Paraphilias

Exhibitionism is characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving exposing one’s genitals to a stranger. Exhibitionism may include masturbation and/or intent to surprise or shock the observer. In some cases, the individual exposing himself/herself hopes the observer will become sexually aroused. While in other cases, the individual will discontinue the behavior if the observer does become sexually aroused. Age of onset usually begins before age 18 years, although the behavior can begin later in life.

Fetishism is characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects. Individuals prefer or require the object to be present for sexual excitement. Many times the individual with the fetish will masturbate while holding, rubbing, or smelling the object. Several common fetish items include: women’s underpants, bras, stockings, shoes, or boots. This behavior usually begins during the adolescent years.

Pedophilia is characterized by sexual fantasies and sexual contact with a prepubescent child, generally age 13 years or younger. The individual with pedophilia must be at least age 16 years and at least 5 years older than the child. Some individuals prefer males, some prefer females, and some do not have a preference. Individuals with pedophilia who act on their sexual urges may limit their contact to undressing or touching, while others engage in using foreign objects, oral sex, or sexual intercourse. Many individuals with pedophilic fantasies do not experience significant distress. Pedophilia generally begins in adolescence.

Sexual masochism is characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving the act of being humiliated, beaten, bound, or made to suffer. Some individuals carry out their masochistic fantasies during masturbation or sexual intercourse, while others engage in sexual masochistic behavior alone (bind themselves, stick themselves with needles, or shock themselves). Masochistic fantasies are likely to begin in childhood and masochistic behavior appears to begin in early adulthood. Masochistic behavior can be dangerous, resulting in injury or death.

Sexual sadism is characterized by intense sexually arousing fantasies, sexual urges, or behaviors involving acts which involve the psychological or physical suffering of another person. Some individuals with sexual sadism gain pleasure from having complete control over another person who is terrified by anticipation about what is going to happen. Others engage in sexual acts with a consenting partner who willfully suffers pain or humiliation. In all cases, the suffering of an individual is sexually arousing for the sexual sadist.   Sadistic fantasies are likely to be present in childhood and sexual sadistic behaviors are likely to begin in early adulthood.