Frotteuristic disorder is a mental health condition that centers on using the genitals to make non-consensual contact with another person’s body in order to gain sexual gratification. The Diagnostic and Statistical Manual of Mental Disorders, a guidebook with a longstanding history of use among US mental health professionals, classifies this condition along with a group of disorders called paraphilic disorders. In May 2013, the definition of frotteuristic disorder contained in the Diagnostic and Statistical Manual was changed in order to reflect current understanding regarding the difference between the disorder as a mental illness and the underlying pattern of behavior (called frotteurism) that produces its core symptoms.
Basics of Frotteurism and Paraphilia
The pattern of behavior found in frotteurism is just one example of a number of unusual, abnormal or (in some cases) legally prohibited patterns of sexual behavior practiced by small numbers of US adults. Collectively, the mental health community refers to these sexual behaviors as paraphilias. In addition to frotteurism, clearly defined examples of paraphilia include fetishism (using inanimate objects for sexual gratification), exhibitionism (exposing one’s genitals for sexual gratification), transvestism (wearing clothes normally associated with the opposite sex for sexual gratification), sexual sadism (inflicting pain and humiliation on another person for sexual gratification) and pedophilia (making inherently non-consensual contact with a prepubescent child for sexual gratification).
Generally speaking, paraphilias are noteworthy for their ability to produce some sort of tangible mental or physical harm, either in the person who engages in a paraphilic pattern of behavior or in another individual who acts as the target of a paraphilic behavior. However, in mental health terms, not all paraphilic practices are inherently harmful. For instance, if a person who practices fetishism finds an adult partner who willingly incorporates fetish-based activities into his or her sexual life, neither of these parties may experience adverse effects from participation in that particular paraphilia. Still, any paraphilia has the potential to produce harmful effects in either the person who initiates the sexual behavior or in the (usually unwilling) focus of the paraphilia. One paraphilia in particular—pedophilia—always produces harm when acted upon.
Individuals involved in frotteurism either simply touch other people’s bodies with their genitals or use their genitals to actively rub against other people’s bodies. Typical areas used for frotteuristic activity are the parts of another person’s body within easy reach of the genital region, namely the buttocks, thighs or lower torso. While a frotteur can genitally touch or rub the body of a consensual partner, the behavior is rightfully associated with non-consensual contact, which frequently takes place in crowded locations such as elevators, mall concourses, or subway or train cars. Researchers have only conducted a limited number of studies on frotteurism, according to the authors of a 2009 study review published in the Archives of Sexual Behavior. For this reason, no one really knows how many people engage in frotteuristic behaviors.
Before the publication of the fifth edition of the Diagnostic and Statistical Manual in 2013, the guidelines used by the nation’s mental health professionals employed the same word—paraphilia—to designate both abnormal patterns of sexual behavior and the mental disorders that sometimes develop as a result of involvement in those patterns of behavior. In practical terms, this dual usage of the word made it difficult for doctors to conceptually establish a difference between sexual behavioral patterns that don’t produce damaging effects and sexual behavioral patterns that do produce damaging effects. The new Diagnostic and Statistical Manual (commonly known as DSM 5) corrects this situation by referring to all paraphilias that result in mental illness specifically as “disorders.” In line with this new naming practice, a case of frotteurism that leads to mental health problems is identified as frotteuristic disorder.
DSM 5 also sets specific criteria that doctors must follow when diagnosing the newly named frotteuristic disorder in their patients. First, an affected individual must experience some sort of internally generated mental distress as a result of his or her involvement in frotteurism, or in an alternate scenario, he or she must be the source of distress or physical harm in a person(s) targeted for a frotteuristic act. In addition, the affected individual must actively engage in frotteurism for six months or more, or have strong, repeated urges or fantasies regarding frotteurism for an equal amount of time.