By BitterGrey
For the most part, modern medicine has eliminated mythology, except for some potentially confusing terms. Hysterectomies (removal of the uterus) are no longer thought to cure hysteria (once thought to have been caused by a misplaced uterus). Sadly, sexology is a particularly less modern field.
Modern science advances by experimentally testing hypotheses. However, this isn't practical for sexology: Experiments are often either comical, as in the case of XKCD, or tragic, as in the case of David Reimer. Without an empirical foundation, all sexological categorization schemes are fully arbitrary. As seen time and again, their terminology and assertions are more a matter of fashion than of science. As a result, those seeking a detailed understanding of infantilism need to be aware of the origins and history of the terminology.
Around the turn of the previous century, Sigmund Freud presented his theory that human sexuality progressed through various stages; oral, anal, etc. Individuals would mature into "normal" heterosexuality unless they were arrested at some immature state, a state of psychosexual infantilism. A well-known work on the topic is Wilhelm Stekel's Patterns of Psychosexual Infantilism. It emphasized diaper-related or babyhood-related cases, since they lined up well with the prevailing theory of the day. This included functional and non-functional cases, as well as sexual and non-sexual cases. Most of the cases would now receive more specific and better documented diagnoses, and wouldn't be considered ABDLs.
Wilhelm Stekel also coined the term "paraphilia."
"We consider the term 'perversion' unscientific and ... carrying an unnecessary moralistic stigma... We prefer to use the term paraphilia for all those conditions where the sexual attraction ('philia') is directed toward a goal that lies outside ('para") the normal, heterosexual object relationship."[9]
The culturally-dependent definition of "normal" is something sexology has yet to outgrow. Ideally, a condition is a problem or not based on its symptoms. In contrast, a desire would be a paraphilia or not based on whether or not the majority would admit to having it. The specification of heterosexuality at least partially tied paraphilia(1) to reproductively effective practices, which had an absolute biological definition. (This was not the case for the later paraphilia(2) and paraphilia(3).) The presence of a driving condition was implicit: The examples Stekel wrote about were seeking medical help.
"There is a rare form of 'transvestism' (if one can call it such) in which the patient does not dress in the clothes of the opposite sex but as a child. This was first described by Pettow in 1910."[1] Infantosexual transvestism was described as usually occurring in women, so it might be more of a kink, similar to what would now be called ageplay.
Particularly in the 70's and 80's, the ABDLs were building their own community, and with it, some stable nomenclature. An "Adult Baby" was simply an adult who wanted to be a baby at times. A "Diaper Lover" was simply someone who enjoyed diapers. Both may have come in to use more as phrases than terms. The acronym "AB/DL" (now more commonly "ABDL") eventually followed. Publications such as the (remarkably un-analytic) Infantile Analysis (1976) show that the contraction "infantilism" was also in use in the 70's.
This community also demonstrated a population significant enough to warrant attention. While a paraphilia had to lack sufficient popularity to be "normal," it needed to be populous enough to be notable. This is one of two ways in which terminology is a popularity contest.
Dr. Speaker's 1980 thesis[7] and 1986 dissertation[8] used psychosexual infantilism to refer specifically to ABDL cases, including diaper fetishes as well as infantilism. While the first important empirical work on infantilism, its use of psychosexual infantilism could easily be confusing if read outside of its historical context. It was widely republished within the ABDL community, and may have been instrumental in the formal definition of an alternate term, paraphilic infantilism, by the American Psychological Association (APA) in 1987.
The essential features of a Paraphilia are recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one's partner, or 3) children or other non-consenting persons, that occur over a period of at least 6 months (Criterion A) ... [For fetishism, sexual masochism, transvestic fetishism, and paraphilias not otherwise specified] the diagnosis is made if the behavior, sexual urges, or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion B) [3]
With the publication of the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM III) in 1980, the APA formally adopted/redefined the term paraphilia. This definition of paraphilia wasn't connected to reproductive effectiveness or any other absolute definition. Specifically, homosexuality was no longer a paraphilia. Homosexuals were judged to be either numerous or influential enough to have become "normal." Popularity was now the sole determining factor. The next revision (DSM IIIR in 1987) altered the diagnostic criteria to separate specific paraphilias (desires driven by conditions) and kinks (voluntary matters of taste). This differentiation is important. However, there was no explanation for why a fetishist might expect distress or impairment from his desires while a homosexual would not.
Money proposed a system of categorization in 1984, called "lovemaps." Working with a linguist, he coined many new terms, pejoratively known as "Moneyisms." It is unclear if he had been in contact with any ABDLs before coining the term autonepiophilia(1984), which he defined simply as a diaper fetish. Other than seeking naming credit, it is unclear why Money thought a new term was necessary.
Between the 1984 article and the 1986 book, Money redefined autonepiophilia without an explanation as to why. Autonepiophilia(1984) was object-focused, a fetish. Autonepiophilia(1986) was suddenly role-focused, no longer a fetish. The new definition also had a different asserted cause. That paraphilias could be arbitrarily shuffled around within his framework demonstrated that the framework itself was arbitrary. It was just some map drawn up by a sexologist to try to claim authority. Autonepiophilia was superseded by the formal definition of paraphilic infantilism the following year.
The limited but continued use of moneyisms such as autonepiophilia outside of that three-year window (1984-1987) is difficult to explain. Lacking an empirical basis on which to judge what terminology is best, the more popular or more actively promoted terminology will tend to be perpetuated. In effect, this is the second way in which terminology is a popularity contest.
A formal definition of infantilism appeared in DSM IIIR (1987) through DSM IV TR (2000): "The term infantilism is sometimes used to describe a desire to be treated as a helpless infant and clothed in diapers."[2] It was roughly in line with Dr. Speaker's empirical work. Mostly correct, the definition had two primary faults. First, it asserted that infantilism was inherently sexual. Later surveys would show it to often involve sex and often be sexual, but not have the consistent sexuality expected of a condition that was inherently sexual. Second, the definition required distress or impairment. This was a necessary diagnostic artifact. An ABDL who hadn't suffered distress or impairment - who hadn't suffered because of his condition - wouldn't be certain that he had a condition, not just a kink. However, it excluded ABDLs who had the condition, but hadn't suffered because of it.
This definition, with those two corrections, closely matches how this website uses the term infantilism.
"The act of achieving adult sexual arousal by activities or objects one was exposed to as an infant"[5]. This term doesn't appear to be widely adopted in English, outside of specific sex dictionaries.
This term was coined by a writer for a 2002 episode of the TV medical drama ER and adopted by one important paper on an adult baby who did not meet the diagnostic criteria for paraphilic(2) infantilism, published in 2006[6]. The paper described one case in detail, but didn't enumerate multiple, independent symptoms and so technically didn't define a syndrome. A number of other doctors responded to the article, describing similar patients of their own.
The term paraphilia denotes any intense and persistent sexual interest other than the sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners.[4]
In 2013, the APA redefined paraphilia again. The paraphilias of the prior editions were now "paraphilic disorders". Kinks and other maters of taste that did not cause distress or impairment, but that weren't popular or influential enough for exclusion, were now paraphilias per the new definition. Given that the book's title is still the "Diagnostic and Statistical Manual of Mental Disorders", inclusion still caries a stigma. Why would a happy, well adjusted fetishist need to be listed when an equally happy, well adjusted homosexual doesn't? While the other sections of the DSM might be beneficial, this one remains largely an arbitrary sexological categorization scheme.
When reading these terms, and especially when using them, we need to be aware of their historical context and the baggage that these terms carry.
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