Fetishism is the use of an inanimate object (the fetish) or nongenital body parts as the preferred method of producing sexual excitement. Fetishistic disorder refers to recurrent, intense sexual arousal from use of an inanimate object or from a very specific focus on a nongenital body part (or parts) that causes clinically significant distress or functional impairment in 1 or more important areas of life.
Fetishism is a form of paraphilia that has been described since the 19th century. Most people who have fetishism do not meet the clinical criteria for fetishistic disorder (a paraphilic disorder) which require that the person's behavior, fantasies, or intense urges result in clinically significant distress or functional impairment. The condition must also have been present for ≥ 6 months. No specific etiology has been identified, but some hypothesize that the disorder is related to the impact of early childhood experiences that become associated with sexual arousal or gratification after puberty (1).
There are many fetishes; the most common ones include aprons, shoes, leather or latex items, feet, and underclothing. The fetish may replace typical sexual activity with a partner or may be integrated into sexual activity with a willing partner. Minor fetishistic behavior as an adjunct to consensual sexual behavior is not considered a disorder because distress, disability, and significant dysfunction are absent. More intense, obligatory, and highly compulsive fetishistic arousal patterns and behaviors may cause problems in a relationship or become all-consuming and destructive in a person’s life.
Fetishes may encompass items such as clothing of another gender (eg, women's undergarments), but if sexual arousal occurs mainly from wearing that clothing (ie, cross-dressing) rather than using it in some other way, the behavior is considered transvestic fetishism.
General reference
1. Cristian D. Fetishist disorder. Internat J Adv Stud Sexology. 2019;1(2):73-77. DOI:10.46388/ijass.2019.12.11.123
Treatment of Fetishistic Disorder
Psychotherapy or couples therapy
Selective serotonin reuptake inhibitors (SSRIs)
There are no randomized trials of any treatments for fetishistic disorder. Selective serotonin reuptake inhibitors and androgen-reducing strategies have been used with limited success in some patients who request treatment (1). As with most other paraphilias, few people with the condition voluntarily seek out professional help.
Treatment reference
1. Eusei D, Delcea C. Fetishistic disorder. In: Delea C, ed. Theoretical-Experimental Models in Sexual and Paraphilic Dysfunctions. Int J Adv Stud Sexology. 1(1):67-21, 2020.
