Sexual fetishism: definition, history, types, and clinical distinctions

"Fetish" is borrowed via the French fétiche from the Portuguese feitiço, meaning "spell" or "enchantment." The ultimate origin of the term lies in the Latin factīcius, meaning "counterfeit" or "fake." The term, regardless of its erotic connotation, is usually used in the sense of an "object worthy of veneration" or that of idolatry. It is also understood in the colloquial language used neologisms such as "order fetish" (-ism), "paragraph fetish" or "cleanliness fetish". These play with the original meaning of fetishism as well as with the sexual note.

The term fetishism is used in different contexts in different meanings: There are sometimes significant differences between the colloquial use of the word and the scientific term. Sometimes sexual inclinations are generally referred to as sexual fetishes, which some practitioners see as discrimination.

On the one hand, a clear conceptual distinction is sought in order to distinguish normal sexual behaviour, as understood by medicine, jurisprudence and the corresponding subculture, from problem cases requiring treatment, but on the other hand it is practically impossible to reach a consensus.

Development of the term

The term originally referred to the concept of religious fetishism among so-called "primitive peoples". The starting point was the worship of inanimate objects charged with "supernatural powers" - so-called fetishes - in some West African ethnic religions. However, the widespread transfer to other ethnic groups and cultures as fetishism was abandoned. In 1887, this meaning was introduced by the French psychologist Alfred Binet with his paper "Le Fétichisme dans l'amour." in the "Revue Philosophique" extended it to the field of sexual life.

For a long time, the term remained unnoticed by the non-scientifically interested population, while its meaning expanded in professional circles; as early as 1912, for example, Richard von Krafft-Ebing called sexual devotion to a single body part fetishism. Through Sigmund Freud's psychoanalytical considerations, which also reached non-medical people, the term "fetishism" became popular after 1927. Here, sexual fetishism was understood as a pathological deviation. The idea of the "commodity fetish" coined by Karl Marx, which was based on religious fetishism and did not have sexual connotations, also contributed to the spread of the term, but further publicized the word fetish in its ambiguity.

In the course of the sexual revolution, the understanding of human sexuality changed fundamentally: it was no longer acceptable to value all sexual attitudes deviating from the norm as mental illnesses. The definition of the medical-psychological term fetishism, together with that of paraphilia, became much more distinct. According to today's understanding, fetishism is not a mental disorder in the context of sexual orientation per se, but is only to be understood as a disorder requiring treatment if the person concerned suffers from its effects. Within the scientific reorientation in the understanding of sexual deviance and the resulting discussions on its definitions, a dichotomy of the term emerged: the internationally used manual ICD, published by the World Health Organization, reverted to the original narrower meaning and understands fetishism to mean only sexual fixation on objects. The influential American Psychiatric Association, which publishes the DSM manual, initially used only nationally, opted for a broader definition and understands fetishism to mean fixation on objects or body parts. With the publication of a German edition of the DSM, this concept was also adopted in German-speaking countries.

The general understanding of the term fetishism remained unaffected by the scientific debates. Fetishism had already established itself as a common term and scene term for a variety of sexual play types; colloquially, any sexual fixation on a single object or a specific sexual practice is often called fetishism. Furthermore, the term is often understood to be synonymous with paraphilia, expanding the term to include numerous sexual inclinations that do not fall under the psychological or psychiatric use of the term. The subtleties of the diagnostic distinction between pathological fetishism and fetishism not requiring treatment are not used in the vernacular.

General understanding of the term

Colloquial usage includes sexual inclinations beyond the scientific definition, in addition to wordplay with the sexual and religious connotations of fetishism. In contrast to the fetish scene, however, the term is usually used pejoratively in colloquial language. Often already an inclination is called fetishism, in which the persons concerned are not subject to any pressure of suffering. This definition of fetishism does not presuppose that the inclination is a necessary sexual preference, and can also circumscribe one or more preferences. Here the term can also denote inclinations which, according to both scientific understanding and the self-image of practitioners, are part of a normal sexuality and which do not affect the practitioners. A close connection with the earlier term for sexual deviance, perversion, is common, although the idea of which deviant sexual behaviour is to be tolerated and which belongs to a healthy sexuality both depends on cultural factors and has been and is subject to change across cultures.

Medical definition

The medical-psychological definition follows the basic diagnostic criteria, the ICD-10-GM (GM: German Modification) and the frequently cited Diagnostic and Statistical Manual of Mental Disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published in the United States by the American Psychiatric Association.

According to ICD-10-GM F65.0, the "use of dead objects as stimuli for sexual arousal and gratification" is defined as sexual fetishism. The further diagnostic criteria for the need for treatment include unusual sexual fantasies or urge-like behaviours that persist over a period of more than six months, as well as the subjective suffering of the person affected by these fantasies and behaviours and the restriction in several areas of functioning, for example in social contact or employment. If another person is harmed, injured or abused in the process, this is already sufficient for the diagnosis.

In the ICD-10-GM, the term fetishism is not assigned to any animate object; this also applies analogously to body parts of the partner. All fetishistic behaviors that are not directed at an inanimate object are therefore not assigned to F65.0, although they can certainly belong to the paraphilias. According to DSM-IV, sexual fetishism includes both the use of inanimate objects and erotic simulation by body parts; the DSM-IV code for this term is 302.81. Beyond this, the diagnostic criteria do not differ, but should not be understood as hierarchical. Due to the differing definitions and the vertical and horizontal arrangement of the diagnostic criteria, however, misunderstandings can arise, especially in statistical values and descriptive publications from different countries, since fetishism according to DSM-IV encompasses a wider field. Erotic and sexual preferences, for example for blond hair, are not covered by the medical-psychological definitions of sexual fetishism.

Subcultural understanding

In the concept of subculture, no clear boundaries are set for the fetish; role-playing can be understood as a fetish in the same way as wearing lingerie. In this definition, the fetish is usually understood as a legitimate and equal sexual play that does not need to be cured or treated. The application of the scientific definition in terms of the ICD-10-GM is often understood as discriminatory in this context.

In addition to the classic media for contact and information about different areas of fetishism, for example magazines such as Bizarre, with the emergence of the Internet has developed its own scene, often dependent on the respective fetish. As a result, fetishists find support and like-minded people in forums, communities and subcultures. The term fetish is defined in the respective group and partly own terms for special fetishes are developed.

Partial and complete fetishism, delimitations

In sexual science and psychology, a conceptual distinction is made in some considerations between partial fetishism and complete fetishism. The intensity and the necessity of fetishistic behavior for sexual satisfaction is decisive here. If an orgasm cannot be reached without the help of a fetish, it is called complete fetishism. Other forms, in which the fetish serves only for arousal, but is not absolutely necessary for the fulfillment of sexual satisfaction, are called partial. The restriction to partial attraction is also used by Hirschfeld, who uses this term to describe the distinction between a healthy and a pathological fetishistic desire. In his view, the fetishistic attraction of one person to another is always a partial aspect of his totality; healthy fetishism ends at the overvaluation of a single feature.

This use of the term partial fetishism must be distinguished from the term partialism, the focus on a particular body part, as well as morphophilia, in which a particularly pronounced or, in the case of amelotatism, an absent body part is the object of arousal. Transvestic fetishism, in which the wearing of clothing of a different sex triggers the arousal, is defined as a separate form under ICD-10-GM F65.1.