Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent and intense arousal from frotteurism (manifested by fantasies, urges, or behaviors) and has either acted on these sexual urges or the urges cause clinically significant distress or impaired functioning.
Frotteuristic disorder is a form of paraphilia. The word frottage comes from the French frotter, which means "to rub or to put pressure on someone." The term is now associated with obtaining intense sexual arousal as a result of touching (nongenitally) or rubbing one’s genital area against a person who does not give consent.
Part of the excitement appears to be in the risk of getting caught in a public place. Common locations for frotteurism are subways, buses, elevators, sporting events, and other crowded public events. Most of these cases occur with males touching females, although there have been cases of persons of any sex touching another person of any sex (1). In addition, there are cases of adults of any sex touching children of any sex. Such behavior by adults is considered a criminal offense because it is a form of nonconsensual sex.
This is one of the least studied of the major paraphilias, possibly because most frotteurs do not present themselves for evaluation or treatment, and it is difficult to apprehend frotteurs in crowded public spaces (2). Many women throughout the world report being victims of frotteurs. For example, in a study of young female passengers (in their twenties or thirties) on public trains in Tokyo, over 66% reported that they had been subject to acts of frotteurism (rubbing, touching, groping) (2). The prevalence of the disorder is not known, but nonconsensual rubbing or touching of others for sexual gratification, largely among males, has been reported in between 7.9% and 35% (3).
The exact causes of frotteurism are not fully understood; however, several factors may contribute to its development. These include a combination of psychological, social, and biological factors, such as:
Interruptions or alterations in psychosexual development: Frotteurism may be associated with an individual's early experiences and psychosexual development. Factors such as childhood trauma, sexual abuse, or exposure to inappropriate sexual content may influence the development of this paraphilic disorder.
Social and environmental factors: Cultural and societal factors, such as a lack of sexual education, restrictive attitudes towards sex, or limited access to consensual sexual relationships, may influence the development of frotteurism. Social isolation or difficulties in establishing healthy intimate relationships can also be contributing factors.
Associated psychiatric disorders: Frotteurism can be comorbid with other disorders, such as personality disorders, mood disorders, or additional paraphilias.
General references
1. Ranger R, Fedoroff P: Frotteurism. The International Encyclopedia of Human Sexuality. First Edition. 369-426, 2015.
2. Stan IC: Frotteuristic disorder. In Transtheoretical approaches to paraphilic disorders, Chapter 6. Edited by Rusu DO, Cristian D. Internat J Adv Stud Sexology 2019-2020, ISSN 2668-7194 (print), ISSN 2668-9987 (online). doi: 10.46388/ijass.2020.13.17
3. Johnson RS, Ostermeyer B, Sikes KA, et al: Prevalence and treatment of frotteurism in the community: a systematic review. J Am Acad Psychiatry Law 42(4):478-483, 2014. PMID: 25492074.
Diagnosis of Frotteuristic Disorder
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria
Diagnosis of frotteuristic disorder requires the following (1):
Recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.
The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The condition has been present for ≥ 6 months.
The clinician must specify whether the individual is living in a controlled environment (eg, institution) or is in full remission (ie, at least 5 years without distress/impairment in an uncontrolled environment).
Diagnosis reference
1. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition,Text Revision (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC.
Treatment of Frotteuristic Disorder
Psychotherapy (individual or group)
Selective serotonin reuptake inhibitors (SSRIs)
Sometimes antiandrogen medications
1]). People with this condition are usually ordered into treatment after arrest for sexual assault and are often unwilling and unmotivated participants in their treatment programs (2).
Treatment references
1. Ranger R, Fedoroff P: Frotteurism. The International Encyclopedia of Human Sexuality. First Edition. 369-426, 2015.
2. Stan IC: Frotteuristic disorder. Transtheoretical approaches to paraphilic disorders, Chapter 6. Internat J Adv Stud Sexology 2019-2020, ISSN 2668-7194 (print), ISSN 2668-9987 (online). doi: 10.46388/ijass.2020.13.17
