Hypoactive Sexual Desire Disorder: Sexual fantasies and desire for sexual activity are absent or persistently or recurrently deficient, and this disturbance causes significant personal distress, interpersonal difficulties, or both. This category is not meant to include occasional problems with sexual desire. The disorder excludes hypoactive sexual desire caused by some other psychiatric disorder (Major Depressive Disorder, Obsessive-Comulsive Disorder, or Posttraumatic Stress Disorder), a substance (e.g., a drug of abuse, a medication), or a general medical condition.

Sexual Aversion Disorder: An individual with this type of sexual desire disorder experiences persistent or recurrent extreme aversion to, and avoids, all or virtually all genital sexual contact with a sexual partner, and this disturbance causes significant personal distress, interpersonal difficulties, or both. This category is not meant to include occasional sexual aversion. The category also excludes aversion caused by some other psychiatric disorder (Major Depressive Disorder, Obsessive-Comulsive Disorder, Posttraumatic Stress Disorder, or Specific Phobias).

For some people, a sexual desire disorder has been present during their entire life, whereas in others it is acquired during their lifetime. For some people, the problem is situational, meaning the difficulty arises only in certain circumstances (people, places, etc.). For other people, the difficult is generalized, meaning it happens with more than one partner and in a variety of situations.

Female Sexual Arousal Disorder: A female with this sexual arousal disorder suffers from the persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement, and this disturbance causes her significant personal distress, interpersonal difficulty, or both. This category is not meant to include occasional problems with sexual arousal. This category excludes sexual arousal dysfunction caused by another psychiatric disorder (e.g., Major Depressive Disorder, Obsessive-Comulsive Disorder, Posttraumatic Stress Disorder), a substance (e.g., a drug of abuse, a medication), or a general medical condition.

Male Erectile Disorder: A male with this sexual arousal disorder suffers from the persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate erection, and this disturbance causes him significant distress, interpersonal difficulty, or both. This category is not meant to include occasional problems with having erections. This category excludes erectile dysfunction caused by another psychiatric disorder(e.g., Major Depressive Disorder, Obsessive-Comulsive Disorder, Posttraumatic Stress Disorder), a substance (e.g., a drug of abuse, a medication), or a general medical condition.

Female Orgasmic Disorders: A female with orgasmic disorder experiences a persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase, and this disturbance causes her significant emotional distress, interpersonal difficulty, or both. This clinical judgement is made after giving due consideration to the woman's age, sexual experience, and the adequacy of sexual stimulation she receives. This category is not meant to include occasional orgasmic problems. This category excludes orgasmic dysfunction caused by another psychiatric disorder (e.g., Major Depressive Disorder), a substance (e.g., a drug of abuse, a medication), or a general medical condition.

Male Orgasmic Disorder: A male with this type of orgasmic disorder experiences a persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person's age, judges to be adequate in focus, intensity, and duration. The disturbance causes the man significant emotional distress, interpersonal difficulty, or both. This category is not meant to include occasional orgasmic problems. This category excludes orgasmic dysfunction caused by another psychiatric disorder (e.g., Major Depressive Disorder), a substance (e.g., a drug of abuse, a medication), or a general medical condition.

Premature Ejaculation: A male with this type of orgasmic disorder experiences a persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it, and this disturbance causes the man significant emotional distress, interpersonal difficulty, or both. This clinical judgement takes into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity. This category is not meant to include occasional problems with premaure ejaculation or erectile dysfunction caused by a general medical condition (diabetes mellitus). This category excludes premature ejaculation due exclusively to the direct effects of a substance (e.g., withdrawal from opioids).

Dyspareunia: A female with this type of sexual pain disorder experiences recurrent or persistent genital pain associated with sexual intercourse with either a male or a female, and the disturbance causes the woman significant emotional distress, interpersonal difficulty, or both. This category is not meant to include the occasional pain associated with sexual intercourse. This category excludes similar disturbance caused by Vaginismus or lack of lubrication, another psychiatric disorder, the direct physiological effects of a substance (e.g., a drug of abuse, a medication), or a general medical condition.

Vaginismus: A female with this other type of sexual pain disorder experiences recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse, and this disturbance causes her significant emotional distress, interpersonal difficulty, or both. This category excludes similar disturbances caused by another psychiatric disorder (e.g., Somatization Disorder) or the direct physiological effects of a general medical condition.

The male or female with Sexual Dysfunction Due to A General Medical Condition has a clinically significant sexual dysfunction that results in significant emotional distress, interpersonal difficulty, or both. What distinguishes this dysfunction from others is that there is evidence from the history, physical examination, or laboratory findings that the sexual dysfunction is fully explained by the direct physiological effects of a general medical condition. This category excludes disturbances better accounted for by another mental disorder (e.g., Major Depressive Disorder). This type of dysfunction is not meant to include diminished sexual interest and functioning that may accompany aging.

Substance-Induced Sexual Dysfunction: A clinically significant sexual dysfunction (i.e., impaired desire, impaired arousal, impaired orgasm, or sexual pain) that results in significant emotional distress, interpersonal difficulty, or both, and is distinguished from other dysfunctions by evidence from the history, physical examination, or laboratory findings that the sexual dysfunction is fully explained by substance use as manifested by either: (1) the symptoms developed during, or within a month of, Substance Intoxication; or (2) medication use is causally related to the disturbance. Various substances can be implicated in this dysfunction, including alcohol, amphetamines, cocaine, opioids, sedatives, hypnotics, and anxiolytics.

Paraphilias: The main features of this disorder include recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors that occur over a period of at least six months and are related to (1) nonhuman objects, (2) the suffering or humiliation of oneself or one's partner, or (3) children or other non-consenting persons. The fantasies, sexual urges, or behaviors cause clinically significant emotional distress or impairment in social, occupational, or other important areas of functioning. This category is not meant to include non-pathological use of sexual fantasies, behaviors, or objects as a stimulus for sexual excitement.

• Exhibitionism: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the exposure of one's genitals to an unsuspecting stranger. This category is generally not meant to include public urination.
• Fetishism: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects (e.g., female undergarments). This category excludes the use of articles of female clothing in cross-dressing (as in Transvestic Fetishism) or devices designed for the purpose of tactile genital stimulation (e.g., a vibrator).
• Frotteurism: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving touching and rubbing against a nonconsenting person.
• Pedophilia: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger). The person is at least age 16 years and at least 5 years older than the child or children. Technically excluded from this category are individuals in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old.
• Sexual Masochism: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.
• Sexual Sadism: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Transvestic Fetishism: This paraphilia is present in a heterosexual male who has recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing. One subtype involves Gender Dysphoria in which the male has persistent discomfort with his gender role or identity.
• Voyeurism: This paraphilia is marked by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity.
• Paraphilia Not Otherwise Specified: This category is reserved for Paraphilias that do not meet the criteria for any of the specific categories above. Examples include, but are not limited to, telephone scatologia (obscene phone calls), necrophilia (corpses), partialism (exclusive focus on part of body), zoophilia (animals), coprophilia (feces), klismaphilia (enemas), and urophilia (urine).

Gender Identity Disorder: This disorder is marked by (a) a strong and persistent cross-gender identification and not just a desire for some perceived cultural advantages of being the other sex, (b) persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex, and (c) this disturbance causes clinically significant emotional distress or impairment in social, occupational, or other areas of functioning. This category is not meant to include people who exhibit nonconformity to stereotypical sex role behavior or people with a concurrent physical intersex condition. The symptoms of this disorder also need to be differentiated from those sometimes exhibited by people suffering from schizophrenia or transvestic fetishism.

In children, the disturbance of having a strong and persistent cross-gender identification is manifested by at least four of the following: (1) repeatedly stating the desire to be, or insistence that he or she is, the other sex; (2) in boys, preferring cross-dressing or simulating female attire, or, in girls, insistence on wearing only stereotypical masculine clothing; (3) strongly and persistently preferring cross-sex roles in make-believe play or persistently fantasizing being the other sex; (4) intensely desiring to participate in the stereotypical games and pastimes of the other sex; and (5) strongly preferring playmates of the other sex. The other disturbance of having persistent discomfort with one's sex or gender role is manifested by any of the following: in boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities; in girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.

In adolescents and adults, the disturbance of having a strong and persistent cross-gender identification is manifested by a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex. The second disturbance of feeling persistent discomfort with one's sex or gender role is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.

Gender Identity Disorder Not Otherwise Specified: This category is reserved for disorders in gender identity that do not meet the specific criteria for Gender Identity Disorder. Some examples are (1) intersex conditions (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia) and accompanying gender dysphoria; (2) transient, stress-related cross-dressing behavior; and (3) persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex.