Paraphilia: Definition and Symptoms Displayed in Fetishism, Transvestism & Exhibitionism Paraphilias

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  • 0:06 Paraphilia
  • 1:04 Fetishism
  • 2:59 Transvestism
  • 4:48 Exhibitionism
  • 5:56 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

Sexual urges and fantasies are part of the lives of most healthy adults. But, what happens when the urges and fantasies center on a specific object or scenario and cause distress or impairment? In this lesson, we will look at several paraphilias and how they are treated.


Steve is in love with his girlfriend Susan. But, there's a problem: he has intense fantasies about women's feet. He loves women's shoes and their bare feet, and sometimes he gets so turned on by rubbing or kissing Susan's feet that he doesn't explore the rest of her body, and therefore, doesn't please her.

Steve might be suffering from a paraphilia, which is a general term that covers several specific psychological disorders that involve being sexually turned on by fantasizing about or engaging in sexual activity with a particular object or characteristic, like Steve's love of feet, or a specific act, like being humiliated. In short, paraphilias are disorders that involve unusual sexual fantasies and acts. There are many types of paraphilias. Let's look closer at three of them: fetishism, transvestism, and exhibitionism.


Remember Steve? He fantasizes about women's feet. His obsession with feet goes beyond what's normal. Steve might be suffering from fetishism, a paraphilia that involves fantasies and behaviors that have to do with a particular object or situation. Imagine that you are a psychologist, and Steve comes to you to talk about his foot fetish. In order to diagnose him with fetishism, you have to check off a few things.

  1. Intense fantasies or sexual acts focused on an object or situation for at least six months. When you talk to Steve, he admits that his urges have been present for years, so you know that this criterion is met.
  2. The fetish causes significant distress or impairment. Maybe Steve is upset about his fantasies, or maybe it is causing him to be unable to carry on a normal relationship or hold down a job. If any of these things are true, then you can check this one off, too.
  3. The object of the fetish is not used in cross-dressing or in genital stimulation. In other words, if Steve was obsessed with women's shoes because he likes to wear them as part of cross-dressing, it doesn't fall into this category. And, preoccupation with objects like vibrators, which stimulate the genitals, are also not fetishes. But, neither of these is the case for Steve, so this criterion is met.

Congratulations: You've just diagnosed Steve with fetishism. Well, what now? No one knows what causes paraphilias like fetishism, but there are several treatments that are effective. Therapy and drugs to lower the hormone testosterone are sometimes used in conjunction with each other.

Specifically, aversive therapy is sometimes used for fetishism. This is when the object of a fetish is paired with physical pain or humiliation, and gradually the person begins to lose the sexual longing for it.


If you think back to the criteria for fetishism, you'll remember that it's not a fetish if the object is worn as part of a focus on cross-dressing. When a heterosexual male is sexually aroused by dressing in female clothing, it is called transvestism, or transvestic fetishism. Often, men with transvestic fetishes dress in women's clothing without a partner, and part of the fantasy is that they are both partners.

Sully is a man who comes to visit you in your psychology practice. He really wants to fall in love, get married, and have children, but he's so hung up on his fantasies of dressing like a woman that he isn't able to let anyone into his life. He says he's felt the urges to cross-dress since he was a teenager.

As with fetishism, you go down a brief checklist for transvestism:

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