Psychiatry's viewpoint of sexual deviance has waved between the normal and the pathological. “Normal” is not determined by nature but by the values of a specific society.

To review the main landmarks in paraphilias history and the importance of social and cultural dimensions to it.

PubMed database was searched using the keywords perversion, sexual deviance, paraphilia, culture and society.

Throughout Middle Age and Renaissance any sexual act that differed from the natural/divine law was considered a vice. Unnatural vices (masturbation, sodomy, bestiality) were the most severely punished, as they could not result in conception. In 1886, Krafft-Ebing stated perversions were functional diseases of the sexual instinct caused by “hereditary taintedness” in the family pedigree and worsened by excessive masturbation. Proper perversions were sadism, masochism, antipathic sexuality (homosexuality, transvestism, transsexuality) and fetishism. Later, Havelock Ellis and Hirschfeld claimed sexual interest in the population followed a statistical norm, opposed the idea that masturbation led to diseases and demanded the decriminalization of homosexuality. Freud believed the “perverse disposition” to be universal in the childhood giving rise to healthy and pathological adult behaviors. In 1950's, Albert Kinsey surprised America when he proved many supposedly deviant sexual practices were quite common. The first Diagnostic and Statistical Manual (1952) was mainly psychoanalytic. Later, by 1973, homosexuality was removed from classifications. Recently, DSM-5 distinguishes between paraphilias and paraphilic disorders.

A progress in the paraphilic instincts’ acceptance has occurred. We hypothesize, in the future, paraphilias will follow homosexuality out of the diseases’ classifications.

The authors have not supplied their declaration of competing interest.