behaviors or distress ov er a nontransient period  shorter than 6 months. 
Prevalence
The prevalence of exhibitionistic disorder is unknown. However, based on exhibitionistic
sexual acts in nonclinical or general populati ons, the highest possible prevalence for exhi-
bitionistic disorder in the male population is 2%–4%. The prevalence of exhibitionistic dis-
order in females is even more uncertain but is  generally believed to be much lower than in
males. 
Development and Course
Adult males with exhibitionistic disorder often report that they first became aware of sex-
ual interest in exposing their genitals to unsuspecting persons during adolescence, at a
somewhat later time than the typical development of normative sexual interest in women
or men. Although there is no minimum age re quirement for the diagno sis of exhibitionis-
tic disorder, it may be difficult to different iate exhibitionistic be haviors from age-appro-
priate sexual curiosity in adolescents. Wher eas exhibitionistic impulses appear to emerge
in adolescence or early adulthood, very little is known about persistence over time. By def-
inition, exhibitionistic disord er requires one or more contributing factors, which may
change over time with or without treatment; subjective distress (e.g., guilt, shame, intense
sexual frustration, lo neliness), mental disorder comorb idity, hypersexuality, and sexual
impulsivity; psychosocial impair ment; and/or the propensity to act out sexually by expos-
ing the genitals to unsuspecting persons. Ther efore, the course of exhibitionistic disorder
is likely to vary with age. As with other sexual preferences, advancing age may be associ-
ated with decreasing exhibitionistic  sexual preferences and behavior.
Risk and Prognostic Factors
Temperamental. Since exhibitionism is a necessary pr econdition for exhibitionistic dis-