April 16, 2014

Understanding Sexual Fetishes And Paraphilias

From pathologizing fetishes to advocating that we ban the word, psychiatrists don't always agree on the role of sexual fetishes in human sexuality.

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A photograph of artist Katherine Dube's sculpture representing handcuffs.

A photograph of artist Katherine Dube's sculpture representing handcuffs.

According to a recent Psychology Today editorial, there’s no such thing as a fetish. Their reasoning? In an era of search terms and niche pornography, researchers find that most adult-website users demonstrate consistent, specific sexual preferences. Naturally, understandings of “normal human sexuality” are always in flux. But what exactly is a fetish, and how can it affect someone’s sexual experiences?

Fetish versus Paraphilia

Sometimes people use the word “fetish” to imply any kind of “atypical” sexual interest, or kink. For sex researchers (and for this blog post), “fetish” specifically refers to a strong sexual preoccupation with an object, material or body part. Fetishism is not in itself recognized as a psychiatric disorder. Usually the focus of a fetish is something not traditionally considered sexual. Examples include:

  • Alvinolagnia- a fetish for stomachs
  • Dorophilia- a fetish for animal furs, leather and skins
  • Balloon fetishism- …well, you get the idea.

Paraphilia,” according to Robert T. Francouer’s The Complete Dictionary of Sexology, means compulsively responding in a sexual way to an unusual or socially unacceptable stimulus. Psychiatrists might refer to The Diagnostic and Statistical Manual of Mental Disorders (DSM), the American medical community’s primary source on mental disorders. The most recent edition, the DSM-IV, only describes paraphilia as a psychiatric disorder if it causes distress to the individual or harm to others. For example, the list of paraphilia in the DSM-IV includes pedophilia and frotteurism, or compulsive sexual rubbing of non-consenting strangers. Fetishism, as defined above, is a subcategory of paraphilia, but only qualifies as a disorder if it causes distress or harm.

This system helps psychiatrists when counseling individuals with harmful or distressing sexual desires. However, it’s important to remember that sometimes the political and cultural biases of a particular era can influence medical assumptions. Homosexuality was listed in the DSM under unhealthy paraphilia until 1973. When the DSM-V is published in May 2013, it will relabel the diagnosis “fetishism” as “fetishistic disorder” and place a little more emphasis on the distress some fetishes may cause.

In fact, there may be a time when such “paraphilia” as fetishism, transvestism and sadomasochism are removed from the DSM altogether, mirroring a move made by psychiatrists in Sweden. The way therapists and researchers understand certain fetishes to be problematic develops and changes over time.

Fetish Origins

Kinsey Confidential sexual health educator Debby Herbenick notes that while many people have sexual interests outside of the mainstream, there’s not much information about how many people experience atypical sexual desires like fetishes in the United States.

Most scientists of sexuality believe that fetishes usually begin early in life, with some incident leading an individual to associate sexual pleasure with a particular object, material or body part. However, Janet Hyde and John Delamater’s great resource Understanding Human Sexuality explains that fetishes can also start after childhood- one study found that it could condition adult men to associate arousal with boots.

Most of the research on fetishes focuses on men, but women and genderqueer people have fetishes, too. In Human Sexuality and its Problems, John Bancroft explains that the specific causes of arousal and orgasm might just be easier to study in male-bodied people, who tend to experience erections and consistent ejaculation.

A fetish might be an important part of someone’s sexual identity, but it is not the same as someone’s sexual orientation or their gender expression. A relatively common fetish is a “panty fetish”, in which men get sexual gratification from touching, smelling and wearing underwear designed for women. This fetish is almost singularly found in heterosexual men, and male-bodied people who wear women’s clothing as part of their public gender expression are not the same as panty fetishists.

Sexual Fetishes… Got One?

There’s nothing wrong with fetishes in themselves. However, some people might feel inconvenienced when they can’t experience arousal without their fetish-object. It also might happen that an individual’s fetish is incompatible with their partner’s sexual preferences. Finally, people may find that their specific fetishes make them feel uncomfortable, unethical or upset. A non-judgmental, sex-positive therapist should be able to talk people about these issues.

As with all fantasies, discussing fetishes with a partner may make some people nervous. However, the above-mentioned Psychology Today article is right to suggest that many, many people have sexual interests that fall outside the norm. As long as you are communicative and safe and your partners are consenting adults, your fetish is yours to explore and enjoy.

  • Interesting. I’ve heard that fetishes are more common in men then women. Does the data support that?

  • Anonymous

    Very interesting and informative article. I wonder what the author thinks about sexual fetishes beyond the sex act. For example, a man who’s wife dies and that shows remarkable fortitude- until his wife’s favorite pet dies, after which he makes a suicide attempt. Maybe another view on fetishes is that not only do they help us “get it up” in bed, but also “get up” out of bed? Also, while the DSM may be an inherently oppressive institution (ruling some folks “normal” and others “abnormal”), are all fetishes to be taken as just a harmless quirk? Doesn’t the example of the favorite pet illustrate a negative consequence of fetishism? Isn’t “fetishistic disorder” a neat semantic workaround that says “hey, you can like feet all you want- but if you cry after foot sex you need help”?

  • Rosalyn Sternberg

    @6d5f5577e12ed69b40c7d7e81f2846cf:disqus For this article I mostly looked at research that identifies “fetish” with arousal and orgasm, so I’m no expert on fetishistic interest “beyond the sex act”. Definitely interesting stuff, and demonstrates the sometimes surprising ways that sexuality can affect our lives and relationships. My point is not that all fetishes are “harmless quirks”. However, most of the psychologists and researchers I reference in this overview seemed to express the consensus that while specific manifestations of fetishistic disorder are cause for concern, the mere presence of a fetish should not cause people the distress it often does. 
    Thanks for reading and reviewing! These are all good things to think about. 

  • Rosalyn Sternberg

    Chrystal- It does! Most researchers do suggest that far more men have fetishes than women. In fact, some people have suggested that only men have fetishes. Personally, I’m a bit skeptical of this idea, and think it might demonstrate a limited interpretation both of fetishism and women’s sexuality- besides the fact that it enforces a gender binary that leaves out a lot of sexuality-havers! 

    Still, it’s worth noting that our personal conceptions of masculinity and femininity totally affect our sexuality- and perhaps the greater frequency of fetishism in men is a good example of that. 

  • Wild Orchid

    Definitely not only men – my scientific study with a sample of 1 proves that 😉
    I think that society has a negative influence on women searching for things that tap into the deepest, most intense areas of their sexuality. So some women might suffer unarousing sex, never suspecting what they could achieve if they explored. Other thing is that women’s sexuality seems to be more adaptable and fluid. They may have a couple of kinks that would enhance their encounters but the absence of those kinks wouldn’t totally inhibit arousal.

    I have a fetish that arouses me 90% of time I think about it (10% I’m too tired and I fall asleep). I almost always explore it mentally because it’s inconvenient and not very physically stimulating in real life. Meanwhile I use “traditional” means like vibration on the clitoris, sometimes combined with vaginal penetration to get off. There are rare occasions where things that are not my fetish and don’t resemble it turn me on physically to a great degree. It’s always a surprise – I never know beforehand. 

    When I was a kid I had a mild obsession with things that later became my fetish. I asked strange questions and frequently looked up certain words in dictionaries. I don’t remember how m fetish got started – must likely ’cause I would ave been very young, less than 3.