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F65.0 Fetishism

Reliance on some non-living object as a stimulus for sexual arousal and sexual gratification. Many fetishes are extensions of the human body, such as articles of clothing or footware [sic]. Other common examples are characterized by some particular texture such as rubber, plastic, or leather. Fetish objects vary in their importance to the individual: in some cases they serve simply to enhance sexual excitement achieved in ordinary ways (e.g. having the partner wear a particular garment).

Diagnostic guidelines. Fetishism should be diagnosed only if the fetish is the most important source of sexual stimulation or essential for satisfactory sexual response.

Fetishistic fantasies are common, but they do not amount to a disorder unless they lead to rituals that are so compelling and unacceptable as to interfere with sexual intercourse and cause the individual distress.

Fetishism is limited almost exclusively to males.

F65.1 Fetishistic transvestism

The wearing of clothes of the opposite sex principally to obtain sexual excitement.

Diagnostic guidelines. This disorder is to be distinguished from simple fetishism inn that the fetishistic articles of clothing are not only worn, but worn also to create the appearance of a person of the opposite sex. Usually more than one article is worn and often a complete outfit, plus wig and makeup. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. A history of fetishistic transvestism is commonly reported as an earlier phase by transsexuals and probably represents a stage in the development of transsexualism in such cases.

Includes: transvestic fetishism

F65.5 Sadomasochism

A preference for sexual activity that involves bondage or the infliction of pain or humiliation. If the individual prefers to be the recipient of such stimulation this is called masochism; if the provider, sadism. Often an individual obtains sexual excitement from both sadistic and masochistic activities.

Mild degrees of sadomasochistic stimulation are commonly used to enhance otherwise normal sexual activity. This category should be used only if sadomasochistic activity is the most important source of stimulation or if necessary for sexual gratification.

Sexual sadism is sometimes difficult to distinguish from cruelty in sexual situations or anger unrelated to eroticism. Where violence is necessary for erotic arousal, the diagnosis can be clearly established.

Includes: masochism sadism

Fetishism

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This paraphilia is characterized by sexual fantasies, urges, or behaviors involving use of non-human objects to produce or enhance sexual arousal with or in the absence of a partner.

Diagnostic criteria for 302.81 Fetishism
(cautionary statement)
A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects (e.g., female undergarments).

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The fetish objects are not limited to articles of female clothing used in cross-dressing (as in Transvestic Fetishism) or devices designed for the purpose of tactile genital stimulation (e.g., a vibrator).