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Surprising Science

Are Sexual Fetishes Psychologically Healthy?

So far, 549 separate paraphilias have been officially identified.   
Fetish events like the one this couple attended are cropping up all over the US.

50 Shades of Grey has changed the calculus on how our society views fetishes and BDSM. Though once considered deviant and shameful, today most psychologists lend us an entirely different view. Sexual fetishes are far more common than we think. A recent study published in the Journal of Sex Research, finds that one in three people in the US have taken part in one, at least once in their lives. 


Sex researchers are just starting to delve into the fetish world to see what can be gleaned from it. Some studies have reaped interesting results. Though there may be fetishists who have experienced a past trauma, it’s not a reliable predictor. And there might be some benefits to engaging in a fetish or BDSM.

How do we define a fetish? It comes from feitico, a Portuguese word meaning “obsessive fascination.” The technical term in psychology is paraphilia, which is an atypical sexual interest in an object, act, body part, or sensation. So far, 549 separate paraphilias have been identified, and there may be many more.

According to a study out of the University of Bologna in Italy, the most common fetishes deal with non-sexual parts of the body. A foot fetish is the most common. Nearly half of all fetishes are foot fetishes. Usually, its men focused on women’s feet. The second most common is for accessories such as stockings, boots, or gloves.

Though some of us have a predilection for something, the fetishist cannot technically climax without his or her fetish present. For instance, a couple might enjoy incorporating bondage, food, or role play occasionally into their sex life, in order to “spice things up.” That doesn’t mean their fetishists. They just enjoy a little kink. Desiring to wear a diaper, to be spanked, to kiss a woman’s foot, be peed on, don a collar and leash, be tied down, or feel leather against one’s skin can all be considered fetishes. Even such things as voyeurism, cross dressing, or exhibitionism are parahilias.

There are some really strange ones, like getting caught in quicksand. There’s sploshing or WHAM which is covering your partner in whip cream, baby oil, body paint, or other substances. You might even fantasize about getting swallowed by a large, imaginary predator (vorarephilia), digested by it, and expelled, while parts of you remain and become part of that creature. Harvard research psychologist Justin Lehmiller, Ph.D. says, “Pretty much anything you can think of, someone out there probably has sexual associations attached to it.”

One-third of Americans have taken part in some sort of fetish or kink play, and elements of BDSM such as bondage are becoming more mainstream.

Once thought of as depraved or deviant, today, paraphilias are only thought to be negative, if engaging in it causes harm or distress to the person or another. Paraphilia was removed from the DSM V, when the so-called bible of mental disorders was updated in 2012. Though the field of sexology is new, most therapists today believe that having a fetish is perfectly healthy, as long as it is expressed with a consenting, adult partner.

Study after study finds no correlation between a fetish and any sort of pathology. But suppressing one or trying to condition it out could cause psychological damage. Dr. Richard Krueger is an associate professor of psychiatry at Columbia University Medical Center. He told Healthline, “The literature is limited, but it would suggest that they’re (fetishists) healthy or healthier” than those who don’t have one.

Sex counselor Jessica O’Reilly, Ph.D. said that just as people have different tastes for food, they have diverse sexual fantasies. So a fetish may be “one element of our diversity in terms of sexual interest and arousal.” O’Reilly believes that usually, it’s something that’s imprinted in the mind when a person is first becoming aware of their own sexuality. Most people remember when they first acquired their fetish, though not always.

Say a boy loses his virginity to a woman wearing thigh-highs. From that day forward, he may associate the stockings with sexuality, and so become aroused when he sees them. Other fetishes may be imprinted in the same fashion. One study in the 1960s showed men naked photos of women, alongside pictures of boots. After a protracted period, participants began to associate boots with arousal.

With wider acceptance, kink, fetishism, and BDSM have become big business. The industry brings in $9 billion per year in the US, according to IBISWorld.

This suggests that developing a fetish is Pavlovian in nature. Further research supports the claim that paraphilias are non-sexual elements which though a certain experience, somehow get associated with sex. As a result, the more such impressions we encounter, the more fetishes we might acquire over time.

Paraphilias are often considered the realm of men. But women are the largest consumers of erotica. 50 Shades of Grey sold 10 million copies, and was read almost exclusively by women. This book includes bondage, dominance, submission, and sadomasochism (BDSM). These are not only separate fetishes, but have become an acronym for what some consider a lifestyle, while for others it’s a hobby or interest. BDSM on the surface appears to deviate from the norm. But the practice is actually more common than we think.

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Consider how popular spanking is, which could be considered a part of BDSM. Somewhere between five and 10% of Americans have either spanked or been spanked by a partner, according to the National Coalition for Sexual Freedom. This involves no real damage. Yet, some of the same biochemicals released during sex, such as endorphins and serotonin, flood the system during instances of pain. So a little pain might even heighten the experience.

Rather than depraved, one study published in the Journal of Sexual Medicine, suggests that those couples who take part in BDSM might actually be emotionally healthier than those who only partake in “vanilla” sex.” 902 BDSM practitioners and 434 controls participated. Researchers found that BDSM practicing couples had better communication, less neurosis, were more open with one another, better able to communicate their needs, and were more sensitive to the needs of their partner.

Though the sexual revolution had a lot to do with it, the internet has acted as a catalyst for increasing our comfort level surrounding BDSM and fetishism. Even those thought to have an “extreme” fetish can find legions of others with the same interest on websites and chatrooms, and through certain venues, even meet in person.

Moreover, some mainstream dating sites like OKCupid are now allowing users to communicate their fetish to would-be mates. Before the internet, those with interests outside the sexual norm felt isolated or even “sick.” Today, we realize how common atypical sexual interests are. And it’s likely that as more knowledge about paraphilias settles into the general population, harmless fetishes are bound to become more widely accepted.

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