landmark cases in the Supreme Court of the United States, persons diagnosed with paraphilias, particularly pedophilia (Kansas v. Hendricks, 1997) and exhibitionism (Kansas v. Crane, 2002), with a history of anti-social behavior and related criminal history (that includes at a determination of at least "some lack-of-control" by the person), can be held indefinitely in civil confinement under various state legislation generically known as sexually violent predator laws and the federal Adam Walsh Act (United States v. Comstock, 2010). See also
-phil- (list of philias)
Courtship disorder
Dorian Gray syndrome
Erotic target location error
Human sexuality
List of paraphilias
Lovemap
Object sexuality
Perversion
Psychosexual development
Sex and the law
Sexual ethics
Richard von Krafft-Ebing

References
Citations
General bibliography
D. Richard Laws, William T. ODonohue (ed.