background In dsm-iv-tr, the subject of ‘sexual and gender identity disorders’ was dealt with in one chapter; in dsm-5, however, the subject is divided into three chapters, namely sexual dysfunctions , gender dysphoria, and paraphilic disorders. aim To discuss the above-mentioned changes. method The one-chapter version in dsm-iv is compared with the three-chapter contribution in dsm-5 and the differing criteria are tested for their clinical utility. results There are minor changes in the chapter ‘sexual dysfunctions’. The content of the chapters on ‘gender dysphoria’ and ‘paraphilic disorders’ differs substantially from the content of the sections on these subjects in dsm-iv. In the section on gender dysphoria the term ‘sex’ has been replaced by ‘gender’ and the term ‘identity disorder’ has been dropped. With regard to paraphilias, a distinction is now made between a paraphilia and a paraphilic disorder. The DSM-5 makes a new distinction between pathology (paraphilic disorder) on the one hand and other unusual or unconventional non-pathological sexual behavior on the other hand. In the dsm-5 the highly relevant clinical concept ‘hypersexuality’ has still not been incorporated as a separate category. conclusion In the dsm-5 many parts of the chapters on sexual disorders have been substantially revised.