From Psychopathia Sexualis to the DSM/ICD

How do psychiatrists and other mental health practitioners explain why some people seek to sexually harm others? Their views about perpetrators of sexual violence have changed dramatically over time, as well as in different geographical contexts.

Perpetrators of sexual violence have been understood through medical and psychiatric lenses, including those of moral insanity, degeneration, psychopathy, paedophilia, and sexual sadism. What do these different classification systems tell us about the meaning ascribed to sexual violence, including the ‘medicalisation of criminality’.

How has knowledge about the ‘nature’ or ‘identity’ of sex offenders changed over the past two centuries? We trace shifts from nineteenth-century notions of sexual danger to late-twentieth century evaluations of risk. Forensic psychiatry and medicine have attempted to make sense of sexually violent men and women through debates about degeneracy, psychosexual development, brain malformation, conditioning, hormonal balances, genetics, personality traits, and so on.

Psychiatrists and other mental health professionals have attempted to distinguish ‘ordinary sex offenders’ from ‘perverse’ or ‘sadistic’ ones. They have introduced techniques and technologies seeking to predict who is at risk of becoming a sex offender (e.g. phrenological and other physiological measurements, psychological and personality tests, penile plethysmograph). These have major implications for punishment and treatment regimes. Attention will be paid to the self-fashioning of offenders, who were not only subjects of psychiatry but also co-creators of scientific knowledge.