Paraphilia is abnormal sexual behavior that the society finds difficult or impossible to accept. In some cases, Paraphilic behaviors are even viewed as criminal offences by the law. Know all about the causes, symptoms, diagnosis, treatment and prognosis of this type of disorder.

Paraphilia Definition

“Paraphilia” is a term used in psychology to describe complex sexual behaviors that are outside socially accepted norms. It refers to sexual response to situations or objects that are considered abnormal in contemporary society.

Some of the behaviors exhibited by Paraphilia sufferers are aggressive in nature while some others are non-aggressive. Some forms of Paraphilia are criminal offenses. These are:

  • Exhibitionism
  • Frotteurism
  • Pedophilia
  • Sadism
  • Voyeurism

Paraphilia Epidemiology

This is a rare condition and is more common in men than in women. It has a 20:1 male-female ratio. It is not known what exactly causes this disparity.

Paraphilia Symptoms

The abnormal sexual behaviors that are considered to be part of Paraphilia include the following, which are considered to be various types of Paraphilia:

Exhibitionism or Flashing

People with this type of behavioral problem are known as “flashers”. Such individuals have an urge to impress, shock or surprise their victims. It is characterized by fantasies that are acute and sexually arousing. They indulge in seemingly indecent behaviors like exposing their genitals to an unsuspecting stranger. The problem is usually restricted only to exposure and not any other harmful behaviors or advances. It is only rarely that any sexual contact is made with victims.

However, patients may masturbate during exposure or during fantasizing about exposure.


People with this form of behavior have sexual urges related to non-living objects, such as underwear, shoes, rubber clothing, lingerie or other things belonging to victims. This fetish (abnormal attraction) may be integrated into sexual activities with willing partners or replace sex with partners. Actual sexual relationships are often avoided when the fetish becomes the only object of sexual desire.

Partialism, an associated condition, is characterized by sexual arousal by a part of human body such as breasts, buttocks or feet.


In this condition, the focus of the sexual urges of sufferers is associated to touching the body of unwilling partners or rubbing the genitals against the body of non-consenting people. In most case of the disease, males rub their genitals against the body of females – usually in crowded public spaces such as bus, train or stations. This is a criminal activity as bodily contact with an unwilling or unsuspecting person with sexual intent is illegal in nature.


It involves urges, behaviors or fantasies that involve illegal sexual activity with a child or person who has not yet entered the stage of puberty – usually 13 or younger in age. Abnormal behaviors displayed by Pedophilic people include:

  • Undressing children
  • Touching or fondling the genitals of children
  • Encouraging a child to watch the person masturbate
  • Forcefully performing sex with the child

Some pedophiles are sexually attracted only to children and are referred to as “Exclusive pedophiles.” They are not attracted to adults at all. Some pedophiles restrict sexual activities to their own kids or those of their relatives, even younger members of the same family (incest). Others tend to victimize other children and are called “Predatory pedophiles.” They may threaten or force their victims with the fear of causing harm if they disclose the abuse. Doctors and medical professionals tending to abused minors are legally bound to report such cases. If the sexual activities constitute rape, they would be recognized as felony offenses and punished by imprisonment.

Sexual masochism

Such people have sexual fantasies of being beaten up, humiliated or made to suffer to achieve sexual arousal and climax. The acts or fantasies may be limited to verbal abuse or physical abuse including being bound, beaten or injured in some other way. Masochists may seek other partners to cause injury to themselves, such as beating or cutting them, or cause injury to their own body to have sexual excitement. They may pierce, cut or burn their own skin. Masochistic activities with a partner may involve spanking, bondage and simulated rape.

Among consenting adults, instances of sadomasochistic activities and fantasies are not uncommon. In the majority of these cases, however, the abuse and humiliation are restricted to fantasy. Those who take part in the activities know that the behavior is a part of “sexual game” and tend to avoid pain and injury.

Autoerotic partial asphyxiation is a potentially dangerous, and sometimes fatal, activity that is associated to this kind of Paraphilia. A person suffering from this form of the condition uses nooses, plastic bags or ropes to interrupt their breathing and induce a state of asphyxia to achieve a state of orgasm. This activity sometimes results in accidental death although it is mainly conducted to enhance orgasm.

Sexual sadism

Sexual sadists have constant fantasies in which inflicting physical or psychological suffering on a partner gives sexual excitement. The condition is distinct from minor acts of aggression that is common during sexual activity, such as rough sex. In certain cases, such people can find sexual partners who are willing to take part in sadistic activities.

Most extreme cases of this disorder include criminal activities like torture, rape or even murder. In cases involving murder, the death of victims can lead to sexual excitement. It is noteworthy that although rape may express sexual sadism, causing suffering to victims is not usually the aim for the majority of rapists. The pain of victims does not usually increase the sexual excitement of rapists. Sadistic actions like rape are a combination of sex and forceful dominance on victims. Sexual sadists require intensive psychiatric treatment and they may be incarcerated for such activities.


Also known as Transvestic fetishism, it is characterized by heterosexual males dressing themselves up in female clothes to arouse themselves sexually. The arousal generally does not involve a real sexual partner but involves the fantasy of an actual partner. Some men suffering from this condition wear only one specific piece of female cloth, such as the underwear of a woman, while others completely dress themselves up as a female which includes feminine make-up and hairstyle. Usually, cross-dressing is not a problem. However, it can indicate a psychological problem if an individual finds it necessary to experience sexual climax or become sexually aroused.


Also referred to as Peeping Tom Syndrome, it involves achieving sexual arousal by observing an unsuspecting person undressing himself or herself or engaging in sexual activity. Such behavior may have a sexual climax in the masturbation of the voyeur. Usually, such people do not seek sexual contact with their victims. Their behavior is only restricted to “peeping” and probably climaxed by masturbation.

Paraphilia Causes

The actual cause of these behaviors is not known. According to certain experts, it is the result of a childhood trauma, such as sexual abuse. Others are of the opinion that certain situations or objects can become sexually arousing if they are repeatedly and frequently associated with a sexually pleasurable activity. In the majority of cases, Paraphilic patients experience difficulties in developing healthy personal and sexual relationships with others.

The majority of cases of Paraphilia arises at the time of adolescence and continues into the stages of adulthood. The occurrence and intensity of the fantasies related with Paraphilic behaviors tend to vary from one person to another. However, they generally reduce with increasing age of sufferers.

Paraphilia Risk Factors

The risk factors of the condition include:

Being male

Males are seen to be at around 20 times greater risk of displaying Paraphilic behaviors than females. Men are naturally supposed to be more susceptible to this disorder than women.

Being sexually abused

People who are sexually abused during childhood are supposed to be more prone to the condition than those having a healthy childhood.

Paraphilia Diagnosis

Mental health care providers use the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association as a guide for detecting mental health problems. Paraphilia may be diagnosed as a subcategory of another mental disorder like Obsessive Compulsive Disorder or Impulse Control Disorder.

The diagnosis of Paraphilia may involve asking patients or their family members (or legal officials) about their problems or fantasies. In some cases, a set of questions may be used to ascertain the sexual preferences of sufferers.

Paraphilia Treatment

The majority of cases of this disorder are cured with the aid of therapy and counseling. The aim of such treatment is to modify the behavior of sufferers. Medicines may help reduce the compulsiveness related with the condition and lower the number of abnormal behaviors and sexual fantasies in sufferers.

In certain cases, hormones are prescribed to people who suffer from frequent urges of abnormal or potentially dangerous sexual behavior. Most of these drugs yield benefit by reducing the sex drive of patients.

In order to yield the best results, treatment must be administered for a long time for the disorder. Unwillingness to undergo treatment can hinder the success of cure. It is necessary for people with potentially criminal sexual urges receive professional assistance before they indulge in criminal sexual activities and cause harm to others or themselves.

Paraphilia Prognosis

With effective treatment and counseling, patients may show a positive outcome and get rid of Paraphilic behaviors. Over time, they can be able to get out of all objects and events that can give rise to abnormal sexual behaviors or acts.

Paraphilia Complications

The complications which are generally associated to this condition include:

  • Struggling with shame and feelings of guilt
  • Getting arrested for sexual offences
  • Having an unwanted pregnancy
  • Having financial debts due to purchase of sexual services or pornographic materials

Paraphilia Prevention

The complications associated with this condition can be prevented by seeking medical care and psychiatric help for childhood sexual abuse and dark fantasies of an abnormal sexual nature. One should also avoid frequenting strip clubs, pornographic websites and other activities that may promote unusual sexual fantasies and acts.


Suffering from Paraphilic fantasies or behavior does not always indicate that people having them suffer from some mental illness. The behaviors and fantasies can exist in less acute forms that may not be dysfunctional in any way. Also, they may not come in the way of development of healthy relationships or harm an individual in any way such as making them indulge in criminal offenses. They may be restricted to fantasies during masturbation or intercourse.


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