How Common Are Paraphilias?
Most paraphilias are rare and are about 20 times more common among males than among females. However, the reason for this disparity is not clearly understood. While several of these disorders are associated with aggressive behavior, others are not aggressive or harmful. Some paraphilias -- such as pedophilia, exhibitionism, voyeurism, sadism, and frotteurism -- are criminal offenses.
Having paraphilic fantasies or behavior, however, does not always mean the person has a mental illness. The fantasies and behaviors can exist in less severe forms that are not dysfunctional in any way, do not impede the development of healthy relationships, do not harm the individual or others, and do not entail criminal offenses. They may be limited to fantasy during masturbation or intercourse with a partner.
What Causes Paraphilia?
It is not clear what causes paraphilia. Some experts believe it is caused by a childhood trauma, such as sexual abuse. Others suggest that objects or situations can become sexually arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. In most cases, the individual with a paraphilia has difficulty developing personal and sexual relationships with others.
Many paraphilias begin during adolescence and continue into adulthood. The intensity and occurrence of the fantasies associated with paraphilia vary with the individual, but they usually decrease as the person ages.
How Is Paraphilia Treated?
Most cases of paraphilia are treated with counseling and therapy to help the person modify his or her behavior. Medications may help to decrease the compulsiveness associated with paraphilia and reduce the number of deviant sexual fantasies and behaviors. In some cases, hormones are prescribed for individuals who experience frequent occurrences of abnormal or dangerous sexual behavior. Many of these medications work by reducing the individual's sex drive.
How Successful Is Treatment for Paraphilia?
To be most effective, treatment for paraphilia must be provided on a long-term basis. Unwillingness to comply with treatment can hinder its success. It is imperative that people with paraphilias of an illegal nature receive professional help before they harm others or create legal problems for themselves.