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ICD-10 Learning Lab Exit Presentation Mode

Category: F60 F61 F62 F63 F64 F65 F66 F68 F69

F65 — Disorders of sexual preference: facilitator sheet

Teaching objective

The single boundary test that applies across this category, as ICD-10 frames it, is whether the pattern causes the person genuine distress, involves acting on urges toward a person who has not consented, or otherwise causes harm — an unusual but private, consensual, non-distressing sexual interest does not meet this threshold and is not classified as a disorder here.

Choose material

Worked example · Case: Preference, or orientation? A classification exercise

Worked example

Show scenario

A clinical documentation exercise presents two brief, anonymised case summaries for classification-reasoning practice: one describes a private, consensual sexual interest disclosed without any associated distress, relationship difficulty, or involvement of a nonconsenting person; the other describes a pattern involving acting on urges toward people who had not consented, causing significant legal and personal consequences.

(or reveal one step at a time below)
  1. Reveal step 1

    Step 1 — Apply the category's threshold to the first summary: private, consensual, no distress, no nonconsenting person involved.

  2. Reveal step 2

    Step 2 — Conclude the first summary does not meet this category's threshold, as ICD-10 frames it.

  3. Reveal step 3

    Step 3 — Apply the same threshold to the second summary: involves a nonconsenting person and significant harm.

  4. Reveal step 4

    Conclusion — The classification threshold, as ICD-10 defines it, is met only by the second summary; the first describes non-disordered private variation.

Comparison points

As ICD-10 frames this category, a sexual preference becomes classifiable only with genuine distress, involvement of a nonconsenting person, or harm — private, consensual, non-distressing variation is not a disorder.

Discussion prompts

(or reveal one at a time below)
  1. Prompt 1

    State the threshold ICD-10 applies before a sexual preference is classified as a disorder under F65.

  2. Prompt 2

    Explain why a private, consensual sexual interest is not, by itself, classified as a disorder here.

  3. Prompt 3

    Explain this tool's editorial policy on F65.4 and why it is applied.

Summary

F65 classifies a sexual preference as a disorder, per ICD-10, only with genuine distress, involvement of a nonconsenting person, or harm — not private, consensual variation.