Fetishism is use of an inanimate object (the fetish) or nongenital body parts as the preferred method of producing sexual excitement. Fetishistic disorder refers to recurrent, intense sexual arousal from use of an inanimate object or from a very specific focus on a nongenital body part (or parts) that causes clinically significant distress or functional impairment in one or more important areas of life.
Fetishism is a form of paraphilia, but most people who have fetishism do not meet the clinical criteria for a paraphilic disorder, which require that the person's behavior, fantasies, or intense urges result in clinically significant distress or functional impairment. The condition must also have been present for ≥ 6 months.
There are many fetishes; common fetishes include aprons, shoes, leather or latex items, feet, and women’s underclothing. The fetish may replace typical sexual activity with a partner or may be integrated into sexual activity with a willing partner. Minor fetishistic behavior as an adjunct to consensual sexual behavior is not considered a disorder because distress, disability, and significant dysfunction are absent. More intense, obligatory, and highly compulsive fetishistic arousal patterns and behaviors may cause problems in a relationship or become all-consuming and destructive in a person’s life.
Fetishes may include clothing of another gender (eg, women's undergarments), but if sexual arousal occurs mainly from wearing that clothing (ie, cross-dressing) rather than using it in some other way, the behavior is considered transvestism .
Treatment of Fetishistic Disorder
Psychotherapy or couples therapy
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors and androgen-reducing strategies have been used with limited success in some patients who request treatment (1). As with most other paraphilias, few people with the condition voluntarily seek out professional help.
Treatment reference
1. Eusei D, Delcea C: Fetishistic disorder. In Theoretical-Experimental Models in Sexual and Paraphilic Dysfunctions. Edited by Delea C. Int J Adv Stud Sexology 1(1):67-21, 2020. https://www.researchgate.net/publication/344473505
