Rape as a mental illness

This is one of the proposals for DSM-V.

Some people gain sexual pleasure from rape and I think this is what the
disorder will pathologise. The thing is there are people who have this
fetish but engage with it in a safe way, i.e. they don't go out and rape
people. It can be safe as part of a relationship or as part of a sexual
community. Other people may have these thoughts and never act on them.

Undoubtably it's important to pathologise rape. Interestingly it seems
that it's only rape for sexual gratification that will become a mental
illness and something that will be dealt with outside the criminal
system. People rape for other reasons.

I remember speaking to a GP friend of mine about one of his patients.
He'd disclosed that he had paedophile thoughts. He'd had them for a
while but never acted on them. He came to the doctor to get them fixed.
He didn't want them. My GP friend was unsure whether he should contact
the police. Apart from the whole doctor-patient confidentiality thing
the patient hadn't done anything about these feelings and thoughts. The
patient wanted to be rid of them. Their fear was acting upon them.

So it may make sense that some people will want behavioural modification
for their thoughts of rape for sexual gratifcation. I don't know what
sort of therapist or therapy could treat this but the option is there if
it's included in DSM-V. America has an insurance-based system of
healthcare so without a diagnosis a person can't get treatment.

Rape as a mental illness - specifically rape for sexual gratification
rather than opportunity or domination of a person or deliberate harm -
means the individual gets treated by the psychiatric system rather than
the criminal justice one. I wonder how a raped person might feel if the
rapist was sent to a ward instead of a prison. I wonder if rapists who
rape for other reasons other than sexual gratification from raping
people would try to argue their case so what they did could be seen as a
mental illness. Motivations for rape are hard to prove.

However there's the problem of pathologising people who have a rape
fantasy but don't act on it or act on it in safe ways. It's a fetish.
People should be allowed to have their fetishes even if they may seem
repugnant to people. There are people who enjoy being raped just as
their are people who want to rape. There may be a rape sex scene and the
medicalisation of this fetish might overpathologise a scene that's
predominantly people who cause no harm.