Sexual fantasies are involved both in the normal functioning of human beings and in their pathological functioning. No one is responsible for their fantasies, and no fantasy is punished by law. On the other hand, each individual is responsible for his actions.

From the Greek “para”, next to and “philos”, love. The essential characteristics of a paraphilia, according to the DSM-IV (1), are imaginative sexually arousing fantasies, sexual impulses or behaviors that occur repeatedly and intensely over a period of at least six months, and involving objects. inanimate, suffering or humiliation of oneself or one’s partner, children or other unwilling people.

These paraphilias, in fact, express the existence of a parallel sexual activity, but at the same time deviating from what we consider to be normal sexuality, while knowing how difficult it is to define the characteristics of a such normality. This is the reason why there are many controversies surrounding paraphilia and what is normal versus deviant or disorderly behavior. This stems in part from the malleability of sexual norms across time and cultures, which creates problems for those who define and diagnose paraphilia. Various sexual “preferences” and interests defined as paraphilic are no longer so. This is, for example, the case of homosexuality which, until 1973, was classified as paraphilic in the DSM-II. Its subsequent withdrawal has led some to argue that while homosexual orientation is not inherently abnormal, then the inclusion of other sexual behaviors classified as paraphilic cannot be justified as a concept and should be removed entirely from future editions.

If human sexuality is complex, it is important to distinguish the difference between fantasy and perversion. Sexual fantasies tell about each person’s personality. For Freud, it is an imaginary scenario. All is well when the fantasies, spices of the sex life are normal, habitual and non-deviant. They allow you to have a balanced sex life. From the Latin “pervetere”, “upset”, perversion would then be characterized as “a deviation from the normal sexual act”. A pervert is the one who emphasizes his instinctual satisfaction and not his partner considered as an object. Today, modern psychopathology uses the term paraphilia rather than perversion.

There are a number of types of paraphilic disorders. While some of them are relatively common, others, to be satisfied, result in actions which, by their harmful nature, can potentially harm someone and will therefore be considered tort or criminal.

Exhibitionist

He exposes his own genitals to an unsuspecting person in public places without the need for closer contact. The excitement is relieved by masturbation.

Fetishism

The excitement is caused by an object, a part of the body or a material endowed with a strong symbolic power. According to a study by the University of Bologna (2), podophilia (foot and toe fetishism) is at the top of the ranking of the most adored “objects”.

Sexual masochism

Obtaining pleasure consists in inflicting humiliation, suffering.

Pédophilie

This is any sexual activity on children.

Sexual sadism

Pleasure is obtained by inflicting humiliations, punishments or painful acts.

Voyeurism

It consists of spying on others in their privacy, when they are unsuspecting, unwilling (they are naked, undress or engage in sexual activity).

Zoophilia

It is about sexual practices on animals. In France, since 2006, “exercising serious abuse, or of a sexual nature, or committing an act of cruelty towards a domestic animal, or tamed, or held in captivity is punishable by 2 years of imprisonment and 30 euros of In other countries the law is much stricter. In Canada, for example, it is punishable by imprisonment for up to 000 years.

In most cultures, paraphilias are much more common in males. The number of people with paraphilia is difficult to estimate for several reasons. Many people with one of these disorders suffer in secret or silently out of shame, and some engage in sexually offensive behavior and therefore are invested in not reporting their paraphilia. Most individuals with this sexual deviation are men (3% – 5% of the male population), with only 1% – 6% of these individuals being women. Many people who suffer from paraphilia have more than one. For example, about a third of pedophiles also suffer from another paraphilia. More than half engage in three or four of these types of behaviors rather than just one.

The therapeutic management of paraphilic patients who are perpetrators of sexual violence is a major medical and societal issue. These are primarily male subjects (over 90% of cases) and adult subjects. It is more than rare that paraphilic subjects consult before a passage to the act. In the majority of cases, in France, the subject is brought to consult at the injunction of the judge after a crime or a sexual offense. Drug treatment of paraphilias is insufficient on its own, because the mechanisms of denial are such that only the sexual drives are accessible, with a significant risk of recurrence. Care therefore has several dimensions: medical, psychological and socio-educational. In the context of penalized care, the patient is followed both by a socio-educational team and by a team of health professionals.