Women live with men who are "afflicted" with this philia for years and never know they are "that", even when they are actively or passively "practicing/acting on" their philia. So how is science, in a clinical setting, going to make a determination between "thinking" it and "doing it?" and harmless and harmful? Maybe, maybe, maybe, after the fact, you might be able to glimpse "state of mind", but that's a little late isn't it? what would be classified as active/engaged anyway? the pursuit of materials for viewing? the possession of those materials? the manufacture/creation of those materials? what materials included? maybe even articles of clothing, and lord don't get me started with the foot fetishes? can the clinicians tell the difference between accidentally exposed and intentionally exposed(aka exhibitionism), or accidently saw in an open curtain, or peeped on purpose? Or between, I just picked him up, he looked like he needed a ride, or I was cruising the strip for some action? Can they tell the difference between babysitting and grooming a family?