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Sexual sadism is a form of paraphilia, but mild sadistic sexual behavior is a common sexual practice between consenting adults, is usually limited in scope, is not harmful, and does not meet the clinical criteria for a paraphilic disorder, which require that a person’s behavior, fantasies, or intense urges result in clinically significant distress or functional impairment or cause harm to others. However, in some people, the behaviors escalate to the point of harm. When sadism becomes pathologic is a matter of degree, what will you do?

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