What is a paraphilia? What are the different types of paraphilias?

The word paraphilia derives from Greek; para means around or beside, and philia means love. The definition of paraphilia is any emotional disorder characterized by sexually arousing fantasies, urges, or behaviors that are recurrent, intense, occur over a period of at least 6 months, and cause significant distress or interfere with the sufferer’s work, social function, or other important areas of functioning. This is as opposed to sexual variants, which are sexual behaviors that are not typical but are not a part of any illness.

The number of people who suffer from a paraphilia is difficult to gauge for a number of reasons. Many people with one of these disorders suffer in secret or silence out of shame, and some engage in sexually offensive behaviors and so are invested in not reporting their paraphilia. Therefore, many of the estimates on the prevalence of paraphilic disorders come from the number of people involved with the criminal-justice system due to pedophilia. Most individuals with this sexual deviation are men (3%-5% of the male population), with just 1%-6% of those individuals being women. However, women tend to be under-diagnosed with paraphilias, wrongfully given the benefit of the doubt by those assessing their sexual behaviors.

Except for masochism, which is 20 times more common in women than men, paraphilias are almost exclusively diagnosed in men. Many people who suffer from one paraphilia have more than one. For example, about one-third of pedophiles also have another paraphilia. More than half engage in three or four such kinds of behaviors rather than just one. Most people who develop a paraphilia begin having fantasies about it before they are 13 years old.

According to the most current standard reference for mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), preceded by the DSM-IV and DSM-IV-TR, there are a number of different types of paraphilias, each of which has a different focus of the sufferer's sexual arousal:

Voyeurism: watching an unsuspecting/non-consenting individual who is either nude, disrobing, or engaging in sexual activity

Exhibitionism: exposing one’s own genitals to an unsuspecting person

Frotteurism: touching or rubbing against a non-consenting person

Sexual masochism: being humiliated, beaten, bound, or otherwise suffering

Sexual sadism: the physical or emotional suffering of another person

Pedophilia: sexual activity with a child that is prepubescent (usually 13 years old or younger)

Fetishism: sexual fascination with nonliving objects or highly specific body parts (partialism). Examples of specific fetishisms include somnophilia (sexual arousal by a person who is unconscious) and urophilia (deriving sexual pleasure from seeing or thinking about urine or urinating)

Transvestism: cross-dressing that is sexually arousing and interferes with functioning

Autogynephilia is a subtype of transvestism that refers specifically to men who become aroused by thinking or visualizing himself as a woman.

Other specified paraphilia: some paraphilias do not meet full diagnostic criteria for a paraphilic disorder but may have uncontrolled sexual impulses that cause enough distress for the sufferer that they are recognized. Examples of such specific paraphilias include necrophilia (corpses), scatologia (obscene phone calls), coprophilia (feces and defecation), and zoophilia (animals).

Urges to engage in coercive or otherwise aggressive sex like rape are not symptoms of a mental illness. Such sexual offending is therefore not considered a paraphilia.