The defense of psychiatric practice will then need to proceed in a piecemeal fashion, with different disorders each being understood in different terms, depending on their contexts. Cases involving the diagnosis of Oppositional defiant disorder raise a particularly problematic set of issues. The diagnostic manual also notes, “It is not unusual for individuals with Oppositional defiant disorder to show the behavioral features of the disorder without problems of negative mood.” As criteria that are sufficient for a psychiatric diagnosis, these are problematic. Values must again play a role in the psychiatrist’s decision to recognize that there is an instance of disorder. The second half of the twentieth century saw the emergence of a new understanding of the role that is played by sexuality in human well-being. Prior to the moral progress in our understanding of sexuality, deviations from the heterosexual norm were assumed to be cases in which we did well to treat the person, instead of changing our society.