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Sexual Abuse: A Journal of Research and Treatment
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Multiplex Versus Multiple Taxonomy of Paraphilia: Case Example

Gregory K. Lehne

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, gregory.lehne{at}verizon.net

John Money

Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, Department of Pediatrics, The Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland

Several different paraphilias are presently diagnosed in some individuals whereas a more parsimonious taxonomy would be that of one multiplex paraphilia. A multiplex paraphilia may be expressed by variations of content at different times in an individual's life or in different situations. The present case example shows the unfolding of a multiplex paraphilia over a lifetime. At age 7 the subject was dressed in public as a girl wearing a diaper as a humiliation for bed-wetting. This experience had 3 paraphilic components that were separately manifested at different times in his life: fetishistic transvestism, pedophilic incest, and infantilism. A multiplex paraphilia taxonomy may lead to improved identification of etiology, prognosis, and treatment of paraphilia.

Key Words: paraphilia • transvestism • infantilism • incest.

Sexual Abuse: A Journal of Research and Treatment, Vol. 15, No. 1, 61-72 (2003)
DOI: 10.1177/107906320301500105
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