Dealing with deviant sexual disorders

Dr Sacrifice Chirisa Mental Health Matters
Sex and human sexuality are a core part of being human, so it is natural to wonder about sex in all its different forms. This week we look at common behavioural sexual disorders that are seen and misunderstood in the community. This has led to individuals suffering from these being physically attacked instead of bringing them for psychiatric help and attention.

Exhibitionism Disorder is a condition characterised by recurrent, intense sexually arousing fantasies, sexual urges, or behaviours involving the exposure of one’s genitals to an unsuspecting stranger. These feelings have been with the individual for at least six months.

These fantasies, sexual urges or behaviours cause clinically significant distress or impairment in social, occupational or other important areas of functioning. The individual might recognise that what they are doing is wrong but derive sexual gratification from the response of the victims.

Fetishistic Disorder is characterised by a behaviour and feeling involving the eroticisation of non-living objects and or body parts for sexual gratification. Among the more common non-living fetish objects are women’s underpants, bras, stockings, shoes, boots or any other apparel. An individual with a fetish for a body part, like feet or hair will focus primarily on the eroticised non-genital body part during sexual encounter.

It is not uncommon for sexualised fetishes to include both inanimate objects and body parts like dirty socks with feet.

Fetishistic disorder can be a multisensory experience, including holding, tasting, rubbing, inserting or smelling the fetish object while masturbating or preferring that a sexual partner wear or utilise a fetish object during sexual encounters. These individuals might also steal female clothing on the washing line and can be found with a collection.

Frotteuristic Disorder is characterised by recurrent, intense sexually arousing fantasies, sexual urges or behaviours involving touching and rubbing against a non-consenting person over a period of at least six months.

The fantasies, sexual urges or behaviours cause clinically significant distress or impairment in social, occupational or other important areas of functioning. This is seen mainly in crowded places like in overloaded buses, trains and chaotic queues. Individuals suffering from this are usually subjected to public justice and beating for lack of understanding of the psychiatric condition.

Transvestic disorder is characterised by recurrent and intense sexually arousing fantasies, sexual urges or behaviours involving cross-dressing in a heterosexual male over a period of at least six months. The fantasies, sexual urges or behaviours cause clinically significant distress or impairment in social, occupational or other important areas of function- ing.

Though not necessary, this disorder can occur with fetishism; the person is sexually aroused by materials, garments or fabrics or with autogynephilia is when the person is sexually aroused by thoughts or images of oneself as a female.

Voyeurism disorder is characterised by deriving sexual pleasure and gratification from looking at the naked bodies and genital organs or observing the sexual acts of others.

The voyeur is usually hidden from view of others. A variant or version form of voyeurism involves listening to erotic conversations. This is commonly referred to as telephone sex, although it is usually considered voyeurism primarily in the instance of listening to unsuspecting persons. The object of voyeurism is to observe unsuspecting individuals who are naked, in the process of undressing or engaging in sexual acts.

The person being observed is usually a stranger to the observer. The act of looking or peeping is undertaken for the purpose of achieving sexual excitement. The observer generally does not seek to have sexual contact or activity with the person being observed. If orgasm is sought, it is usually achieved through self pleasuring. This may occur during the act of observation or later, relying on the memory of the act that was observed.

Treatment to be successful there is voluntary need to want to modify existing patterns of behaviour. This initial step is difficult for most deviant sexual disorders; to admit and then submissively undergo behavioral therapy.

These individuals are taught to control the impulse and just as importantly to acquire more acceptable means of sexual gratification. There are no direct drug treatments. In the treatment seeking samples observed, this disorder occurs almost exclusively in males; women generally do not exhibit these disorders, and more information is needed to determine whether this disorder occurs in a significant degree within the female sex.

Please refer these individuals early for psychiatric evaluation and treatment.