Fetish, fe•tish noun: an object or bodily part whose real or fantasized presence is psychologically necessary for sexual gratification and that is an object of fixation to the extent that it may or may not be required for complete sexual expression

—Merriam Webster, 2012

Sexual fetishes* are defined as recurrent and intensely arousing sexual fantasies, urges, and behaviors that incorporate specific roles and/or physical objects. Theses objects and roles are brought into one’s sexual life because they feel compelling to the individual and because they are a primary source of sexual arousal.

Involvement in and fascination with fetishistic sexual behavior lies on a continuum. Some individuals or couples may occasionally incorporate a fetish object or act to add a little spice into their sexual lives, while others are solely aroused by fetishistic behavior, finding sex to be neither interesting nor arousing without that element.

In other words, for some people fetishes are nonexclusive, meaning the fetish is only one element of a wider arousal pattern, whereas for others the fetish is exclusive, meaning the individual can’t become aroused without it.

While the majority of sexual fetishes are playful and harmless means of sexual arousal, some are also illegal, pathological and dangerous. This blog will focus on the less pathologic, better-known fetish behaviors. In future blogs we will discuss more profound fetish related sexual pathology.

Some of the more well-known sexual fetishes are:

• Sexual behavior involving inanimate objects such as high heels, women’s lingerie, etc.

• Sexual behavior that incorporates “toys” such as dildos, vibrators, cock rings, nipple clamps, etc.

• A strong attraction to specific physical traits in sexual partners and/or porn “performers” such as body size (petite or chubby) or body parts (XL or XS sized breasts, penises, buttocks, etc.)

• Highly specific sexualized acts like those involving physical suffering and/or humiliation of oneself or one’s partner, also known as BDSM (Bondage, Discipline, Sadism and Masochism)

Other relatively common sexual fetishes include arousal involving “water sports” (urination), coprophilia (fecal matter), cross dressing, attraction to contortionism, foot worship, verbal humiliation, body hair, skin color, armpits, amputations, leather, rubber, denim, cigars, perfumes, food, exhibitionism, voyeurism, frotteurism, transvestites, children, etc. Literally, the list is endless.

Putting terms and clinical labels aside for the moment, one simple way to understand a fetishistic attraction is to consider what it is like for most adults to have a “type” of person toward whom they feel more sexually attracted than others.

For example, Matt “likes” leggy blonde women—supermodel Heidi Klum might exemplify Matt’s type—whereas his brother Joe likes curvy women with large breasts such as actress Sofia Vergara. Joe’s friend Ramona reports being “totally turned on” by dark haired men with beards and long hair, while Ray’s boss Alan seems unable to turn away from his fascination with slim Asian women. While not fetishes themselves, but more preferences if you will, the concept of having a sexual type offers some insight into those with more profoundly fetishistic attractions.

To those who somehow think of sexual fetishes as solely a men’s issue… Wake up! The burgeoning Fifty Shades series of fetishistic erotic novels recently surpassed 10 million copies sold—and the primary buyers were adult women. In case you missed it, the trilogy’s male protagonist is a handsome BDSM enthusiast whose “Red Room of Pain” hosts numerous hardcore sex scenes. Many women do indeed exhibit strong fetish interest and behavior.

BDSM (as in Fifty Shades) is one of the better-known fetish experiences, even though most people don’t necessarily wish to experience it firsthand. But don’t let that fool you, as a significant segment of the population does find immense sexual satisfaction when engaging in a little bit of consensual spanking. In fact, the National Coalition for Sexual Freedom estimates that between 5 and 10 percent of American adults engage in sadomasochism for sexual pleasure on at least an occasional basis (with most incidents being either mild or staged incidents in which no real pain is involved).

And there is nothing clinically “wrong” with any of the above. Consensual sexual activity that lies outside the sexual bell curve or “norm” is not considered a crime, an addiction, or even a problem for most people.

The Internet: Destigmatizing the Misunderstood

In pre-Internet days, individuals with uncommon patterns of sexual arousal found it very difficult to connect with one another. Many of them felt as if they were sick or broken, as there were no easily accessible models or peer groups to validate their particular arousal pattern. Consider Charlie, a gay “chubby chaser”:

I always had a thing for big guys, right from the start. In school, we had this science teacher and he was huge. Huge! And I had such a crush on him. To me, fat guys are sexy, and the bigger the better. For a long time, though, I felt like a freak because gay culture told me that I was supposed to be attracted to the guys in tight jeans and muscle shirts—not the ones in caftans! I felt totally out of place, and also learned that the obese guys who turned me on felt that way, too. In fact, a lot of the guys I was attracted to told me that most evenings and weekends they just stayed at home, hiding, with no way for someone like me to meet them. But that was then. Today, thanks to the Internet, I can find like-minded friends and/or partners all over the world. It doesn’t matter where I live or who I know, I can go online and feel part-of, not alone, and not a freak. Nowadays I’m just another guy with “special needs,” if you will.

Virtually every fetish can now be discussed and experienced (both vicariously and in real life) via the Internet. The web today offers up pornography to eroticize nearly everything. More importantly, there are support groups that allow those with certain fetishes to meet, interact and share practices. No longer do people have to feel as if they are the only one aroused by this or that particular thing, or that there’s something wrong with them for having a different pattern of arousal than the average person.

But Aren’t Fetishes Psychological Disorders?

Most fetishes are harmless sources of sexual pleasure, play and physical intimacy. The vast majority of fetish behavior is NOT considered to be psychologically unhealthy as long as the person is accepting of his or her feelings and open to sharing those feelings with partners. It is far more likely that someone with a fetish will enter therapy due to the psychological stress, shame and confusion they feel about having or sharing these sexual feelings than because of an underlying mental disorder. And, in fact, we have little to demonstrate that an adult sexual fetish is in any way treatable.

Though someone’s ego-dystonic (unhappy) feelings about what turns them on them can be resolved, but (similar to sexual orientation) even the person sincerely dedicated to change his or her fetishistic arousal pattern is unlikely to succeed. While uncovering past trauma and coming to understand the cause of a particular arousal pattern may be of interest to some in the analytic world, insight is highly unlikely to make that arousal pattern go away.

As the political and social climate toward various non-pathological fetishes changes (thanks in large part to the Internet) so too does the medical/psychological climate. Thus, as time passes and society becomes inured to “uncommon” sexual fantasies and behaviors—by hearing about them in chat rooms and blogs, or learning about them through erotic sites, fetish apps, and elsewhere—such fantasies and behaviors are becoming less stigmatized, less pathologized, and more generally accepted.

There are of course many profoundly concerning, disturbing, illegal and pathological fetishes (child porn, exhibitionism, voyeurism, pedophilia, bestiality, etc.), and, as mentioned earlier, those will be addressed in future blogs. To quickly learn more basics about fetish behavior I suggest websites such as WebMd, AASECT.org , PositivePassions.com, and lovepanky.com.

* clinically designated by the APA as paraphilias