In this chapter, we focus on a number of sexual behaviors that have been variously labeled as deviant, perverted, aberrant, or abnormal. More recently, the less judgmen­tal term paraphilia (pair-uh-FILL-ee-uh) has been used to describe these somewhat uncommon types of sexual expression. Literally meaning "beyond usual or typical love," this term stresses that such behaviors are usually not based on an affectionate or loving relationship but rather are expressions of behavior in which sexual arousal or response, or both, depends on some unusual, extraordinary, or even bizarre activity (American Psychiatric Association, 2000; Shindel & Moser, 2011). The term paraphilia is used in much of the psychological and psychiatric literature. However, in our own experience in dealing with and discussing variant sexual behaviors, the one common character­istic that stands out is that each behavior in its fully developed form is not typically expressed by most people in our society. Therefore we also categorize the behaviors discussed in this chapter as atypical sexual behaviors.

Several points should be noted about atypical sexual expression in general before we discuss specific behaviors. First, as with many other sexual expressions discussed in this book, the behaviors singled out in this chapter represent extreme points on a con­tinuum. Atypical sexual behaviors exist in many gradations, ranging from mild, infre­quently expressed tendencies to full-blown, regularly manifested behaviors. Although these behaviors are atypical, many of us may recognize some degree of such behaviors or feelings in ourselves—perhaps manifested at some point in our lives, or mostly repressed, or emerging only in private fantasies.

A second point has to do with the state of our knowledge about these behaviors. In most of the discussions that follow, the person who manifests the atypical behavior is assumed to be male, and evidence strongly indicates that in most reported cases

of atypical or paraphilic behaviors, the agents of such acts are male (J. Miller, 2009). However, the tendency to assume that males are predominantly involved may be influ­enced by the somewhat biased nature of differential reporting and prosecution. Female exhibitionism, for example, is far less likely to be reported than is similar behavior in a male. Of the paraphilias discussed in this chapter, sexual masochism is the one most likely to be expressed by women (J. Miller, 2009). John Money (1981) suggested that atypical sexual behavior is decidedly more prevalent among males than females because male erotosexual differentiation (the development of sexual arousal in response to vari­ous kinds of images or stimuli) is more complex and subject to more errors than that of the female.

A third noteworthy point is that atypical behaviors often occur in clusters. That is, the occurrence of one paraphilia appears to increase the probability that others will also be manifested, simultaneously or sequentially (Bradford et al., 1992; Kafka, 2009). Research on men whose paraphilias resulted in medical or legal attention revealed that over half of the men reported engaging in more than one paraphilia and almost one in five reported experience with four or more paraphilias (Abel & Osborn, 2000). One hypothesis offered to account for this cluster effect is that engaging in one atypical behavior, such as exhibitionism, reduces the participant’s inhibitions to the point that engaging in another paraphilia, such as voyeurism, becomes more likely (Stanley, 1993).

A final consideration is the effect of atypical behaviors both on the person who exhibits them and on the people to whom they may be directed. People who manifest atypical sexual behaviors often depend on these acts for sexual satisfaction. The behav­ior is frequently an end in itself. It is also possible that the unconventional behavior will alienate others. Consequently, these people often find it difficult to establish satisfying sexual and intimate relationships with partners. Instead, their sexual expression can assume a solitary, driven, even compulsive quality. Some of these behaviors do involve other people whose personal space is violated in a coercive, invasive fashion. In the fol­lowing section, we consider the distinction between coercive and noncoercive paraphil­ias. ■ Table 16.1 summarizes the paraphilias discussed in this chapter.

At a Glance

■ TABLE 16.1 Summary of Several Paraphilias

Name

Description

Classification

Fetishism

Sexual arousal associated with focus on inanimate object or body part

Noncoercive

Transvestic fetishism

Sexual arousal derived from wearing clothing of other sex

Noncoercive

Sexual sadism

Association of sexual arousal with pain

Noncoercive

Sexual masochism

Sexual arousal through receiving physical or psychological pain

Noncoercive

Autoerotic asphyxia

Enhancement of sexual arousal by oxygen deprivation

Noncoercive

Klismophilia

Sexual pleasure associated with receiving enemas

Noncoercive

Coprophilia and Urophilia

Sexual arousal associated with contact with feces or urine, respectively

Noncoercive

Exhibitionism

Sexual arousal associated with exposing one’s genitals to unwilling observer

Coercive

Obscene phone calls

Sexual arousal associated with obscene telephone conversation with unwilling recipient

Coercive

Voyeurism

Sexual arousal associated with observing naked bodies or sexual activities of people without their consent

Coercive

Frotteurism

Obtaining sexual pleasure by pressing or rubbing against another person in a crowded public place

Coercive

Zoophilia

Sexual contact between humans and animals

Coercive

Necrophilia

Sexual gratification obtained by viewing or having intercourse with a corpse

Coercive

Atypical Sexual Behavior