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Involve deviant sexual stimuli or acts
According to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision, (DSM-IV-TR),[1] paraphilias are characterized by "recurrent, intense, sexually arousing fantasies, sexual urges or behaviours, generally involving (1) nonhuman objects, (2) the suffering or humiliation of oneself or one's partner, or (3) children or other nonconsenting persons that occur over a period of 6 months" and "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." Such stimuli or acts deviate from socially accepted sexual behaviour, but may be necessary, and in some cases sufficient, for affected individuals to experience sexual arousal and orgasm.[2] This article summarizes a recent review of the current pharmacological treatment for paraphilias by Garcia and Thibaut.[2]
Examples of categories of paraphilia in the DSM-IV-TR[1] include recurrent, intense, sexually arousing fantasies, sexual urges or behaviours involving:
the exposure of one's genitals to an unsuspecting stranger (exhibitionism);
the use of nonliving objects, such as female shoes or underwear (fetishism);
touching and rubbing against a nonconsenting person (frotteurism);
sexual attraction to prepubescent children (paedophilia);
the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer (sexual masochism);
acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person (sexual sadism);
observing an unsuspecting person who is in the process of disrobing, is naked or is engaging in sexual activity (voyeurism);
other objects or behaviours, including, but not limited to, coprophilia (faeces), necrophilia (corpses), telephone scatologia (obscene telephone calls) and zoophilia (animals) [paraphilia not otherwise specified].
Predominately a male disorder
Males account for 90% of cases of paraphilia (with the exception of sexual masochism, which is 20-fold more likely in women).[2,3] The onset of paraphilic sexual interest usually occurs before 18 years of age, with most paraphilias persisting for many years, if not a lifetime. Most paraphilias are heterogeneous and complex, with individuals often having more than one paraphilic disorder.[2,3]
In themselves, paraphilias are not illegal; the paraphilic individual may have deviant sexual fantasies or urges without acting on them, or their deviant sexual behaviour does...