The new DSM specifies that in order for an atypical sexual behavior to be classified as a mental condition, a person must:

1. Feel personal distress about their interest, not merely distress resulting from society’s disapproval; or

2. have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.

Under the previous DSM, there was no need for the personal distress condition, meaning that anyone into impact play, CNC or a whole host of other things was technically suffering a mental health disorder.

I am mental for rope and tentacles though.