Many individuals who self-identify as fetish ist practitioners do not necessarily report
clinical impairment in association with their fetish-associated behavi ors. Such individuals
could be considered as having a fetish but not fetishistic diso rder. A diagnosis of fetishistic
disorder requires concurrent fulfillment of both the behaviors in Criterion A and the clin-
ically significant distress or impairment in functioning noted in Criterion B.
Associated Features Supporting Diagnosis
Fetishistic disorder can be a multisensory ex perience, including holding, tasting, rubbing,
inserting, or smelling the fetish object while ma sturbating, or preferring that a sexual part-
ner wear or utilize a fetish object during sexual encounters. Some individuals may acquire
extensive collections of high ly desired fetish objects.
Development and Course 
Usually paraphilias have an onset during pube rty, but fetishes can develop prior to ado-
lescence. Once established, fetish istic disorder tends to have a continuous course that fluc-
tuates in intensity and freq uency of urges or behavior. 
Culture-Related Diagnostic Issues
Knowledge of and appropriate consideration fo r normative aspects of sexual behavior are
important factors to explore to establish a clinical diagnosis of fetishistic disorder and to
distinguish a clinical diagnosis from a socially acceptable sexual behavior.
Gender-Related Diagnostic Issues
Fetishistic disorder has not been systematically reported to occur in females. In clinical
samples, fetishistic disorder is ne arly exclusively re ported in males.
Functional Consequences of Fetishistic Disorder
Typical impairments associated with fetishistic disorder include sexual dysfunction
during romantic reciprocal rela tionships when the preferred fe tish object or body part is