Today, we’ll look at some of the studies that have helped scientists redefine fetishism and open new inquiries into why fetishes exist and how fetishists process these allegedly radical sex behaviors.
First: please put your own prejudices aside. Remember (from Fetish 101) that two-thirds of respondents in a massive research project (Ahlers et al. 2011, German men) said they had kink or fetish desires. We don’t know how many acted on them; we do know that the vast majority of them were comfortable with those desires.
Now, a basic definition of fetish.
What Is a Fetish?
A fetish is an intense, persistent sexual attraction to a specific object, body part, or material. The clinical term is fetishism. The object of desire is called the fetish object. Common fetishes include feet, shoes, leather, rubber, lingerie, and specific body parts. We know from the Internet that there are hundreds of different fetishes out there; there is reason to believe there may be thousands more that no one has ever admitted to or considered a fetish. Are people having romances with farm equipment or a specific piece of living room furniture? We’ll never know.
When I see someone admit to some far-flung fetish lust, or an object that seems almost impossible to eroticize, like a table or a wall, I don’t doubt them. I only wonder how many other people have the same fetish but would never ever reveal it to anyone.
Scientists Clinically Split Over the Definition
I’d be remiss not to mention the clinical divide between the American Psychiatric Association (APA) and the World Health Organization (WHO). In the US, psychiatrists treat “Fetishistic Disorder” as a diagnosable condition based on the American DSM-5-TR (Diagnostics and Statistics Manual, the U.S. handbook of mental disorders).
WHO removed fetishism, fetishistic transvestism, and sadomasochism as distinct categories from their diagnostic manual, ICD-11. WHO was clear that sexual behaviors that are solitary or consensual do not belong on a list of mental disorders. These days, progressive, evidence-based therapists do not “treat” a fetish, much less attempt to cure it. Their focus is on treating the shame and self-hatred that some fetishists experience.
Compared to the WHO, the APA seems out of date, unscientific, and almost constitutionally cringing before public opinion and politicians.
I’m With the Science
I support WHO’s judgment. Of course, I’m hardly the only U.S. sexologist who places the emphasis strictly on the new science of sex. While the APA has been dragging its feet, researchers across numerous medical and science disciplines around the world have been assiduously compiling studies on fetish, kink, and BDSM. The evidence base that contradicts the pathology model has grown so huge as to be incontrovertible.
TL;DR Fetishism itself is pretty normal. It’s the people who hate themselves for having the fetish who are in emotional trouble.
How Common Are Fetishes? Landmark Studies
The largest single dataset on fetish prevalence comes from Scorolli and colleagues at the University of Bologna. The team examined 381 online discussion groups, conservatively estimating that at least 5,000 individuals participated. Preferences for body parts and for objects associated with the body were the most common categories. Feet and objects associated with feet were the most common target of all.
The strongest population-based evidence comes from a German community study by Ahlers and colleagues. Working from a sample of 1,915 men aged 40 to 79, they found 62.4% reported at least one paraphilia-associated sexual arousal pattern. The pattern caused distress in only 1.7% of cases. Translation: most men have at least one paraphilic interest. Almost none of them are bothered by it.
A separate Canadian study led by Christian Joyal surveyed 1,516 adults and asked them to rank 55 sexual fantasies. Only two fantasies qualified as statistically rare. Thirty were common. Submission and dominance themes appeared in both.
These numbers are almost certainly low. Sexual shame suppresses honest self-reporting. Still, the data are clear. Atypical sexual interests are statistically typical.
Four Studies of Special Interest
If you want to dig into the scholarship, here are my picks for the most impactful studies on Fetishism in the 21st Century.
The Study That Ended Fetish as a Diagnosis
Krueger, R. B., Reed, G. M., First, M. B., Marais, A., Kismodi, E., & Briken, P. (2017). Proposals for paraphilic disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11). Archives of Sexual Behavior, 46(5), 1529–1545. https://pmc.ncbi.nlm.nih.gov/articles/PMC5487931/
This is the study that ended fetishism as a disorder at the global level. Their argument rested on three principles. Consensual or solitary sexual behavior is not a public health concern. Atypical arousal patterns are not disorders unless they cause distress, dysfunction, or harm. Stigmatizing diagnoses without clinical benefit violates human rights standards. The paper also notes that Denmark, Sweden, Norway, and Finland had already removed these categories from their national ICD lists by 2011. This is the document of record for any therapist, clinician, or scholar who needs to cite the official basis for the depathologization of fetish.
Mapping the Fetish Landscape
Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S., & Jannini, E. A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19(4), 432–437. https://doi.org/10.1038/sj.ijir.3901547
Scorolli and colleagues at the University of Bologna analyzed 381 internet discussion groups dedicated to specific fetishes. They conservatively estimated 5,000+ adults were selected. By counting community size, participant numbers, and message volume, they ranked fetishes by relative popularity. Preferences for body parts and features topped the list at 33%, followed by body-associated objects at 30%. Within the body parts category, feet and everything associated with them were the most common targets. This study is the reason every researcher who writes about fetish prevalence today cites a number that begins with “feet are number one.”
How Many Men Have Paraphilic Interests?
Ahlers, C. J., Schaefer, G. A., Mundt, I. A., Roll, S., Englert, H., Willich, S. N., & Beier, K. M. (2011). How unusual are the contents of paraphilias? Paraphilia-associated sexual arousal patterns in a community-based sample of men. Journal of Sexual Medicine, 8(5), 1362–1370. https://doi.org/10.1111/j.1743-6109.2009.01597.x
(Note: Paraphilia is the clinical umbrella term for atypical sexual interests, including fetishism.)
In another landmark study, a research team in Germany recruited 367 male volunteers from a community sample of 1,915 men aged 40 to 79 in Berlin. The surprise finding: 62.4% reported at least one paraphilia-associated sexual arousal pattern! Voyeurism and fetishism were the most commonly reported; sadism and masochism followed at 24.8% and 18.5%.
Most fascinating to this sexologist, only 1.7% of respondents reported distress about their turn-ons. It brings to life the reality of fetishism for me. Since the 1880s in the US, psychiatrists have seen perhaps hundreds of thousands, if not millions, of patients whom they tried to “cure” of their kinkiness/fetishism.
Those were mainly unhappy people who couldn’t find healthy outlets for their desires. And the reason they were in such mental turmoil was that psychiatrists kept telling them they were abnormal perverts who should be locked up.
Redefining “Unusual” Sexual Fantasy
Joyal, C. C., Cossette, A., & Lapierre, V. (2015). What exactly is an unusual sexual fantasy? Journal of Sexual Medicine, 12(2), 328–340. https://doi.org/10.1111/jsm.12734
Focused on an exploration of sex fantasies, this Canadian research team surveyed 1,516 adults from Quebec about 55 different sexual fantasies. The team statistically analyzed which fantasies were rare, common, or universal. The result reframed the entire conversation about what counts as deviant. Fantasies long classified as paraphilic, including fetishistic and sadomasochistic content, turned out to be statistically common! Another deliciously surprising piece of data.
Based on these results, Joyal and colleagues argued that the DSM definition of paraphilia is statistically indefensible because the so-called “unusual” interests are reported by significant percentages of ordinary adults. This study was also directly influential in shaping the ICD-11 changes.
Stay Fetishy
In Part 103 of this series, I go deeper into common questions about fetishes, like where fetishes come from, how fetishists develop across a lifetime (based on my original models), and why the shame attached to them is the real problem we must treat.
photo credit José Martin Segura Benites@Pexels.com
Don’t forget to visit the Pleasure Literacy Emporium and pick something up to enhance your erotic life!
