Fetishistic Disorder

Fetishistic disorder is an intense sexual attraction to either inanimate objects or to body parts not traditionally viewed as sexual, coupled with clinically significant distress or impairment.

Fetishistic arousal may become a problem when it interferes with normal sexual or social functioning, or when sexual arousal is impossible without the fetish object.

Fetishism disorder is characterized as a condition in which there is a persistent and repetitive use of or dependence on nonliving objects (such as undergarments or high-heeled shoes) or a highly specific focus on a body part (most often nongenital, such as feet) to reach sexual arousal. Only through use of this object, or focus on this body part, can the individual obtain sexual gratification.

Since fetishes occur in many normally developing individuals, a diagnosis of fetishistic disorder is only given if there is accompanying personal distress or impairment in social, occupational, or other important areas of functioning as a result of the fetish. People who identify as fetishists but do not report associated clinical impairment would be considered to have a fetish but not fetishistic disorder.

Common fetish objects include undergarments, footwear, gloves, rubber articles, and leather clothing. Body parts associated with fetishistic disorder include feet, toes, and hair. It is common for the fetish to include both inanimate objects and body parts (e.g., socks and feet). For some, merely a picture of the fetish object may cause arousal, though many with a fetish prefer (or require) the actual object in order to achieve arousal. The fetishist usually holds, rubs, tastes, or smells the fetish object for sexual gratification or asks their partner to wear the object during sexual encounters.

Fetishism falls under the general category of paraphilic disorders, which refers to intense sexual attraction to any objects or people outside of genital stimulation with consenting adult partners.


The sexual acts of people with fetishistic disorder are characteristically focused almost exclusively on the fetish object or body part. Sexually active adults without fetishistic disorder—or adults with a specific fetish that causes them no distress—may at various times become aroused by a particular body part or an object and make it a part of their sexual interaction with another person, but not fixate on it. In many cases, a person with fetishistic disorder can only become sexually aroused and reach orgasm when the fetish is being used, often feeling intense shame or distress about their inability to become aroused using “typical” stimuli. In other instances, a sexual response may occur without the fetish, but at a diminished level, which may cause shame or relationship tension.


Paraphilias such as fetishistic disorder typically have an onset during puberty, but fetishes can develop prior to adolescence. No cause for fetishistic disorder has been conclusively established.

Psychological research has shown that many fetishes appear to be the result of early imprinting and conditioning experiences in childhood or adolescence (for instance, where sexual excitement and/or orgasm is paired with non-sexual objects or body parts) or as a consequence of strong traumatic, emotional and/or physical experience. Fetishes may in part be influenced by rejection of the opposite sex and/or by youthful arousal being channelled elsewhere (deliberately or accidentally). Some children have been said to associate sexual arousal with objects that belong to an emotionally significant person like a mother or older sister. However, there is also evidence that some fetishes have more biological origins, as in people whose fetish results from conditions such as temporal lobe epilepsy.

Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors may learn to imitate or later be reinforced for the behavior. Compensation models suggest that these individuals may be deprived of normal social sexual contacts, and thus seek gratification through less socially acceptable means.

In cases involving males, some experts have suggested that fetishistic disorder may stem from doubts about one’s own masculinity, potency, or a fear of rejection and humiliation. By using fetishistic practices to exert control over an inanimate object, the theory goes, an individual may safeguard himself from or compensate for feelings of inadequacy.


Fetishistic fantasies are common and in many cases harmless. They should only be treated as a disorder when they cause distress or impair a person’s ability to function normally in day-to-day life.

Fetishistic disorder tends to fluctuate in intensity and frequency of urges or behavior over the course of an individual’s life. As a result, effective treatment is usually long-term. Successful approaches have included various forms of therapy as well as medication therapy potentially reducing sex drive and aggression—and, in the case of an individual with fetishistic disorder, potentially resulting in a reduction of the frequency of erections, sexual fantasies, and initiation of sexual behaviors, including masturbation and intercourse. Some prescription medications may help to decrease the compulsive thinking associated with fetishistic disorder.

  • Sertraline (brand name Zoloft)
  • Fluoxetine (brand name Prozac)
  • Fluvoxamine (brand name Luvox)
  • Paroxetine (brand name Paxil)

This allows a patient to concentrate on counseling with fewer distractions.

Increasingly, evidence suggests that combining drug therapy with cognitive behavioral therapy can be effective, although research on the outcome of these therapies remains inconclusive. A class of drugs called antiandrogens can drastically lower testosterone levels temporarily, and have been used in conjunction with other forms of treatment for fetishistic disorder. This medication lowers sex drive in males and thus can reduce the frequency of sexually arousing mental imagery.