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Selective serotonin reuptake inhibitors (SSRIs) are used, especially with exhibitionists, non-offending pedophiles, and compulsive masturbators. They are proposed to work by reducing sexual arousal, compulsivity, and depressive symptoms. However, supporting evidence for SSRIs is limited.
According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress. Goals of treatment can include elimination of criminal activity, reduction in reliance on the fetish for sexual satisfaction, improving relationship skills, or attempting to remove deviant arousal altogether. The evidence for treatment efficacy is limited and largely based on case studies, and no research on treatment for female fetishists exists.
Cognitive behavioral therapy is one popular approach. Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute non-fetishistic fantasies for ones involving the fetish. Aversion therapy can reduce fetishistic arousal in the short term, but is unlikely to have any permanent effect.
Antiandrogens and selective serotonin reuptake inhibitors (SSRIs) may be prescribed to lower sex drive. Cyproterone acetate is the most commonly used antiandrogen, except in the United States, where it may not be available. A large body of literature has shown that it reduces general sexual fantasies. Side effects may include osteoporosis, liver dysfunction, and feminization. Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain. Some hospitals use leuprolide acetate and goserelin acetate to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens. A number of studies support the use of SSRIs, which may be preferable over antiandrogens because of their relatively benign side effects. None of these drugs cure sexual fetishism, but they can make it easier to manage.
Relationship counselers may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing. Partners may agree to incorporate the fetish into their activities in a controlled, time-limited manner, or set aside only certain days to practice the fetishism. If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).
Antiandrogens are used in more severe cases. Similar to physical castration, they work by reducing androgen levels, and have thus been described as chemical castration. The antiandrogen cyproterone acetate has been shown to substantially reduce sexual fantasies and offending behaviors. Medroxyprogesterone acetate and gonadotropin-releasing hormone agonists (such as leuprolide acetate) have also been used to lower sex drive. Due to the side effects, the World Federation of Societies of Biological Psychiatry recommends that hormonal treatments only be used when there is a serious risk of sexual violence, or when other methods have failed. Surgical castration has largely been abandoned because these pharmacological alternatives are similarly effective and less invasive.
Sexual fetishism or erotic fetishism is a sexual fixation on a nonliving object or nongenital body part. The object of interest is called the fetish; the person who has "a fetish" for that object is a fetishist. A sexual fetish may be regarded as a non-pathological aid to sexual excitement, or as a mental disorder if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. Sexual arousal from a particular body part can be further classified as partialism.
While medical definitions restrict the term "sexual fetishism" to objects or body parts, "fetish" can also refer to sexual interest in specific activities in common discourse.
The following are some of the partialisms commonly found among people:
Hand fetishism or hand partialism or also Quirofilia is the sexual fetish for hands. This may include the sexual attraction to a specific area such as the fingers, palm or nails, or the attraction to a specific action performed by the hands; which may otherwise be considered non-sexual—such as washing or drying dishes. This fetish may manifest itself as a desire to experience physical interaction, or as a source of sexual fantasy.
Hand fetishism is recognized by the porn industry; however, it is one of the least common fetishes, despite foot fetishism being the most common.
Hand fetishism is usually based in the biological indication that a partner is healthy and a good potential mate.
As a paraphilia, breast fetishism (also known as mastofact, breast partialism, or mazophilia) is a highly atypical sexual interest focused on female breasts (see partialism). The term "breast fetishism" is also used in the non-paraphilic sense, to refer to cultural attention to female breasts and the sexuality they represent, with debate existing as to whether the modern widespread fascination with breasts among heterosexual males in western societies is a sexual fetish.
A hand fetish is a sexual attraction to the hands. This attraction is most commonly expressed with fingering, handjobs, sucking on the fingers and licking the palms. Fingering and Handjobs are an extremely common sexual act, so are not always linked to hand fetishism. However, fingering and handjobs play a major role in hand fetishism.
Fingernail fetishism, a sub-type of hand fetishism is often expressed with scratching with the fingernails and painting the fingernails.
Partialism is sexual interest with an exclusive focus on a specific part of the body other than the genitals. Partialism is categorized as a fetishistic disorder in the DSM-5 of the American Psychiatric Association only if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. In the DSM-IV, it was considered a separate paraphilia (not otherwise specified), but was merged into fetishistic disorder by the DSM-5. Individuals who exhibit partialism sometimes describe the anatomy of interest to them as having equal or greater erotic attraction for them as do the genitals.
Partialism occurs in heterosexual, bisexual, and homosexual individuals. The foot is considered one of the most common partialisms.
Foot fetishism has been defined as a pronounced sexual interest in feet. Extensions of this fetish include shoes and tickling. Sigmund Freud considered foot binding as a form of fetishism. For a foot fetishist, points of attraction include the shape and size of feet and toes (e.g., long toes, short toes, painted toenails, high arches, soles etc.), jewelry (e.g., toe rings, anklets, etc.), treatments (such as massaging, washing partner's feet or painting partner's toenails), state of dress (barefoot, flip flops, sandals, high heels, hosiery, socked feet, etc.), odor and/or sensory interaction (e.g., rubbing the foot, tickling, smelling, kissing, biting, licking, sucking toes, rubbing genitals on foot, etc.).
Nose fetishism, nose partialism, or nasophilia is the partialism (or paraphilia) for the nose. This may include the sexual attraction to a specific form of physical variation of appearance (such as shape and size), or a specific area (for example; the bridge or nostrils). The fetish may manifest itself in a desire for actual physical contact and interaction, or specific fantasies such as the desire to penetrate the nostrils.
Other fantasies may include the desire to observe or experience a transformation of a nose with reference to an element of a fictional work such as Pinocchio, or ideas concerning the transformation of the nose into that of another creatures' like a pig's snout as a means of sexually humiliating a partner or acquaintance. These fantasies may be assisted with use of props, role-play or transformation fiction, in the form of writing, artwork, or modified photographs of people (known as morphing).
Sigmund Freud interpreted the nose as a substitute for the penis.
Armpit fetishism (also known as "maschalagnia") is a partialism in which an individual is sexually attracted to armpits - something which may lead to axillism, or armpit intercourse (sexual activity with one or both armpits).
The natural body smell is a powerful force in sexual attraction, and can be focused by the strong pungent odor of the armpit: Alex Comfort considered that for a woman to shave her armpits was “simply ignorant vandalism”, obliterating a powerful sexual tool, and praised the French for greater sexual awareness than American deodorant culture in this regard.
A woman's armpits, armpit hair, and secretions can be seen as essential components of her femininity, whether this is positively or negatively valued. Havelock Ellis found evidence that (in a non-sexual context) smelling one's own armpit could act as a temporary energy boost.
Scientists have hypothesized that non-paraphilic sexual attraction to breasts is the result of their function as a secondary sex characteristic. For instance, zoologist and ethologist Desmond Morris theorizes that cleavage is a sexual signal that imitates the image of the cleft between the buttocks, which according to Morris in "The Naked Ape" is also unique to humans, other primates as a rule having much flatter buttocks. Evolutionary psychologists theorize that humans' permanently enlarged breasts, in contrast to other primates' breasts, which only enlarge during ovulation, allows human females to "solicit [human] male attention and investment even when they are not really fertile".
The reverence and theorizing shown to breasts also appears in the science of modern civilization. Breast fetishism is claimed to be an example of a contagious thought (or meme) spreading throughout society, and that breasts are features that have evolved to influence human sexuality rather than serve an exclusive maternal function.
In clinical literature of the 19th century, the sexual focus on breasts was considered a form of paraphillia, but, in modern times, this attraction is considered normal unless it is highly atypical and is therefore a form of partialism.
Foot fetishism, foot partialism, foot worship or podophilia is a pronounced sexual interest in feet. It is the most common form of sexual fetishism for otherwise non-sexual objects or body parts and is more prevalent in men than women.
A navel fetishist can be sexually aroused by a variety of stimuli, including key words, thoughts or specific forms of physical interaction with the navel.
Technically, hair fetishism is called trichophilia, which comes from the Greek ""trica-"" (τρίχα), which means hair, and the suffix ""-philia"" (φιλία), which means love.
Hair fetishism, also known as hair partialism and trichophilia, is a partialism in which a person sees hair most commonly, head hair as particularly erotic and sexually arousing. Arousal may occur from seeing or touching hair, whether head hair, pubic hair, axillary hair, chest hair or fur. Head-hair arousal may come from seeing or touching very long or short hair, wet hair, certain colors of hair or a particular hairstyle. Pubic hair fetishism is a particular form of hair fetishism.
Haircut fetishism is a related paraphilia in which a person is aroused by having their head hair cut or shaved, by cutting the hair of another, by watching someone get a haircut, or by seeing someone with a shaved head or very short hair.
Some navel fetishists find physical acts involving the navel to be turn-ons. Physical acts can include licking the navel with the tongue or rubbing body lotion or suntan oil. Some fetishists get a turn-on from pouring drops of champagne, honey, chocolate sauce, whipped cream, etc., into and around the navel and then licking or sucking it up. Similarly, licking or rolling the tongue into the navel while underwater can produce erotic sensations. An ice cube when rubbed over or rested over the navel can produce erotic sensations.
The navel is an erogenous zone with a heightened sensitivity. The navel and the region below when touched by the finger or the tip of the tongue result in the production of erotic sensations, and some people are very ticklish to touch in that area. Some people can be aroused by tickling, lickling, blowing raspberries/zerberts (blowing air with lips), and teasing with a feather, flower or a piece of grass, especially when the person is ticklish in the navel. Fingering the navel is also a common act.
Some prefer to perform navel torture, a series of pain-inflicting acts such as sucking or pulling the navel out (often with a syringe), dripping hot oil or wax into the navel, poking pins into the navel, and stabbing the navel.
This attention is usually directed at a partner's navel, but may include a fixation on the fetishist's own navel.
A sex worker in Turkey stated that some men have attempted to have sexual intercourse by inserting their penis into her navel.
Some fetishists get a turn-on from touching or rubbing their belly region.
Anthropologists and behaviorists have discovered substantial evidence that the waist-hip ratio (WHR) is a significant measure for female attractiveness, Some find a slender muscular stomach with a defined V-zone to be a turn-on.