Sexual dysfunctions are significantly more common in people with paraphilias

A study of individuals with paraphilic interests and paraphilic disorder in Hungary found that these individuals were much more likely to suffer from various sexual dysfunctions compared to individuals without paraphilias. Participants with paraphilic interests had 3.1 times higher odds of suffering from erectile dysfunction, and 1.59 times higher odds of suffering from female orgasmic disorder. The odds of sexual dysfunctions were even higher in individuals with paraphilic disorder. The paper was published in the Journal of Sex & Marital Therapy.

Paraphilias are persistent or recurrent and intensive sexual interests that focus on atypical objects, situations, or activities. Legal classifications distinguish between criminal and noncriminal paraphilias. Psychiatric perspectives distinguish between paraphilic interests and paraphilic disorders.

Paraphilic interests are unusual sexual interests that do not, in themselves imply pathology – having an unusual sexual interest is not automatically a mental disorder. Some people have atypical interests without being distressed by them and without harming anyone. In those cases, the interest may be classified as a paraphilic interest but not as a paraphilic disorder. Most individuals with unusual sexual interests do not meet the criteria for a paraphilic disorder.

A paraphilic disorder is diagnosed only when the interest causes clinically significant distress or impairment, or when acting on it involves harm, risk of harm, or a non-consenting person. Paraphilic disorders include conditions such as voyeuristic disorder, exhibitionistic disorder, frotteuristic disorder (sexual arousal from rubbing against a non-consenting person, often in a crowded public place), fetishistic disorder, sexual masochism disorder, sexual sadism disorder, and pedophilic disorder.

Study author Dávid Pócs and his colleagues explored sexual behavior history and sexual dysfunctions in individuals reporting paraphilic interests or paraphilic disorders and compared them to a group of individuals matched with them on sociodemographic characteristics, but without paraphilias. They wanted to know more about the relationship between paraphilia and sexual dysfunction and also to see whether the two groups differ in sexual behavior history.

Study participants were 8,282 individuals recruited through social media advertisements and online university platforms. Their average age was 22 years. 69% were women. 97% considered themselves to be Hungarian.

Study participants completed an online questionnaire that asked about various sociodemographic characteristics, sexual behavior (e.g., exposure to pornography, age at first exposure, early sexual experiences, age at first sexual intercourse etc.), sexual dysfunctions, and paraphilic interests (using a set of self-report items closely following psychiatric diagnostic criteria for paraphilic interests and paraphilic disorder).

For the analysis, participants with paraphilic disorder were matched with an equal-sized group of participants without paraphilias and with similar sociodemographic characteristics. The same was done for participants with paraphilic interests. In the whole group, there were 164 participants with paraphilic disorder and 1,878 with paraphilic interests.

Comparing the group of participants with paraphilic interests with matched participants without paraphilias, results showed that participants with paraphilic interests had 3.1 times higher odds of suffering from erectile dysfunction, 60% higher odds of premature ejaculation, and 59% higher odds of suffering from female orgasmic disorder.

Participants with paraphilic disorders had 4.47 times higher odds of suffering from erectile dysfunction and premature ejaculation. They were also more likely to suffer from male hypoactive sexual desire disorder (low sexual desire), and had 7.67 times higher odds of suffering from female sexual interest/arousal disorder compared to the matched group of participants without paraphilias.

Participants with paraphilic interests were more likely to have been exposed to pornography, and both those with paraphilic interests and paraphilic disorders tended to first encounter pornography at an earlier age, on average. Participants with paraphilias were also nearly twice as likely to report having experienced childhood sexual abuse. Additionally, they tended to consider their sexual education as inadequate more often and rated the quality of their first sexual intercourse as lower.

“Paraphilic interests and disorders were significantly associated with multiple sexual dysfunctions in a nonclinical population. These findings highlight clinically relevant comorbid patterns,” the study authors concluded.

The study contributes to the scientific understanding of the links between paraphilias and sexual functioning. However, it should be noted that most of the participants of this study were young adults. Results on other demographic groups might differ. Additionally, the design of this study does not allow any causal inferences to be derived from the results.

The paper, “Sexual Dysfunction in Individuals with Paraphilic Interests: Findings from a Large Matched Cross-Sectional Study,” was authored by Dávid Pócs, Csaba Erdős, Ádám Tőtös, Jezdancher Watti, Gergely Tari, and Oguz Kelemem.