"Based on advances in research and clinical practice, and major shifts in social attitudes and in relevant policies, laws, and human rights standards", the World Health Organization (18 June 2018) removed Fetishism, Transvestic Fetishism and Sadomasochism as psychiatric diagnoses.The ICD-11 classification consider Sadomasochism as a variant in sexual arousal and private behavior without appreciable public health impact and for which treatment is neither indicated nor sought. "Further the ICD-11 guidelines "respect the rights of individuals whose atypical sexual behavior is consensual and not harmful. "WHOs ICD-11 Working Group admits that psychiatric diagnoses have been used to harass, silence, or imprison sadomasochists. Labeling them as such may create harm, convey social judgment, and exacerbate existing stigma and violence to individuals so labeled.According to ICD-11, psychiatric diagnoses can no longer be used to discriminate against BDSM people and fetishists.Recent surveys on the spread of BDSM fantasies and practices show strong variations in the range of their results. Nonetheless, researchers assume that 5 to 25 percent of the population practices sexual behavior related to pain or dominance and submission. The population with related fantasies is believed to be even larger. Forensic classification
According to Anil Aggrawal, in forensic science, levels of sexual sadism and masochism are classified as follows:
Sexual masochists:

Class I: Bothered by, but not seeking out, fantasies. May be preponderantly sadists with minimal masochistic tendencies or non-sadomasochistic with minimal masochistic tendencies
Class II: Equal mix of sadistic and masochistic tendencies. Like to receive pain but also like to be dominant partner (in this case, sadists).
Moreover, discrimination of fetish- and BDSM individuals is considered inconsistent with human rights principles endorsed by the United Nations and The World Health Organization.The classifications of sexual disorders reflect contemporary sexual norms and have moved from a model of pathologization or criminalization of non-reproductive sexual behaviors to a model which reflects sexual well-being and pathologizes the absence or limitation of consent in sexual relations.The ICD-11 classification, contrary to ICD-10 and DSM-5, clearly distinguishes consensual sadomasochistic behaviours (BDSM) that do not involve inherent harm to self or others, from harmful violence on non‐consenting persons (Coercive sexual sadism disorder).In this regard, "ICD-11 go further than the changes made for DSM-5 … in the removal of disorders diagnosed based on consenting behaviors that are not in and of themselves associated with distress or functional impairment. "In Europe, an organization called ReviseF65 has worked to remove sadomasochism from the ICD. On commission from the WHO ICD-11 Working Group on Sexual Disorders and Sexual Health, ReviseF65 in 2009 and 2011 delivered reports documenting that sadomasochism and sexual violence are two different phenomena. The report concluded that the Sadomasochism diagnosis were outdated, non scientific, and stigmatizing. In 1995, Denmark became the first European Union country to have completely removed sadomasochism from its national classification of diseases. This was followed by Sweden in 2009, Norway in 2010, Finland in 2011 and Iceland in 2015.