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16 February, 2016 - 09:24

A third class of sexual disorders relates to sexual practices and interest. In some cases sexual interest is so unusual that it is known as a paraphilia—a sexual deviation wheresexual arousal is obtained from a consistent pattern of inappropriate responses to objects orpeople, and in which the behaviors associatewith the feelings are distressing and dysfunctional. Paraphilias may sometimes be only fantasies, and in other cases may result in actual sexual behavior (Table 12.8).

Table 12.8 Some Paraphilias




Sex with animals


Exposing genitals to an unsuspecting person


Nonliving or unusual objects or clothing of the opposite sex


Rubbing up against unsuspecting persons


Being beaten, humiliated, bound, or otherwise made to suffer


Sexual activity with a prepubescent child


Witnessing suffering of another person


Observing an unsuspecting person who is naked, disrobing, or engaged in intimate behavior


People with paraphilias are usually rejected by society but for two different reasons. In some cases, such as voyeurismand pedophilia, the behavior is unacceptable (and illegal) because it involves a lack of consent on the part of the recipient of the sexual advance. But other paraphilias are rejected simply because they are unusual, even though they are consensual and do not cause distress or dysfunction to the partners. Sexual sadism and sexual masochism, for instance, are usually practiced consensually, and thus may not be harmful to the partners or to society. A recent survey found that individuals who engage in sadism and masochism are as psychologically healthy as those who do not (Connolly, 2006). 1 Again, as cultural norms about the appropriateness of behaviors change, the new revision of the DSM, due in 2013, will likely change its classification system of these behaviors.


  • Somatoform disorders, including body dysmorphic disorder and hypochondriasis, occur when people become excessively and inaccurately preoccupied with the potential that they have an illness or stigma.
  • Patients with factitious disorder fake physical symptoms in large part because they enjoy the attention and treatment that they receive in the hospital. In the more severe form of factitious disorder known as Münchhausen syndrome, the patient has a lifelong pattern with a series of successive hospitalizations for faked symptoms.
  • Sexual dysfunction is a psychological disorder that occurs when the physical sexual response cycle is inadequate for reproduction or for sexual enjoyment. The types of problems experienced are different for men and women. Many sexual dysfunctions are only temporary or can be treated with therapy or medication.
  • Gender identity disorder (GID, also called transsexualism) is a rare disorder that is diagnosed when the individual displays a repeated and strong desire to be the other sex, a persistent discomfort with one’s sex, and a belief that one was born the wrong sex, accompanied by significant dysfunction and distress.
  • The classification of GID as a mental disorder has been challenged because people who suffer from it do not regard their own cross-gender feelings and behaviors as a disorder and do not feel that they are distressed or dysfunctional.
  • A paraphilia is a sexual deviation where sexual arousal is obtained from a consistent pattern of inappropriate responses to objects or people, and in which the behaviors associated with the feelings are distressing and dysfunctional. Some paraphilias are illegal because they involve a lack of consent on the part of the recipient of the sexual advance, but other paraphilias are simply unusual, even though they may not cause distress or dysfunction.


  1. Consider the biological, personal, and social-cultural aspects of gender identity disorder. Do you think that this disorder is really a “disorder,” or is it simply defined by social-cultural norms and beliefs?
  2. Consider the paraphilias in Table 12.8 "Some Paraphilias". Do they seem like disorders to you, and how would one determine if they were or were not?
  3. View one of the following films and consider the diagnosis that might be given to the characters in it: AntwoneFisher, OrdinaryPeople, GirlInterrupted,GrossePointeBlank, ABeautifulMind, What AboutBob?, Sybil, One FlewOverthe CuckoosNest.