Sex is a hot topic, a topic of taboo, a hush hush affair, an affair to indulge in utmost secrecy, a private matter, a matter for “non-veg” jokes… it is everywhere and it is nowhere. Sex is undoubtedly the most ironic human function because while we all are products of sex, we are hesitant to acknowledge the very function behind our existence. As it is we hardly speak openly about sex, the chances are obviosly slimmer for us to talk about sex related disorders. 

Sex-related disorders can be related to sexual function like sexual desire disorder, arousal disorder, orgasm disorder and pain disorder. However, a more threatening sexual disorder relates to sexual deviance.

According to the American Psychological Association (APA), sexual deviance involves sexual behavior “that is regarded as significantly different from the standards established by a culture or subculture”. Such deviant sexuality disorders are called paraphilias. 

Paraphilias

The DSM-5 defines paraphilia as “any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physiologically mature, consenting human partners.” Some common paraphilias are Pedophilia (sexual focus on children), Exhibitionism (exposure of genitals to strangers), Voyeurism (observing private activities of unaware victims) and Frotteurism (touching or rubbing against a nonconsenting person). Other less common paraphilias are Fetishism (use of inanimate objects), sexual masochism (being humiliated or forced to suffer), Sexual sadism (inflicting humiliation or suffering) and Transvestic Disorder (sexually arousing cross-dressing). 

Read our featured article about sex addiction: THE DELUSIVE LOVE – MY PERSONAL STORY OF SEX ADDICTION

Paraphilic Disorder

DSM-5 uses the term paraphilic disorder to refer to the persistent and intense atypical sexual arousal patterns that are accompanied by clinically significant distress or impairment. For a person to be diagnosed with a paraphilic disorder, they must further have the following characteristics:

• feel personal distress about their interest, not merely distress resulting from society’s disapproval; or
• have a sexual desire or behavior that involves another person’s psychological distress, injury, or death, or a desire for sexual behaviors involving unwilling persons or persons unable to give legal consent.

In addition to the above characteristics, when a person shows paraphilic behavior for over a period of 6 months, then it is considered a paraphilic disorder.

1. Exhibitionistic Disorder: the exposure of one’s genitals to an unsuspecting person

2. Voyeuristic Disorder: observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity. The individual experiencing the arousal and/or acting on the urges is at least 18 years of age.

3. Frotteuristic Disorder: touching or rubbing against a nonconsenting person

4. Sexual Sadism Disorder: the physical or psychological suffering of another person

5. Sexual Masochistic Disorder: the act of being humiliated, beaten, bound, or otherwise made to suffer

6. Fetishistic Disorder: the use of nonliving objects or a highly specific focus on nongenital body part(s)

7. Transvestic Disorder: cross-dressing

8. Pedophilic Disorder: intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).   

There is no one size fits all treatment solution available for the paraphilic disorders but an integrated pharmacological and psychological approach could be considered. However, very little research is available regarding the treatment options or their effectiveness.

Since sex is an activity people indulge in within the privacy of the four walls, what happens in the enclosed room usually stays in the room. Therefore, what is considered normal sexual behavior and what is not is a debatable topic. Having said that, the paraphilic disorders can cause serious distress and also have traumatic effects on people involved. What we can do for now is to educate ourselves of sexual behaviors and understand when these behaviors become disorders.

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