The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) describes a Paraphilia as recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving 1) nonhuman objects, 2) the suffering or humiliation of oneself or one’s partner, or 3) children or other non-consenting persons that occur over a period of time.

Individual paraphilias can further be distinguished based upon differences in the focus of the paraphilia. Paraphilias have been classified into eight (8) different types by the DSM-IV-TR. The following paragraphs will attempt to briefly describe each of these paraphilias. 


The paraphilic focus of Exhibitionism is the exposure of one’s genitalia to strangers. Sometimes the individual masturbates during the exposure, or even while fantasizing about exposing himself. Generally speaking, there is no attempt at further sexual activity with the observer. In many cases, the individual is aware of a desire for the shock of the observer and sometimes the individual fantasizes that the observer will become sexually aroused. 


The paraphilic focus in Fetishism is the use of nonliving objects, the ‘fetish’. The most common examples of fetish objects are women’s underpants, bras, stockings, shoe, boots or other wearing apparel. The individual with Fetishism may frequently masturbate with the object or may even ask the sexual partner to wear the object during sexual encounters. Once established, Fetishism tends to be chronic. 


Frotteurism involved touching and rubbing against an unconsenting person. Usually, this behavior occurs in crowed places where escape, if necessary, is easy. Generally, the individual, usually a male, will rub his genitals against the victim’s thighs and buttocks or fondle her genitalia or breasts with his hand. It is interesting to note that the perpetrator recognizes that in order to avoid possible prosecution, he must escape quickly after touching his victim. Most acts of frottage occur when the individual is between 15-25 years old, after which there is a gradual decline in frequency. 


Pedophilia involves sexual activity with a prepubescent child. The perpetrator must be at least 16 years old and at least 5 years older than the victim. Generally speaking, individuals with Pedophilia report an attraction to children of a particular age range. Some prefer males, some prefer females, and some do not have a gender preference. Pedophilia involving female victims is reported more frequently than Pedophilia involving male victims.

Pedophilic acts may be limited to undressing the child, exposing him/herself to the child, masturbating in the presence of the child, or gentle touching and fondling of the child. However, other acts include intercourse or other sexual activity. 

Sexual Masochism

Sexual Masochism involves the act of being humiliated, beaten, bound or otherwise made to suffer. Some people are bothered by their masochistic fantasies, which may be invoked during sexual intercourse or masturbation but not otherwise acted on. Some masochists act upon their sexual urges by themselves (for example, binding or self-mutilation) or with a partner. Acts sought with a partner include physical bondage, blindfolding, spanking, whipping, electrical shocks, cutting, and various forms of humiliation. One particularly dangerous form of Sexual Masochism is called ‘hypoxyphilia’, sexual arousal obtained from oxygen deprivation. 

Sexual Sadism

Sexual Sadism is the act in which an individual derives sexual excitement from the psychological or physical suffering of the victim. As with Sexual Masochism, some individuals are bothered by their sadistic fantasies of complete control over the terrified victim. However, there are others who act upon their sadistic urges with a consenting partner (who may have Sexual Masochism) who suffers the pain and humiliation willingly. Sometimes, individuals with Sexual Sadism act upon their urges with non-consenting victims. Sadistic acts include dominance over the victim, restraint, blindfolding, paddling, spanking, whipping, pinching, beating, burning, electrical shocks, rape, cutting, stabbing, strangulations, torture, mutilation, or killing.

 Transvestic Fetishism

The focus of Transvestic Fetishism involves cross-dressing by a male in women’s attire. The garments used by the individual are arousing primarily as symbols of his femininity, not as fetishes with specific objective properties. Sometimes, the male may keep a collection of female attire that he intermittently uses. Transvestic phenomena ranges from occasional solitary wearing of female clothes to extensive involvement in a transvestic subculture. Some men wear a singe item of female clothing, such as underwear or hosiery, under their masculine attire. Other males dress entirely as females and wear makeup. Transvestic Fetishism is described only in heterosexual males. 


Voyeurism involves the act of observing unsuspecting individuals, usually strangers, who are naked, in the process of disrobing, or engaging, in sexual activity. The act of looking, peeping, is for the purpose of achieving sexual excitement, and generally no sexual activity with the observed person is sought. However, the individual may have the fantasy of having a sexual experience with the observed person.

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