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In psychology and [[sexology]], '''paraphilia''' (in [[Greek language|Greek]] ''para'' παρά = besides and '[[-philia]]' φιλία = love) is a term that describes [[sexual arousal]] in response to sexual objects or situations which may interfere with the capacity for reciprocal affectionate sexual activity. ''Paraphilia'' may also be used to imply non-mainstream sexual practices without necessarily implying any dysfunction or moral deviance.
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'''Paraphilia''' (in Greek ''para'' παρά = besides and ''[[-philia]]'' φιλία = love)&mdash;in [[psychology]] and [[sexology]], is a term that describes a family of persistent, intense fantasies, aberrant urges, or behaviors involving [[sexual arousal]] to nonhuman objects, pain or humiliation experienced by oneself or one's partner, children or other nonconsenting individuals or unsuitable partners. ''Paraphilias'' may interfere with the capacity for reciprocal affectionate sexual activity. <ref>American Psychiatric Association (2000). ''Diagnostic and statistical manual of mental disorders: DSM-IV (4<sup>th</sup> ed., text revision). Pp. 566-567. ''</ref> ''Paraphilia'' is also used to imply non-mainstream sexual practices without necessarily implying dysfunction or deviance (see [[Paraphilia#Clinical views of paraphilias|Clinical warnings]] section). Also, it may describe sexual feelings toward otherwise non-sexual objects.
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{{Sexual orientation}}
  
   
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==Definition==
  
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The word is used differently by different groups. As used in [[psychology]] or [[sexology]], it is simply a neutral [[umbrella term]] used to cover a wide variety of atypical sexual interests.
 
   
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==Clinical context==
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;Clinical definition: A paraphilic interest is not normally considered clinically important by clinicians unless it is ''also'' causing suffering of some kind, or strongly inhibiting a "normal" sex life (according to the subjective standards of the culture and times).
  
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Clinical literature discusses eight major paraphilias individually.<ref>[http://psyweb.com/Mdisord/DSM_IV/jsp/Axis_I.jsp psyweb.com "Axis I. Clinical Disorders, most V-Codes and conditions that need Clinical attention". Retrieved: 23 November, 2007.]</ref><ref>World Health Organization, International Statistical Classification of Diseases and Related Health Problems, (2007), [http://www.who.int/classifications/apps/icd/icd10online/ Chapter V, Block F65; Disorders of sexual preference.] Retrieved 2007-11-29.</ref> According to the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'', the activity must be the sole means of sexual gratification for a period of six (6) months, and either cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning" or involve a violation of [[Consent (criminal)|consent]] to be diagnosed as a paraphilia.<ref>[http://ajp.psychiatryonline.org/cgi/content/full/159/7/1249 Letter to the Editor of The American Journal of Psychiatry: Change in Criterion for Paraphilias in DSM-IV-TR.] Russell B. Hilliard, Robert L. Spitzer. 2002. Retrieved: 23 November, 2007.</ref>
   
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*[[Exhibitionism]]: the recurrent urge or behavior to expose one's genitals to an unsuspecting person.
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;Lay-public view: Paraphilia is sometimes used by laypeople in a more judgmental or prejudicial sense, to categorize [[sexual desire]]s or [[sexual activities|activities]] lying well outside the societal [[norm]]. Many sexual activities now considered harmless or even beneficial by many (such as [[masturbation]]) have often been considered [[perversion]]s or [[psychosexual disorder]]s in various societies, and how to regard these behaviors has been, and continues at times to be, a [[controversial]] matter. ''(For a contrasting view see: [[Wisdom of repugnance]])''
  
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*[[Sexual fetish|Fetishism]]: the use of inanimate objects to gain sexual excitement. ''[[Partialism]]'' refers to fetishes specifically involving nonsexual parts of the body.
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*[[Frotteurism]]: the recurrent urges to slap yourself or behavior of touching or rubbing against a nonconsenting person.
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*[[Incest]]: Sexual relations withi members of ones own family
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*[[Pedophilia]]: the sexual attraction to [[puberty|prepubescent or peripubescent]] children. (See also: [[Chronophilia]] [[Ephebophilia]], [[Hebephilia]])
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*[[Sadism and masochism as medical terms|Sexual Masochism]]: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer for sexual pleasure.
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*[[Sadism and masochism as medical terms|Sexual Sadism]]: the recurrent urge or behavior involving acts in which the pain or humiliation of a person is sexually exciting.
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*[[Transvestitism]]
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*[[Transvestic fetishism]]: a sexual attraction towards the clothing of the opposite gender. (Compare to [[autogynephilia]].)
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*[[Voyeurism]]: the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all.
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*Other rarer paraphilias are grouped together under ''Other paraphilias not otherwise specified'' (ICD-9-CM equivalent of "Sexual Disorder NOS") and include [[telephone scatalogia]] (obscene phone calls), [[necrophilia]] (corpses), [[partialism]] (exclusive focus on one part of the body), [[zoophilia]] (animals), [[coprophilia]] (feces), [[klismaphilia]] (enemas), [[urophilia]] (urine), [[emetophilia]] (vomit).
   
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;Usage of the term in English: The term "paraphilia" is rarely used in general English, with references to the actual interest concretely being more common. Some see the term as ''helping to aid objectivity'' when discussing [[taboo]] behaviors or those meeting public disapproval, but which may not in fact be a problem. Some have even interpreted the term pejoratively, seeing paraphilias as "rare conditions or serious disorders" that should either be criminalized or require serious treatment.
  
   
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===Clinical procedures===
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;Clinical warnings: It is worth noting typical clinical warnings given against improper assumptions about paraphilias:
  
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{{wikinews|Dr. Joseph Merlino on sexuality, insanity, Freud, fetishes and apathy}}
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:* ''"Paraphilias are ... sexual fantasies urges and behaviors that are considered deviant with respect to cultural norms..."''
  
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Observation of paraphiliac behavior has provided valuable scientific information on the mechanisms of [[sexual attraction]] and [[sexual desire|desire]], such as [[behavioral imprinting]]. Investigation has also led to the tentative conclusions that biological processes may sometimes be manifested in idiosyncratic ways in at least some of the paraphilias, and that these manifestations are frequently associated with (and especially traumatic) events associated with early sexual experience. They tend to be caused by [[classical conditioning]] in that a sexual stimulus has been paired with stimuli and situations that do not typically result in sexual response and has then been perpetuated through [[operant conditioning]] because the sexual response is its own reward or [[positive reinforcement]].{{Fact|date=November 2007}}
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:* ''"Although several of these disorders can be associated with aggression or harm, others are neither inherently violent nor aggressive"''
  
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:* ''"The boundary for social as well as sexual deviance is largely determined by cultural and historical context. As such, sexual orientations once considered paraphilias (e.g., homosexuality) are now regarded as variants of normal sexuality; so too, sexual behaviors currently considered normal (e.g., masturbation) were once culturally proscribed"''
  
   
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According to Dr. [[Joseph Merlino (doctor)|Joseph Merlino]], Senior Editor of the book ''Freud at 150: 21st Century Essays on a Man of Genius'' and psychiatry adviser to the ''New York Daily News'', a paraphilia is by definition a disorder. "It's the blurring of what I might do that is a turn-on for me, and what might get me into problems with others," said Merlino in an interview. "Once you cross that line, it exists as a problem....the term itself is a diagnosis and if you look at the current listing of diagnoses, the one thing you will find as a qualifier on every one of them for it to be considered a disorder is that it must interfere with functioning, personal interrelationships, career, etc. Absent that, we can't give it a diagnosis."<ref>[http://en.wikinews.org/wiki/Dr._Joseph_Merlino_on_sexuality%2C_insanity%2C_Freud%2C_fetishes_and_apathy#Gender_identity_and_Heteronormativity Interview with Dr. Joseph Merlino], David Shankbone, ''Wikinews'', October 5, 2007.</ref>
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:(Source: [http://www.psychiatrictimes.com/p960627.html Psychiatric Times])
  
   
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====Intensity and specificity====
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;Social norms: What is considered to be "[[perversion]]" or "deviation" varies from society to society. Some paraphilias fall into the kinds of activities often called 'sexual perversions' or 'sexual deviancy' with negative connotations or '[[Kink (sexual)|kinky]] sex' with more positive connotations. Some specific paraphilias have been or are currently [[crime]]s in some jurisdictions. In some religions certain sexual interests are forbidden, and this has led to some people believing that all paraphilias must be [[sin]]s. Since the development of [[psychology]] attempts have been made to characterize them in terms of their [[etiology]] and in terms of the ways they change the functioning of individuals in [[sociology|social]] situations. Some of these psycho-medical [[etiology|etiologies]] and descriptions have allowed many societies and religious/ethical traditions to view some of the paraphilias in a less negative light, at least in some circumstances. Some behaviors that might be classified as paraphilias by some subsets of society may be viewed as harmless [[eccentricity (behaviour)|eccentricities]] by other [[subculture|subsets of society]], or entirely normal behavior within other societies.
  
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Clinicians distinguish between optional, preferred and exclusive paraphilias, though the terminology is not completely standardized. An "optional" paraphilia is an alternative route to sexual arousal. For example, a man with otherwise unremarkable sexual interests might sometimes seek or enhance sexual arousal by wearing women's underwear. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but also engages in conventional sexual activities. For example, a man might prefer to wear women's underwear during sexual activity, whenever possible. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia.
   
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Optional paraphilias are far more common than preferred paraphilias, which are, in turn, far more common than exclusive paraphilias.{{Fact|date=November 2007}}
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Due to the somewhat subjective nature of their definition, the specific acts included under the umbrella of ''paraphilia'' vary from time to time and from place to place, and indeed from edition to edition of such works as the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' (DSM).
  
   
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Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. Preferred paraphilias often disrupt otherwise stable relationships. Open communication and mutual support can minimize or prevent such disruption in both of these cases. Exclusive paraphilias often preclude normal courtship and committed romantic relationships, even when the person in question desires such a relationship. Loneliness or social isolation are common consequences. In extreme cases, preoccupation with a preferred or exclusive paraphilia completely displaces the more typical desire for loving human relationships.
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==History of the term==
  
   
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===Drug treatments===
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Although its coinage is often attributed to [[sexologist]] [[John Money]], the term was coined by Croatian Jewish sexologist [[Friedrich Salomon Krauss]] during the 19th century, first popularized by Viennese psychotherapist [[Wilhelm Stekel]] (in his book ''Sexual Aberrations'') in 1925, from the Greek ''para-'' (beside) + ''philos'' (loving), and first used in English in Stekel's translated works. It was not in widespread use until the 1950s, and was first used in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) in 1980. It was used by [[Sigmund Freud]] as well.
  
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The treatment of men with paraphilias and related disorders has been challenging for patients and clinicians. In the past, surgical [[castration]] was advocated as a therapy for men with paraphilias, but it was abandoned because it is considered a cruel punishment and is now illegal in most countries. Psychotherapy, self-help groups, and pharmacotherapy (including the controversial hormone therapy sometimes referred to as "chemical castration") have all been used but are often unsuccessful. Here are some current drug treatments for these disorders.<ref>M. Williams. [http://www.brainphysics.com/paraphilias.php Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments"]. Retrieved 23 November, 2007</ref>
   
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====Hormone drug treatments====
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== Categorization of paraphilias ==
  
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In humans, [[testosterone]] has a crucial role not only in the development and maintenance of male sexual characteristics but also in the control of sexuality, aggression, cognition, emotion, and personality. Testosterone is a major determinant of sexual desire, fantasies, and behavior, and it increases the frequency, duration, and magnitude of spontaneous and nocturnal erections. The deviant sexual fantasies, urges, and behavior of men with paraphilias also appear to be triggered by testosterone. Therefore, reducing testosterone secretion or inhibiting its action is believed to control these symptoms.
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There is much debate about what (if anything) should constitute a paraphilia, and how these should be clinically classified ''(see [[#Controversy over the term|Controversy]], below)''.
  
   
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Antiandrogenic drugs such as medroxyprogesterone (also known as the long-acting contraceptive [[Depo Provera]]) have been widely used as therapy in these men to reduce sex drive. However, their efficacy is limited and they have many unpleasant side effects, including breast growth, headaches, weight gain, and reduction in bone density. Even if compliance is good, only 60 to 80 percent of men benefit from this type of drug. Long-acting gonadotropin-releasing hormones, such as Triptorelin (Trelstar) which reduces the release of gonadotropin hormones, are also used. This drug is a synthetic hormone which may also lead to reduced sex drive.<ref>M. Williams. [http://www.brainphysics.com/paraphilias.php Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments"]. Retrieved 23 November, 2007</ref>
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=== Clinically recognized paraphilias===
  
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Clinical literature discusses eight major paraphilias individually, and according to the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'', the activity must be the sole means of sexual gratification for a period of six (6) months, and cause "marked distress or interpersonal difficulty" to be considered such. In the clinical sense, many professionals and lay people prefer the term "disorders of sexual preference".
  
   
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====Psychoactive drug treatments====
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Note that their listing in DSM is mostly because, either due to widespread commonality or the nature of any psychological distress, standardized clinical assessment methods (as opposed to general guidance) is considered valuable for these.
 
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[[Selective serotonin reuptake inhibitor]] (SSRI) class of antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxitine (Paxil), have all been used to treat paraphilias and related disorders by reducing impulse control problems and/or [[sexual obsessions]] with some success.
   
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Tricyclic antidepressants (TCA), such as imipramine (Tofranil) and desipramine (Norpramin), are also used.
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They are:
  
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* [[Exhibitionism]]: the recurrent urge or behavior to expose one's genitals to an unsuspecting person.
  
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* [[Sexual fetish|Fetishism]]: the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. ''Partialism'' refers to fetishes specifically involving nonsexual parts of the body.
  
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* [[Frotteurism]]: the recurrent urges or behavior of touching or rubbing against a nonconsenting person.
  
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* [[Sadism and Masochism|Masochism]]: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer.
  
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* [[Pedophilia]]: the sexual attraction to prepubescent children.
  
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* [[Sadism and masochism as medical terms|Sadism]]: the recurrent urge or behavior involving acts in which the pain or humiliation of the victim is sexually exciting.
 
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* [[Transvestic fetishism]]: a sexual attraction towards the clothing of the opposite gender.
  
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* [[Voyeurism]]: the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities.
  
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Other paraphilias are grouped together under "Other paraphilias not otherwise specified."
  
   
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Lithium, the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients, which they attribute to the drug's enhancement of serotonergic functioning.
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[[Homosexuality]] was previously listed as a paraphilia in the [[DSM-I]] and [[DSM-II]], but this was declassified from both [[DSM-III]] and [[DSM-IV]], consistent with the change of attitude among psychiatrists. There is still a disorder of homosexuality, but this refers to clinical distress caused by the ''repression'' of homosexuality. Likewise, [[zoophilia]] was clinically re-evaluated between DSM-III and DSM-IV as a result of research, and is now not considered a clinical problem unless distress is caused. As of 2004, [[transvestic fetishism]] was still listed as a paraphilia in the [[DSM-IV-TR]]. There are also many other paraphilias, both common and rare.
 
   
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Anxiolytics are not considered a typical treatment for these type of disorders, however the efficacy of buspirone (BuSpar) has been clinically demonstrated.
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It seems that anything can (in theory) become sexualized, given the right circumstances, and that therefore paraphilias can (in theory) encompass almost any imaginable subject.
  
   
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Psychostimulants have been used recently to augment the effects of [[serotonergic]] drugs in paraphiliacs. In theory, the prescription of a psychostimulant without pretreatment with an SSRI might further disinhibit sexual behavior, but when taken together, the psychostimulant may actually reduce impulsive tendencies. Methylphenidate (Ritalin) is an amphetamine like stimulant used primarily to manage the symptoms of attention deficit hyperactivity disorder (ADHD). Recent studies imply that methylphenidate may also act on serotonergic systems; this may be important in explaining the paradoxical calming effect of stimulants on ADHD patients. Amphetamine is also used medically as an adjunct to antidepressants in refractory cases of depression.<ref>M. Williams. [http://www.brainphysics.com/paraphilias.php Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments"]. Retrieved 23 November, 2007</ref>
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=== Intensity and Specificity ===
  
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Clinicians often distinguish between optional, preferred and exclusive paraphilias, though the terminology is not completely standardized. An "optional" paraphilia is an alternate route to sexual arousal. For example, a man with otherwise unremarkable sexual interests might sometimes seek or enhance sexual arousal by wearing women's underwear. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but also engages in conventional sexual activities. For example, a man might prefer to wear women's underwear during sexual activity, whenever possible. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia.
  
   
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==Religion and morality==
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Optional paraphilias are far more common than preferred paraphilias, which are, in turn, far more common than exclusive paraphilias.
  
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{{main|Religion and sexuality}}
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Some religious adherents view various paraphilias as deviations from a divine plan for human sexuality, as understood through their religious tradition or laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual [[sin]], [[mental illness]], or simply harmless sexual variation. Another variable is whether it is the acting out, or (less commonly) just the desirous thought alone, which is critically viewed in such cases. In any event, several paraphilias, as with many other behavior patterns outside the mainstream, are viewed negatively by various religions.{{Nonspecific|date=November 2007}}
   
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Some religious traditions include forms of extreme [[asceticism]], such as [[flagellation|whipping]] , which, when practiced as sexual activities, would usually be considered masochism and popularly viewed as paraphilias. When practiced for non-sexual reasons, they are usually valued by the religious groups concerned as a part of their religious observance and submission to [[God]].
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Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. Preferred paraphilias often disrupt otherwise stable relationships. Open communication and mutual support can minimize or prevent such disruption in both of these cases. Exclusive paraphilias often preclude normal courtship and committed romantic relationships, even when the person in question desires such a relationship. Loneliness or social isolation are common consequences. In extreme cases, preoccupation with a preferred or exclusive paraphilia completely displaces the more typical desire for loving human relationships.
  
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==Psychology of paraphilias==
  
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===Behavioral imprinting===
  
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Observation of paraphiliac behavior has provided valuable scientific information on the mechanisms of [[sexual attraction]] and [[sexual desire|desire]], such as [[behavioral imprinting]]. Careful investigation has also led to the tentative conclusions that normal biological processes may sometimes be manifested in idiosyncratic ways in at least some of the paraphilias, and that these unusual manifestations are frequently associated with unusual (and especially traumatic) events associated with early sexual experience. They tend to be caused by [[classical conditioning]] in that a sexual stimulus has been paired with stimuli and situations that do not typically result in sexual response, then perpetuated through [[operant condition]] because the sexual response is its own reward or [[positive reinforcement]].
  
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==Views on paraphilias==
  
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===Religious views===
  
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{{main|Religion and sexuality}}
  
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Some religious adherents view various paraphilias as deviations from their conception of God's original plan for human sexuality, or from their religious laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual [[sin]], [[mental illness]], or simply harmless sexual variation. Another variable is whether it is the acting out, or (less commonly) just the desirous thought alone, which is critically viewed in such cases. In any event, several paraphilias, as with many "non-mainstream" behaviors, are viewed negatively (or with distaste) by various religions.
  
   
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===Controversy over the term===<!-- This section is linked from [[Perversion]] -->
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Some religious traditions include forms of extreme [[asceticism]] such as [[scourging]], when practiced as a sexual activity would usually be considered masochism and popularly viewed as paraphilias. When practiced for non-sexual reasons, they are usually valued by the religious groups concerned as a part of their religious observance and submission to [[God]].
  
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The definition of various sexual practices as paraphilias has been met with opposition. Advocates for changing these definitions stress that there is nothing inherently pathological about non-criminal paraphilic practices, and they are stigmatized by being lumped together with crimes. Those who profess such a view hope that, much as with the removal of [[homosexuality]] from the [[Diagnostic and Statistical Manual of Mental Disorders]] (''see'' [[homosexuality and psychology]]), future psychiatric definitions will not include most of these practices, or that consensual paraphilias will be clearly separated from nonconsensual paraphilias.
   
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===Legal views===
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==Legality==
 
{{main|Sex and the law}}
  
{{main|Sex and the law}}
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As a general rule, the law in many countries often intervenes in paraphilias involving young or adolescent children below the legal [[age of consent]], nonconsensual deliberate displays or illicit watching of sexual activity, harm to animals, acts involving [[death|dead people]], harassment, nuisance, fear, injury, or assault of a sexual nature. Separately, it also usually regulates or controls [[censorship]] of [[pornography|pornographic]] material.
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As a general rule, the law in many countries often intervenes in paraphilias involving young or adolescent children below the legal [[age of consent]], nonconsensual deliberate displays or illicit watching of sexual activity, consensual sex with animals, illegal manipulation of [[death|dead people]], harassment, nuisance, fear, injury, or assault of a sexual nature. Separately, it also usually regulates or controls [[censorship]] of [[pornography|pornographic]] material.
   
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''Non-consensual'' exhibitionism, where people who have not previously consented to watch are exposed to sexual display, is also an offense in most jurisdictions, as is non-consensual voyeurism. ''(See [[indecent exposure]] and [[peeping tom]])''
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''Exhibitionism'', in cases where people who have not previously agreed to watch are exposed to sexual display, is also an offense in most jurisdictions, as is [[voyeurism]] when unarranged ''(see [[indecent exposure]] and [[peeping tom]])''.
   
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''Non-consensual'' sadomasochistic acts may legally constitute assault, and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of [[consent (criminal)|legal consent]] and impose liability for any injuries caused and that, for these purposes, non-physical injuries are included in the definition of [[grievous bodily harm]] in [[English law]]. ''(See [[Consent (BDSM)]])''
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''Non-consensual'' sadomasochistic acts may legally constitute assault and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of [[consent (criminal)|legal consent]], and impose liability for any injuries caused. For these purposes, non-physical injuries are included in the definition of [[grievous bodily harm]] in [[English law]]. ''(See [[Consent (BDSM)]], [[Operation Spanner]]'')
   
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The paraphilias listed below may carry a condition of illegality in some areas if acted out (though they may usually be legally role-played between [[consensuality|consenting partners]]).
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The paraphilias listed below may carry a condition of illegality in some areas, even when they are performed between [[Consent|consensual]] partners.
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*[[Raptophilia]]: sexual pleasure from being raped (when agreed upon beforehand but acted out in public).
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*[[pedophilia]]: sexual attraction to prepubescent children
  
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*[[Exhibitionism]] and [[voyeurism]]: sexual pleasure by exposing oneself or by being peeped on
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*[[ephebophilia]]: sexual attraction to adolescents (ie, postpubescent youth, such as [[teenager]]s)
  
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*[[frottage (sexology)|frotteurism]]: sexual arousal through rubbing one's self against a non-consenting stranger in public
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*[[Frotteurism]]: sexual arousal through rubbing oneself against an unknowing stranger in public
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*[[Lust murder]]: sexual arousal from committing (or trying to commit) murder
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*[[exhibitionism]] and [[voyeurism]], if deliberate and non-consensual
  
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*[[Pedophilia]]: sexual attraction to [[puberty|peripubescent]] or pre-pubescent [[Minor (law)|minors]]
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*[[telephone scatologia]]: being sexually aroused by making obscene telephone calls
  
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*[[Telephonicophilia]]: being sexually aroused by making obscene telephone calls
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*[[zoophilia]]: emotional or sexual attraction to animals
  
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*[[biastophilia]]: sexual pleasure from committing [[rape]]
  
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*[[lust murder]]: sexual arousal through committing murder
  
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*[[necrophilia]]: sexual attraction to corpses
  
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*[[necrozoophilia]]: sexual attraction to the corpses or killings of animals (also known as necrobestiality)
  
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*[[zoosadism]]: the sexual enjoyment of causing pain and suffering to animals.
  
   
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The paraphilias listed below, that cannot involve consent since they involve non human animals or objects, may carry a condition of illegality in some areas:
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===Paraphilia in popular culture===
  
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*[[Necrophilia]]: sexual attraction to corpses
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<!-- Image with unknown copyright status removed: [[Image:Rampling-britney.jpg|frame|right|An outfit that was shocking in 1974 had become mainstream by 2003.]] -->In the late twentieth and early twenty-first century, previously censored or stigmatized images of many paraphilias became more prevalent in the popular culture of Western countries.
  
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*[[Zoosadism]]: sexual attraction to torturing or killing animals
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*[[Zoophilia]]: sexual attraction to animals
   
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==List of paraphilias==
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* Sadomasochism: In the independent 1974 Italian film ''[[The Night Porter]]'', [[Charlotte Rampling]] wore a hat from a Nazi uniform in a sadomasochistic sex scene. At the time, the image was startling and new, but over the following years the use of Nazi-tinged iconography in a sexual context became mainstream, appearing first in mass-marketed pornography like [[Playboy]] and [[Penthouse]], and finally becoming so tame that teen queen [[Britney Spears]] wore a similar outfit to a primetime awards show in 2003.
  
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Used in a sexual context, terms with the ''-philia'' suffix refer to conditions in which the person's primary sexual interest involves the stimulus or situation mentioned (the suffix is also used for non-sexual interest in or admiration of a subject). Terms with the ''-lagnia'' suffix refer to an action involving the stimulus or situation. For example, someone who is consistently sexually excited by feces would have coprophilia; any sexual act involving feces, even by someone for whom that is not a primary interest, would be coprolagnia.
   
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The following terms mostly represent combinations of Greek or Latin words or roots, but few qualify as clinical paraphilias. Some of the following sexual interests are fairly common, while others are very rare.
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* By 2006, sadomasochistic imagery had become mainstream enough for singer [[Justin Timberlake]] to have a hit song with the lyric "Just see these shackles baby, I'm your slave! / I'll let you whip me if I misbehave!"
  
   
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*[[Abasiophilia]]: love of (or sexual attraction to) people who are lame or crippled and/or who use [[leg brace]]s or other orthopaedic appliances
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* [[Pedophilia and child sexual abuse in films|Pedophilia]]: Pedophiliac imagery famously burst into popular culture at the beginning of the 1980s with the success of [[Brooke Shields]] in such movies as ''[[Pretty Baby]]'' and ''[[The Blue Lagoon]]''. Even at the time, however, the negative response to these movies was strong. Since then, popular culture has continued to simultaneously promote and censor pedophiliac imagery. In 1999 the fetishistic use of a school uniform helped make the video for "[[...Baby One More Time (song)|...Baby One More Time]]" (again by Britney Spears) a huge hit. But just two years earlier, the film ''[[Lolita (1997 film)| Lolita]]'' could not find a theatrical distributor despite the fame of its director and star, and was instead premiered on cable television.
  
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*[[Acousticophilia]]: sexual arousal from certain sounds
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*[[Algolagnia]]: sexual pleasure from [[Pain and nociception|pain]]
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*[[Amaurophilia]]: sexual arousal by a partner whom one is unable to see due to artificial means, such as being blindfolded or having sex in total darkness.
  +
*[[acrotomophilia|Acrotomophilia and apotemnophilia]]: sexual attraction to amputation or amputees.
  +
*[[Andromimetophilia]] (also ''gynemimetophilia''): sexual attraction towards women dressed as men or who have had a sex change operation
  +
*[[Aquaphilia Fetish|Aquaphilia]]: arousal from water and/or in watery environments, including bathtubs and swimming pools
  +
*[[Aretifism]]: sexual attraction to people who are without footwear, in contrast to [[retifism]]
  +
*[[Autogynephilia]]: love of oneself as a woman (see [[Blanchard, Bailey, and Lawrence theory]] for discussion on controversy)
  +
*[[Autoassassinophilia]]: sexual arousal from fantasizing about or staging one's own murder
  +
*[[Biastophilia]]: sexual arousal from assault and rape.
  +
*[[Chronophilia]]: sexual attraction to a partner of the same chronological age, but whose sexuoerotic age is discordant with that chronological age.
  +
*[[Coprophilia]]: sexual attraction to (or pleasure from) feces.
  +
*[[Covert incest]]iphilia: arousal from non-contact sexual behavior with a child.
  +
*[[Dacryphilia]]: sexual pleasure in eliciting tears from others or oneself.
  +
*[[Dendrophilia (paraphilia)|Dendrophilia]]: sexual attraction to trees and other large plants.
  +
*[[Emetophilia]] (also ''vomerophilia''): sexual attraction to vomiting.
  +
*[[Ephebophilia]] (also ''hebephilia''): sexual attraction towards adolescents.
  +
*[[Erotic asphyxia]]: sexual attraction from [[asphyxia]] (also called "breath control play" or "strangulation"), including autoerotic asphyxiation.
  +
*[[Erotic lactation]] (also ''galactophilia'' or ''lactophilia''): sexual attraction to human milk or lactating women
  +
*[[Exhibitionism]] (also ''autagonistophilia'' or ''peodeiktophilia''): sexual arousal by engaging in sexual behavior in view of third parties (also includes the recurrent urge or behavior to expose one's genitals to an unsuspecting person).
  +
*[[Fecophilia]]: sexual arousal from defacation or watching a partner defecate, particularly on oneself
   
  +
*Fetishes and partialisms
−
* Zoophilia: Sex with animals has been a theme in a number of popular comedies, including [[Bachelor Party (film)|Bachelor Party]], [[Clerks II]], and [[The 40-Year-Old Virgin]]. All these movies present the paraphilia as funny rather than erotic, as something ordinary young men are curious about but in the end find disgusting. In all three movies the animal involved is an equine.
  
  +
::[[Anesthesia fetishism]] - [[Blood fetish]](ism) (also ''haematophilia'') - [[Breast fetishism]] - [[Breast expansion fetish]] - [[Crush fetish]] – [[Diaper fetishism]] - [[Doll fetish]] - [[Fat fetishism]] (also ''lipophilia'') - [[Foot fetishism]] (podophilia) – [[Garment fetishism]] (Clothing, garments, materials and uniforms) - [[Hand fetishism]] – [[Hypnofetishism]] - [[Impregnation fetish]] - [[Medical fetishism]] - [[Navel fetishism]] - [[Nose fetishism]] (also ''nasophilia'') - [[Panty fetishism]] – [[Pregnancy fetishism]] - [[Robot fetishism]] – [[Shoe fetishism]] – [[Silk/Satin fetishism]] – [[Smoking fetishism]] (Capnolagnia) – [[Sneezing fetishism]] – [[Spandex fetishism]] – [[Tickling fetishism]] (also ''acarophilia'') - [[Total enclosure fetishism]] - [[Transformation fetish]] -
   
  +
*[[Food play]]: sexual arousal from food
−
* [[Yiff| Furries]] and [[webcomics]] both gained popularity on the Internet at roughly the same time, so it's natural that furries have been featured as characters or objects of satire in many webcomics, including [[Diesel Sweeties]][http://www.dieselsweeties.com/hstrips/0/1/0/1/01010.png], [[Overcompensating]] [http://wigu.com/overcompensating/pictures/cheetara.png], and [[Something Positive]] [http://somethingpositive.net/arch/sniggles.gif], among others.
  
  +
*[[Formicophilia]]: sexual attraction to smaller animals, insects, etc. crawling on parts of the body
  +
*[[Forniphilia]]: sexual objectification in which a person's body is incorporated into a piece of furniture
  +
*[[Frotteurism]]: sexual arousal from the recurrent urge or behavior of touching or rubbing against a non-consenting person
  +
*[[Gerontophilia]]: sexual attraction towards the elderly
  +
*[[Hebophilia]]: sexual attraction to adolescents (those who are no longer children, but have not completed puberty)
  +
*[[Homeovestism]] or [[Transvestic fetishism]]: sexual arousal by wearing the clothing of one's own gender
  +
*[[Human animal roleplay]]: sexual arousal by having oneself or a partner taking on the role of real or imaginary animal
  +
*[[Hybristophilia]]: sexual arousal to people who have committed crimes, in particular cruel or outrageous crimes
  +
*[[Incest]]ophilia: sexual attraction to a member of one's own family
   
  +
*Japanese terms
−
===Controversy over the term===
  
  +
**[[Nyotaimori]]: sexual arousal by eating sashimi or sushi from the body of a (usually naked) woman
−
The definition of various sexual practices as paraphilias has been met with opposition. Advocates for changing these definitions stress that, aside from "paraphilias" with a criminal element, there is nothing inherently pathological about these practices; they are undeserving of the stigmatism associated with being "singled out" as such. Those who profess such a view hope that, much as with the removal of [[homosexuality]] from the DSM (''see'' [[homosexuality and psychology]]), future psychiatric definitions will not include most of these practices.
  
  +
**[[Omorashi]]: sexual arousal to one's or a partner's feeling of having a full bladder
  +
**[[Tamakeri]]: sexual arousal from having a male kicked in the groin by a woman
  +
**[[Wakamezake]]: sexual arousal by drinking alcohol from a woman's body.
   
  +
*[[Katoptronophilia]]: sexual arousal from having sex in front of mirrors
−
== List of paraphilias ==
  
  +
*[[Kleptophilia]]: sexual arousal from stealing things
−
:''Also see article [[-philia]] for "-philias" in other fields''
  
  +
*[[Klismaphilia]]: sexual pleasure from enemas
−  
  +
*[[Lust murder]] (also ''homicidophilia'' or ''erotophonophilia''): sexual arousal from committing (or trying to commit) murder
−
''Note: This article needs some clean-up. Many terms have been represented incorrectly. Terms with the ''-philia'' suffix refer to conditions in which the person's primary sexual interest involves the stimulus or situation mentioned. Each term with the ''-lagnia'' suffix refers to any action involving the stimulus or situation. For example, someone who is consistently sexually excited by feces would have coprophilia; any sexual act involving feces, even by someone for whom that is not a primary interest, would be coprolagnia.''
  
  +
*[[Macrophilia]]: sexual attraction to giants or giant body parts (such as breasts and genitalia)—the opposite of microphilia
−  
  +
*[[Masochism]]: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer
−
''The following terms represent combinations of greek words, but do not necessarily represent reality. Some of the following sexual interests are fairly common. For instance, problems with sexual abuse of children, associated with pedophilia, are well-known, and at least a few bars or clubs dedicated to bondage and discipline (sadism and masochism) can be found in most large cities in the U.S. Others are vanishingly rare, if they exist at all and are not documented in any reliable source. Some items portray personal preferences that don't reasonably qualify as paraphilias. Finally, the following list might contain some dubious items.''
  
  +
*[[Microphilia]]: sexual attraction to miniature people or miniature body parts—the opposite of macrophilia
−  
−
* [[Abasiophilia]]: love of (or sexual attraction to) people who use [[leg brace]]s or other orthopaedic appliances
 +
*[[Mysophilia]]: sexual attraction to soiled, dirty, foul or decaying material
  +
*[[Narratophilia]]: sexual arousal in the use of dirty or obscene words to a partner
−
* [[Acrotomophilia]]: love of (or sexual attraction to) [[amputation|amputees]]
  
−
* [[Agalmatophilia]]: sexual attraction to [[statue]]s or [[mannequin]]s or immobility
 +
*[[Necrophilia]]: sexual attraction to corpses
  +
*[[Nepiophilia]] (also ''infantophilia''): sexual attraction to children three years old or younger
−
* [[Algolagnia]]: sexual pleasure from [[pain]]
  
  +
*[[Oenophilia]] Sexual arousal from wine
−
* [[Amaurophilia]]: sexual arousal by a partner whom one is unable to see due to artificial means, such as being blindfolded or having sex in total darkness. ''(See: [[sensory deprivation]])''
  
  +
*[[Olfactophilia]]: sexual stimulus with smells or odors. (see also [[Jock sniffing]]).
−
* [[Andromimetophilia]]: love of women dressed as men
  
  +
*[[Paraphilic infantilism]]: sexual pleasure from dressing, acting, or being treated as a baby.
−
* [[Apodysophilia]]: desire to undress, see also [[nudism]]
  
  +
*[[Parthenophilia]]: sexual attraction to [[Virginity|virgins]]
−
* [[Apotemnophilia]]: desire to have (or sexual arousal from having) a healthy appendage (limb, digit, or male genitals) amputated
  
  +
*[[Pedophilia]]: sexual attraction to prepubescent children (British spelling: ''paedophilia'')
−
* [[Aquaphilia]]: arousal from water and/or in watery environments, including [[swimming pool]]s
 
−
* [[Aretifism]]: sexual attraction to people who are without footwear, in contrast to [[retifism]]
 +
*[[Pictophilia]]: sexual attraction to pictorial pornography or erotic art
  +
*[[Plushophilia]]: sexual attraction to stuffed animals and/or people dressed in animal costumes
−
* [[Asphyxiophilia]]: sexual attraction to [[asphyxia]]; also called breath control play; including [[autoerotic asphyxiation]]; see [http://members.aol.com/oldrope/breath.htm medical warnings]
  
  +
*[[Pyrophilia]]: sexual arousal through watching, setting, hearing, talking or fantasizing about fire
−
* [[Autogynephilia]]: love of oneself as a woman (also see [[Blanchard, Bailey, and Lawrence theory]] for discussion on controversy)
  
−
* [[Biastophilia]]: sexual pleasure from committing [[rape]]
 +
*[[Sadism]]: deriving pleasure, or in some cases sexual arousal from giving pain
  +
*[[Salirophila]]: sexual arousal by soiling (only the appearance of) the object of one's desired partner
−
* [[Celebriphillia]]: pathological desire to have sex with a celebrity.
  
−
* [[Coprophilia]]: sexual attraction to (or pleasure from) [[feces]]
 +
*[[Sitophilia]]: sexual arousal by involving food in sex
−
* [[Crush fetish]]: sexual arousal from seeing small creatures being crushed by members of the opposite sex, or being crushed oneself
 +
*[[Somnophilia]]: sexual arousal from sleeping or unconscious people
−
* [[Dacryphilia]]: sexual pleasure in eliciting tears from others or oneself
 +
*[[Statuephilia]]: sexual attraction to statues or mannequins or immobility
−
* [[Diaper fetishism]]: sexual arousal from [[diaper]]s
 +
*[[Sthenolagnia]]: sexual arousal from the demonstration of strength or muscles
  +
*[[Technophilia]]: sexual arousal from techno or technology.
−
* [[Emetophilia]] (a.k.a. ''vomerophilia''): sexual attraction to [[vomit]]
  
  +
*[[Telephone scatologia]]: being sexually aroused by making [[obscene phone call]]s to strangers
−
* [[Ephebophilia]] (a.k.a. ''hebephilia''): sexual attraction towards adolescents
  
−
* [[Eproctophilia]]: sexual attraction to [[flatulence]]
 +
*[[Teratophilia]]: sexual attraction to deformed or monstrous people
  +
*[[Tightlacing#Tightlacing today|Tightlacing]]: sexual arousal by wearing or having a partner wear a tightly laced corset
−
* [[Exhibitionism]]: sexual arousal through sexual behavior in view of third parties (also includes the recurrent urge or behavior to expose one's genitals to an unsuspecting person, known as [[indecent exposure]])
  
−
* [[Faunoiphilia]]: sexual arousal from watching animals mate
 +
*[[Trichophilia]]: sexual arousal from hair
  +
*[[Troilism]]: sharing a sexual partner with another person while looking on
−
* [[Sexual fetishism|Fetishism]]: is the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. Examples include:
  
  +
*[[Urolagnia]]: sexual attraction to urine, including urinating in public, urinating on others, and being urinated on by others
−
:: [[Balloon fetishism]] -- [[breast fetishism]] -- [[foot fetishism]] (podophilia) -- [[fur fetishism]] -- [[leather fetishism]] -- [[lipstick fetishism]] -- [[medical fetishism]] -- [[panty fetishism]] -- [[robot fetishism]] -- [[rubber fetishism]] -- [[shoe fetishism]] -- [[smoking fetishism]] -- [[spandex fetishism]] -- [[transvestic fetishism]] (see below)
  
  +
*[[Urophagia]]: sexual attraction to drinking urine or watching others drink urine
−
* [[Frotteurism]]: sexual arousal from the recurrent urge or behavior of touching or rubbing against a nonconsenting person
  
  +
*[[Vorarephilia]] (also ''gynophagia''): sexual attraction at the thought of being eaten by or eating another person or creature. It includes ''endosomataphillia''—a sexual fetish of being within someone (a sub-genre is ''partial unbirthing''—a sexual attraction to inserting an adult head into a vagina).
−
* [[Galactophilia]]: sexual attraction to human milk or lactating women
  
  +
*[[Voyeurism]]: sexual arousal through secretly watching others having sex (also includes ''scoptophilia''—the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities (see [[Peeping Tom]])
−
* [[Gerontophilia]]: sexual attraction towards the elderly
  
  +
*[[Wet and messy fetishism]]: sexual arousal by having substances deliberately and generously applied to the naked skin, or to the clothes people are wearing
−
* [[Blood fetish|Haematophilia]]: sexual attraction involving [[blood]] (either on a sex partner/attractive person or the liquid itself; '''not to be confused with [[haemophilia]]''', a genetic disorder of the blood)
  
  +
*[[Xenophily]]: sexual attraction to foreigners (in science fiction, it can also mean sexual attraction to aliens)
−
* [[Harpaxophilia]]: sexual arousal from being the victim of a robbery or burglary
  
−
* [[Hematolagnia]]: sexual attraction to blood
 +
*[[Zelophilia]]: sexual arousal from jealousy
  +
*[[Zoophilia]]: sexual attraction to animals
−
* [[Hybristophilia]]: sexual arousal to people who have committed crimes, in particular cruel or outrageous crimes
  
  +
*[[Zoosadism]]: sexual gratification derived from causing pain and suffering to animals. ''Necrozoophilia'' (also ''necrobestiality'') strictly applies to killing animals.
−
* [[Infantilism]]: sexual pleasure from dressing, acting, or being treated as a [[baby]]
  
−
* [[Klismaphilia]]: sexual pleasure from [[enema]]s
  
−
* [[Lust murder]]: sexual arousal through committing murder
  
−
* [[Macrophilia]]: sexual attraction to larger people and large things (including larger body organs such as breasts and genitalia)
  
−
* [[Maiesiophilia]]: sexual attraction to [[childbirth]] or [[pregnant]] women
 
−
* Masochism: is the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer
  
−
* [[Microphilia]]: sexual attraction to smaller people and things of smaller size
  
−
* [[Mysophilia]]: sexual attraction to soiled, dirty, foul or decaying material
  
−
* [[Necrophilia]]: sexual attraction to corpses
  
−
* [[Necrozoophilia]]: sexual attraction to the corpses or killings of animals (also known as necrobestiality)
  
−
* [[Nepiophilia]]: the same as [[infantophilia]] sexual attraction to children between the age of 0 - 3 yrs.
  
−
* [[Pedophilia]]: sexual attraction to prepubescent children (also spelt paedophilia in some countries)
  
−
* [[Pictophilia]]: inability to become sexually aroused except through the use of pictorial pornography
  
−
* [[Plushophilia]]: sexual attraction to stuffed toys or people in animal costume, such as theme park characters
  
−
* [[Pyrophilia]]: sexual arousal through watching, setting, hearing/talking/fantasizing about fire
  
−
* [[Retifism]]: sexual arousal from shoes
  
−
* Sadism: sexual arousal from giving pain
  
−
* [[Sitophilia]]: sexual arousal from [[food]]
  
−
* [[Somnophilia]]: sexual arousal from sleeping or unconscious people
  
−
* [[Spectrophilia]]: sexual attraction to ghosts
  
−
* [[Telephone scatologia]]: being sexually aroused by making obscene telephone calls
  
−
* [[Teratophilia]]: sexual attraction to deformed or monstrous people
  
−
* [[Toonophilia]]: love (or sexual arousal) to cartoon characters/situations
  
−
* [[Transformation fetish]]: sexual arousal from depictions of transformations of people into objects or other beings
  
−
* [[Transvestic fetishism]]: is a sexual attraction towards the clothing of the opposite gender (also known as transvestitism)
  
−
* [[Trichophilia]]: love (or sexual arousal) from [[hair]]
  
−
* [[Urolagnia]]: sexual attraction to [[urine]]
  
−
* [[Vorarephilia]]: sexual attraction to being eaten by, and/or eating, another person or creature
  
−
* [[Voyeurism]]: sexual arousal through watching others having sex (also includes the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, see [[peeping tom]])
  
−
* [[Xenophilia]]: sexual attraction to foreigners (in [[science fiction]], can also mean sexual attraction to aliens)
  
−
* [[Zoophilia]]: emotional or sexual attraction to animals
  
−
* [[Zoosadism]]: the sexual enjoyment of causing pain and suffering to animals
  
−  
−  
−  
−
Note:
  
−
# Sadism and masochism are often grouped together, under [[sadomasochism]], or (as a lifestyle interest) [[BDSM]]. See also " [[bondage and discipline]]" and [[algolagnia]].
  
   
 
==See also==
  
==See also==
  +
*[[-philia]] (list of philias)
−
*[[Psychosexual development]]
  
 
*[[Developmental psychology]]
  
*[[Developmental psychology]]
  +
*[[Dorian Gray syndrome]]
  +
*[[Female perversion]]
 
*[[Human development]]
  
*[[Human development]]
 
*[[Human sexuality]]
  
*[[Human sexuality]]
  +
*[[Impulse control disorders]]
  +
*[[Pornography]]
  +
*[[Psychosexual development]]
  +
*[[Sex and the law]]
  +
*[[Sexual fetishism]]
  +
*[[Sex offenses]]
  +
*[[Sexual abuse]]
  +
*[[Sexual addiction]]
  +
 
*[[John Money]]
  
*[[John Money]]
−
*[[kink (sexual)]]
  
−
*[[-philia]] (list of philias)
  
 
*[[Richard Freiherr von Krafft-Ebing]] for history of classifying sexual object choice as a disease
  
*[[Richard Freiherr von Krafft-Ebing]] for history of classifying sexual object choice as a disease
−
*[[sex crime]]s
  
−
*[[Sexual Fetishism]]
  
−
*[[Dorian-Gray-Syndrome]]
  
   
  +
==References==
−
== External links ==
  
  +
{{Reflist}}
  +
  +
  +
==External links==
 
*[http://www.behavenet.com/capsules/disorders/paraphilias.htm DSM-IV and DSM-IV-TR list of paraphilias]
  
*[http://www.behavenet.com/capsules/disorders/paraphilias.htm DSM-IV and DSM-IV-TR list of paraphilias]
  +
*[http://www2.hu-berlin.de/sexology/IES/index.html The International Encyclopedia of Sexuality]
  +
  +
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{{paraphilia}}
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[[category:Human sexuality]]
  
   
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Paraphilia (in Greek para παρά = besides and -philia φιλία = love)—in psychology and sexology, is a term that describes a family of persistent, intense fantasies, aberrant urges, or behaviors involving sexual arousal to nonhuman objects, pain or humiliation experienced by oneself or one's partner, children or other nonconsenting individuals or unsuitable partners. Paraphilias may interfere with the capacity for reciprocal affectionate sexual activity. [1] Paraphilia is also used to imply non-mainstream sexual practices without necessarily implying dysfunction or deviance (see Clinical warnings section). Also, it may describe sexual feelings toward otherwise non-sexual objects.


Clinical context

Clinical literature discusses eight major paraphilias individually.[2][3] According to the Diagnostic and Statistical Manual of Mental Disorders, the activity must be the sole means of sexual gratification for a period of six (6) months, and either cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning" or involve a violation of consent to be diagnosed as a paraphilia.[4]

  • Exhibitionism: the recurrent urge or behavior to expose one's genitals to an unsuspecting person.
  • Fetishism: the use of inanimate objects to gain sexual excitement. Partialism refers to fetishes specifically involving nonsexual parts of the body.
  • Frotteurism: the recurrent urges to slap yourself or behavior of touching or rubbing against a nonconsenting person.
  • Incest: Sexual relations withi members of ones own family
  • Pedophilia: the sexual attraction to prepubescent or peripubescent children. (See also: Chronophilia Ephebophilia, Hebephilia)
  • Sexual Masochism: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer for sexual pleasure.
  • Sexual Sadism: the recurrent urge or behavior involving acts in which the pain or humiliation of a person is sexually exciting.
  • Transvestitism
  • Transvestic fetishism: a sexual attraction towards the clothing of the opposite gender. (Compare to autogynephilia.)
  • Voyeurism: the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all.
  • Other rarer paraphilias are grouped together under Other paraphilias not otherwise specified (ICD-9-CM equivalent of "Sexual Disorder NOS") and include telephone scatalogia (obscene phone calls), necrophilia (corpses), partialism (exclusive focus on one part of the body), zoophilia (animals), coprophilia (feces), klismaphilia (enemas), urophilia (urine), emetophilia (vomit).


Clinical procedures

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Observation of paraphiliac behavior has provided valuable scientific information on the mechanisms of sexual attraction and desire, such as behavioral imprinting. Investigation has also led to the tentative conclusions that biological processes may sometimes be manifested in idiosyncratic ways in at least some of the paraphilias, and that these manifestations are frequently associated with (and especially traumatic) events associated with early sexual experience. They tend to be caused by classical conditioning in that a sexual stimulus has been paired with stimuli and situations that do not typically result in sexual response and has then been perpetuated through operant conditioning because the sexual response is its own reward or positive reinforcement.[How to reference and link to summary or text]

According to Dr. Joseph Merlino, Senior Editor of the book Freud at 150: 21st Century Essays on a Man of Genius and psychiatry adviser to the New York Daily News, a paraphilia is by definition a disorder. "It's the blurring of what I might do that is a turn-on for me, and what might get me into problems with others," said Merlino in an interview. "Once you cross that line, it exists as a problem....the term itself is a diagnosis and if you look at the current listing of diagnoses, the one thing you will find as a qualifier on every one of them for it to be considered a disorder is that it must interfere with functioning, personal interrelationships, career, etc. Absent that, we can't give it a diagnosis."[5]

Intensity and specificity

Clinicians distinguish between optional, preferred and exclusive paraphilias, though the terminology is not completely standardized. An "optional" paraphilia is an alternative route to sexual arousal. For example, a man with otherwise unremarkable sexual interests might sometimes seek or enhance sexual arousal by wearing women's underwear. In preferred paraphilias, a person prefers the paraphilia to conventional sexual activities, but also engages in conventional sexual activities. For example, a man might prefer to wear women's underwear during sexual activity, whenever possible. In exclusive paraphilias, a person is unable to become sexually aroused in the absence of the paraphilia.

Optional paraphilias are far more common than preferred paraphilias, which are, in turn, far more common than exclusive paraphilias.[How to reference and link to summary or text]

Optional paraphilias sometimes disrupt stable relationships when discovered by an unsuspecting partner. Preferred paraphilias often disrupt otherwise stable relationships. Open communication and mutual support can minimize or prevent such disruption in both of these cases. Exclusive paraphilias often preclude normal courtship and committed romantic relationships, even when the person in question desires such a relationship. Loneliness or social isolation are common consequences. In extreme cases, preoccupation with a preferred or exclusive paraphilia completely displaces the more typical desire for loving human relationships.

Drug treatments

The treatment of men with paraphilias and related disorders has been challenging for patients and clinicians. In the past, surgical castration was advocated as a therapy for men with paraphilias, but it was abandoned because it is considered a cruel punishment and is now illegal in most countries. Psychotherapy, self-help groups, and pharmacotherapy (including the controversial hormone therapy sometimes referred to as "chemical castration") have all been used but are often unsuccessful. Here are some current drug treatments for these disorders.[6]

Hormone drug treatments

In humans, testosterone has a crucial role not only in the development and maintenance of male sexual characteristics but also in the control of sexuality, aggression, cognition, emotion, and personality. Testosterone is a major determinant of sexual desire, fantasies, and behavior, and it increases the frequency, duration, and magnitude of spontaneous and nocturnal erections. The deviant sexual fantasies, urges, and behavior of men with paraphilias also appear to be triggered by testosterone. Therefore, reducing testosterone secretion or inhibiting its action is believed to control these symptoms.

Antiandrogenic drugs such as medroxyprogesterone (also known as the long-acting contraceptive Depo Provera) have been widely used as therapy in these men to reduce sex drive. However, their efficacy is limited and they have many unpleasant side effects, including breast growth, headaches, weight gain, and reduction in bone density. Even if compliance is good, only 60 to 80 percent of men benefit from this type of drug. Long-acting gonadotropin-releasing hormones, such as Triptorelin (Trelstar) which reduces the release of gonadotropin hormones, are also used. This drug is a synthetic hormone which may also lead to reduced sex drive.[7]

Psychoactive drug treatments

Selective serotonin reuptake inhibitor (SSRI) class of antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxitine (Paxil), have all been used to treat paraphilias and related disorders by reducing impulse control problems and/or sexual obsessions with some success.

Tricyclic antidepressants (TCA), such as imipramine (Tofranil) and desipramine (Norpramin), are also used.

Lithium, the mood-stabilizing drug also known as Eskalith is typically used for the treatment of mania in bipolar disorder. There are some reports of reduced sexual compulsive behavior and a reduction in obsessive sexual thoughts in patients, which they attribute to the drug's enhancement of serotonergic functioning.

Anxiolytics are not considered a typical treatment for these type of disorders, however the efficacy of buspirone (BuSpar) has been clinically demonstrated.

Psychostimulants have been used recently to augment the effects of serotonergic drugs in paraphiliacs. In theory, the prescription of a psychostimulant without pretreatment with an SSRI might further disinhibit sexual behavior, but when taken together, the psychostimulant may actually reduce impulsive tendencies. Methylphenidate (Ritalin) is an amphetamine like stimulant used primarily to manage the symptoms of attention deficit hyperactivity disorder (ADHD). Recent studies imply that methylphenidate may also act on serotonergic systems; this may be important in explaining the paradoxical calming effect of stimulants on ADHD patients. Amphetamine is also used medically as an adjunct to antidepressants in refractory cases of depression.[8]

Religion and morality

Main article: Religion and sexuality

Some religious adherents view various paraphilias as deviations from a divine plan for human sexuality, as understood through their religious tradition or laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual sin, mental illness, or simply harmless sexual variation. Another variable is whether it is the acting out, or (less commonly) just the desirous thought alone, which is critically viewed in such cases. In any event, several paraphilias, as with many other behavior patterns outside the mainstream, are viewed negatively by various religions.Template:Nonspecific

Some religious traditions include forms of extreme asceticism, such as whipping , which, when practiced as sexual activities, would usually be considered masochism and popularly viewed as paraphilias. When practiced for non-sexual reasons, they are usually valued by the religious groups concerned as a part of their religious observance and submission to God.

Controversy over the term

The definition of various sexual practices as paraphilias has been met with opposition. Advocates for changing these definitions stress that there is nothing inherently pathological about non-criminal paraphilic practices, and they are stigmatized by being lumped together with crimes. Those who profess such a view hope that, much as with the removal of homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (see homosexuality and psychology), future psychiatric definitions will not include most of these practices, or that consensual paraphilias will be clearly separated from nonconsensual paraphilias.

Legality

Main article: Sex and the law

As a general rule, the law in many countries often intervenes in paraphilias involving young or adolescent children below the legal age of consent, nonconsensual deliberate displays or illicit watching of sexual activity, consensual sex with animals, illegal manipulation of dead people, harassment, nuisance, fear, injury, or assault of a sexual nature. Separately, it also usually regulates or controls censorship of pornographic material.

Exhibitionism, in cases where people who have not previously agreed to watch are exposed to sexual display, is also an offense in most jurisdictions, as is voyeurism when unarranged (see indecent exposure and peeping tom).

Non-consensual sadomasochistic acts may legally constitute assault and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of legal consent, and impose liability for any injuries caused. For these purposes, non-physical injuries are included in the definition of grievous bodily harm in English law. (See Consent (BDSM), Operation Spanner)

The paraphilias listed below may carry a condition of illegality in some areas, even when they are performed between consensual partners.

  • Raptophilia: sexual pleasure from being raped (when agreed upon beforehand but acted out in public).
  • Exhibitionism and voyeurism: sexual pleasure by exposing oneself or by being peeped on
  • Frotteurism: sexual arousal through rubbing oneself against an unknowing stranger in public
  • Lust murder: sexual arousal from committing (or trying to commit) murder
  • Pedophilia: sexual attraction to peripubescent or pre-pubescent minors
  • Telephonicophilia: being sexually aroused by making obscene telephone calls

The paraphilias listed below, that cannot involve consent since they involve non human animals or objects, may carry a condition of illegality in some areas:

  • Necrophilia: sexual attraction to corpses
  • Zoosadism: sexual attraction to torturing or killing animals
  • Zoophilia: sexual attraction to animals

List of paraphilias

Used in a sexual context, terms with the -philia suffix refer to conditions in which the person's primary sexual interest involves the stimulus or situation mentioned (the suffix is also used for non-sexual interest in or admiration of a subject). Terms with the -lagnia suffix refer to an action involving the stimulus or situation. For example, someone who is consistently sexually excited by feces would have coprophilia; any sexual act involving feces, even by someone for whom that is not a primary interest, would be coprolagnia.

The following terms mostly represent combinations of Greek or Latin words or roots, but few qualify as clinical paraphilias. Some of the following sexual interests are fairly common, while others are very rare.

  • Abasiophilia: love of (or sexual attraction to) people who are lame or crippled and/or who use leg braces or other orthopaedic appliances
  • Acousticophilia: sexual arousal from certain sounds
  • Algolagnia: sexual pleasure from pain
  • Amaurophilia: sexual arousal by a partner whom one is unable to see due to artificial means, such as being blindfolded or having sex in total darkness.
  • Acrotomophilia and apotemnophilia: sexual attraction to amputation or amputees.
  • Andromimetophilia (also gynemimetophilia): sexual attraction towards women dressed as men or who have had a sex change operation
  • Aquaphilia: arousal from water and/or in watery environments, including bathtubs and swimming pools
  • Aretifism: sexual attraction to people who are without footwear, in contrast to retifism
  • Autogynephilia: love of oneself as a woman (see Blanchard, Bailey, and Lawrence theory for discussion on controversy)
  • Autoassassinophilia: sexual arousal from fantasizing about or staging one's own murder
  • Biastophilia: sexual arousal from assault and rape.
  • Chronophilia: sexual attraction to a partner of the same chronological age, but whose sexuoerotic age is discordant with that chronological age.
  • Coprophilia: sexual attraction to (or pleasure from) feces.
  • Covert incestiphilia: arousal from non-contact sexual behavior with a child.
  • Dacryphilia: sexual pleasure in eliciting tears from others or oneself.
  • Dendrophilia: sexual attraction to trees and other large plants.
  • Emetophilia (also vomerophilia): sexual attraction to vomiting.
  • Ephebophilia (also hebephilia): sexual attraction towards adolescents.
  • Erotic asphyxia: sexual attraction from asphyxia (also called "breath control play" or "strangulation"), including autoerotic asphyxiation.
  • Erotic lactation (also galactophilia or lactophilia): sexual attraction to human milk or lactating women
  • Exhibitionism (also autagonistophilia or peodeiktophilia): sexual arousal by engaging in sexual behavior in view of third parties (also includes the recurrent urge or behavior to expose one's genitals to an unsuspecting person).
  • Fecophilia: sexual arousal from defacation or watching a partner defecate, particularly on oneself
  • Fetishes and partialisms
Anesthesia fetishism - Blood fetish(ism) (also haematophilia) - Breast fetishism - Breast expansion fetish - Crush fetish – Diaper fetishism - Doll fetish - Fat fetishism (also lipophilia) - Foot fetishism (podophilia) – Garment fetishism (Clothing, garments, materials and uniforms) - Hand fetishism – Hypnofetishism - Impregnation fetish - Medical fetishism - Navel fetishism - Nose fetishism (also nasophilia) - Panty fetishism – Pregnancy fetishism - Robot fetishism – Shoe fetishism – Silk/Satin fetishism – Smoking fetishism (Capnolagnia) – Sneezing fetishism – Spandex fetishism – Tickling fetishism (also acarophilia) - Total enclosure fetishism - Transformation fetish -
  • Food play: sexual arousal from food
  • Formicophilia: sexual attraction to smaller animals, insects, etc. crawling on parts of the body
  • Forniphilia: sexual objectification in which a person's body is incorporated into a piece of furniture
  • Frotteurism: sexual arousal from the recurrent urge or behavior of touching or rubbing against a non-consenting person
  • Gerontophilia: sexual attraction towards the elderly
  • Hebophilia: sexual attraction to adolescents (those who are no longer children, but have not completed puberty)
  • Homeovestism or Transvestic fetishism: sexual arousal by wearing the clothing of one's own gender
  • Human animal roleplay: sexual arousal by having oneself or a partner taking on the role of real or imaginary animal
  • Hybristophilia: sexual arousal to people who have committed crimes, in particular cruel or outrageous crimes
  • Incestophilia: sexual attraction to a member of one's own family
  • Japanese terms
    • Nyotaimori: sexual arousal by eating sashimi or sushi from the body of a (usually naked) woman
    • Omorashi: sexual arousal to one's or a partner's feeling of having a full bladder
    • Tamakeri: sexual arousal from having a male kicked in the groin by a woman
    • Wakamezake: sexual arousal by drinking alcohol from a woman's body.
  • Katoptronophilia: sexual arousal from having sex in front of mirrors
  • Kleptophilia: sexual arousal from stealing things
  • Klismaphilia: sexual pleasure from enemas
  • Lust murder (also homicidophilia or erotophonophilia): sexual arousal from committing (or trying to commit) murder
  • Macrophilia: sexual attraction to giants or giant body parts (such as breasts and genitalia)—the opposite of microphilia
  • Masochism: the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer
  • Microphilia: sexual attraction to miniature people or miniature body parts—the opposite of macrophilia
  • Mysophilia: sexual attraction to soiled, dirty, foul or decaying material
  • Narratophilia: sexual arousal in the use of dirty or obscene words to a partner
  • Necrophilia: sexual attraction to corpses
  • Nepiophilia (also infantophilia): sexual attraction to children three years old or younger
  • Oenophilia Sexual arousal from wine
  • Olfactophilia: sexual stimulus with smells or odors. (see also Jock sniffing).
  • Paraphilic infantilism: sexual pleasure from dressing, acting, or being treated as a baby.
  • Parthenophilia: sexual attraction to virgins
  • Pedophilia: sexual attraction to prepubescent children (British spelling: paedophilia)
  • Pictophilia: sexual attraction to pictorial pornography or erotic art
  • Plushophilia: sexual attraction to stuffed animals and/or people dressed in animal costumes
  • Pyrophilia: sexual arousal through watching, setting, hearing, talking or fantasizing about fire
  • Sadism: deriving pleasure, or in some cases sexual arousal from giving pain
  • Salirophila: sexual arousal by soiling (only the appearance of) the object of one's desired partner
  • Sitophilia: sexual arousal by involving food in sex
  • Somnophilia: sexual arousal from sleeping or unconscious people
  • Statuephilia: sexual attraction to statues or mannequins or immobility
  • Sthenolagnia: sexual arousal from the demonstration of strength or muscles
  • Technophilia: sexual arousal from techno or technology.
  • Telephone scatologia: being sexually aroused by making obscene phone calls to strangers
  • Teratophilia: sexual attraction to deformed or monstrous people
  • Tightlacing: sexual arousal by wearing or having a partner wear a tightly laced corset
  • Trichophilia: sexual arousal from hair
  • Troilism: sharing a sexual partner with another person while looking on
  • Urolagnia: sexual attraction to urine, including urinating in public, urinating on others, and being urinated on by others
  • Urophagia: sexual attraction to drinking urine or watching others drink urine
  • Vorarephilia (also gynophagia): sexual attraction at the thought of being eaten by or eating another person or creature. It includes endosomataphillia—a sexual fetish of being within someone (a sub-genre is partial unbirthing—a sexual attraction to inserting an adult head into a vagina).
  • Voyeurism: sexual arousal through secretly watching others having sex (also includes scoptophilia—the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities (see Peeping Tom)
  • Wet and messy fetishism: sexual arousal by having substances deliberately and generously applied to the naked skin, or to the clothes people are wearing
  • Xenophily: sexual attraction to foreigners (in science fiction, it can also mean sexual attraction to aliens)
  • Zelophilia: sexual arousal from jealousy
  • Zoophilia: sexual attraction to animals
  • Zoosadism: sexual gratification derived from causing pain and suffering to animals. Necrozoophilia (also necrobestiality) strictly applies to killing animals.

See also

References

  1. ↑ American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed., text revision). Pp. 566-567.
  2. ↑ psyweb.com "Axis I. Clinical Disorders, most V-Codes and conditions that need Clinical attention". Retrieved: 23 November, 2007.
  3. ↑ World Health Organization, International Statistical Classification of Diseases and Related Health Problems, (2007), Chapter V, Block F65; Disorders of sexual preference. Retrieved 2007-11-29.
  4. ↑ Letter to the Editor of The American Journal of Psychiatry: Change in Criterion for Paraphilias in DSM-IV-TR. Russell B. Hilliard, Robert L. Spitzer. 2002. Retrieved: 23 November, 2007.
  5. ↑ Interview with Dr. Joseph Merlino, David Shankbone, Wikinews, October 5, 2007.
  6. ↑ M. Williams. Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments". Retrieved 23 November, 2007
  7. ↑ M. Williams. Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments". Retrieved 23 November, 2007
  8. ↑ M. Williams. Sexual Compulsivity: Defining Paraphilias and Related Disorders "Psychoactive Drug Treatments". Retrieved 23 November, 2007


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