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Abstract

We used a random sample of 2,450 18-60 year-olds in the general population of Sweden to study the prevalence as well as the social, sexual, and health correlates of transvestic fetishism (sexual arousal from cross-dressing). Almost three percent (2.8%) of men and 0.4% of women reported at least one episode of transvestic fetishism. Separation from parents, same-sex sexual experiences, being easily sexually aroused, pornography use, and higher masturbation frequency were significantly associated with transvestic fetishism. A positive attitude to this sexual practice and paraphilia indicators--sexual arousal from using pain, exposing genitals to a stranger, and spying on others having sex--were particularly strong correlates to the dependent variable.
Journal of Sex & Marital Therapy, 31:87–95, 2005
Copyright © 2005 Brunner-Routledge
ISSN: 0092-623X print
DOI: 10.1080/00926230590477934
Transvestic Fetishism in the General
Population: Prevalence and Correlates
NIKLAS L
a
ANGSTR
¨
OM
Centre for Violence Prevention, Karolinska Institutet, Stockholm, Sweden
KENNETH J. ZUCKER
Child and Adolescent Gender Identity Clinic, Child Psychiatry Program, Centre for Addiction
and Mental Health, Toronto, Ontario, Canada
We used a random sample of 2,450 18–60 year-olds in the general
population of Sweden to study the prevalence as well as the so-
cial, sexual, and health correlates of transvestic fetishism (sexual
arousal from cross-dressing). Almost three percent (2.8%) of men
and 0.4% of women reported at least one episode of transvestic
fetishism. Separation from parents, same-sex sexual experiences,
being easily sexually aroused, pornography use, and higher mas-
turbation frequency were significantly associated with transvestic
fetishism. A positive attitude to this sexual practice and paraphilia
indicators—sexual arousal from using pain, exposing genitals to a
stranger, and spying on others having sex—were particularly strong
correlates to the dependent variable.
According to the World Health Organization (1992), fetishistic transvestism
is the wearing of clothes of the opposite sex principally to obtain sexual
excitement. No limitations with respect to the gender or sexual orientation
of the subject or any requirement of temporal stability are given. In contrast,
the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,
Text revision (DSM-IV-TR, American Psychiatric Association, 2000) defines
transvestic fetishism or transvestism as sexual arousal related to dressing in
clothes pertaining to the opposite sex (cross-dressing) among heterosexual
males. The fantasies, urges, or behaviors should occur over a period of at
least six months and cause clinically significant distress or impairment in
We thank the Swedish Public Health Institute for kindly providing us with the data set.
Address correspondence to Niklas L
˚
angstr
¨
om, Centre for Violence Prevention, Karolinska
Institutet, P.O. Box 23000, S-104 35 Stockholm, Sweden. E-mail: niklas.langstrom@cns.ki.se
87
88 N. L ˚angstr¨om and K. J. Zucker
social, occupational, or other areas of functioning (see Zucker & Blanchard,
1997, for an overview).
Many researchers have not used impairment criteria or excluded non-
heterosexual males when investigating transvestic fetishism. For example,
Buhrich and Beaumont (1981) studied transvestism in Australia and the U.S.
with a questionnaire mailed to transvestite club members. A total of 222 male
subjects reported any period of fetishism to women’s clothes. Characteristics
of transvestism were remarkably similar across countries. Almost half of the
subjects first cross-dressed in prepuberty and a majority reported established
cross-dressing by late adolescence. Docter and Prince (1997) conducted a sur-
vey in the U.S. of 1032 self-defined, periodic male cross-dressers recruited
with announcements at transvestite club meetings, conventions, and maga-
zines. No cross-dressing females were identified in either of the two studies,
and 75% and 89% percent of the subjects, respectively, described themselves
as heterosexual.
Two subgroups of cross-dressers have been identified based on differ-
ences in cross-gender identity (Blanchard, Racansky, & Steiner, 1986; Docter
& Prince, 1997), usually defined as the tendency to view oneself as hav-
ing core personality attributes and gender characteristics opposite to one’s
genetic sex. The first group, termed nuclear or periodic transvestites, are typ-
ically satisfied with cross-dressing only. The second group, called marginal
(more transgendered or transsexually inclined) transvestites, often desire
feminization by hormonal treatment or reconstructive genital surgery, report
lower sexual arousal to cross-dressing, and a stronger interest in same-sex
sex (Docter & Prince, 1997). For a genetic male, an intense and persistent
sense of cross-gender identity could lead to complete gender role change,
as in transsexualism.
Transvestic fetishism may be associated with increased risks for sexual
acting out that could injure the individual and victimize others. Among sub-
jects who accidentally died when engaged in autoerotic asphyxia, a high-
risk paraphilic behavior based on self-induced cerebral anoxia by hang-
ing or suffocation during masturbation, transvestic fetishism was common
(Blanchard & Hucker, 1991). Co-occurrence of non-paraphilic hypersexuality,
including extensive masturbation and promiscuity, and transvestic fetishism
has been identified in clinical outpatient populations (Black, Kehrberg,
Flumerfeldt, & Schlosser, 1997; Kafka & Hennen, 1999, 2002). Finally, a sem-
inal investigation of 561 male subjects voluntarily seeking help for para-
philic behavior revealed that many had additional DSM-II/III paraphilias in
addition to the presenting diagnosis (Abel, Becker, Cunningham-Rathner,
Mittelman, & Rouleau, 1988). Up to 20% of individuals with transvestic
fetishism also had been involved in the sexual molestation of children, and
36% had committed exhibitionistic acts (see also Langevin, Checkley, & Pugh,
1987).
Previous studies have focused either on referred cross-dressing individ-
uals or those attending clubs or subscribing to newsletters addressing these
Transvestism in the General Population 89
issues. No epidemiological study has been published so far (cf. Zucker, 1997).
The aim of this study was to elucidate prevalence and correlates to transvestic
fetishism in the general population.
METHOD
Sample
A total of 5,250 randomly selected 18–74 year-olds from the general popula-
tion of Sweden (N = 6,200,000) were contacted by mail as part of a large in-
terview study of sexual attitudes, behaviors, and health in Sweden. The study
was sponsored by the Swedish Public Health Institute (Lewin, Fugl-Meyer,
Helmius, Lalos, & M
˚
ansson, 1998) and approved by the research ethics com-
mittee of the Swedish Research Council for Humanistic and Social Sciences.
After subjects with language problems, severe visual or hearing impairment,
long-term illness, or who had emigrated had been excluded, the remaining
4,781 individuals were invited to participate. A total of 59% (n = 2,810) of
these subjects chose to participate in the survey. After written informed con-
sent, trained research assistants collected all data in the spring of 1996, almost
exclusively in the homes of the subjects. Sociodemographic information was
obtained through face-to-face interviews. All questions related to sexuality
and health were administered in the form of questionnaires embedded in
the interview and were completed by the subject without involvement from
the research assistant. The subject was reminded that no name or details al-
lowing personal identification were present on forms or questionnaires, and
that nobody would be able to trace specific answers to him or her.
Comparisons revealed no social, or geographic differences between
participants and non-participants. In addition, cross-validation of interview
data did not find general social desirability bias or untruthfulness in an-
swer patterns, not even for sensitive sexuality-related data (Lewin et al.,
1998). However, since elder individuals, particularly females, were un-
derrepresented among responders, we included only subjects up to age
60. This yielded a final sample of 2,450 individuals (1,279 males and
1,171 females).
Measures
The questionnaire item “Have you ever dressed in clothes pertaining
to the opposite sex and become sexually aroused by this?” tapped the
dependent variable, sexual arousal from actual cross-dressing. Thirty po-
tential correlates to the dependent variable were identified from a liter-
ature review and are displayed in Table 1. All listed items were trans-
lated into English closely following the intent of the original questions in
Swedish.
90 N. L ˚angstr¨om and K. J. Zucker
TABLE 1. Correlates of Transvestic Fetishism among 1,279 18–60-year-old Men in a Repre-
sentative General Population Sample
Ever sexually aroused from cross-dressing
YesNo Mann-
n = 36 n = 1,243 Whitney Odds
Characteristic (2.8%) (97.2%) U or χ
2
ratio 95% CI
Sociodemographic characteristics
Age (years) 36.89 (11.35) 37.02 (12.05) .02 .99 .97–1.03
Immigrant status
a
(%) 11.1 7.7 .58 1.50 .52–4.35
No. of siblings 2.25 (1.86) 2.22 (1.89) .05 1.01 .85–1.20
Separation from parents
during childhood (%)
27.8 14.7 4.67* 2.23 1.06–4.70
Parental attitudes to sex
b
3.03 (.85) 3.33 (.75) 1.77 .57 .35–.95
Current socio-economic
position
c
1.68 (.73) 1.69 (.72) .12 .97 .60–1.57
Currently living in major city
area
d
(%)
38.9 24.5 3.88* 1.96 .99–3.88
Own children (%) 51.4 59.5 .92 .72 .37–1.41
Sexuality
Ever sexually abused before
age 18 (%)
8.8 2.9 3.90* 3.24 .94–11.15
Ever sexually abused (%) 19.4 12.4 1.60 1.71 .74–3.98
Age 1st vaginal intercourse
(years)
17.06 (2.96) 17.02 (3.15) .10 1.01 .90–1.12
Current stable sexual
relationship (%)
72.2 76.1 .30 .82 .39–1.71
Easily sexually aroused
e
(%) 55.6 33.6 7.46** 2.47 1.26–4.81
Ever same-sex sexual
partner (%)
17.1 2.5 26.36*** 8.21 3.17–21.26
No. times vaginal/anal
intercourse last month
5.53 (10.80) 5.52 (6.04) 1.08 1.00 .95–1.06
No. times masturbation last
month
12.40 (11.37) 4.68 (6.55) 5.33*** 1.09 1.06–1.13
No. sexual partners per active
year
f
.79 (.82) .93 (1.41) .05 .91 .67–1.24
No. times used pornography
last year
g
31.17 (49.51) 13.56 (36.36) 4.04*** 1.01 1.01–1.01
Sexual arousal to
cross-dressing acceptable to
self (%)
47.2 2.9 171.24*** 29.70 14.26–61.85
Ever sexually aroused by
actually
...exposing genitals to a
stranger (%)
16.7 3.7 14.84*** 5.15 2.04–12.98
...spying on what others
are doing sexually (%)
33.3 10.9 17.29*** 4.09 2.00–8.37
...using pain (%) 13.9 2.2 19.43*** 7.19 2.60–19.92
Satisfaction with sexual life
h
4.06 (1.26) 4.42 (1.33) 2.11* .83 .66–1.04
General health and substance use
Satisfaction with life in
general
h
4.61 (.77) 4.79 (.95) 1.66 .84 .60–1.15
Psychological health
h
5.03 (.97) 5.22 (.94) 1.32 .83 .60–1.13
Physical health
h
4.92 (.73) 5.09 (.94) 1.84 .84 .60–1.15
Current tobacco smoking
i
(%) 19.4 21.2 .06 .90 .39–2.07
Transvestism in the General Population 91
TABLE 1. Correlates of Transvestic Fetishism among 1,279 18–60-year-old Men in a Rep-
resentative General Population Sample (Continued)
Ever sexually aroused from cross-dressing
YesNo Mann-
n = 36 n = 1,243 Whitney Odds
Characteristic (2.8%) (97.2%) U or χ
2
ratio 95% CI
Ever substantially
drunk last month (%)
38.9 32.2 .70 1.34 .68–2.64
Ever illegal drug use
j
(%)
22.9 11.8 3.90* 2.21 .98–4.96
Current psychiatric
disorder
k
(%)
2.8 1.0 1.12 2.90 .37–22.94
p <.05,
∗∗
p <.01,
∗∗∗
p <.001.
Note:
a
Born and raised abroad;
b
Self-reported on a five-point Likert-type scale from very negative (1) to
very positive (5);
c
Rated on a three-step ordinal scale based on current or latest occupation; the higher
socioeconomic position the higher score;
d
Larger Stockholm, Gothenburg, and Malm
¨
oareas;
e
Rated in
comparison to others;
f
Total number of partners divided by years since first (vaginal) sexual intercourse
until interview;
g
Times used pornographic magazine or watched pornographic movie;
h
Self-reported
satisfaction on a six-point Likert-type scale from very unsatisfying (1) to very satisfying (6);
i
Smoked 5 or
more cigarettes per day last year;
j
Use of narcotics not prescribed to subject by physician;
k
Diagnosed
by a physician with a psychiatric disorder during the last year.
Sexual victimization history was addressed with the question “Were you
ever involved in a sexual activity without wanting it yourself?” A separate
variable was constructed for those reporting their first victimization experi-
ence before age 18. Endorsement of the statement “I can consider myself
becoming sexually aroused by dressing like the opposite sex” was used to
tap tolerability of sexual thoughts and fantasies regarding sexual arousal to
cross-dressing. The ICD-10 (World Health Organization, 1992) and DSM-IV-
TR (American Psychiatric Association, 2000) list diagnostic criteria for para-
philias defined according to their distinctive paraphilic focus. The questions
“Have you ever exposed your genitals to a stranger and become sexually
aroused by this?” and “Have you ever spied on what other people are doing
sexually and become sexually aroused by this?” were used as proxy mea-
sures for exhibitionism and voyeurism, respectively, the two most common
paraphilias in clinical samples (American Psychiatric Association, 2000). Sex-
ual masochism (arousal from receiving suffering or humiliation) and sexual
sadism (arousal from inflicting pain or humiliation) are two paraphilias that
are more rare. “Have you ever deliberately used physical pain and become
sexually aroused by this?” was used as proxy measure for sexual masochism
and/or sadism.
Statistical Analysis
We used the Mann-Whitney U-test (continuous measures) and the χ
2
-test
(dichotomous variables) to examine possible differences between those
reporting sexual arousal from cross-dressing and those who did not. The
92 N. L ˚angstr¨om and K. J. Zucker
strength of the association of each correlate with transvestic fetishism was
expressed as an odds ratio (OR) with 95% confidence interval (95% CI) de-
rived with bivariate logistic regression.
RESULTS
A total of 36 (2.8%) men and 5 (0.4%) women reported ever having experi-
enced sexual arousal from actual cross-dressing behavior. Since the females
were so few, we excluded them from further analysis. However, when the
females were tentatively pooled with the men, associations with correlates
were principally of the same strength (data not shown). Thirty of these men
(85.7%) reported that they had only been sexually attracted by women, and
the remaining five (one man did not respond) that they had mostly been
sexually attracted by women and only sometimes by men. Among the six
subjects with same-sex sexual experiences (Table 1), four endorsed having
been together sexually mainly with women and only two having approx-
imately equal experience with same-sex and opposite-sex sexual activities.
No man with transvestic fetishism reported a main or exclusive focus on men
with respect to sexual attraction or sexual intercourse.
Thirty potential correlates to transvestic fetishism were tested and are
displayed in Table 1. Sixteen of these variables were unrelated to transvestic
fetishism in men: age, immigrant status, family size, socioeconomic position,
being a parent, and any history of sexual victimization. Equally uncorrelated
to the dependent measure were age of sexual debut, current stable sexual re-
lationship, frequency of vaginal or anal intercourse during the last month, and
extended promiscuity. Finally, satisfaction with life in general, psychological
and physical health, tobacco smoking, having been substantially drunk last
month, and current psychiatric morbidity were not significantly associated
with transvestic fetishism.
Nine variables were significantly related to transvestic fetishism. The first
five were: separation from parents during childhood, being more easily sex-
ually aroused than others, same-sex sexual experiences, pornography use,
and masturbation frequency. For example, the OR of 1.09 per unit increase in
masturbation frequency can be interpreted to mean that the odds of transves-
tic fetishism was 2.3 times higher for males who masturbated ten more times
per month than other men (OR = 1.09
10
= 2.37). Transvestic fetishism also
was strongly related to experiences of sexual arousal from using pain, spy-
ing on others having sex, and exposing one’s genitals to a stranger. Sexual
arousal from cross-dressing being acceptable to oneself was the strongest
correlate to an actual experience of this practice.
One limitation with the present study was the low power to statistically
secure other than strong relationships with transvestic fetishism. For the vari-
ables living in a major city, ever sexually abused before age 18 of lower
Transvestism in the General Population 93
satisfaction with sexual life, and illegal drug use, the Mann-Whitney U-test or
the χ
2
-test revealed significant associations with the dependent variable ( p
= .035–.048). In contrast, the corresponding odds ratios for these relation-
ships had 95% confidence intervals including 1, just falling short of statistical
significance. For parental attitudes to sex, the opposite was true in that the
odds ratio was significant but the Mann-Whitney U-test was not. Because of
this statistical lability, we interpreted these five associations as non-significant
trends.
DISCUSSION
This is the first population-based study addressing transvestic fetishism. Al-
most 3% of males reported any sexual arousal from cross-dressing. This life-
time incidence agrees with data presented by Fedora et al. (1992), who found
penile circumference responses consistent with transvestic fetishism in 3% of
60 non-paraphilic males. Previous studies have never identified females re-
porting sexual arousal from cross-dressing and women cannot be diagnosed
with DSM-IV-TR transvestic fetishism. Interestingly, we found five women
who did report sexual arousal from dressing in clothes pertaining to the op-
posite sex. Since they were so few, however, we excluded them from further
analysis. It may be that these females understood the screening question in
some other way than the men did, and more research is needed to determine
whether transvestic fetishism in the same sense as for men really exists in
women.
We found a non-significant trend suggesting that childhood sexual vic-
timization was related to transvestic fetishism. Controlled studies of transves-
tic fetishism and other paraphilias are needed to delineate the relative
importance of sexual and other forms of child abuse for their develop-
ment. Two prior studies (Docter & Prince, 1997; Schott, 1995) indicated that
cross-dressers do not come from highly distressed families. Males reporting
transvestic fetishism in this study were not statistically different from those
who did not report this fetishism in terms of immigrant status, family size, and
parental attitudes to sex. However, they had less often grown up with both
parents, which suggests that parental separation or some associated factor(s)
could influence the development of transvestism (cf. Zucker & Blanchard,
1997).
Transvestic fetishism was further associated with being more easily sex-
ually aroused in general. This may suggest that higher overall arousability or
lower control over sexual impulses could influence also the likelihood for
sexual arousal to cross-dressing. Previous same-sex sexual experience has
been found in up to 30% of cross-dressers (Docter & Prince, 1997). These
authors also found that 87% of subjects defined themselves as heterosexual,
and the remaining 13% as bisexual, homosexual, asexual, or unsure of how
94 N. L ˚angstr¨om and K. J. Zucker
to describe their sexual orientation. No man with transvestic fetishism in our
sample of non-referred subjects reported that other men had been a main
focus for his sexual attraction or partnered sexual behaviour. This lends sup-
port to the notion, currently reflected in DSM-IV-TR diagnostic criteria, that
it is almost exclusively heterosexually oriented men who experience sexual
arousal from cross-dressing. Nevertheless, any experience of sexual activity
with a partner of the same sex was a strong correlate of transvestic fetishism.
Possible underpinnings to this co-occurrence could be more liberal attitudes
to sexuality in general or a tendency to follow sexual impulses of any type
among subjects with transvestic fetishism.
The strongest correlate of transvestic fetishism was the endorsement of
this behavior being acceptable to oneself. However, more than 50% of those
who reported sexual arousal from cross-dressing did not see it as accept-
able to self. In other words, this sexual practice was currently ego-dystonic
for a majority of those who had experienced it. Transvestic fetishism was
strongly associated with ever having been sexually aroused from using pain
when having sex, having exposed one’s genitals to a stranger, and spying on
what others are doing sexually. It is worrying that even though these proxy
measures of paraphilias masochism/sadism, exhibitionism, and voyeurism,
respectively, lack the persistence criteria included in DSM-IV-TR definitions,
at least the latter two likely reflect sexually abusive behavior.
This study has limitations. Our definition of transvestic fetishism was
based on one single questionnaire item and did not include the 6-month per-
sistence threshold and subjective clinical impairment criteria required for a
DSM-IV-TR diagnosis of transvestic fetishism. As in any cross-sectional study,
causality cannot be inferred from associations between transvestic fetishism
and correlates. With respect to generalizability of the results, recent immi-
grants, in particular, may have been underrepresented in our sample because
language problems constituted an exclusion criterion.
The present results suggest that sexual arousal to cross-dressing is rare,
but could be associated with potentially criminal paraphilic sexual behav-
ior such as voyeuristic and exhibitionistic acts. Such negative correlates may
need more attention by those providing services to individuals with transves-
tic fetishism.
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... Dr Christian Joyal (2018) (2017) studied prevalence of paraphilias in Quebec and found that expressed interest in paraphilic activity was higher compared to multiple studies from the early 2000s (Långström & Hanson, 2006;Långström & Seto, 2006;Långström & Zucker, 2005). Castellini et al (2018) also found that 41% of women and 50% of men reported engaging in at least one behaviour that was considered paraphilic. ...
Thesis
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Sexual harassment is a prevalent problem in society across the world and can have devastating consequences for those who are victim to it. Although it is a widespread problem that affects many, there is a lack of research regarding the relationship between harassment and risk factors such as rape myth cognitions and sexual deviance, particularly in the general population. The current study explores the relationship between rape myth cognitions and perception of harassment, with deviant sexual preferences as a moderator. Additionally, the prevalence of paraphilic interest in the general population is explored. Analyses indicate that there is a strong relationship between rape myth cognition and harassment, which is slightly moderated by deviant sexual preferences. Frequency analyses of paraphilic behaviours and fantasies show that masochism is the most prevalent paraphilic interest in the general population and that approximately half of the sample have engaged in at least one paraphilic behaviour. This study has important implications for treatment and intervention, highlighting that cognitions may be a more significant predictor for sexual offending than deviance and thus a key focus for prevention and intervention methods. Furthermore, the current study also shows that paraphilic preferences are becoming more common in society, indicating that the boundaries between normophilic and paraphilic interests should be redefined.
Chapter
Sexuelle Präferenzstörungen (ICD 10 und ICD-11) bzw. paraphile Störungen (DSM 5) umfassen ein großes Spektrum sehr unterschiedlicher Symptombilder, die keineswegs selten auftreten. Sie können gravierend die sexuelle und/oder partnerschaftliche Beziehungszufriedenheit tangieren und Leidensdruck erzeugen. Aus klinischer Sicht besteht eine deutliche Überlappung mit den sexuellen Funktionsstörungen. Einer detaillierten diagnostischen Erfassung der paraphilen Störung unter Berücksichtigung der Beziehungsdimension kommt eine zentrale Bedeutung zu, weil sich hieraus Therapieoptionen und Chancen für Entwicklungsmöglichkeiten ableiten lassen. Wegen der hohen Stabilität der sexuellen Präferenzstruktur nach dem Jugendalter sind das Ausmaß des paraphilen Musters (ausschließlicher oder nicht-ausschließlicher Typus), deren Wertigkeit im Erleben der Betroffenen, das zusätzliche Auftreten von sexuellen Funktionsstörungen und die Fähigkeit zur Selbstrücknahme innerhalb der partnerschaftlichen Beziehung bedeutsame Faktoren, die vor Therapiebeginn geklärt sein müssen. Sexuelle Verhaltensstörungen können auf das Ausleben entsprechender Paraphilien zurückgehen, aber auch von Tätern begangen werden, die keine Präferenzstörungen aufweisen. Gerade beim sexuellen Kindesmissbrauch gibt es pädophile sowie nicht-pädophile Täter, wobei bei letzteren die Übergriffe auf Kinder als Ersatzhandlungen für nicht realisierbare sexuelle Interaktionen mit altersentsprechenden und einverständigen Partnern aufzufassen sind. Störungen der sexuellen Präferenz und Störungen des sexuellen Verhaltens sind genau zu differenzieren und nicht etwa gleichzusetzen. Medikamente zur Dämpfung der sexuellen Impulse und Fantasien, insbesondere die Serotonin-Wiederaufnahmehemmer sowie antiandrogen wirkende Pharmaka wie Cyproteronacetat oder GnRH-Analoga werden zusätzlich eingesetzt.
Article
Child pornography possession/receipt offenders are a controversial offender group due to mixed and occasionally divergent evidence about their risk profile, offending history and psychopathology. Using a population of male offenders who ever perpetrated a sexual offense from a federal jurisdiction in the central United States, the current study developed an exploratory post hoc empirical profile of these offenders. The profile has some success in the validation component of our study and showed significant associations with self-reported sexual abuse of child victims ages 3-12 years, but non-significant associations to adolescent and adult victims. It significantly linked to the conceptually expected victim group and the significant statistical effect withstood controls for generally robust indicators of antisocial conduct including antisocial personality disorder, arrest onset, total adverse childhood experiences, age and race. We view the findings as exploratory and encourage additional empirical study of this important offender group.
Chapter
Paraphilias refer to sexual inclinations that deviate significantly from the norm. According to the DSM-5, there are the voyeuristic, exhibitionistic, frotteuristic, sexually masochistic, sexually sadistic, paedophilic, transvestic, and fetishistic disorders.
Article
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The psychiatric literature suggests that paraphiliacs can be expected to participate in only one type of deviant sexual behavior. Using self-reports gathered with assured confidentiality from 561 nonincarcerated paraphiliacs, we discovered that most paraphiliacs have had significant experience with as many as ten different types of deviant sexual behavior without regard, in many cases, to gender, age, and familial relationship of the victim. The relevance of these findings to our understanding of paraphiliacs and their treatment is discussed.
Article
We examined whether an erotic response to cross‐dressing fantasies could be detected in heterosexual male cross‐dressers (HCDs) who verbally denied any erotic arousal in association with cross‐dressing for at least the past year. Subjects were 37 HCD patients and 10 paid heterosexual controls. HCDs were divided into groups according to their response to a questionnaire item asking the proportion of occasions that cross‐dressing was erotically arousing during the past year and offering response options from always to never. Penile blood volume was monitored while subjects listened to descriptions of cross‐dressing and sexually neutral activities. All HCD groups responded significantly more to cross‐dressing than to neutral narratives (p < .01); controls did not. Results suggest that only those causal hypotheses of heterosexual cross‐dressing need be considered that can account, also, for the presence of fetishism.
Article
34 male exhibitionists and 20 nonviolent non-sex-offender controls were compared on measures of gender identity and sexual and criminal history. Results indicate that 41% of exhibitionists were transvestitic; gender identity was masculine and not significantly different from controls. Exhibitionists engaged in a variety of other sexually anomalous behaviors (voyeurism, obscene telephone calling, frottage, toucheurism, attempted rape). Frequency of exhibiting was uncorrelated with desire for resulting intercourse with the victim. Nearly all exhibitionists hoped the unsuspecting female would enjoy the experience, and 19 indicated that they would have gone with the complainant, if asked. 20% of exhibitionists had a history of violence-related offenses. Findings support the narcissism hypothesis of exhibitionism, rather than the courtship disorder approach by K. Freund et al (see record 1984-15234-001). (French abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Penile circumference responses (PCRs) to a visual age/gender erotic preference battery were analyzed from 60 normal controls and 227 sexual offenders. Sixty offenders were classified as sexual aggressives on the basis of their behavior and damage to their victims. The mean PCR to sadism slides (visual portrayals of nonsexual violence against fully clothed females) was significantly larger for the sexually aggressive group compared to the sexual nonaggressive offender and normal control groups. There were no significant differences in mean victim damage scores between the sexual aggressives who responded significantly to the sadism slides and those who did not. Thus, PCRs were not useful in identifying more from less dangerous sexual aggressives. The incidence of a clinically significant PCR to any of the four paraphilic categories included in the assessment battery was 28, 60, and 65% in the normal controls, sexual nonaggressives, and sexual aggressives, respectively. For sadism, it was 5, 8, and 45% respectively, for these groups. Pedophilia had a low incidence of co-occurrence with other paraphilias whereas sadism, transvestism/fetishism, and the courtship disorder paraphilias had a high incidence of co-occurrence.
Article
Autoerotic asphyxia is the practice of self-inducing cerebral anoxia, usually by hanging, strangulation, or suffocation, during masturbation. This study investigated the relationships between: asphyxiators' ages; two paraphilias commonly accompanying autoerotic asphyxia, bondage and transvestism; and various other types of simultaneous sexual behaviour. Subjects were two concurrent series totalling 117 males aged 10-56 who died accidentally during autoerotic asphyxial activities. Data concerning sexual paraphernalia at the scene of death or among the deceased's effects were extracted from coronors' files using standardised protocols. Anal self-stimulation with dildos, etc., and self-observation with mirrors or cameras were correlated with transvestism. Older asphyxiators were more likely to have been simultaneously engaged in bondage or transvestism, suggesting elaboration of the masturbatory ritual over time. The greatest degree of transvestism was associated with intermediate rather than high levels of bondage, suggesting that response competition from bondage may limit asphyxiators' involvement in a third paraphilia like transvestism.
Article
Information concerning gender identity, sexual orientation, cross-dressing behavior, fetishism, and bondage was obtained from a questionnaire which was posted to members of two transvestite clubs, one in the United States and one in Australia. This study reports the responses of 136 American and 86 Australian self-designated transvestites who reported a period of fetishism to women's clothes at some stage of development. Characteristics of transvestism of subjects in both countries were remarkably similar; all were male, almost half the subjects first cross-dressed in prepuberty, and in the large majority cross-dressing was well established by late adolescence; intense fetishism was usually experienced during adolescence but waned in later years; in almost a quarter of subjects fetishism ceased, although the desire to cross-dress continued; in many subjects transvestism was associated with fantasies of bondage, usually of the subjects bound while cross-dressed; sexual orientation was predominantly or exclusively heterosexual in more than three-quarters of the subject. Subjects were categorized into two groups. One group, termed nuclear transvestites, were satisfied with cross-dressing. The second group, termed marginal transvestites, desired feminization by hormone ingestion or by surgical intervention. Marginal compared to nuclear transvesites reported significantly stronger feminine gender identity and tended to report a stronger interest in the homosexual direction. The differences appeared to be present from childhood. No significant differences were found between the nuclear and marginal transvestites with regard to characteristics of fetishism, bondage, and cross-dressing except that in the American group marginal transvestites currently cross-dressed more frequently than did nuclear transvestites.