(See also Overview of Paraphilic Disorders.)
Fetishism is a form of paraphilia, but most people who have fetishism do not meet the clinical criteria for a paraphilic disorder, which require that the person's behavior, fantasies, or intense urges result in clinically significant distress or functional impairment. The condition must also have been present for ≥ 6 months.
There are many fetishes; common fetishes include aprons, shoes, leather or latex items, and women’s underclothing. The fetish may replace typical sexual activity with a partner or may be integrated into sexual activity with a willing partner. Minor fetishistic behavior as an adjunct to consensual sexual behavior is not considered a disorder because distress, disability, and significant dysfunction are absent. More intense, obligatory, and highly compulsive fetishistic arousal patterns and behaviors may cause problems in a relationship or become all-consuming and destructive in a person’s life.
Fetishes may include clothing of the opposite sex (eg, women's undergarments), but if sexual arousal occurs mainly from wearing that clothing (ie, cross-dressing) rather than using it in some other way, the paraphilia is considered transvestism.
Treatment of fetishistic disorder may include psychotherapy, drugs, or both. Selective serotonin reuptake inhibitors have been used with limited success in some patients who request treatment.
