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Fetishism

(Fetishistic Disorder)

By George R. Brown, MD, Chief of Psychiatry;Professor and Associate Chairman, Department of Psychiatry, Mountain home VAMC, Johnson City, TN;East Tennessee State University

Fetishism is use of an inanimate object (the fetish) as the preferred way to produce sexual arousal. Fetishistic disorder occurs when recurrent, intense sexual arousal from using an inanimate object or focusing on a nongenital body part (such as a foot) causes significant distress, substantially interferes with daily functioning, or harms or may harm another person.

Fetishism is a form of paraphilia.

People with fetishes may become sexually stimulated and gratified in various ways, such as the following:

  • Wearing another person's undergarments

  • Wearing rubber or leather

  • Holding, rubbing, or smelling objects, such as high-heeled shoes

If sexual arousal occurs mainly from wearing clothing of the opposite sex (that is, cross-dressing) rather than using the clothing in some other way, the paraphilia is considered transvestism.

People with fetishistic disorder may not be able to function sexually without their fetish. The fetish may replace typical sexual activity with a partner or may be integrated into sexual activity with a willing partner. The need for the fetish may be so intense and compulsive that it becomes all-consuming and destructive in a person's life. But in most people who have a fetish, their behavior does not meet the criteria for a disorder because it does not cause them significant distress, interfere with daily functioning, or harm others.

Treatment of fetishistic disorder is limited in its effectiveness. It may include one or both of the following: