There are at least three approaches by which psychopathology can be described in terms of dimensions. Each approach involves counting the number and severity of symptoms, but these scores have distinct meanings based on whether the latent construct is considered to be categorical or dimensional. Given a categorical construct, dimensions can index either diagnostic certainty or symptom severity. For inherently dimensional constructs, the severity of the symptoms is essentially isomorphic with the underlying latent dimension. The optimal number of dimensions for describing paraphilias is not known, but would likely include features related to problems in sexual self-regulation, the diversity of paraphilic interests, and the overall intensity of sexual drive and expression. Complex measures of these (and related) dimensions currently exist, but simplified criteria are needed for routine communication among diverse mental health professionals. Establishing these criteria would requires professional consensus on the nature of the latent dimensions, as well as reliable assessment of the core constructs using non-arbitrary scales of measurement.