Paraphilic Fantasies and Disorders in Brazil: Insights from a Nationwide Study on Prevalence, Risk Factors, and Public Health Implications.

Abstract

Background: Paraphilias, atypical sexual preferences outside societal norms, present a psychiatric challenge. The DSM-5-TR differentiates paraphilic fantasies from disorders, with the latter causing distress or impairment. Social stigma and underreporting hinder understanding.

Objectives: This study examines paraphilic fantasies and disorders in Brazil, focusing on pedophilia and hebephilia to inform public health policies and crime prevention.

Methods: This cross-sectional, online study included 5,335 Brazilian participants. The survey collected sociodemographic data and applied the Paraphilic Assessment Protocol, adapted from the Dunkelfeld Project, assessing fantasies, temporal criteria, and distress or impairment.

Results: Most respondents (62.2%) reported three or more paraphilic fantasies, with masochism (64.4%), body part fetishism (58.0%), and sadism (49.2%) being most common. Non-consensual fantasies included pedophilia (3.7%), hebephilia (6.6%), frotteurism (7.5%), and exhibitionism (6.8%). Pedophilic and hebephilic disorders were found in 1.87% and 2.46% of participants, respectively, associated with young age (18-24 years), cisgender male identity, bisexual orientation, and single status. Healthcare and educational professionals showed notable links to these disorders.

Conclusions: As Brazil's first nationwide survey on paraphilias, this study underscores the need for targeted interventions to prevent sexual crimes and improve treatment options. Further research is essential despite ongoing stigma.