{{short description|Atypical sexual attraction}} {{Distinguish|Paraphyly|Paraphernalia|Pareidolia}} {{For|the defined mental disorder|Paraphilic disorder}} {{CS1 config|name-list-style=vanc}} {{Use dmy dates|date=January 2023}} {{Infobox gender and sexual identity | title = Paraphilia | image = Martin van Maele - La Comtesse au fouet 01.jpg | caption = Podophilia (foot fetishism), a paraphilia<ref>{{cite journal |last1=Allely |first1=Clare Sarah |title=Autism spectrum disorder, bestiality and zoophilia: a systematic PRISMA review |journal=Journal of Intellectual Disabilities and Offending Behaviour |date=30 January 2020 |volume=11 |issue=2 |pages=75–91 |doi=10.1108/JIDOB-06-2019-0012 |url=http://usir.salford.ac.uk/id/eprint/53443/1/PDF_Proof-2.pdf }}</ref> | etymology = παρά (''para''; other) + φιλία (''philia''; loving) | definition = Atypical sexual interest | coined_by = Friedrich Salomon Krauss | synonyms = * Sexual perversion (1880s–1920)<ref name=IEHS/> * Sexual deviation (1952–1980; DSM and ICD) | associated_terms = Normophilia (antonym) }}
A '''paraphilia''' is an uncommon, intense, and persistent sexual arousal or attraction to anything not sexual by nature, though ''preference'' is favored for specific designations.<ref name="DSM-5, intro">{{cite book |title=Diagnostic and Statistical Manual of Mental Disorders |edition=Fifth |chapter=Paraphilic Disorders |year=2013 |publisher=American Psychiatric Publishing |location=Philadelphia, Pennsylvania |pages=685–686}}</ref><ref name="DSMTR">{{cite book |url=https://archive.org/details/diagnosticstatis00amer_0 |title=Diagnostic and Statistical Manual of Mental Disorders-IV (Text Revision) |title-link= |date=2000 |publisher=American Psychiatric Publishing |isbn=978-0-89042-024-9 |volume=1 |location=Philadelphia, Pennsylvania |pages=[https://books.google.com/books?id=3SQrtpnHb9MC&pg=PA566 566–76] |doi=10.1176/appi.books.9780890423349 |doi-broken-date=18 May 2026 |url-access=registration}}</ref><ref>{{cite journal |last1=Griffiths |first1=Mark D. |title=Eproctophilia in a Young Adult Male |journal=Archives of Sexual Behavior |date=November 2013 |volume=42 |issue=8 |pages=1383–1386 |id={{CORE output|30634889}} |doi=10.1007/s10508-013-0156-3 |pmid=23852033 }}</ref> Paraphilia has also been defined as a sexual interest in anything other than a legally consenting human partner.<ref>{{cite book |last1=Vandiver |first1=Donna |url=https://books.google.com/books?id=lW2uDQAAQBAJ&pg=PT50 |title=Sex Crimes and Sex Offenders: Research and Realities |last2=Braithwaite |first2=Jeremy |date=8 December 2016 |publisher=Routledge |isbn=978-1-317-38524-0 |access-date=2022-10-08}}</ref><ref>{{cite book |last1=Worthen |first1=Meredith G. F. |url=https://books.google.com/books?id=QSE-EAAAQBAJ&pg=PA333 |title=Sexual Deviance and Society: A Sociological Examination |date=2021-09-30 |publisher=Routledge |isbn=978-1-000-42106-4 |access-date=2022-10-08}}</ref> Paraphilias are contrasted with normophilic ("normal") sexual interests,<ref>{{cite journal |last=Joyal |first=Christian C. |date=2018-10-01 |title=Controversies in the Definition of Paraphilia |journal=The Journal of Sexual Medicine |volume=15 |issue=10 |pages=1378–1380 |doi=10.1016/j.jsxm.2018.08.005 |pmid=30219664 }}</ref><ref name=":2"/> although the definition of what makes a sexual interest normal or atypical remains controversial.
The exact number and taxonomy of paraphilia is under debate; Anil Aggrawal has listed as many as 549 types of paraphilias.<ref>{{cite book |first=Anil |last=Aggrawal |author-link=Anil Aggrawal |title=Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices |date=2008 |pages=369–382 |chapter=Appendix 1 |chapter-url=https://books.google.com/books?id=uNkNhPZQprcC&pg=PA369 |publisher=CRC Press |location=Boca Raton, Florida |isbn=978-1-4200-4308-2}}</ref><ref name=IEHS>{{cite book |title=The International Encyclopedia of Human Sexuality |edition=1 |date=2015-04-10 |publisher=Wiley |editor-last1=Bolin |editor-first1=Anne |editor-last2=Whelehan |editor-first2=Patricia |doi=10.1002/9781118896877.wbiehs344 |isbn=978-1-4051-9006-0}}</ref> Several sub-classifications of paraphilia have been proposed; some argue that a fully dimensional, spectrum, or complaint-oriented approach would better reflect the evident diversity of human sexuality.<ref>{{cite journal |first1=Jack D. |last1=Maser |date=2002 |title=Spectrum concepts in major mental disorders |journal=Psychiatric Clinics of North America |volume=25 |issue=4 |pages=xi–xiii |first2=Hajop S. |last2=Akiskal |pmid=12462854 |doi=10.1016/S0193-953X(02)00034-5}}</ref><ref>{{cite journal |first1=Robert F. |last1=Krueger |first2=David |last2=Watson |first3=David H. |last3=Barlow |title=Introduction to the Special Section: Toward a Dimensionally Based Taxonomy of Psychopathology |journal=Journal of Abnormal Psychology |publisher=American Psychological Association |location=Washington, DC |volume=114 |issue=4 |pages=491–3 |year=2005 |pmid=16351372 |pmc=2242426 |doi=10.1037/0021-843X.114.4.491 }}</ref> Although paraphilias were believed in the 20th century to be rare among the general population, subsequent research has indicated that some level of paraphilic interest is relatively common.<ref name=":2">{{cite journal |last1=Moser |first1=Charles |last2=Kleinplatz |first2=Peggy J. |title=Conceptualization, History, and Future of the Paraphilias |journal=Annual Review of Clinical Psychology |date=7 May 2020 |volume=16 |issue=1 |pages=379–399 |doi=10.1146/annurev-clinpsy-050718-095548 |pmid=32023092 }}</ref>
==Etymology== Coinage of the term ''paraphilia'' (''paraphilie'') has been credited to Friedrich Salomon Krauss in 1903, and it was used with some regularity by Wilhelm Stekel in the 1920s.<ref name="stekel">{{cite book |last=Stekel |first=Wilhelm |title=Sexual Aberrations: The Phenomenon of Fetishism in Relation to Sex |publisher=Boni & Liveright |year=2004 |isbn=978-1-4179-3834-6 |edition=translated from the 1922 original German |location=New York City |translator-last=Parker |translator-first=S. |author-link=Wilhelm Stekel |orig-year=1930}}</ref><ref>{{cite book |last1=Gherovici |first1=Patricia |url=https://books.google.com/books?id=pggqDwAAQBAJ&dq=paraphilia+english+coined&pg=PA48 |title=Transgender Psychoanalysis: A Lacanian Perspective on Sexual Difference – Patricia Gherovici – Google Books |date=2017-07-14 |publisher=Taylor & Francis |isbn=978-1-317-59418-5 |access-date=2022-10-08}}</ref> The term comes from the Greek παρά (''para''), meaning 'other' or 'outside of', and φιλία (''-philia''), meaning 'loving'.<ref name="wiederman2003"/> The word was popularized by John Money in the 1980s as a non-pejorative designation for unusual sexual interests. It was first included in the DSM in its 1980 edition.<ref name="wiederman2003"/><ref name="bullough1995"/><ref name="moser2001"/>
==Definition== There is no broad scientific consensus for definitive boundaries between what are considered "unconventional sexual interests", kinks, fetishes, and paraphilias.<ref>{{cite journal |last=Joyal |first=Christian C. |date=20 June 2014 |title=How Anomalous Are Paraphilic Interests? |journal=Archives of Sexual Behavior |location=New York City |publisher=Springer Science + Business Media |volume=43 |issue=7 |pages=1241–1243 |doi=10.1007/s10508-014-0325-z |issn=0004-0002 |pmid=24948423 |s2cid=34973560}}</ref><ref>{{cite journal |last1=Joyal |first1=Christian C. |last2=Cossette |first2=Amélie |last3=Lapierre |first3=Vanessa |year=2015 |title=What Exactly is an Unusual Sexual Fantasy? |journal=The Journal of Sexual Medicine |location=Amsterdam, Netherlands |publisher=Elsevier |volume=12 |issue=2 |pages=328–340 |doi=10.1111/jsm.12734 |pmid=25359122}}</ref> As such, these terms are often used loosely and interchangeably, especially in common parlance.
===History of paraphilic terminology=== Many terms have been used to describe atypical sexual interests, and there remains debate regarding technical accuracy and perceptions of stigma.<ref name="wiederman2003">{{cite journal |first=Milan |last=Weiderman |date=2003 |title=Paraphilia and Fetishism |journal=The Family Journal |publisher=SAGE Publications |location=Thousand Oaks, California |volume=11 |issue=3 |pages=315–321 |doi=10.1177/1066480703252663 |s2cid=146788566}}</ref><ref name="bullough1995">{{cite book |first=Vern L. |last=Bullough |author-link=Vern Bullough |date=1995 |url=http://www2.hu-berlin.de/sexology/GESUND/ARCHIV/LIBRO.HTM |title=Science in the Bedroom: A History of Sex Research |page=281 |publisher=Basic Books |location=New York City |isbn=978-0-465-07259-0 |url-status=dead |archive-url=https://web.archive.org/web/20061022080700/http://www2.hu-berlin.de/sexology/GESUND/ARCHIV/LIBRO.HTM |archive-date=22 October 2006 |access-date=5 October 2010}}</ref><ref name="moser2001">{{cite book |last=Moser |first=Charles Allen |authorlink=Charles Allen Moser |date=2001 |chapter=Critiques of conventional models of sex therapy |editor-first=Peggy J. |editor-last=Kleinplatz |editor-link=Peggy J. Kleinplatz |title=New directions in sex therapy: innovations and alternatives |publisher=Psychology Press |location=London, England |isbn=978-0-87630-967-4}}</ref><ref name="mccammon2004">{{cite book |last1=McCammon |first1=Susan |last2=Knox |first2=David |last3=Schacht |first3=Caroline |date=2004 |title=Choices in sexuality |page=476 |publisher=Atomic Dog Publishing |location=Mason, Ohio |isbn=978-1-59260-050-2}}</ref> John Money described paraphilia as "a sexuoerotic embellishment of, or alternative to the official, ideological norm".<ref name="money1990">{{cite book |last=Money |first=John |author-link=John Money |date=1990 |title=Gay, Straight, and In-Between: The Sexology of Erotic Orientation |publisher=Oxford University Press |location=Oxford, England |isbn=978-0-19-506331-8 |pages=[https://archive.org/details/gaystraightinbet0000mone/page/139 139]}}</ref> Psychiatrist Glen Gabbard writes that despite efforts by Wilhelm Stekel and John Money, "the term ''paraphilia'' remains pejorative in most circumstances."<ref name="gabbard2007">{{cite book |last=Gabbard |first=Glen O. |author-link=Glen O. Gabbard |date=2007 |title=Gabbard's Treatments of Psychiatric Disorders |publisher=American Psychiatric Press |location=Philadelphia, Pennsylvania |page=581 |isbn=978-1-58562-216-0}}</ref>
In the late 19th century, psychologists and psychiatrists began to categorize various paraphilias so as to have a more descriptive system than the legal and religious constructs of sodomy,<ref name="dailey1989">{{cite book |last=Dailey |first=Dennis M. |title=The Sexually Unusual: Guide to Understanding and Helping |date=1989 |publisher=Haworth Press |isbn=978-1-4179-3834-6 |location=Philadelphia, Pennsylvania |pages=15–16}}</ref> as well as perversion.<ref name="purcell2006">{{cite book |last1=Purcell |first1=Catherine E. |title=The psychology of lust murder: paraphilia, sexual killing, and serial homicide |last2=Arrigo |first2=Bruce A. |date=2006 |publisher=Academic Press |isbn=978-0-12-370510-5 |location=Cambridge, Massachusetts |page=16}}</ref> In 1914, Albert Eulenburg observed a commonality across paraphilias, using the terminology of his time writing, "All the forms of sexual perversion ... have one thing in common: their roots reach down into the matrix of natural and normal sex life; there they are somehow closely connected with the feelings and expressions of our physiological erotism. They are ... hyperbolic intensifications, distortions, monstrous fruits of certain partial and secondary expressions of this erotism which is considered 'normal' or at least within the limits of healthy sex feeling."<ref>Eulenburg (1914). ''Ueber sexualle Perversionen. Ztschr. f. Sexualwissenschaft''. Vol. I, No. 8. Translated by Stekel, Wilhelm (1940). ''Sexual Aberrations: The Phenomena of Fetishism in rRelation to Sex''. New York: Liveright, p. 4. {{OCLC|795528}}.</ref>
Before the introduction of the term ''paraphilia'' in the DSM-III (1980), the term ''sexual deviation'' was used to refer to paraphilias in the first two editions of the manual.<ref>Laws & O'Donohue, p. 384</ref> In 1981, an article published in ''American Journal of Psychiatry'' described paraphilia as "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving":<ref name="AJP">{{cite journal |last1=Spitzer |first1=Robert L. |author-link=Robert Spitzer (psychiatrist) |title=The diagnostic status of homosexuality in DSM-III: A reformulation of the issues |journal=The American Journal of Psychiatry |publisher=American Psychiatric Association |location=Philadelphia, Pennsylvania |volume=138 |issue=2 |pages=210–215 |date=February 1981 |pmid=7457641 |doi=10.1176/ajp.138.2.210}}</ref> * Non-human objects * The suffering or humiliation of oneself or one's partner * Prepubescent children * Non-consenting persons
===Criticism of common definitions=== There is scientific and political controversy regarding the continued inclusion of sex-related diagnoses such as the paraphilias in the DSM, due to the stigma of being classified as a mental illness.<ref>{{cite book |title=Sexual and Gender Diagnoses of the Diagnostic and Statistical Manual (DSM) |chapter=Gender Dissonance: Diagnostic Reform of Gender Identity Disorder for Adults |date=2014 |pages=81–100 |doi=10.4324/9781315864396-9 |isbn=978-1-315-86439-6 |vauthors=Kleinplatz PJ, Moser C }}</ref><ref>{{cite journal |title=Politics versus Science |journal=Journal of Psychology & Human Sexuality |date=2006 |volume=17 |issue=3–4 |pages=135–139 |doi=10.1300/J056v17n03_09 | vauthors = Kleinplatz PJ, Moser C }}</ref> Some groups, seeking greater understanding and acceptance of sexual diversity, have lobbied for changes to the legal and medical status of unusual sexual interests and practices. Charles Allen Moser, a physician and advocate for sexual minorities, has argued that the diagnoses should be eliminated from diagnostic manuals.<ref name="moser2005">{{cite journal |title=''DSM-IV-TR'' and the Paraphilias |journal=Journal of Psychology & Human Sexuality |date=2006 |volume=17 |issue=3–4 |pages=91–109 |doi=10.1300/j056v17n03_05 | vauthors = Moser C, Kleinplatz PJ }}</ref> Ray Blanchard stated that the definition of paraphilia in the DSM done by concatenation (i.e., by listing a set of paraphilias) and that defining the term by exclusion (anything that is not normophilic) is preferable.<ref>{{cite journal |last=Moser |first=Charles |date=2011 |title=Yet Another Paraphilia Definition Fails |journal=Archives of Sexual Behavior |volume=40 |issue=3 |pages=483–485 |doi=10.1007/s10508-010-9717-x |pmid=21210203 }}</ref>
===Inclusion and subsequent exclusion of homosexuality=== Homosexuality, a widely accepted variant of human sexuality, was once categorized as a sexual deviation.<ref name="hutchinson">{{cite journal |last1=Hutchinson |first1=G. E. |title=A Speculative Consideration of Certain Possible Forms of Sexual Selection in Man |journal=The American Naturalist |date=1959 |volume=93 |issue=869 |pages=81–91 |doi=10.1086/282059 |jstor=2458750 |bibcode=1959ANat...93...81H }}</ref> Sigmund Freud and subsequent psychoanalytic thinkers considered homosexuality and paraphilias to result from psychosexual non-normative relations to the Oedipal complex,<ref name="lacan">Lacan, Jacques. Le Séminaire. Livre IV. La relation d'objet, 1956–57. Ed. Jacques-Alain Miller. Paris: Seuil, 1991. p. 201</ref><ref name="Karpman1951">{{cite journal |last1=Karpman |first1=Ben |title=The Sexual Psychopath |journal=Journal of the American Medical Association |date=1951 |volume=146 |issue=8 |pages=721–726 |doi=10.1001/jama.1951.03670080029008 |pmid=14832048 }}</ref> although not in the antecedent version of the 'Three Essays on Sexual Theory' where paraphilias are considered as stemming from an original polymorphous perversity.<ref>{{cite report |title=Three essays on the theory of sexuality (1905). Summary |date=1971 |doi=10.1037/e417472005-189 | vauthors = Freud S }}</ref> As such, the term ''sexual perversion'' or the epithet ''pervert'' have historically referred to gay men, as well as other non-heterosexuals (people who fall outside the perceived norms of sexual orientation).<ref name="hutchinson"/><ref name="lacan"/><ref name="kafka1996">{{cite journal |last=Kafka |first=Martin P. |author-link=Martin Kafka |year=1996 |title=Therapy for Sexual Impulsivity: The Paraphilias and Paraphilia-Related Disorders |journal=Psychiatric Times |publisher=MJH Associates |location=New York City |volume=13 |issue=6}}</ref><ref name="Cantor2012">{{cite journal |last1=Cantor |first1=James M. |author-link=James M. Cantor |title=Is Homosexuality a Paraphilia? The Evidence for and Against |journal=Archives of Sexual Behavior |publisher=Springer Science + Business Media |location=New York City |volume=41 |issue=1 |pages=237–247 |date=February 2012 |pmid=22282324 |pmc=3310132 |doi=10.1007/s10508-012-9900-3}}</ref>
By the mid-20th century, mental health practitioners began formalizing "deviant sexuality" classifications into categories. Originally coded as 000-x63, homosexuality was the top of the classification list (Code 302.0) until the American Psychiatric Association removed homosexuality from the DSM in 1973. Martin Kafka writes, "Sexual disorders once considered paraphilias (e.g., homosexuality) are now regarded as variants of normal sexuality."<ref name="kafka1996"/>
A 2012 literature study by clinical psychologist James Cantor, when comparing homosexuality with paraphilias, found that both share "the features of onset and course (both homosexuality and paraphilia being life-long), but they appear to differ on sex ratio, fraternal birth order, handedness, IQ and cognitive profile, and neuroanatomy." The research then concluded that the data seemed to suggest paraphilias and homosexuality as two distinct categories but regarded the conclusion as "quite tentative" given the current limited understanding of paraphilias.<ref name=Cantor2012/>
==Characteristics== Paraphilias typically arise in late adolescence or early adulthood. Persons with paraphilias are generally egosyntonic and view their paraphilias as something inherent in their being, although they recognize that their sexual fantasies lie outside the norm and may attempt to conceal them.<ref name="wiederman2003"/> Paraphilic interests are rarely exclusive<ref name=":1">{{cite book |title=Encyclopedia of Evolutionary Psychological Science |chapter=Paraphilia |date=2021 |pages=5692–5696 |doi=10.1007/978-3-319-19650-3_3387 |isbn=978-3-319-19649-7 | vauthors = Joyal C, Antfolk J }}</ref> and some people have more than one paraphilia.<ref name=":0">{{cite journal |last1=Castellini |first1=Giovanni |last2=Rellini |first2=Alessandra H. |last3=Appignanesi |first3=Cristina |last4=Pinucci |first4=Irene |last5=Fattorini |first5=Matteo |last6=Grano |first6=Elisa |last7=Fisher |first7=Alessandra D. |last8=Cassioli |first8=Emanuele |last9=Lelli |first9=Lorenzo |last10=Maggi |first10=Mario |last11=Ricca |first11=Valdo |date=2018-09-01 |title=Deviance or Normalcy? The Relationship Among Paraphilic Thoughts and Behaviors, Hypersexuality, and Psychopathology in a Sample of University Students |journal=The Journal of Sexual Medicine |volume=15 |issue=9 |pages=1322–1335 |doi=10.1016/j.jsxm.2018.07.015 |pmid=30224020 }}</ref> Some people with paraphilias may seek occupations and avocations that increase their access to objects of their sexual fantasies (e.g., voyeurs working in rental properties to "peep" on others or pedophiles working with Boy Scouts).<ref name="wiederman2003"/>
Research has found that some paraphilias, such as voyeurism and sadomasochism, are associated with more lifetime sexual partners, contradicting theories that paraphilias are associated with courtship disorders and arrested social development.<ref name=":1"/> Scientific literature includes some single-case studies of very rare and idiosyncratic paraphilias. These include an adolescent male who had a strong fetishistic interest in the exhaust pipes of cars, a young man with a similar interest in a specific type of car, and a man who had a paraphilic interest in sneezing (both his own and the sneezing of others).<ref>{{cite journal |author=Padmal de Silva |date=March 2007 |title=Sexual disorder and psychosexual therapy |journal=Psychiatry |volume=6 |issue=3 |pages=130–134 |doi=10.1016/j.mppsy.2006.12.009}}</ref><ref>{{cite journal |last=King |first=Michael B. |year=1990 |title=Sneezing as a fetish object |journal=Sexual and Marital Therapy |location=London, England |publisher=Routledge |volume=5 |issue=1 |pages=69–72 |doi=10.1080/02674659008407999}}</ref>
Ego alien sexual interests in an individual can cause individuals to become suicidal due to the embarrassment or shame that it causes.<ref>{{cite journal |last1=Yakeley |first1=Jessica |last2=Wood |first2=Heather |date=2 January 2018 |title=Paraphilias and paraphilic disorders: diagnosis, assessment and management |journal=Advances in Psychiatric Treatment |volume=20 |issue=3 |pages=202–213 |doi=10.1192/apt.bp.113.011197 }}</ref>
===Causes and correlations=== The causes of paraphilias in people are unclear, but it is believed to be a mixture of neurological, cultural, and psychodynamic factors. No two or more people with a paraphilia will develop it for the same reasons or be interested in the same qualities of the specific sexual interest.<ref>{{cite web |title=Overview of Paraphilias and Paraphilic Disorders - Psychiatric Disorders |url=https://www.merckmanuals.com/professional/psychiatric-disorders/paraphilias-and-paraphilic-disorders/overview-of-paraphilias-and-paraphilic-disorders |access-date=2025-09-07 |website=Merck Manual Professional Edition |language=en-US}}</ref><ref>{{cite journal |last1=Thibaut |first1=Florence |last2=Barra |first2=Flora De La |last3=Gordon |first3=Harvey |last4=Cosyns |first4=Paul |last5=Bradford |first5=John M. W. |last6=the WFSBP Task Force on Sexual Disorders |date=2010 |title=The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the biological treatment of paraphilias |journal=The World Journal of Biological Psychiatry |volume=11 |issue=4 |pages=604–655 |doi=10.3109/15622971003671628 |pmid=20459370 |url=https://repositorio.uchile.cl/handle/2250/164990 }}</ref><ref name=":3">{{cite journal |id={{Gale|A162871566}} |last1=Malin |first1=H. Martin |last2=Saleh |first2=Fabian M. |title=Paraphilias: Clinical and Forensic Considerations |journal=Psychiatric Times |date=15 April 2007 |volume=24 |issue=5 |pages=32 }}</ref> The specific causes of the development of paraphilic sexuality are numerous and vary from person to person. A 2022 study found that the development of paraphilic sexuality correlated with childhood trauma, particularly emotional abuse, neglect, and sexual abuse.<ref name=troubles>{{cite journal |last1=Longpré |first1=Nicholas |last2=Galiano |first2=Courtney Burdis |last3=Guay |first3=Jean-Pierre |title=The impact of childhood trauma, personality, and sexuality on the development of paraphilias |journal=Journal of Criminal Justice |date=September 2022 |volume=82 |article-number=101981 |doi=10.1016/j.jcrimjus.2022.101981 |doi-access=free }}</ref>{{Request quotation|date=February 2026}}
A 2008 study analyzing the sexual fantasies of 200 heterosexual men by using the Wilson Sex Fantasy Questionnaire exam determined that males with a pronounced degree of fetish interest had a greater number of older brothers, a high 2D:4D digit ratio (which would indicate excessive prenatal estrogen exposure), and an elevated probability of being left-handed, suggesting that "disturbed" hemispheric brain lateralization may play a role in paraphilic attractions.<ref>{{cite journal |last1=Quazi |first1=Rahman |last2=Symeonides |first2=Deano J. |date=February 2007 |title=Neurodevelopmental Correlates of Paraphilic Sexual Interests in Men |journal=Archives of Sexual Behavior |location=New York City |publisher=Springer Science + Business Media |volume=37 |issue=1 |pages=166–172 |doi=10.1007/s10508-007-9255-3 |pmid=18074220 |s2cid=22274418}}</ref> Behavioral explanations propose that paraphilias are conditioned early in life, during an experience that pairs the paraphilics stimulus with intense sexual arousal.<ref name="Nolen-Hoeksema2013">{{cite book |last=Nolen-Hoeksema |first=Susan |url=http://connect.customer.mheducation.com/products/connect-for-nolen-hoeksema-abnormal-psychology-6e/ |title=Abnormal Psychology |date=2013 |publisher=McGraw-Hill |isbn=978-0-07-803538-8 |edition=6th |location=Boston, Massachusetts |page=385 |author-link=Susan Nolen-Hoeksema |access-date=15 April 2015 |archive-url=https://web.archive.org/web/20171104143831/http://connect.customer.mheducation.com/products/connect-for-nolen-hoeksema-abnormal-psychology-6e/ |archive-date=4 November 2017 |url-status=dead}}</ref> Susan Nolen-Hoeksema suggests that, once established, masturbatory fantasies about the stimulus reinforce and broaden the paraphilic arousal.<ref name="Nolen-Hoeksema2013"/>
Genetic causes, particularly genes that encode the behavior of neurotransmitter receptors and androgen release have been implicated in studies, though others have shown no correlation between genetics and paraphilic behavior.<ref>{{cite journal |last1=Jakubczyk |first1=Andrzej |last2=Krasowska |first2=Aleksandra |last3=Bugaj |first3=Marcin |last4=Kopera |first4=Maciej |last5=Klimkiewicz |first5=Anna |last6=Łoczewska |first6=Agata |last7=Michalska |first7=Aneta |last8=Majewska |first8=Aleksandra |last9=Szejko |first9=Natalia |last10=Podgórska |first10=Anna |last11=Sołowiej |first11=Małgorzata |last12=Markuszewski |first12=Leszek |last13=Jakima |first13=Sławomir |last14=Płoski |first14=Rafał |last15=Brower |first15=Kirk |last16=Wojnar |first16=Marcin |title=Paraphilic Sexual Offenders Do Not Differ from Control Subjects with Respect to Dopamine- and Serotonin-Related Genetic Polymorphisms |journal=The Journal of Sexual Medicine |date=January 2017 |volume=14 |issue=1 |pages=125–133 |doi=10.1016/j.jsxm.2016.11.309 |pmid=27989490 }}</ref><ref>{{cite journal |last1=Alanko |first1=Katarina |last2=Gunst |first2=Annika |last3=Mokros |first3=Andreas |last4=Santtila |first4=Pekka |title=Genetic Variants Associated with Male Pedophilic Sexual Interest |journal=The Journal of Sexual Medicine |date=May 2016 |volume=13 |issue=5 |pages=835–842 |doi=10.1016/j.jsxm.2016.02.170 |pmid=27114195 }}</ref>
It is possible for an individual to acquire a paraphilia from various types of brain lesions and epilepsy.<ref>{{cite journal |last1=Baird |first1=Amee D. |last2=Wilson |first2=Sarah J. |last3=Bladin |first3=Peter F. |last4=Saling |first4=Michael M. |last5=Reutens |first5=David C. |date=22 December 2006 |title=Neurological control of human sexual behaviour: insights from lesion studies |journal=Journal of Neurology, Neurosurgery, and Psychiatry |volume=78 |issue=10 |pages=1042–1049 |doi=10.1136/jnnp.2006.107193 |pmc=2117556 |pmid=17189299}}</ref>
==Prevalence== Although paraphilic interests in the general population were believed to be rare, research has shown that fantasies and behaviors related to voyeurism, sadomasochism, and couple exhibitionism are not statistically uncommon among adults.<ref name=":1"/> The DSM-5 estimates that 2.2% of males and 1.3% of females in Australia engaged in bondage and discipline, sadomasochism, or dominance and submission within the past 12 months. The population prevalence of sexual masochism disorder is unknown.<ref name="DSM-5">{{citation|last=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition |date=2013 |pages=694 |edition=5th |id={{ASIN |0890425558 |country=uk}}}}</ref>
===Among men=== In a study conducted in a population of men, 62% of participants reported at least one paraphilic interest. In another sample of college students, voyeurism was reported in 52% of men.<ref name=":0"/>
===Among women=== Paraphilias are often observed in women,<ref>{{cite journal |title=Sensual, Erotic, and Sexual Behaviors of Women from the "Kink" Community |journal=Archives of Sexual Behavior |date=2015 |volume=44 |issue=4 |pages=825–836 |doi=10.1007/s10508-015-0524-2 |pmid=25795531 |pmc=4379392 |vauthors=Rehor JE}}</ref><ref>{{cite web |title=Kinky Sex Survey Says: You're Not as Deviant as You Think |date=11 November 2014 |url=https://reason.com/2014/11/11/kinky-sex-survey-finds-everybodys-weird/}}</ref> and there have been some studies focusing exclusively on females with paraphilias.<ref>{{cite journal |last1=Chow |first1=Eva W. C. |last2=Choy |first2=Alberto L. |title=Clinical Characteristics and Treatment Response to SSRI in a Female Pedophile |journal=Archives of Sexual Behavior |date=April 2002 |volume=31 |issue=2 |pages=211–215 |doi=10.1023/A:1014795321404 |pmid=11974646 }}</ref> Men and women differ on the content of their sexual fantasies, with men reporting greater proportions of fetishism, exhibitionism, sadism, and women reporting greater proportions of masochism.<ref>{{cite journal |last1=Dawson |first1=Samantha J. |last2=Bannerman |first2=Brittany A. |last3=Lalumière |first3=Martin L. |date=2016 |title=Paraphilic Interests: An Examination of Sex Differences in a Nonclinical Sample |journal=Sexual Abuse |language=en |volume=28 |issue=1 |pages=20–45 |doi=10.1177/1079063214525645 |pmid=24633420 }}</ref> Sexual masochism has been found to be the most commonly observed paraphilia in women, with approximately 1 in 20 cases.<ref name=DSM>American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). pp. 569–570, 572, 574, Washington, DC: Author.</ref><ref name="DSM-V">{{citation|last=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition |date=2013 |pages=685–706 |edition=5th |id={{ASIN |0890425558 |country=uk}}}}</ref>
==In ancient cultures== Paraphilic fantasies and behaviors have been registered in multiple old and ancient sources. Voyeurism, bestiality, and exhibitionism have been described in the Bible. Sexual relations with animals have also been depicted in cave paintings.<ref>{{cite book |title=Practical Guide to Paraphilia and Paraphilic Disorders |chapter=General Information: History, Etiology and Theory (E.g., Courtship), Diagnosis, Comorbidity and Prevalence |date=2016 |pages=15–29 |doi=10.1007/978-3-319-42650-1_2 |isbn=978-3-319-42648-8 | vauthors = Balon R }}</ref> Some ancient sex manuals such as the ''Kama Sutra'' (450), ''Koka Shastra'' (1150), and ''Ananga Ranga'' (1500) discuss biting, marks left after sex and love blows. Although evidence suggests that paraphilic behaviors have existed prior to the Renaissance, it is difficult to ascertain how common they were and how many people had persistent paraphilic fantasies in ancient times.<ref name=":2"/>
[[File:Esther Huillard - Leda et le cygne.jpg|thumb|"Leda and the Swan" (from the Greek tale) by Esther Huillard]] Bestiality has been depicted multiple times in Greek mythology, although the act itself usually involved a deity in zoomorphic form, such as Zeus seducing Europa, Leda, and Persephone while disguised as a bull, a swan, and a serpent, respectively. Zeus was also depicted, in the form of an eagle, abducting Ganymede, an act that alludes to both bestiality and pederastry. Some fragments of Hittite law include prohibitions of and permissions to engage in specific acts of bestiality.<ref>Peled, Ilan (2020). "Bestiality in Hittite Thought." ''Journal of the Ancient Near Eastern Society'' 34 (1).</ref>
Havelock Ellis pointed to an example of sexual masochism in the fifteenth century. The report, written by Giovanni Pico della Mirandola, described a man who could only be aroused by being beaten with a whip dipped in vinegar.<ref name=":2"/> Wilhelm Stekel also noted that Rousseau also discussed his own masochism in his ''Confessions''.<ref name="Stekel 2013 p. 17">{{cite book |last=Stekel |first=W. |url=https://books.google.com/books?id=tih-CgAAQBAJ&pg=PT17 |title=Sadism and Masochism – The Psychology of Hatred and Cruelty – Vol. II |publisher=Read Books Limited |year=2013 |isbn=978-1-4733-8951-9 |page=17 |access-date=2023-06-14 }}</ref> Other similar instances of persistent paraphilic fantasies were reported between 1516 and 1643 by Coelius Sedulius, Rhodiginus, Brundel and Meibomius.<ref name=":2"/>
==Paraphilic disorder== {{Excerpt|Paraphilic disorder}}
==References== {{Reflist}}
{{Paraphilias}} {{Human sexuality}} {{Sex}} {{Authority control}}
Category:Paraphilias Category:Sexology