What is a “paraphilia”? I think Wikipedia’s definition is the clearest, stating that the term “describes sexual arousal to objects, situations, or individuals that are not part of normative stimulation.” The American Psychiatric Association whittles that down to: “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving a) non-human objects, b) the suffering or humiliation of oneself or one’s partner, c) children, d) non-consenting persons”.

According to the American Psychiatric Association, when a paraphilia causes distress to self or others, they are considered mental disorders. The Diagnostic and Statistical Manual IV-TR lists eight specific paraphilias, not including the all-inclusive category of “Not Otherwise Specified”:

Fetishism: arousal in response to inanimate objects

Transvestic fetishism: erotic cross-dressing

Sexual masochism/sadism: arousal when receiving/giving pain or humiliation (respectively). The pain or humiliation has to be real, not simulated.

Exhibitionism: arousal when exposing one’s genitals to non-consenting people

Voyeurism: arousal when watching non-consenting people doing intimate or sexual acts

Frotteurism: arousal when rubbing one’s genitals against a non-consenting person

Pedophilia: sexual attraction to pre-pubescent children

The whole concept of paraphilias is under considerable debate in the scientific community. If paraphilias are essentially “abnormal sexuality” then where is the boundary? For example, if being aroused by knee-high black leather high-heeled boots is a fetish (paraphilia), what about nylon stockings? Frilly lacy women’s underwear? What if the clothing is on a person? And so on… the lines are very blurry. Another problematic aspect for paraphilias is that homosexuality was once considered a paraphilia. There’s a lot more to the debate, but I’m going to have to save it for a post or two of its own.

This study looked at a sample of middle aged, mostly straight adult men in Berlin, Germany; paraphilias are more commonly diagnosed in men, except for sexual masochism. Participants were evaluated via questionnaire for whether they would meet criteria for a paraphilia. Their results are illuminating. 62.4% of their participants reported sexual arousal in response to a paraphilic stimulus. Here’s some of the breakdown:

Fantasy (%) Reality (%) Distress? (%) Fetishism 30.0 24.5 0 Transvestic Fetishism 4.9 2.7 3.7 Masochism 15.8 2.3 1.5 Sadism 21.8 15.5 0 Voyeurism 34.9 18.0 0.7 Exhibitionism 3.5 2.2 0 Frotteurism 13.4 6.5 1.8 Pedophilia 9.5 3.8 5.3 Not Otherwise Specified 6.3 4.6 6.9 More than 1 58.6 44.4 1.7

Where “Fantasy” refers to a sexual fantasy which did not involve masturbation, “Reality” refers to actual sexual experiences, and “Distress” reflects the percentage of participants who reported being upset by their arousal.

There’s a lot of analyzing you can do on just those numbers alone. I want to call attention to the numbers for fetishism (~25%), voyeurism (18%) and sadism (15.5%). I don’t know about you, but I think about things a lot better this way…

Roughly 1 in 4 men in this sample had fetishistic experiences, where they were aroused by a non-sexual object.

Roughly 1 in 6 men in this sample had sadistic experiences, where they were aroused by the pain or humiliation of their partner(s).

Roughly 1 in 6 men in this sample had voyeuristic experiences, where they were aroused by watching others doing intimate things.

Further, nearly half of the men had more than one paraphilic sexual experience.

That’s really pretty common for a “mental illness.”

Now, it’s not known how well these participants actually fit the diagnostic criteria for a paraphilia. For example, it’s not known whether the men who participated in sadistic experiences actually had the consent of their partners or not. It’s not known whether the participants were distressing others. But it IS worth noting that very few men were actually distressed by their arousal. Hmm…

The other point of focus I find interesting is the difference between fantasy and reality, and in how much that difference differs between paraphilias. What influenced these participants to not act on their fantasies? Or, from my perspective, what can be done to help some of them express themselves safely with no harm to others, and what can be done to help others (e.g., pedophiles) refrain? What’s going on here? Sadly, I don’t have answers here.

In conclusion, the authors state: “The findings suggest that paraphilia-related experience can not be regarded as unusual from a normative perspective.” I whole-heartedly agree.

The abstract is publicly available on PubMed.

Edit (2/24/2013):

There has been some confusion over the percentages I quoted. Let me clarify:

There were 367 participants total. As an example, of those, 27 reported having either fantasy, masturbation fantasy, or real experience with transvestic fetishism. And that breaks down to 18 having fantasy, 21 having masturbation fantasy, and 10 having reality. The researchers divided those breakdown numbers by the total number of participants (367) to get the percentages (i.e., 4.9% of the sample having transvestic fetishism fantasies, 2.7% of the sample having transvestic fetishim real experiences). Of those 27 people, only 1 was distressed by it. Thus, 3.7% were distressed by their arousal.

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