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Frotteuristic Disorder

By

George R. Brown

, MD, East Tennessee State University

Reviewed/Revised Jul 2023
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Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent and intense arousal from frotteurism (manifested by fantasies, urges, or behaviors) and has either acted on these sexual urges or the urges cause clinically significant distress or impaired functioning.

Frotteuristic disorder 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 . The word frottage comes from the French frotter, which means "to rub or to put pressure on someone." The term is now associated with obtaining intense sexual arousal as a result of touching (nongenitally) or rubbing one’s genital area against a person who does not give consent.

Part of the excitement appears to be in the risk of getting caught in a public place. Common locations for frotteurism are subways, buses, elevators, sporting events, and other crowded public events. Most of these cases occur with males touching females, although there have been cases of persons of any sex touching another person of any sex (1 General references Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent... read more ). In addition, there are cases of adults of any sex touching children of any sex. Such behavior by adults is considered a criminal offense because it is a form of nonconsensual sex.

This is one of the least studied of the major paraphilias, possibly because most frotteurs do not present themselves for evaluation or treatment, and it is difficult to apprehend frotteurs in crowded public spaces (2 General references Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent... read more ). Many women throughout the world report being victims of frotteurs. For example, in a study of young female passengers (in their twenties or thirties) on public trains in Tokyo, over 66% reported that they had been subject to acts of frotteurism (rubbing, touching, groping) (2 General references Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent... read more ). The prevalence of the disorder is not known, but nonconsensual rubbing or touching of others for sexual gratification, largely among males, has been reported in between 7.9% and 35% (3 General references Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent... read more ).

The exact causes of frotteurism are not fully understood; however, several factors may contribute to its development. These include a combination of psychological, social, and biological factors, such as:

General references

  • 1. Ranger R, Fedoroff P: Frotteurism. The International Encyclopedia of Human Sexuality. First Edition. 369-426, 2015.

  • 2. Stan IC: Frotteuristic disorder. In Transtheoretical approaches to paraphilic disorders, Chapter 6. Edited by Rusu DO, Cristian D. Internat J Adv Stud Sexology 2019-2020, ISSN 2668-7194 (print), ISSN 2668-9987 (online). doi: 10.46388/ijass.2020.13.17

  • 3. Johnson RS, Ostermeyer B, Sikes KA, et al: Prevalence and treatment of frotteurism in the community: a systematic review. J Am Acad Psychiatry Law 42(4):478-483, 2014. PMID: 25492074.

Diagnosis of Frotteuristic Disorder

  • Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria

  • Recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.

  • The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

  • The condition has been present for 6 months.

The clinician must specify whether the individual is living in a controlled environment (eg, institution) or is in full remission (ie, at least 5 years without distress/impairment in an uncontrolled environment).

Diagnosis reference

  • 1. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition,Text Revision (DSM-5-TR). American Psychiatric Association Publishing, Washington, DC.

Treatment of Frotteuristic Disorder

  • Psychotherapy (individual or group)

  • Selective serotonin reuptake inhibitors (SSRIs)

  • Sometimes antiandrogen medications

There are no large studies of treatment approaches specific to frotteuristic disorder. The typical approaches to paraphilias in general have been tried (eg, treating comorbid psychiatric disorders, combining group or individual psychotherapy with the use of SSRIs and antiandrogens such at gonadotropin-releasing hormone [GnRH] agonists, medroxyprogesterone acetate and cyproterone acetate [ 1 Treatment references Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent... read more ]). People with this condition are usually ordered into treatment after arrest for sexual assault and are often unwilling and unmotivated participants in their treatment programs (2 Treatment references Frotteurism is intense sexual arousal from touching or rubbing against a nonconsenting person. Frotteuristic disorder is diagnosed when a person experiences, for at least 6 months, recurrent... read more ).

Treatment references

  • 1. Ranger R, Fedoroff P: Frotteurism. The International Encyclopedia of Human Sexuality. First Edition. 369-426, 2015.

  • 2. Stan IC: Frotteuristic disorder. Transtheoretical approaches to paraphilic disorders, Chapter 6. Internat J Adv Stud Sexology 2019-2020, ISSN 2668-7194 (print), ISSN 2668-9987 (online). doi: 10.46388/ijass.2020.13.17

Drugs Mentioned In This Article

Drug Name Select Trade
Amen, Depo-Provera, Depo-subQ Provera 104, Provera
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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