"Being Talked to Like I Was a Sex Toy, Like Being Transgender Was Simply for the Enjoyment of Someone Else": Fetishization and Sexualization of Transgender and Nonbinary Individuals

Despite the growing interest in the experiences of transgender individuals, the phenomenon of fetishization of transgender bodies and identities has been overlooked. The present study was aimed at investigating the experiences of fetishization of transgender and nonbinary (TGNB) people. Participants in the current study represent a sample of 142 TGNB volunteers from the community who answered the prompt: "If you feel comfortable, could you describe your experience of being fetishized?" Using thematic analysis, we developed three overarching themes relevant to the experiences of fetishization of TGNB participants: (1) context of fetishization; (2) negative experiences of fetishization; and (3) positive or ambiguous experiences of fetishization. The results demonstrated that, in most cases, fetishization was understood by TGNB people as a negative experience of sexual objectification, although some individuals experienced fetishization as a positive experience, perceiving the sexual desire of the other person or living it as a kink. Consistent with the integrated theory of dehumanization, the results demonstrated that both sexual objectification and minority stress contributed to participants' understanding of fetishization for TGNB individuals. Implications for clinical work with TGNB individuals are discussed.

Rape of the lock: note on nineteenth-century hair fetishists

The ostensibly bizarre crime of braid-cutting invited occasional alienist inferences from the late 1850s onwards, until it entered mid-1880s police profiles and forensic-psychiatric taxonomies as a corollary of perversion, specifically sadism and fetishism. Cases were rare, but were reported as late as the mid-1930s and enduringly cited as encompassing a staple variety of fetishism. This note briefly reconstructs entries in German, French and English forensic psychiatry, sexual psychopathology and psychoanalysis.

Self-Reported Childhood Maltreatment and Erotic Target Identity Inversions Among Men with Paraphilic Infantilism

Adults with paraphilic infantilism may desire to wear diapers or engage in infant-like role play. Erotic target identity inversions (ETII) and childhood maltreatment have been hypothesized to cause regressive interests. To evaluate these two etiological hypotheses, we surveyed the online adult baby/diaper lover community. Data from 1904 cis-gender men revealed a prevalence of pedophilic interests comparable with the general male population, arguing against ETIIs as common in paraphilic infantilism. In contrast, self-reported childhood neglect and abuse were highly prevalent, suggesting that infantilism might be correlated with childhood maltreatment. Additionally, some participants described repetition and/or sexualization of negative childhood experiences.

Fetishes and factishes: Durkheim and Latour

This paper defends the concept of 'fetishism' as an explanatory parameter in sociological theorizing on Durkheimian grounds, while at the same time paying due attention to important insights regarding the role of objects in social life, originating from Actor-Network Theory (ANT). It critically assesses the current critique of the concept of fetishism propagated by ANT protagonist Bruno Latour. Latour and suggests a compromise between these two 'schools'. First, to place the paper firmly in context, I analyse some examples of modern fetishism and outline the themes of the ensuing discussion. Next, I turn to Durkheim, seeking to develop a distinct interpretation of the concept of the social and of fetishism, and then point to some of Durkheim's shortcomings and attempt to make room for Latourian perspectives. Finally, I critically assess Latour's dismissal of forms of social 'explanation' and of the concept of fetishism.

Demographics, behavior problems, and psychosexual characteristics of adolescents with gender identity disorder or transvestic fetishism

This study provided a descriptive and quantitative comparative analysis of data from an assessment protocol for adolescents referred clinically for gender identity disorder (n = 192; 105 boys, 87 girls) or transvestic fetishism (n = 137, all boys). The protocol included information on demographics, behavior problems, and psychosexual measures. Gender identity disorder and transvestic fetishism youth had high rates of general behavior problems and poor peer relations. On the psychosexual measures, gender identity disorder patients had considerably greater cross-gender behavior and gender dysphoria than did transvestic fetishism youth and other control youth. Male gender identity disorder patients classified as having a nonhomosexual sexual orientation (in relation to birth sex) reported more indicators of transvestic fetishism than did male gender identity disorder patients classified as having a homosexual sexual orientation (in relation to birth sex). The percentage of transvestic fetishism youth and male gender identity disorder patients with a nonhomosexual sexual orientation self-reported similar degrees of behaviors pertaining to transvestic fetishism. Last, male and female gender identity disorder patients with a homosexual sexual orientation had more recalled cross-gender behavior during childhood and more concurrent cross-gender behavior and gender dysphoria than did patients with a nonhomosexual sexual orientation. The authors discuss the clinical utility of their assessment protocol.

A new classification system for lesbians: the Dyke Diagnostic Manual

There has been a long-standing need for a diagnostic manual that documents the unique pathological behaviors of lesbians. The Dyke Diagnostic Manual (DDM) is meant to supplement mainstream classification systems used to identify problematic behaviors in heterosexuals. This article presents thirteen uniquely lesbian conditions that are nowhere to be found in heterosexist diagnostic systems. The DDM may help to reduce the pain and suffering found in many lesbian relationships where one or both partners are afflicted.

Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - case report

A case is reported of a 36-year-old male, found dead in his locked room, lying on a bed, dressed in his mother's clothes, with a plastic bag over his head, hands tied and with a barrel wooden cork in his rectum. Two pornographic magazines were found on a chair near the bed, so that the deceased could see them well. Asphyxia was controlled with a complex apparatus which consisted of two elastic luggage rack straps, the first surrounding his waist, perineum, and buttocks, and the second the back of his body, and neck. According to the psychological autopsy based on a structured interview (SCID-I, SCID-II) with his father, the deceased was single, unemployed and with a part college education. He had grown up in a poor family with a reserved father and dominant mother, and was indicative of fulfilling DSM-IV diagnostic criteria for alcohol dependence, paraphilia involving hypoxyphilia with transvestic fetishism and anal masturbation and a borderline personality disorder. There was no evidence of previous psychiatric treatment. The Circumstances subscale of Beck's Suicidal Intent Scale (SIS-CS) pointed at the lack of final acts (thoughts or plans) in anticipation of death, and absence of a suicide note or overt communication of suicidal intent before death. Integration of the crime scene data with those of the forensic medicine and psychological autopsy enabled identification of the event as an accidental death, caused by neck strangulation, suffocation by a plastic bag, and vagal stimulation due to a foreign body in the rectum.

Sexuality of male-to-female transsexuals

Blanchard's (J Nerv Ment Dis 177:616-623, 1989) theory of autogynephilia suggests that male-to-female transsexuals can be categorized into different types based on their sexuality. Little previous research has compared the sexuality of male-to-female transsexuals to biological females. The present study examined 15 aspects of sexuality among a non-clinical sample of 234 transsexuals and 127 biological females, using either an online or a paper questionnaire. The results showed that, overall, transsexuals tended to place more importance on partner's physical attractiveness and reported higher scores on Blanchard's Core Autogynephilia Scale than biological females. In addition, transsexuals classified as autogynephilic scored significantly higher on Attraction to Feminine Males, Core Autogynephilia, Autogynephilic Interpersonal Fantasy, Fetishism, Preference for Younger Partners, Interest in Uncommitted Sex, Importance of Partner Physical Attractiveness, and Attraction to Transgender Fiction than other transsexuals and biological females. In accordance with Blanchard's theory, autogynephilia measures were positively correlated to Sexual Attraction to Females among transsexuals. In contrast to Blanchard's theory, however, those transsexuals classified as autogynephilic scored higher on average on Sexual Attraction to Males than those classified as non-autogynephilic, and no transsexuals classified as autogynephilic reported asexuality.

Relative prevalence of different fetishes

The aim of this study was to estimate the relative frequency of Fetishes in a large sample of individuals. Using the Internet as a data source, we examined 381 discussion groups. We estimate, very conservatively, that at least 5000 individuals were targeted. The relative frequency of each preference category was estimated considering (a) the number of groups devoted to the category, (b) the number of individuals participating in the groups and (c) the number of messages exchanged. The three measures agree both parametrically (Cronbach's alpha=0.91) and non-parametrically (Kendall's W=0.94, P<0.01). Preferences for body parts or features and for objects usually associated with the body were most common (33 and 30%, respectively), followed by preferences for other people's behavior (18%), own behavior (7%), social behavior (7%) and objects unrelated to the body (5%). Feet and objects associated with feet were the most common target of preferences. These findings provide the first large database in an area, where the knowledge is particularly scarce.

Pentheus rather than Oedipus: on perversion, survival and analytic 'presencing'

Following an introductory review of the main developments in the psychoanalytic thinking on perversion, the author focuses on her own understanding of perversion and its treatment, based on the psychoanalytic treatment of patients with severe sexual perversions. This paper uses the term 'autotomy' (borrowed from the field of biology) to describe perversion formation as an 'autotomous' defence solution involving massive dissociative splitting in the service of psychic survival within a violent, traumatic early childhood situation; thus, a compulsively enacted 'desire for ritualised trauma' ensues. The specific nature of the perverse scenario embodies the specific experiential core quality of the traumatic situation. It is an actual repetition in the present of the imprint of a past destructive experience which is pre-arranged and stage-managed; it thus encounters haunting scenes of dread or psychic annihilation while, at the same time, controlling, sanitising and disavowing them. Hence, the world of severe perversion is no longer oedipal, but rather the world of Pentheus, Euripides's most tragic hero--a world dominated by a mixture of a mother's madness, devourment, destruction and rituals of desire. According to this view, the (difficult) psychoanalytic treatment of perversion focuses on patient-analyst interconnectedness--brought about by the analyst's 'givenness to being present' or 'presencing'--at a deep, primary level of contact and impact (the emphasis being on the ontological dimension of experience). This evolving therapeutic entity creates and actualises a new, alternative experiential-emotional reality within the pervert's alienated world, eventually generating a change in the perverse essence. The author illustrate this approach with three clinical vignettes.

An animal model of fetishism

An animal model of sexual fetishism was developed with male Japanese quail based on persistence of conditioned sexual responding during extinction to an inanimate object made of terrycloth (Experiments 1 and 3). This persistent responding occurred only in subjects that came to copulate with the terrycloth object, suggesting that the copulatory behavior served to maintain the fetishistic behavior. Sexual conditioning was carried out by pairing a conditioned stimulus (CS) with the opportunity to copulate with a female (the unconditioned stimulus or US). Copulation with the CS object and persistent responding did not develop if the CS was a light (Experiment 1) or if conditioning was carried out with a food US (Experiment 2). In addition, subjects that showed persistence in responding to the terrycloth CS did not persist in their responding to a light CS (Experiment 3). The results are consistent with the hypothesis that conditioned copulatory behavior creates a form of self-maintenance that leads to persistent responding to an inanimate object. The development of an animal model of such fetishistic behavior should facilitate experimental analysis of the phenomenon.

Transvestic fetishism in the general population: prevalence and correlates

We used a random sample of 2,450 18-60 year-olds in the general population of Sweden to study the prevalence as well as the social, sexual, and health correlates of transvestic fetishism (sexual arousal from cross-dressing). Almost three percent (2.8%) of men and 0.4% of women reported at least one episode of transvestic fetishism. Separation from parents, same-sex sexual experiences, being easily sexually aroused, pornography use, and higher masturbation frequency were significantly associated with transvestic fetishism. A positive attitude to this sexual practice and paraphilia indicators--sexual arousal from using pain, exposing genitals to a stranger, and spying on others having sex--were particularly strong correlates to the dependent variable.

[A case of diaper fetishism]

Some people cannot obtain satisfaction from ordinary sexual relationships; instead they prefer alternative methods. They are referred to in psychiatric terminology as paraphiliacs. Fetishism is a type of paraphilia in which a person is sexually attracted to objects and some body parts. Most fetishists do not intend to cause harm to other people, but may have problems when others become involved in the problem. Underlying personality disorders extending through childhood are thought to be the source of the etiology. Perverted people do not wish to change their behavior pattern. They never seek treatment from a therapist. Psychological issues obviously play a crucial role in determining the choice of paraphilia and the underlying meaning of the sexual acts. Psychodynamic models (object relations theory, self psychology, drive theory) can shed light on the meaning of a perversion. In this case report, a 22- year-old man with diaper fetishism is presented. When family dynamics are considered, the mother has been described as psychologically distant from her son. The fetish object was recognized during childhood at around the age of four. During puberty, the fetish object became sexually attractive. Our patient exhibited his first perverted behavior when he was six years old. Later, he could control this behavior. At the age of twelve, the perverted behavior became sexually arousing. This paper emphasizes the diaper fetishism case through the patient's past psychiatric and medical history. Diaper fetishism is discussed in the light of forensic, cognitive and psychodynamic theories.

[A case of Williams syndrome who exhibited fetishism]

Williams syndrome is a rare congenital disease in which the etiological locus is a micro-deletion in chromosome 7. Here, we describe the case of a 22-year-old male who was diagnosed with Williams syndrome at the age of 3 years. As a child, the patient exhibited patterns of behavior characteristic of this syndrome including hyperactivity, attention deficit, and over-friendliness. He also showed persistent interest in construction vehicles, playgrounds, and gloves. He became interested in gloves after watching a television program in which the heroine fought her enemies while wearing gloves. Watching pornographic movies allowed him to attach strong sexual significance to gloves when he was 19 years old. Since that time, he has assaulted women wearing gloves four times to rob them of the gloves. The current paper discusses both the role of the cognitive profile unique to Williams syndrome and that of environmental factors in the development of fetishism in this case.

Perverse thought

Based on Bion's work on the 'psychotic and non-psychotic parts of the personality', the author hypothesises the existence of a special type of thought disorder known as 'perverse thought'. First the author presents an overview of the major contributions to the concept of perversion that have a bearing on 'perverse thought'. These include Freud's splitting and disavowal concepts, Klein's projective identification concept, Bion's -K link and Meltzer's transference perversion. Then, by means of a case study and some vignettes, the author illustrates how this thought disorder is configured within the analytic process. The author focuses on three main aspects of this pathology: the specific modality of projective identification in a perverse scheme, the lie and some important clinical events that reveal an attack against knowledge through the formation of the -K link. Perverse thought is an important resistance mechanism in the analytic process. Its clarification is essential, given that its main objective is to attack the knowledge process, and therefore truth, in order to pervert the analytic relationship.

Sexualization of the female foot as a response to sexually transmitted epidemics: a preliminary study

The authors reviewed historical literature and hypothesized a relationship between epidemics of sexually transmitted diseases and foot fetishism. They tested this hypothesis by quantifying foot-fetish depictions in the mass-circulation pornographic literature during a 30-yr. interval. An exponential increase was noted during the period of the current AIDS epidemic. The authors offer reasons for this possible relationship.

A cat as fetish: a contribution to the theory of fetishism

Since Freud's original study of fetishism and his description of the genesis of the symptom, many additions and elaborations have been made to those propositions. In the past decade, fetishism has been increasingly applied to a wide variety of behavior and mentation, some with no overt sexual component. In this paper, the author, drawing on his observations made during a very lengthy analysis of a female patient, underscores the need to broaden the applicability of the diagnosis of fetishism but sees value in limiting it to the sexual situation. He suggests that a fetish does not need to be an inanimate object and expresses agreement with those who feel that fetishism is not limited to males. Additionally, he offers for consideration the idea that fetishism belongs on a continuum with a whole gamut of phenomena such as the need for a transitional object, the use of amulets, and the endowment of magical properties to words, ideas, rituals and objects. All these phenomena have in common the use of an outside object bestowed by magic and illusion to control anxiety. The hierarchical level of such anxiety and its ideational content (oedipal versus pre-oedipal) are of less causative value than the ego's inability to master it without resorting to an outside object.

The phenomena of police fantasies, leg fetish, and father identification in a homosexual male

TOPIC

The relationship of police fantasies and leg fetish to identification with the father in a homosexual male.

PURPOSE

To describe two manifestations of identification with the father in a male homosexual.

SOURCE

The author's clinical work.

CONCLUSION

It is important to decode current behavior in light of theory and past history, to help clients move from potentially destructive behavior to satisfying interpersonal interactions.

The ontogeny of a sexual fetish from birth to age 30 and memory processes. A research case report from a prospective longitudinal study

From a longitudinal study that began at birth, a case is described in which a man at the age of 30 recalls the onset of a sexual fetish in his fifth or sixth year of life. The memories activated and dreams reported during the thirty-year follow-up interview, were synthesised with parent-infant film data and historical information contained in the research record concerning the child's development, his parents' behaviour and traumatic experiences. Taken together they provide a detailed description of the psychological ontogenesis of the fetish. The case provides unusual information about the manner in which early childhood events-objectively documented-interdigitate with intrapsychic processes and mental structuralisation. This also illuminates processes by which memories are retained, condensed, distorted and lost. In addition, information from other participants in the project who reported sexually anomalous histories at the age of 30 raises questions of what can be predicted from early life experiences.

The analyst's interpretation as fetish

This paper explores the transference dynamics and underlying fantasies of analysands whose characters have been shaped by conflict solutions common to perversion. Giving the impression of a serious engagement for therapeutic ends, these individuals live out in the treatment a sexualized enactment in which the analyst's interventions are transformed into a fetish. This enactment is designed to support a defensive effort to avoid external perceptions that trigger certain fantasies of danger, including that of castration. It is designed also to cancel out interventions of the analyst that become equated with these frightening fantasies. Since the analyst's efforts to explore and interpret this enactment are also turned into a fetish, such a transference poses grave difficulties for the analysis. A technical approach is suggested in which the analyst focuses on the contradiction itself, the operation of the disavowal, the fantasy of danger that motivates the persistent use of disavowal, and the underlying, often vengeful and envious wishes that contribute both to the undermining of the analysis and to the content of the fantasies of danger that provoke so much anxiety.

Two types of fetishism

This study attempted to differentiate two clinical types of fetishism-fetishism proper and tranvestism-and to determine if tranvestites are truly fetishistic. The transvestites were further divided into gender-conforming and gender-noncomforming groups according to their score on a gender identity scale. These groups were compared using a self-report scale measuring fetishistic interests, and a set of questionnaire items regarding their childhood history, parental characteristics, and their emotional closeness with their parents. In addition, the penile responses of a subset of fetishists and tranvestites were recorded while they were presented with visual depictions of female and male public regions and potentially fetishistic objects (nylon stockings, female and male shoes, panties, male underwear, female and male feet). The fetishists proper and the transvestite subgroups did not differ from each other in terms of self-reported fetishistic interest or childhood and family histories. Moreover, there were no differences between these groups in their penile response to the potentially fetishistic stimulus they were most aroused by, relative to the depictions of the pubic region of their preferred gender. These results suggest that transvestites are in fact fetishistic, and that they are difficult to distinguish from fetishists proper.

Constitutive signifiers or fetishes in Shakespeare's the Merchant of Venice?

Assessments of psychodynamic structures and processes implicit in 'The Merchant of Venice' vary considerably according to whether Lacanian or object-relations tenets are applied. Aspects of the play resemble a pattern described in Lacan's seminar on E. A. Poe's story 'The purloined letter': the 'itinerary' of the 'signifier' represented by a roving letter in Poe's story closely matches in outline the adventures surrounding roving rings in Shakespeare's play. Using Poe's story as evidence, Lacan's seminar argues that human identity is a product of 'signifiers', and not vice-versa. This conclusion that human subjectivities are constituted by signifiers does not stand up well in relation to the power of the rings and other signifying physical objects appearing in Shakespeare's play and its source stories. Recently expanded understandings of Freud's ideas about fetishism better explain the often malevolent power of the play's many signifying physical objects. In these the essential potential for damage is to sound personal relations with inner and outer objects of love. Explanations emphasising that distorted object relations and damaged subjectivities may be redeemed accord well with the dramatic and poetic patterns of Shakespeare's play, indicating that it, while portraying painful dilemmas, is still a comedy.

Homosexual foot fetishism

262 respondents from an organization for homosexual foot fetishists provide information from a broader sample than clinical cases and allow examination of the effects of sexual preference on fetishism. Data show a wide range of feet/footwear objects to be arousing. Such interests were often associated with particular types of men, yet interests were subject to change over time. Fetishistic arousal rested on both sensual and symbolic aspects of the fetish. Symbolically, it was the theme of "masculinity" that made male feet/footwear arousing, showing parallels to "femininity" evoked by female feet/footwear for male heterosexual fetishists. For many of the respondents, fetishism did not seem to be a substitute for living persons. Respondents had intimate relationships and were able to incorporate their fetish interests into stable relationships and less intimate ones. Considerable involvement in sadomasochistic practices was also found as was involvement in the gay world. Finally, nothing about a fetishistic interest seemed to preclude the development of subcultural forms around the practice.

Psychoanalysis as a lifeline: a clinical study of a transference perversion

Case material from the analysis of a fetishistic cross-dresser is reported. The evolution of a transference perversion and treatment impasse, in the form of the recalcitrant symptom of anal flatulence, is described. The patient's contrasting needs to cling perversely and addictively to the analyst, on the one hand, and to provoke an acting out of the countertransference, on the other, are placed in the context of his dread of rejection and potentially suicidal reaction. The author argues in favour of offering psychoanalysis as a lifeline, but with the condition that the psychoanalytic setting and boundaries are maintained and that gratifications are denied. Limited but precise interpretive psychoanalytic work in the transference was maintained. The relatively good outcome is explained in terms of the provision of safety, survival of the analyst and avoidance of countertransference acting out, which, in the author's view, represents an implicit and mutative transference interpretation, the specific factor in bringing about psychic change. This enabled the patient to recognise and accept the analyst as a 'new' object and, as a consequence, to question and reject his idealisation of the anal universe that he inhabited.

Homosexual erotomania and HIV infection

A case of homosexual erotomania is described in a patient with AIDS-related complex. Direct involvement of the central nervous system was thought an unlikely cause, as specific stressors appeared to have precipitated a reactive psychosis. A psychodynamic understanding of these factors and their interaction with the patient's masochism, fetishism, and personality disorder provided an alternative explanation for the onset of the paranoid illness and its symptom content. The psychodynamic aspects of acute psychotic disorders without evidence of cognitive impairment in patients with HIV infection is a neglected area of study.

The treatment of fetishism and socially inappropriate sexual behavior in a young male with dull normal intelligence

A young adult male with dull normal intelligence who had a fetish to female undergarments and was engaging in socially inappropriate sexual behavior was evaluated and treated in a multimodal treatment approach. Mild and diffuse encephalopathies were noted through EEG recordings. No definite epileptiform abnormalities or focal supratentorial lesions were seen and the pattern was consistent with patients with post-encephalitis. Treatment of this patient involved the use of anti-androgen and antianxiety pharmacotherapy along with counseling to provide basic sex education and specific education for socially accepted sexual behavior. Follow-up evaluation several yrs later indicated good treatment results. This case illustrates potential sources of sexually deviant behavior and treatment options. Promising new drug treatments are available which act as sexuoerotic tranquilizers as well as treatments for underlying or concomitant psychiatric disorders. In this case, however, family dynamics and poor sex education seemed to account for most of this patient's difficulties. Counseling and psychoeducation proved to be quite effective in resolving problematic behavior.

Cross-dressing in men with learning disabilities

Four men with learning disabilities were considered to show transvestic fetishism, and a fifth to show transvestism. However, developmental retardation and personality problems may modify the concepts behind such categorisation.

Erotic target location errors in male gender dysphorics, paedophiles, and fetishists

A clinical series of male paedophiles who dressed or fantasised themselves as children suggests that certain paraphilias represent developmental errors in locating erotic targets in the environment and that proneness to such errors is a paraphilic dimension in its own right, apart from the specific nature of the erotic target.

Gender identity disorder and courtship disorder

A hypothetical connection between gender identity disorder and courtship disorder was investigated in 274 heterosexual male patients of the following types: nontransvestic fetishists for female attire; transvestic fetishists; patients with gender identity disorder of adolescence and adulthood, nontranssexual type; and transsexuals. Of these patients, 53 had also demonstrated one or more of the putative expressions of courtship disorder. The proportion each of these types contributed to this group of 53 patients with a courtship disorder was compared with the same type's proportional contribution to the group of 221 gender identity patients without a courtship disorder. The transvestic fetishists contributed a significantly larger percentage and the transsexuals a significantly smaller percentage of individuals to the group with a courtship disorder than to that without a courtship disorder. Theoretical implications of this asymmetry are discussed.

Use of the analyst as a fetish

In some cases a gratifying transference fantasy is the subject of progressive analytic work, while in other cases the same type of fantasy eludes investigation, and its enactment causes treatment to become an unproductive endless task. One cause for the latter difficulty can be that the patient uses his or her analyst as a fetish, permitting the distinction between reality and fantasy to remain inconclusive, so that relinquishment of magical expectations does not take place. The particular form of thinking involved in use of the analyst as a fetish is described. The role of illusion, its various clinical manifestations, the countertransference reactions they can evoke, and the technical problems posed are discussed. Special attention is given to the crucial issue of termination. By considering extreme instances in which use of the analyst as a fetish predominates, the author hopes to call attention to a phenomenon that appears to some degree in many, if not all, analyses.

A sex caused inconsistency in DSM-III-R: the definition of mental disorder and the definition of paraphilias

The DSM-III-R definition of mental disorder is inconsistent with the DSM-III-R definition of paraphilias. The former requires the suffering or increased risk of suffering some harm while the latter allows that deviance, by itself, is sufficient to classify a behavioral syndrome as a paraphilia. This inconsistency is particularly clear when examining the DSM-III-R account of a specific paraphilia, Transvestic Fetishism. The author defends the DSM-III-R definition of mental disorder and argues that the DSM-III-R definition of paraphilias should be changed. He recommends that the diagnostic criteria for specific paraphilias, particularly that for Transvestic Fetishism, be changed to make them consistent with the DSM-III-R definition of mental disorder.

Nonmonotonic relation of autogynephilia and heterosexual attraction

In this study I investigated the relation between normal heterosexual attraction and autogynephilia (a man's propensity to be sexually aroused by the thought or image of himself as a woman). The subjects were 427 adult male outpatients who reported histories of dressing in women's garments, of feeling like women, or both. The data were questionnaire measures of autogynephilia, heterosexual interest, and other psychosexual variables. As predicted, the highest levels of autogynephilia were observed at intermediate rather than high levels of heterosexual interest; that is, the function relating these variables took the form of an inverted U. This finding supports the hypothesis that autogynephilia is a misdirected type of heterosexual impulse, which arises in association with normal heterosexuality but also competes with it.

Personality and sexual functioning of transvestitic fetishists and other paraphilics

Utilizing the NEO Personality Inventory (NEO-PI) and the Derogatis Sexual Functioning Inventory (DSFI), 24 transvestitic fetishists (TVs) were compared with a similar clinic-evaluated group of 26 other paraphilics (OPs). The data replicated previous results and extended them by showing that TVs did not differ from OPs on most dimensions of the NEO-PI and the DSFI. Both groups were significantly higher on neuroticism and significantly lower on agreeableness than the NEO-PI male normative population. The other paraphilic group tended to score lower on conscientiousness than the TVs and the normative comparison group. For nine of the 10 DSFI variables, there were no significant differences between the TVs and the OPs. The TVs were significantly higher than the OPs on role identity, indicating a more feminine identification. Both the TVs and OPs reported elevated levels of fantasy. The implications of these findings suggest that, in general, TVs and OPs are more similar than they are different, with a common personality profile and a similar pattern of sexual functioning.