The Sexual Attraction Toward Disabilities
The Sexual Attraction Toward Disabilities
An interesting finding emerging from our study is that the vast majority of subjects who define themselves as devotees have characteristics suggestive of paraphilic behavior. These subjects are unable to become sexually aroused in the absence of the paraphilic object (in this case disability) and reported experiencing discomfort due to their condition. This, coupled with their lack of any sexual relationship with able-bodied people, may suggest that these subjects may fall, on the basis of DSM 5 criteria for the definition of paraphilia, in the category 'exclusive paraphilia'.
This is a reasonable inference, considering that 71.8% of participants (150/209) in our survey reported that they had sexual intercourse with an able-bodied person. However, the evidence that 71 of the 91 participants who experienced discomfort during sexual intercourse with able-bodied people belonged to the first population indicates that they certainly do not prefer sexual intercourse with an able-bodied person. We suggest therefore that this subpopulation can be preferentially attracted by disability, although those of them who also experienced discomfort due to their sexual attraction toward disability may have characteristics closer to a paraphilic behavior.
DSM-IV-TR defines paraphilia as 'recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving (1) nonhuman objects, (2) the suffering or humiliation of oneself or one's partner or (3) children or other non-consenting persons that occur over a period of at least 6 months (Criterion A). For some individuals, paraphilic fantasies or stimuli are obligatory for erotic arousal and are always included in sexual activity. In other cases, the paraphilic preferences occur only episodically (e.g., perhaps during periods of stress), whereas at other times the person is able to function sexually without paraphilic fantasies or stimuli. (…) The diagnosis is made if the behavior, sexual urges or fantasies cause clinically significant distress or impairment in social, occupational or other important areas of functioning (Criterion B)'.
Some authors have questioned the essence of Criterion A, stressing that the distinction between a mental disorder and a healthy sexual interest depends on the nature of the specific sexual interest rather than its intensity. In addition, doubts were also present as to the utility of Criterion B. In the past, it was believed that people with paraphilia were not usually distressed by their condition itself but by the onset of problems in social relations due to their sexual behavior.
The DSM-5 subgroup proposes a new definition of paraphilia, which distinguishes, on the basis of Criterion B, paraphilia from paraphilic disorder. Most people with atypical sexual interests do not have a mental disorder, which is a paraphilic disorder http://www.dsm5.org. According to the new definition, a paraphilic disorder is 'a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not automatically justify or require clinical intervention http://www.dsm5.org'.
Although our survey was not tailored to investigate characteristics such as intensity and specificity of paraphilia, our data seem to suggest that a subset of our first subpopulation of devotees may prefer the paraphilia to conventional sexual intercourse. Although they may also engage in conventional sexual activity, these subjects may fall in the category 'preferred paraphilia'.
The second subpopulation consists of individuals who are not sexually attracted by the disability per se but rather by the way people with disabilities deal with their condition ('their adaptability, fortitude, courage and ability to overcome obstacles'). This is the main distinctive characteristic that leads us to believe that this sexual attraction cannot be considered a form of fetishism, given that the object of attraction is seen as a whole rather than in terms of disability, and that it does not reflect the essence of paraphilia. In addition, these subjects experience low levels of discomfort due to their sexual preference and are able to build and maintain lasting relationships with their partners, whether disabled or able bodied.
On the basis of these considerations, this population could represent the boundary between a true pathological condition, ranging from paraphilic disorder to an 'unusual' sexual preference (paraphilia), and what is socially considered as 'conventional sexuality'.
Similar to any method, Internet-based studies (IBSs) have been criticized, in this case due to lack of control over the participant's environment, vulnerability to fake responses and possible non-representativeness of the general population. Although these are fair criticisms, some of these preconceptions have proved unfounded due to consistency with findings using traditional methods. Repeat responders can be another problem, although this was mitigated in our survey as the questionnaires were not filled out anonymously. It should be noted that IBSs can also offer important advantages over traditional methods, in particular, the ability to access very large potential study populations and, consequently, to collect data on particularly rare fetishism.
A possible bias of our study is that data were only gathered from subscribers to Yahoo! groups, who may not represent the general population of devotees. In addition, it is also possible that not all the disability typologies have been included in our search strategy, although we believe to have covered a wide range of those. However, it should be acknowledged that most research on unusual sexual behavior is based on data sources that are, in all likelihood, even less representative. Another significant limitation is that, taken individually, some of the questions may not be sufficiently specific to investigate some of the characteristics of devotism. In any case, as with any new methodology, prudence is justified and our data should be interpreted cautiously. Finally, the use of a non-standardized semi-structured questionnaire can represent another evident limit of this study.
Devotism may cover a wide array of conditions, ranging from unambiguously pathological conditions to more blurred clinical pictures. Although this represents only a first study on this kind of sexual attraction, data could be of interest for the discussion of future inclusion criteria of the large family of paraphilias. Future research investigating specific aspects related to paraphilia such as intensity, specificity and preference of paraphilic symptom will be necessary to identify subjects with clear paraphilic behavior.
Discussion
An interesting finding emerging from our study is that the vast majority of subjects who define themselves as devotees have characteristics suggestive of paraphilic behavior. These subjects are unable to become sexually aroused in the absence of the paraphilic object (in this case disability) and reported experiencing discomfort due to their condition. This, coupled with their lack of any sexual relationship with able-bodied people, may suggest that these subjects may fall, on the basis of DSM 5 criteria for the definition of paraphilia, in the category 'exclusive paraphilia'.
This is a reasonable inference, considering that 71.8% of participants (150/209) in our survey reported that they had sexual intercourse with an able-bodied person. However, the evidence that 71 of the 91 participants who experienced discomfort during sexual intercourse with able-bodied people belonged to the first population indicates that they certainly do not prefer sexual intercourse with an able-bodied person. We suggest therefore that this subpopulation can be preferentially attracted by disability, although those of them who also experienced discomfort due to their sexual attraction toward disability may have characteristics closer to a paraphilic behavior.
DSM-IV-TR defines paraphilia as 'recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving (1) nonhuman objects, (2) the suffering or humiliation of oneself or one's partner or (3) children or other non-consenting persons that occur over a period of at least 6 months (Criterion A). For some individuals, paraphilic fantasies or stimuli are obligatory for erotic arousal and are always included in sexual activity. In other cases, the paraphilic preferences occur only episodically (e.g., perhaps during periods of stress), whereas at other times the person is able to function sexually without paraphilic fantasies or stimuli. (…) The diagnosis is made if the behavior, sexual urges or fantasies cause clinically significant distress or impairment in social, occupational or other important areas of functioning (Criterion B)'.
Some authors have questioned the essence of Criterion A, stressing that the distinction between a mental disorder and a healthy sexual interest depends on the nature of the specific sexual interest rather than its intensity. In addition, doubts were also present as to the utility of Criterion B. In the past, it was believed that people with paraphilia were not usually distressed by their condition itself but by the onset of problems in social relations due to their sexual behavior.
The DSM-5 subgroup proposes a new definition of paraphilia, which distinguishes, on the basis of Criterion B, paraphilia from paraphilic disorder. Most people with atypical sexual interests do not have a mental disorder, which is a paraphilic disorder http://www.dsm5.org. According to the new definition, a paraphilic disorder is 'a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others. A paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not automatically justify or require clinical intervention http://www.dsm5.org'.
Although our survey was not tailored to investigate characteristics such as intensity and specificity of paraphilia, our data seem to suggest that a subset of our first subpopulation of devotees may prefer the paraphilia to conventional sexual intercourse. Although they may also engage in conventional sexual activity, these subjects may fall in the category 'preferred paraphilia'.
The second subpopulation consists of individuals who are not sexually attracted by the disability per se but rather by the way people with disabilities deal with their condition ('their adaptability, fortitude, courage and ability to overcome obstacles'). This is the main distinctive characteristic that leads us to believe that this sexual attraction cannot be considered a form of fetishism, given that the object of attraction is seen as a whole rather than in terms of disability, and that it does not reflect the essence of paraphilia. In addition, these subjects experience low levels of discomfort due to their sexual preference and are able to build and maintain lasting relationships with their partners, whether disabled or able bodied.
On the basis of these considerations, this population could represent the boundary between a true pathological condition, ranging from paraphilic disorder to an 'unusual' sexual preference (paraphilia), and what is socially considered as 'conventional sexuality'.
Similar to any method, Internet-based studies (IBSs) have been criticized, in this case due to lack of control over the participant's environment, vulnerability to fake responses and possible non-representativeness of the general population. Although these are fair criticisms, some of these preconceptions have proved unfounded due to consistency with findings using traditional methods. Repeat responders can be another problem, although this was mitigated in our survey as the questionnaires were not filled out anonymously. It should be noted that IBSs can also offer important advantages over traditional methods, in particular, the ability to access very large potential study populations and, consequently, to collect data on particularly rare fetishism.
A possible bias of our study is that data were only gathered from subscribers to Yahoo! groups, who may not represent the general population of devotees. In addition, it is also possible that not all the disability typologies have been included in our search strategy, although we believe to have covered a wide range of those. However, it should be acknowledged that most research on unusual sexual behavior is based on data sources that are, in all likelihood, even less representative. Another significant limitation is that, taken individually, some of the questions may not be sufficiently specific to investigate some of the characteristics of devotism. In any case, as with any new methodology, prudence is justified and our data should be interpreted cautiously. Finally, the use of a non-standardized semi-structured questionnaire can represent another evident limit of this study.
Devotism may cover a wide array of conditions, ranging from unambiguously pathological conditions to more blurred clinical pictures. Although this represents only a first study on this kind of sexual attraction, data could be of interest for the discussion of future inclusion criteria of the large family of paraphilias. Future research investigating specific aspects related to paraphilia such as intensity, specificity and preference of paraphilic symptom will be necessary to identify subjects with clear paraphilic behavior.