Exhibitionistic Disorder

Exhibitionism is a form of paraphilia Overview of Paraphilias and Paraphilic Disorders Paraphilic disorders are recurrent, intense, sexually arousing fantasies, urges, or behaviors that are distressing or disabling and that involve inanimate objects, children or nonconsenting... read more , but most people who have exhibitionism do not meet the clinical criteria for a paraphilic disorder, which require that a person's behavior, fantasies, or intense urges result in clinically significant distress or impaired functioning or cause harm to others (which in exhibitionism includes acting on the urges with a nonconsenting person). The condition must also have been present for ≥ 6 months.

Although the true prevalence is unknown, estimated prevalence in men is approximately 2 to 4% (1 General references Exhibitionism is characterized by achievement of sexual excitement through genital exposure, usually to an unsuspecting stranger. It may also refer to a strong desire to be observed by other... read more ); prevalence appears to be lower in women. Few females are diagnosed with exhibitionistic disorder. Thomas et al (2 General references Exhibitionism is characterized by achievement of sexual excitement through genital exposure, usually to an unsuspecting stranger. It may also refer to a strong desire to be observed by other... read more ) suggest that sex differences in sociosexuality may be relevant in this long-observed sex difference.

Exhibitionists (usually male) may masturbate while exposing or fantasizing about exposing themselves to others. They may be aware of their need to surprise, shock, or impress the unwilling observer. The victim is almost always a female adult or a child of either sex. Actual sexual contact is rarely sought, and physical harm to the unsuspecting witness is unusual.

Onset is usually during adolescence; occasionally, the first act occurs at a wider range of ages, during preadolescence or middle age.

About 30% of apprehended male sex offenders are exhibitionists (3 General references Exhibitionism is characterized by achievement of sexual excitement through genital exposure, usually to an unsuspecting stranger. It may also refer to a strong desire to be observed by other... read more ). Recidivism rates as high as approximately 40% have been reported (4 General references Exhibitionism is characterized by achievement of sexual excitement through genital exposure, usually to an unsuspecting stranger. It may also refer to a strong desire to be observed by other... read more ). Although it is reported to occur, the vast majority of those with exhibitionism do not engage in physically aggressive sexual behaviors.

Although many exhibitionists marry, the marriage is often troubled by poor social and sexual adjustment, including frequent sexual dysfunction (see Male Sexual Function and Dysfunction Overview of Male Sexual Function and Dysfunction There are 4 main components of male sexual function: Libido Erection Ejaculation Orgasm read more and Female Sexual Function and Dysfunction Overview of Female Sexual Function and Dysfunction Women commonly have concerns about sexual function ( 1). Concerns that cause personal or interpersonal distress are considered a sexual dysfunction disorder. Approximately 12% of women in the... read more ).

Exhibitionists may also have a personality disorder Overview of Personality Disorders Personality disorders in general are pervasive, enduring patterns of thinking, perceiving, reacting, and relating that cause significant distress or functional impairment. Personality disorders... read more (usually antisocial Antisocial Personality Disorder (ASPD) Antisocial personality disorder is characterized by a pervasive pattern of disregard for consequences and for the rights of others. Diagnosis is by clinical criteria. Treatment may include cognitive-behavioral... read more ) or conduct disorder Conduct Disorder Conduct disorder is a recurrent or persistent pattern of behavior that violates the rights of others or violates major age-appropriate societal norms or rules. Diagnosis is by clinical criteria... read more (5 General references Exhibitionism is characterized by achievement of sexual excitement through genital exposure, usually to an unsuspecting stranger. It may also refer to a strong desire to be observed by other... read more ).

For some people, exhibitionism is expressed as a strong desire to have other people watch their sexual acts. What appeals to such people is not the act of surprising an audience but rather of being seen by a consenting audience. People with this form of exhibitionism may make pornographic films or become adult entertainers. They rarely experience distress or impairment due to this desire and thus may not have a psychiatric disorder.