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What are paraphilias?

Paraphilias are sometimes referred to as sexual deviations or perversions. Paraphilias include fantasies, behaviors, or sexual urges focusing on unusual objects, activities, or situations. Paraphilias include:

  • Sexual urges or sexual fantasies with non-human objects
  • Sexual behaviors with non-human objects
  • Sexual behaviors involving humiliation or suffering of oneself or another person
  • Adult sexual behavior that involves children or nonconsenting adults

Some of the common paraphilias include:

  • Exhibitionism
  • Fetishism
  • Frotteurism
  • Pedophilia
  • Masochism
  • Sadism
  • Transvestitism
  • Voyeurism
  • Exhibitionism: Exhibitionism is a tendency to sexually expose oneself to others. For example, a man's behavior is exhibitionistic when he exposes part his naked body, usually his genitals, to a total stranger. The sexual behavior is almost always limited to the genital exposure, and the person may make no further harmful advances toward the stranger. Most often exhibitionism begins during adolescence and continues into adulthood.
  • Fetishism: People with a fetish experience sexual urges and behavior which are associated with non-living objects. For example, the object of the fetish could be an article of female clothing, like female underwear. Usually the fetish begins in adolescence and tends to be quite chronic into adult life.
  • Frotteurism: Men have a paraphilia called Frotteurism when the focus of their sexual urges are related to the touching or rubbing of their body against a non-consenting, unfamiliar woman. Usually the male rubs his genital area against the female. Most commonly, the man chooses to attack in a crowded public location and then he disappears into the throng of people. Frotteurism usually begins in adolescence and the abnormal behavior tends to decrease when the man reaches his late twenties.
  • Pedophilia: A pedophile is a person, most frequently a man, who focuses his sexual fantasies and behavior toward children. People who enjoy child pornography or "kiddie porn" are pedophiles. Some pedophiles are sexually attracted only toward children and are not at all attracted toward adults. Pedophilia is usually a chronic condition.When a pedophile becomes sexually active with a child he/she may:
    • Undress the child
    • Encourage the child to watch them masturbate
    • Touch or fondle the child's genitals
    • Forcefully perform sexual acts on the child
  • Masochism: Masochism is the getting of pleasure, often sexual, from being hurt or humiliated. Sometimes the masochistic acts are limited to verbal humiliation or blindfolding. However, masochistic behavior might include being bound or beaten. Masochism may become even more harmful, however, when a person permits another to use arm or leg restraints accompanied by acts of beating, whipping, or cutting.
  • Sadism: Sadism is deriving pleasure, often sexual, from mistreating others. Like other paraphilias, some people have fantasies which are sadistic, but they never act upon them. Also, some people have sexual urges of a sadistic nature, and they find a willing partner who agrees to participate in the sadistic activity. There are people, however, who have sadistic sexual urges who find others whom they victimize with their behavior. Some of the severe activities involved in sexual sadism include burning, beating, stabbing, raping, and killing. Usually the thoughts and/or behaviors of sexual sadism begin in adolescence or early adulthood. The behaviors are not only chronic, but they usually increase in severity with time.
  • Transvestitism: Cross-dressing by heterosexual males is called transvestic fetishism or transvestitism. The male with this fetish usually has a variety of female clothes that he uses to cross-dress. While some males will wear only one special piece of female apparel, others fully dress as a female and use full facial make-up to achieve a total female appearance. Often this disorder begins in childhood. It tends to be chronic in nature.
  • Voyeurism: Voyeurism is seeking sexual pleasure by secretly observing another. Another name for the behavior is "peeping" or "peeping Tom". The activity brings on sexual excitement and may conclude with masturbation by the voyeur. Voyeurism usually starts in adolescence and tends to persist into adulthood.

Do paraphilias affect males, females, or both?

Paraphilias are primarily male disorders.

At what age do paraphilias appear?

Most paraphilic fantasies begin in late childhood or adolescence and continue throughout adult life. Intensity and occurrence of the fantasies are variable, and they usually decrease as people get older.

How are paraphilias treated?

Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilias. Some prescription medicines have been used to help decrease the compulsive thinking associated with the paraphilias. Hormones are prescribed occasionally for individuals who experience intrusive sexual thoughts, urges, or abnormally frequent sexual behaviors. Almost always the treatment must be long-term if it is to be effective.

What happens to someone with paraphilias?

The course of paraphilias is usually chronic in nature. The prognosis for complete recovery is generally considered to be guarded.

What can people do if they need help?

If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.

Reviewed by athealth on February 6, 2014.