173 Transvestic Fetishism (302.3)
DSM-IV-TR criteria
- Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
- The fantasies, sexual urges, or behaviors cause significant distress or impairment in social, occupational, or other important areas of functioning. It involves using nonliving objects to obtain sexual arousal.
- Specify if :
- With Gender Dysphoria: if the person has persistent discomfort with gender role or identity
Associated features
- Common symptoms associated with this psychological disorder do not seem to vary greatly, but these symptoms do vary in severity. Transvestic Festishism is defined as a paraphilia by the DSM and usually occurs in patients as one of several paraphilias. The main feature of this disorder is recurrent sexual urges or sexual desires involving dressing in clothing normally worn by the opposite sex. This is often also referred to as cross-dressing. A diagnosis of this disorder is usually made only if an individual has acted out on these urges or if the urges seem to interfere with everyday activities for the individual. The frequency at which the urges occur is the deciding factor in the severity of cases. For some individuals, the urge occurs often and is necessary for sexual arousal, while in some individuals they may not be necessary or present unless triggered by outside influences (e.g. stress). When these outside influences are absent, individuals with less severe cases are typically able to function in a normal sexual manner. Participation in transvestism is usually gradual, over time the sufferer begins to assume the identity of a member of the opposite sex based on his or her perceptions of that sex. Transvestic behavior in patients is closely associated with achieving some sort of sexual gratification. A person that practices transvestic fetishism often finds it difficult to distinguish from the opposite gender. They have often adopted many qualities specific to that gender (e.g. mannerisms, clothing, materials, and other items associated with the opposite gender). In extreme cases some individuals undergo hormonal or surgical procedures to change their appearance to that of the opposite sex (gender reassignment surgery.) The DSM states that one should not be considered homosexual in nature just because of transvestism, although some do occasionally have homosexual encounters. Some individuals with transvestic behavior appear to be motivated by autogynephilia which is a condition in which the individual is sexually stimulated by fantasies that their own bodies are female.
- The ICD-10 adds the additional exclusion criteria that the disorder is not a symptom of another mental disorder such as schizophrenia. It also includes a separate diagnosis of Dual-role Transvestitism characterized by non-erotic cross-dressing and the absence of desire toward permanent sex reassignment.
Child vs. adult pres