Fetishes: Healthy & Enjoyable Fun Or Pathology?

Sexual Fetishes Are Common

Authors of the Cambridge dictionary (n.d.) define a fetish as a sexual interest in a part of the body other than sexual organs. Those readers more versed in the field of fetishes may cry foul at that definition. After all, that definition doesn’t account for any specific type of relationships such as dominant-submissive, or human interactions such as arousal to tickling other people (titillagnia) or arousal to hellfire and damnation (stygiophilia). A common misconception is that sexual fetishesor any sexual act not involving sex in the missionary position, is abnormal or unhealthy. This perspective is only strengthened by the fact that many states have laws outlawing various sexual position in anything commonly considered indecent (Anders, 2013). However, fetishes are relatively common. Soh (2016) interviewed hundreds of people in an attempt to understand the prevalence and origin of fetishes. She found that 1 in 6 individuals have a sexual fetish. Additionally, every 1 in 3 people have acted upon their fetish. Yet, regardless of those statistics, a very popular opinion is that only depraved individuals pursue fetishistic sex (Rapaport, 2016).

What Is Paraphilic Disorder?

Labeling some sexual behavior as pathological, or mental health disorders, has only worsened the perception. In the Diagnostic and Statistical Manual 5 (American Psychiatric Association, 2013), several urges and behaviors commonly noted as fetishes have been listed as mental health disorders. For those unfamiliar, the DSM 5 is the tool utilized by psychologists, psychiatrists, counselors, social workers, and other individuals in the mental health professions to label and code mental health diagnoses. There are two sections pertaining to sexuality. The first section pertains to issues with being able to perform sexually. The second section, the one we are going to focus on, is titled paraphilic disorders. A paraphilic disorder can be defined as a recurrent, intense, sexually arousing fantasies, urge, or behavior, that is distressing or disabling, and that involves inanimate objects, children, or nonconsenting adults, or humiliation of oneself or to partner, with the potential to cause harm. It should be noted that the authors of the DSM 5, the American psychiatric Association, have noted that sexual interest fall into two categories: nonmophilic (normal) and paraphilic (anomalous).

Differences Between A Fetish And A Paraphilic Disorder

The average individual reading the preceding passage may not understand the difference between a paraphilic disorder and a fetish. As an example, there are many fetishes focusing on humiliation of oneself or one’s partner. Anyone in a dominant/submissive partnership, anyone that enjoys the experiences of the rope-play or bonds, or individuals with any other number of fetishes, may identify with some aspects of paraphilic disorders. However, there are some significant differences between a fetish and a paraphilic disorder.

To understand those differences, we must first explore the categories of paraphilic disorders. They include voyeuristic disorder, exibitionistic disorder, frotteuristic disorder, sexual masochism disorder, sexual sadism disorder, pedophilic disorder, fetishistic disorder, and transvestic disorder. Readers interested in the specific criteria of each diagnosis should review the manual for further information. However, I will briefly explain each. Voyeuristic disorder can be described as an individual who takes sexual gratification and pleasure from watching other people in sexual acts. Those individuals are unaware and nonconsenting to being viewed. Frotteuristic disorder can be conceptualized as an individual, rubbing his or her genitalia on unsuspecting people in crowded spaces. Sexual masochism disorder refers to individuals who receive sexual gratification from being hurt, humiliated, or bound. Sexual sadism disorder refers toindividuals who receive sexual gratification from hurting, humiliating, or blaming others. Pedophilic disorder refers to individuals who receive sexual gratification from fantasies or sexual acts with children. Fetishistic disorders can be conceptualized as individuals who receive sexual gratification from fantasies urges, or interactions with non-genital body parts were nonliving items. Finally, transvestite disorder can be considered as an individual who receive sexual gratification from dressing in the clothing of the opposite gender.

Again, the casual reader may read the afore-mentioned passage and see any number of fetishes. However, there are some very significant differences between a fetish and a paraphilic disorder.

The main difference lies in what differentiates a behavior from a mental health disorder. On page 20 of the DSM 5 (APA, 2013), readers will find the definition of a mental disorder. There are two key pieces readers should note. The first is that a mental disorder involves clinically significant disturbances in cognition, emotional regulation, or behavior. In other words, the behavior must disturb how a person thinks, their ability to emotionally regulate, or appear as a disturbance in conduct. This is not something that we see most people who practice fetishes. Additionally, a mental disorder is associated with significant distress or disability in social, occupational, or other areas of life. Essentially, a person’s fetishistic behavior has to impair him or her in one or more areas of life. This may mean being unable to go to work due to trying to obtain sexual gratification, damaging family relationships, losing friends, or any other impairment.

Again, many fetishes can appear almost identical to label mental health disorders. However, these two key distinguishers, disturbance an impairment, are what separates labels of pathology from a very normal sexual experience.A fetish in and of itself does not denote any level of harm to the individual or other individuals with whom the person engages. A fetish is not considered to be a mental health disorder unless it causes significant distress and impairment.

Whether or not behaviors seen as fetishes cause significant distress or impairment can only be determined by the individual. Should an individual feel that his or her fetishistic behavior is out of hand or causing problems in his or her life, there are an abundance of clinicians at the ready.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., text revision). Washington, DC: Author. Anders, C. (2016). A map of the weirdest sex laws in the united states. Retrieved from https://io9.gizmodo.com/a-map-of-the-weirdest-sex-laws-in-the-united-states-1485053434

Cambridge University Press. (n.d). Cambridge online dictionary. Retrieved from https://dictionary.cambridge.org/dictionary/english/fetish

Rapaport, L. (2016). Lots of people like kinky sex psychologist call abnormal. Retrieved from https://www.reuters.com/article/us-health-sex-norms/lots-of-people-like-kinky-sex-psychologists-call-abnormal-idUSKCN0WK2HZ

Soh, H. (2016). 1 in 6 peole has a sex fetish. Neuroscience explains why. Retrieved from https://www.menshealth.com/sex-women/extreme-fetishes