Jan 042013

CC BY 2.0 - Maegan Tintari

What is a “paraphilia”? I think Wikipedia’s definition is the clearest, stating that the term “describes sexual arousal to objects, situations, or individuals that are not part of normative stimulation.” The American Psychiatric Association whittles that down to: “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors generally involving a) non-human objects, b) the suffering or humiliation of oneself or one’s partner, c) children, d) non-consenting persons”.

According to the American Psychiatric Association, when a paraphilia causes distress to self or others, they are considered mental disorders. The Diagnostic and Statistical Manual IV-TR lists eight specific paraphilias, not including the all-inclusive category of “Not Otherwise Specified”:

  • Fetishism: arousal in response to inanimate objects
  • Transvestic fetishism: erotic cross-dressing
  • Sexual masochism/sadism: arousal when receiving/giving pain or humiliation (respectively). The pain or humiliation has to be real, not simulated.
  • Exhibitionism: arousal when exposing one’s genitals to non-consenting people
  • Voyeurism: arousal when watching non-consenting people doing intimate or sexual acts
  • Frotteurism: arousal when rubbing one’s genitals against a non-consenting person
  • Pedophilia: sexual attraction to pre-pubescent children

The whole concept of paraphilias is under considerable debate in the scientific community. If paraphilias are essentially “abnormal sexuality” then where is the boundary? For example, if being aroused by knee-high black leather high-heeled boots is a fetish (paraphilia), what about nylon stockings? Frilly lacy women’s underwear? What if the clothing is on a person? And so on… the lines are very blurry. Another problematic aspect for paraphilias is that homosexuality was once considered a paraphilia.  There’s a lot more to the debate, but I’m going to have to save it for a post or two of its own.

This study looked at a sample of middle aged, mostly straight adult men in Berlin, Germany; paraphilias are more commonly diagnosed in men, except for sexual masochism. Participants were evaluated via questionnaire for whether they would meet criteria for a paraphilia. Their results are illuminating. 62.4% of their participants reported sexual arousal in response to a paraphilic stimulus. Here’s some of the breakdown:

Fantasy (%) Reality (%) Distress? (%)
Fetishism 30.0 24.5 0
Transvestic Fetishism 4.9 2.7 3.7
Masochism 15.8 2.3 1.5
Sadism 21.8 15.5 0
Voyeurism 34.9 18.0 0.7
Exhibitionism 3.5 2.2 0
Frotteurism 13.4 6.5 1.8
Pedophilia 9.5 3.8 5.3
Not Otherwise Specified 6.3 4.6 6.9
More than 1 58.6 44.4 1.7


Where “Fantasy” refers to a sexual fantasy which did not involve masturbation, “Reality” refers to actual sexual experiences, and “Distress” reflects the percentage of participants who reported being upset by their arousal.

There’s a lot of analyzing you can do on just those numbers alone. I want to call attention to the numbers for fetishism (~25%), voyeurism (18%) and sadism (15.5%). I don’t know about you, but I think about things a lot better this way…

  • Roughly 1 in 4 men in this sample had fetishistic experiences, where they were aroused by a non-sexual object.
  • Roughly 1 in 6 men in this sample had sadistic experiences, where they were aroused by the pain or humiliation of their partner(s).
  • Roughly 1 in 6 men in this sample had voyeuristic experiences, where they were aroused by watching others doing intimate things.
  • Further, nearly half of the men had more than one paraphilic sexual experience.
That’s really pretty common for a “mental illness.”

Now, it’s not known how well these participants actually fit the diagnostic criteria for a paraphilia. For example, it’s not known whether the men who participated in sadistic experiences actually had the consent of their partners or not. It’s not known whether the participants were distressing others. But it IS worth noting that very few men were actually distressed by their arousal. Hmm…

The other point of focus I find interesting is the difference between fantasy and reality, and in how much that difference differs between paraphilias. What influenced these participants to not act on their fantasies? Or, from my perspective, what can be done to help some of them express themselves safely with no harm to others, and what can be done to help others (e.g., pedophiles) refrain? What’s going on here? Sadly, I don’t have answers here.

In conclusion, the authors state: “The findings suggest that paraphilia-related experience can not be regarded as unusual from a normative perspective.” I whole-heartedly agree.

The abstract is publicly available on PubMed.

Edit (2/24/2013):

There has been some confusion over the percentages I quoted. Let me clarify:

There were 367 participants total. As an example, of those, 27 reported having either fantasy, masturbation fantasy, or real experience with transvestic fetishism. And that breaks down to 18 having fantasy, 21 having masturbation fantasy, and 10 having reality. The researchers divided those breakdown numbers by the total number of participants (367) to get the percentages (i.e., 4.9% of the sample having transvestic fetishism fantasies, 2.7% of the sample having transvestic fetishim real experiences). Of those 27 people, only 1 was distressed by it. Thus, 3.7% were distressed by their arousal.


Apr 032011

Besides feeling good and being great fun, foreplay is important! Foreplay allows more time and stimulation for full arousal, which will likely make whatever activity you’re going to do easier and more pleasurable. Psychologically, foreplay helps lower inhibitions and increases emotional connectedness.

What physically goes on during arousal in foreplay?

For men, the most obvious change is the erection of the penis. Not all penises become erect when a man is aroused – this is especially true for older men. The glans (tip) of his penis may swell, and the foreskin, if he has one, may retract. He will also produce pre-ejaculatory fluid (pre-cum) which comes out through his urethra – this is produced by the bulbourethral glands (also known as Cowper’s glands), near the base of the penis. Why does this happen? Erection and foreskin retraction allow for easier penetration. Pre-ejaculatory fluid helps lubricate the urethra. It also contains chemicals that neutralize any remaining urine in the urethra (Urine is acidic and could be damaging to sperm).

For women, the most obvious changes are lubrication of her vagina (this is produced by the cervix of the uterus). Her vagina expands and the cervix lifts, creating more room in her vagina. Her labia change shape and color in response to increased blood flow, and her clitoris becomes swollen. Why does this happen? Largely to make vaginal penetration easier. Lubrication eases movement within the vagina, and the enlargement of the vagina allows larger items to penetrate. Also, for women, it may help with achievement of orgasm.

There are a bunch of ideas surrounding foreplay that may or may not be true. Here are a few:

  • “Men don’t really need foreplay, and women do.” I don’t think so. A fairly recent study found that both men and women need about ten minutes to reach (physical) peak arousal (Source). So physically, I’d say no. The study didn’t, however, look at mental arousal which could be a factor.
  • “Foreplay increases sexual satisfaction and chance of orgasm.” Maybe….maybe not. While the popular media and personal anecdotes definitely support this idea, a study of Czech women found that duration of sex was more important than the duration of foreplay. So the jury’s out on this one. My money, though, is on the statement being true.
  • “One technique is guaranteed to work on everybody.” Not true! Everyone is different. This is where communication is crucial.
  • “Aim for these erogenous zones.” Not as easy as it sounds. An erogenous zone is supposed to be one with heightened sensitivity…but it’s different for every person and for each situation. For a common example, look at feet. Some people find their feet to be very sensual and erotic. Others don’t feel much with their feet, and some can’t stand having their feet touched at all because they’re too sensitive. The best way to find out where they are? Explore!

What counts as foreplay? That depends very much on the people involved. I think I’ve managed to come up with a few categories of activities, though…

  • Sensual touch: including with  hands, fur, leather, metal, lips (kissing), body paint, temperature (ice/hot wax, etc) and breath. Massage (with or without oils). Includes pain and impact play (e.g., flogging).
  • Psychological play: including dirty talk, humiliation, and roleplaying.
  • Erotic dress and teasing: including strip teases, erotic clothing,
  • Preparatory: Getting ready for a “special night” – cooking, eating special foods (or feeding them to someone), getting dressed up all nice, bathing with extra care, etc.
  • Bondage: including rope, chains, leather, and handcuffs…and anything else you can think of.
  • Voyeurism: watching others having sex – whether with pornography or live.
  • Misc: talking, erotic games, tantra

All of this brings up what is probably the most important part of foreplay (or, heck, any relationship-based act): Communication. Your partner(s) are not psychic, so communicate, communicate, communicate! Even if it’s embarrassing.

There are a couple of things that may cause problems with foreplay or arousal that I feel I should mention. Physical problems or illnesses can make some foreplay activities difficult if not impossible. Nerve damage can affect otherwise sensitive areas. Erectile dysfunction and vaginal dryness are relatively common, especially as we get older. Psychology can also affect everyone’s foreplay (not just women!). Trauma especially can have debilitating effects on sexuality. Some medications or drugs can also affect sexuality. If you’re having troubles with anything like what I’ve mentioned, start by talking with your partner(s). Still need help? Try talking with your doctor or a qualified sex therapist – they ought to be able to help.

The take-away message? Foreplay is good for your sex, good for your relationship(s), and good for you. Go have fun!