Many people have fetishes and there’s nothing wrong with that — but when a fetish becomes a source of discomfort or distress, it may be considered a fetishistic disorder.
Human sexuality comes in many flavors, and fetishes are a common expression of sexual desire.
Engaging in fetishes consensually is on the broad spectrum of healthy sexuality. But if you have a fetish that’s affecting your life negatively, you may want to seek treatment and support.
Fetishistic disorders occur when a fetish — i.e., the use of inanimate objects or non-genitalia body parts for sexual arousal — starts to interfere with your life and well-being.
Treating fetishistic disorders focuses on harm reduction without shame. Often, trained sex therapists can help you find the right support and treatment for you to manage.
What is a fetishistic disorder?
Kinks and fetishes are still sometimes thought of as non-conventional sexual acts. The truth is, many people practice these healthy expressions of ‘nontraditional’ sexuality.
Fetishes become classified as a sexual disorder when they cause significant distress in your life.
A fetishistic disorder is the recurrent, persistent use of nonsexual body parts or inanimate objects to reach sexual arousal to the point of disrupting the way you function in your everyday life.
Fetishistic disorder is 1 of 8 paraphilic disorders — all of which involve sexual fantasies or urges that affect your social and work life, along with daily functioning. Some involve non-consenting partners, self-harm, or harming others.
Aside from fetishistic disorder, the other seven paraphilic disorders are:
- Exhibitionistic disorder. Repeated sexual fantasies, urges, or behaviors about exposing genitals to a stranger.
- Frotteuristic disorder. Recurrent sexual fantasies, urges, or behaviors involving touching and rubbing against a non-consenting person.
- Pedophilic disorder. Feeling aroused by children while also feeling intense distress.
- Sexual masochism disorder. Intermittent and intense fantasies, urges, and behaviors involving physical suffering that are sexually arousing.
- Sexual sadism disorder. Intensely sexually arousing fantasies, urges, and behaviors about inflicting physical or psychological pain on another person.
- Transvestic disorder. Cross-dressing for sexual arousal, causing distress or impairment.
- Voyeuristic disorder. Acting on or being significantly distressed by intense, sexually arousing urges and fantasies involving observing an unaware and non-consenting person who is naked, undressing, or engaged in sexual activity.
You must experience the signs and symptoms of these disorders regularly for at least 6 months to be diagnosed as having a paraphilic disorder.
According to the DSM-5, if you have one paraphilic disorder, you may have others at the same time.
Symptoms of fetishistic disorder
Most people who have fetishes and kinks won’t be classified as having a disorder.
A specific set of characteristics that have negative effects on your life and well-being must occur for a certain amount of time for you to receive this diagnosis.
Fetishistic disorder may be diagnosed if you experience:
- intense sexual arousal stemming from a part of the body that is not genitalia, or from an inanimate object
- recurring urges and fantasies that last more than 6 months
- anxiousness related to the fetish
- disruptions in your day-to-day life at home, work, and in your relationships
Suggested read: Sexual disorders and dysfunctions: What to know
Fetishes versus paraphilic disorders
Fetishes can be a healthy way to sexually express yourself, but for others, can cause distress. There’s a marked difference between fetishes, paraphilia, and paraphilic disorders.
Paraphilia is typically defined as intense and persistent sexual interests in things like non-human objects, pain, or non-consenting people.
A paraphilia by itself does not mean you have a disorder or issue, and it’s not limited to objects intended for sexual stimulation, like sex toys.
Still, the definition of paraphilia has some controversy — since defining what’s “normal” depends on a lot of things like culture, society, and personal beliefs.
A paraphilic disorder is basically when a paraphilia causes intense distress in your life and ability to function.
Paraphilic disorders are characterized by the duration and intensity of the sexual behaviors — including illegal behaviors — which may affect your life and disrupt routines and relationships.
With a disorder, seeking sexual satisfaction for your urges may cause distress, personal harm, or harm to others. People may seek help for the discomfort or if any legal trouble occurs due to their behaviors.
How do fetishes develop?
Fetishes typically show up at the onset of puberty. Whether a fetish or fetishistic disorder, there’s no conclusive evidence on what causes them.
The vast majority of cases of fetishistic disorder are diagnosed in men.
Some research suggests that fetishes stem from a combination of neurobiological, interpersonal, and cognitive processes.
A 2018 study suggests that a complex mix of biological and cultural influences, along with what society teaches you to view as erotic, is the foundation for developing fetishes.
There does appear to be some link between certain paraphilic disorders and childhood trauma, as well as childhood exposure to sexual activity. However, this is often noted in other paraphilic disorders like voyeuristic, not fetishitic.
There are many theories on how and why fetishistic disorder develops, even though there’s no proven cause. Some evidence suggests that people with paraphilic disorders sometimes have increased levels of serotonin.
High serotonin levels are associated with obsessive behaviors that become disruptive. These behaviors are shared among many diagnoses, not just fetishistic disorder or other paraphilic disorders.
Suggested read: Sexual masochism: Signs, possible disorders, and reducing stigma
Treatment options for fetishistic disorder
When symptoms begin to feel unmanageable and cause distress, many people may seek treatment. Occasionally, a person’s urges and behaviors can lead to legal trouble, signaling a need for help.
Anyone diagnosed with fetishistic disorder can work to overcome symptoms they find personally disruptive — there are many strategies available to help you manage your symptoms.
As with most conditions, you may have to try multiple things to find the treatment plan that works best for you.
For most people with fetishistic disorder, the best treatment plan is a combination of therapy and medication.
Working with a therapist that’s trained in sexual disorders can give you the best choice of resources. When seeking treatment, you’ll benefit from discussing your treatment goals and expectations with your therapist.
The most effective treatment for fetishistic disorder is focused on reducing harm to yourself and others, rather than inducing blame, shame, or guilt.
Therapy is often the first step in seeking treatment for fetishistic disorder. With online therapy and telehealth options, you may not even have to leave your home to seek a trained therapist.
There are several forms of therapy that are effective in treating all paraphilic disorders, not just fetishistic disorder:
- Sex therapy. This type of talk therapy focuses on sex and sexual health, without shame or judgment. It’s led by a certified sex therapist.
- Cognitive behavioral therapy (CBT). CBT is especially effective for treating paraphilic disorders. You’ll work with a mental health professional to identify underlying causes and use restructuring techniques and aversion therapy to help change associations between your fetish and sexual behaviors.
When seeking treatment, you may want to find a therapist experienced in treating fetishistic disorder.
For some people with fetishistic disorder, medication makes sense as an effective treatment option.
Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, may help people manage symptoms of fetishistic disorder, as well as some other paraphilic disorders.
SSRIs may help reduce obsessive behaviors, anxiety, and a high sex drive associated with fetishistic disorder, as well as regulate compulsive behaviors and depression.
Often, people diagnosed with fetishistic and other paraphilic disorders have to try different SSRI medications before they find the right one. So, it’s important to work with a psychotherapist or physician to find a medication that works best for you.
Fetishes and kinks are often a healthy expression of your sexuality and desires. They only become classified as a disorder when you experience recurring distress due to the fetish, which disrupts your everyday life and well-being.
Some people seek treatment simply due to their discomfort, while others may experience legal trouble that leads them to find support.
If you’re living with fetishistic disorder — or any other paraphilic or sexual disorder — you’re not alone. With the right support, you can find ways to manage your symptoms.
Effective treatment will focus on harm reduction instead of bringing up feelings of shame or guilt. It’s always beneficial to consider finding a therapist experienced in paraphilic disorders to get the best support.