Sexual Dysfunction in Individuals with Paraphilic Interests: Findings from a Large Matched Cross-Sectional Study.

Abstract

Background: Paraphilic interests are common in nonclinical populations, yet their relationship with sexual dysfunction remains underresearched. Understanding this association may support clinical assessment and treatment planning in sexual health settings.

Aim: To examine the associations between paraphilic interests/disorders and DSM-5 sexual dysfunctions in a large nonclinical adult sample, using sociodemographic matching.

Methods: An online survey of 8,282 participants (aged 18-35) classified individuals into paraphilic disorder, paraphilic interest, and control groups based on DSM-5 criteria. A 1:1 manual sociodemographic matching procedure was applied. Sexual dysfunctions were assessed according to DSM-5 criteria A-C.

Results: Compared with matched controls, paraphilic interests were associated with higher rates of erectile dysfunction (OR = 3.10), premature ejaculation (OR = 1.60), and female orgasmic disorder (OR = 1.59) (all p < .05). Paraphilic disorders showed even higher likelihoods of erectile dysfunction (OR = 4.47), premature ejaculation (OR = 4.47), male hypoactive sexual desire disorder, and female sexual interest/arousal disorder (all p < .05). These associations were independent of sociodemographic factors.

Clinical implications: Screening for sexual dysfunction may be warranted when paraphilic interests or related distress are disclosed in clinical contexts. Awareness of potential comorbidities may support earlier recognition.

Conclusion: Paraphilic interests and disorders were significantly associated with multiple sexual dysfunctions in a nonclinical population. These findings highlight clinically relevant comorbid patterns.