bdsm or paraphilia etc. Are only bad or a mental pathology IF they have negatively impaired functioning for 6 MONTHS or more.

For a therapist to just say oh thats bad without asking how it impacts you is bad.

Also even if a therapist cant get past there negative connotation Ive had success in the past explaining participation in bdsm as a crutch. As in I know it can be bad but its good for me right now and Im not ready to replace it with something else. Of course its not really a crutch and its not really something that can be replaced wholesale. But saying it that way lets them know how important and supportive it is to you.