Is Psychology 'Perverse'?

by Dr. Jem Tosh

(Content warning: discussion of s*xual violence and the pathologization of trans people)

As I write a proposal for the second edition of my first book, Perverse Psychology, I thought it might be useful to outline exactly what I mean by that term and the theory behind it.

Perverse Psychology



  1. Directed away from what is right or good; perverted

  2. Obstinately persisting in an error or fault; wrongly self-willed or stubborn*

My analysis of psychological and psychiatric constructions of sexual abuse started with the 'paraphilias' - sexual activities and behaviours that psychiatry and psychology (controversially) deem to be 'abnormal'. My work started with the 'paraphilias' because the proposals for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were released shortly after I started my PhD. They included the troubling concept of 'paraphilic coercive disorder', despite it being rejected several times before. 'Paraphilic coercive disorder' referred to rape in the main criteria and I argued that the proposed diagnosis medicalised sexual violence. It was a focus of the protest and academic activist intervention I co-organised in 2010, which also addressed problems with the psychiatric treatment and diagnosis of 'gender identity disorder' (now called 'gender dysphoria'**).

One thing that struck me in the critiques of 'paraphilic coercive disorder' was how often it was framed as new - both in terms of those who did not mention the feminist protests and critiques from the 1980s, but also how sexual abuse has been pathologized in psychology and psychiatry throughout the DSM's history and long before it. Whether a part of the (also problematic) 'sexual sadism disorder' or the pre-DSM 'satyriasis', sexual violence has been included as a 'symptom' of mental 'illness' for well over a century.

Instead of challenging abuse and those who enact it, psychiatry and psychology pathologize the victims and subject them to invasive therapies and pathologizing theories that result in discrimination and stigma. This most certainly could be considered an example of being 'directed away from what is right and good' - (Tosh, 2015, p.115)

What I noticed about this construction, which troubled me even more, was the boundary that was put around it. What gets categorised as 'abnormal' sexual violence and what is 'normal' sexual violence? Is there really a concept of 'normal' sexual violence - is it 'normal' at all? What are the implications of framing certain kinds of sexual violence in this way?

I was troubled by this paradox, on the one hand sexual violence was positioned as symptomatic of disorder, and on the other hand it was framed as 'normal' in some situations. That latter group coincided with the normalisation of masculine violence - harmful theories and narratives that centred 'rough and tumble play' as key to boys' development but not girls.*** It framed sex and sexuality in (heteronormative and) oppositional terms, with men being described as active (and 'aggressive') participants with a high sex drive and women framed as the passive and asexual complement that required pursuing and even coercion to 'awaken' a sexual interest.****

Gender Nonconformity

To understand this dichotomy, I needed to examine psychological and psychiatric constructions of gender. What I noticed was, when the violence fit into psychological narratives about masculinity (the 'norm' constructed by psy disciplines) it was most often positioned in that 'normal' violence category. Those instances that were positioned in the other category, the 'abnormal' rape concept, tended to represent gender nonconformity; a combination of 'masculine' violence with (what psychiatry constructed as) a 'feminine' 'over-emotionality'. Like discourses about 'hysteria' (and the present-day version, 'histrionic personality disorder'), it was not the 'masculine' violence that was framed as 'abnormal', but the overly emotional display or expression of it in certain contexts that would result in its pathologisation. I looked again and again and found repeatedly that distinction - 'normal' violence was controlled, functional, necessary, and 'abnormal' violence was emotional, uncontrollable, irrational. The latter replicated psychology and psychiatry's constructions of pathologized femininity (not only through hysteria discourse, but others too, like 'borderline personality disorder').

The persistence of psychiatric interventions with children who defy gender norms continues the profession's stubbornness to acknowledge wrongdoing... - (Tosh, 2015, p. 115)

The other parallel I noticed, was the similarities in the pathologization of gender nonconformity in these psychological and psychiatric texts. From 'transsexualism' and 'transvestic disorder', to 'gender identity disorder' and 'gender dysphoria' (which have a history as long as psychiatric constructions of rape), it was not just femininity being pathologised but also the gender nonconformity - in other words, psychiatry had a problem with the existence of trans women and girls*****. For the constructions of 'abnormal rape', they pathologised the problematic construct of 'feminine' 'over emotionality' as well as (what psychiatry considered to be) the gender nonconformity of it existing or being expressed by a (cisgender) masculine body.

I found this conceptualisation deeply problematic and harmful - to frame gender nonconformity (and transgender and nonbinary people) as 'abnormal' but 'masculine' violence as 'normal'. This is because I don't think we should consider any kind of violence as 'normal', regardless of the gender of the perpetrator.****** Nor do I think that gender nonconformity should be pathologised. So, based on the definition of perversion given at the beginning of this blog post (and the final chapter of the book), I conclude that because of this backward understanding of violence, abnormality, and gender, it is psychology and psychiatry that are perverse:

If psychology considers transgender people to be 'abnormal' and rape to be 'normal', or argues that certain genders should be prevented but masculine violence should be encouraged, then it sounds to me like psychology is the one that is perverse and in need of an intervention. - (Tosh, 2015, p. 116)

Reviews for the First Edition:

"Highly original, closely argued, and ingenious analysis"

Professor Erica Burman, University of Manchester

"A captivating critique of the disciplines of psychology and psychiatry"

Shari Fitzgerald, Memorial University

"At last a book that speaks about the unspoken. Well written, well referenced, a highly stimulating read"

Kirsten Nokling, The Psychologist

"Well written, insightful, interesting, informative, and an excellent resource"

Joan Strutton, PsycCRITIQUES

"Invigorating and provocative"

Pierre Brouard, University of Pretoria

"A very important book about how modern psychology has been used to invalidate and suppress sex and gender diversity"

Jack Molay, Crossdreamers


Shortlisted for The British Psychological Society Book Awards, 2016

Preface by Professor Ian Parker:

"Instead of subjecting those labelled as 'abnormal' to the gaze of psychology, [Jem] Tosh invites us to turn around and look carefully at that gaze. How is it structured, and how is it linked to power? What are the consequences of the proliferating categorisation of sexual disorders, and what does that tell us about knowledge production in psychology? And how are the borders between masculine and feminine policed, and the many different attempts to cross those borders treated by psychology as 'perverse'?"

Perverse Psychology is part of Professor Ian Parker's Concepts for Critical Psychology: Disciplinary Boundaries Re-Thought book series with Routledge. Check out the full range here.

Contents of the First Edition

1. Introduction


Critical psychology

Discourse Analysis


[Trans psychology]


2. Psychology and sexual violence: A historical review


Rape as perversion


Online research

Psychiatric Discourses

Reverse Discourses


3. Remedicalizing rape

Forensic Psychology



Remedicalizing psychiatry

Paraphilic Coercive Disorder

Paraphilia NOS




4. Psychology, homosexuality, and 'feminine boys'





'Feminine boys'