Over the last 24 hours, there have been hundreds of news stories citing unverified claims that U.S. President-Elect paid prostitutes to urinate in front of him. While the allegations may well be false, I thought it would be timely to look at what we know about urophilia (people that are sexually aroused by urine - the sight or thought of either the act of urination or the urine itself). The condition is known by many different names. In scientific circles it can also be called urophagia, urolagnia, renifleurism, undinism, and ondinisme. In non-scientific circles it is more popularly called ‘water sports’, ‘golden showers’ and (most crudely) ‘piss play’. This has also led to dedicated websites where ‘pee lovers’ can meet up.

Press reports have reported a few celebrities engaging in the activity. For instance, in an interview with the music magazine 'Blender', the Puerto Rican popstar Ricky Martin stated that he enjoyed ‘golden showers’. The actor Andy Milonakis and host of MTV’s ‘The Andy Milonakis Show’ said in an interview with 'People Magazine' that liked the feeling of "warm urine" on his chest during sexual intercourse. Interestingly, it was recently discovered that Havelock Ellis – one the ‘founding fathers’ of sexology – was aroused by the sight of a woman urinating.

“In , as his autobiography reveals, Ellis had exclusive from his mother during long absences of his sea captain father. Ellis was the eldest child and only son, whose with his mother included sponging her back and being present when he was twelve and older as she urinated. (His sister, when she heard of one incident, thought that their mother was being flirtatious, since normally she was rather a reserved person.) The consequences of this malimprinting Ellis dignified with the term urolagnia, which he denied had become a real perversion or a dominant interest in his sexual life. His candour had limits, and the evidence is otherwise… In Ellis's instance the of witnessing his mother urinate was converted into the hostile pleasure of humiliating other women, women in no way connected with his mother, by persuading them to do something for reasons mainly unintelligible to them. When he had the gratification of inducing Franroise [his partner] to urinate in crowded Oxford Circus, she may not have felt especially humiliated. With such an initiate his satisfaction was mainly symbolic…The perversion was enough on his mind for him to write it into his seventh volume of Studies in the Psychology of . There he dignifies the pathological sounding "urolagnia" with the new and enticing term "undinism". Grosskurth thinks that this volume came into existence principally to defend the perversion which is not discussed elsewhere” (Andrew Brink’s book review of Phyllis Grosskurth’s biography of Havelock Ellis, 1980).

In the latest American Association’s ' ' (DSM-5), urophilia is listed in the 'Other Specified Paraphilia Disorder' section . As with all in this category, diagnosis is only made "if the behavior, sexual urges, or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Fantasies, behaviors, or objects are paraphilic only when they lead to clinically significant distress or impairment (e. ., are obligatory, result in sexual dysfunction, require participation of non-consenting individuals, lead to legal complications, interfere with social relationships)”.

Urophiliacs typically derive sexual pleasure from urinating on (and/or being urinated upon by) another person. Some urophiliacs may also bathe in urine, enjoy smelling people in urine-soaked clothes, and/or engage in urophagia (i.e., drinking the urine). For urophiliacs, the drinking of the urine typically takes place while someone else urinates directly into their mouth. Urophagia (in and of itself) is not necessarily a sexually arousing activity as there are many urine drinkers who don’t do it for sexual pleasure but for other reasons (e.g., ritualistic and ceremonial purposes or they think there are health or cosmetic benefits as witnessed by those who engage in ‘urine ’).

However, for urophiliacs, the act of urophagia may be sexually stimulating for them. They may also engage in the activity as part of other paraphilic activity such as sadism, masochism, , and infantalism (i.e., being sexually excited from dressing as an adult baby). Some urophiliacs may also experience sexual arousal from having a full bladder and/or feel sexually attracted to someone else who has a full bladder (‘bladder desperation’) or wets themselves (i.e. ‘panty wetting’ or wetting the bed). In Japan, this latter parahilic behaviour occurs as part of a fetish subculture known as ‘omorashi’ and is seen as different from urophilia.

In 2009, Dr Garth Mundiger-Klow published a whole book comprising 15 urophiliac case studies ('The Golden Fetish') but despite the academic credentials of the author, and the lengthy accounts, the book was little more than a collection of erotic stories based around urophiliacs with little analysis provided by the author.

To date, there has been very little scientific research and almost all of what is known is based on either case studies or as a co-occurring behaviour with other paraphilias. For instance, in a survey of 561 non-incarcerated individuals seeking treatment for paraphilias, Dr Abel and colleagues (in the 'Bulletin of the American Academy for Psychiatry and the Law') found that many paraphiliacs engaged in more than one paraphilic behaviour. For instance, all the zoophiles in the sample reported more than one paraphilia and for a small number this included urophilia. However, it appears that urophilia is mostly likely associated with sadomasocism. For instance, in a study of 245 male sadomasochists in the 'Archives of Sexual Behavior', Dr Andreas Spengler reported that 10% of those surveyed had an interest in urophilia. This finding is similar to that of Dr Neil Buhrich (also published in the 'Archives of Sexual Behavior') who found that 8% of his sample of sadomasichists reported an interest in urophilia.

A paper in a 1982 edition of the 'Canadian Journal of Psychiatry' by Dr R. Denson found that the urine fulfilled many different functions for urophiles. The functions of urine included it (i) serving as a fetishistic object, (ii) being used to humiliate or be humiliated (i.e., through urinating on another person or being urinated upon), and/or (iii) capturing the spirit of a sexual partner. Based on the case studies examined, Dr Denson also argued that urination may serve masochistic and/or sadistic purposes and that therefore it should be labeled ‘uromasochism’ or ‘urosadism’.

While most explanations for paraphilic urophilia focus on early behavioural conditioning in childhood and , I also came across an interesting snippet in Professor John Money’s 1980 book 'Love and Love Sickness: The Science of Sex, Difference and ':

“Some years ago, when I visited the Yerkes primate laboratory in Atlanta…How, I asked, did a wild chimpanzee mother keep its baby clean from soiling? The answer was that, as in many other species, she licks it clean…Among the people of Bali, in Indonesia, small dogs lick the babies clean…The dog's assigned duty is to provide diaper service by licking clean the baby, and the mother, whenever the baby soils. Subsequently I have learned that Eskimo mothers once had a custom of licking their babies clean. Even though human primates have graduated from using the mother's snout end to keep the baby's tail end clean, it is safe to assume that, as a species, we still possess in the brain the same phyletic circuitry for infant hygiene as do the subhuman primates. Just as males and females have nipples, so also do both sexes have these brain pathways that relate to drinking urine and eating feces. These are the pathways that, when they become associated with neighboring erotic/sexual pathways, produce urophilia and coprophilia as paraphilias”.

Additionally, an internet essay examining ‘forced retention of bodily waste’ among children, Laurie Couture makes the following observations in relation to the origin of urine-related paraphilias:

“Some sufferers of forced waste retention develop sexual fetishes involving waste and waste retention…adult respondents reported using as a way to dissociate from the pain of a full bladder. Websites that cater to the sadomasochistic desires of urolagnia ('water sports') enthusiasts are prevalent on the Internet…Adults who engage in urolagnia are often reenacting scenes from childhood, some of which involved denial of toilet use by school teachers or caretakers for purposes of or containment…Due to the close proximity of the urethra and bladder to the sex organs, some adults who chronically suffered this form of bodily control as children developed a conditioned response in which wetting themselves or bladder tension was association with sexual arousal”

References and further reading

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Buhrich, N. (1983). The association of erotic piercing with , , bondage, , and tattoos. Archives of Sexual Behavior, 12, 167-171.

Collacott, R.A. & Cooper, S.A. (1995). Urine fetish in a man with . Journal of Research, 39, 145-147.

Couture, L.A. (2000). Forced retention of bodily waste: The most overlooked form of child maltreatment. Located at: http://www.nospank.net/couture2.htm

Denson, R. (1982). Undinism: The fetishizaton of urine. Canadian Journal of Psychiatry, 27, 336–338.

Grosskurth, P. (1980). Havelock Ellis: A Biography. Toronto: McClelland and Stewart.

Massion-verniory, L. & Dumont, E. (1958). Four cases of undinism. Acta Neurol Psychiatr Belg. 58, 446-59.

Money, J. (1980). Love and Love Sickness: The Science of Sex, Gender Difference and Pair- , John Hopkins University Press.

Mundinger-Klow, G. (2009). The Golden Fetish: Case Histories in the Wild World of Watersports. Paris: Olympia Press.

Skinner, L. J., & Becker, J. V. (1985). Sexual dysfunctions and deviations. In M. Hersen & S. M. Turner (Eds.), Diagnostic interviewing (pp. 211–239). New York: Plenum Press.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.