Paraphilias

Atypical objects or orientations for sexual excitement

Stimuli can vary from common objects such as a woman's shoe, a child, animals, instruments of torture, or aggressive acts

Disorders are differentiated by the object or activity used to achieve arousal

When paraphilias are associated with distress, impairment, or risk of harm, they become paraphilic disorders

Some paraphilias or paraphilic disorders include exhibitionism, transvestism, voyeurism, pedophilia, incest, sexual sadism, and sexual masochism

Exhibitionism is the achievement of arousal by exposing genitalia to strangers

Transvestism consists of recurrent cross-dressing in a heterosexual man often in masturbation foreplay

Voyeurism involves attaining arousal watching sexual activities or disrobing of an unknowing person

Pedophilia is the use of a child to achieve sexual arousal and often gratification

Incest involves a sexual relationship with a person—usually a child—in the immediate family

Sexual sadism involves inflicting pain upon the sexual object as a means of arousal

Sexual masochism is erotic pleasure being achieved by being humiliated, enslaved, or physically bound or restrained

Clinical history, often including court-ordered evaluations

Behavioral therapy

Gonadotropin antagonists

Medroxyprogesterone acetate

Selective serotonin reuptake inhibitors