“Fernando, a twenty-four year old man, arrives at the psychologist’s office. Once there, Fernando says that he has gone to the psychologist because of a problem that causes him profound discomfort. He confesses that in the last few months he has had an urgent need to go out into the street, to place himself in a dark corner and, when a woman passes by, to show her his genitals. Later, after seeing his reaction, he proceeds to run away and when he gets home he masturbates thinking about the surprise of the person he has shown, a fact that causes him great excitement and decreases his stress. Because of this fact, Fernando has been arrested and convicted on one occasion, but considers that he will do it again if he does not have help, and this causes him great anxiety as he considers it to be a repugnant behaviour”.

The case cited here is an invented example of one of the most well-known paraphilias, exhibitionism .

Exhibitionism as paraphilia

In order to have a better understanding of exhibitionism it is necessary to understand the main characteristics of the group of disorders of which it is part, the paraphilias.

Formerly called sexual deviance, paraphilias refer to the repeated presentation of intense sexual fantasies in which the object of desire is atypical . Generally these desires are focused on non-human objects or entities, suffering and humiliation of oneself or others, or people who do not consent within a period of six months. These behaviours may or may not be understood as alteration by those who present them, being in many cases considered immoral by the subjects themselves. In any case, paraphilias cause a serious deterioration in various vital areas of the individual, and there may or may not be a discomfort on the part of the subject.

While some of these paraphilias may not have legal repercussions or be too disabling beyond restricting the sexual interest and discomfort it may cause in the subject himself or the difficulty of being accepted by sexual partners (for example, focused desires for objects such as fetishism), other paraphilias may result in serious crimes and even crimes such as pedophilia or somnophilia (sexual desire by sleeping subjects, which involves rape).

Diagnostic criteria and symptoms

By visualizing the type of disorder we are talking about, we can then make a more coherent explanation of what exhibitionism as a paraphilia involves.

The main symptoms are based on the existence during at least six months of recurrent and very exciting fantasies of exposure of the genitals to a stranger who does not expect it, having also taken place and/or producing a clinically significant discomfort in the subject or his functioning in relevant areas of his life.

It is the most common paraphilia, and is often accompanied by others such as voyeurism. This problem usually appears around the age of majority, with maximum prevalence between the ages of twenty and thirty and decreasing from forty onwards.

The excitement and pleasure achieved by the exhibitionist is obtained through the observation of the reactions of the people he shows, generally those of fright, surprise and curiosity. It is possible that the subject masturbates during his exhibition, or after it by re-imagining the reactions of his victims. Generally, they do not really intend to engage in any sexual activity with their victim, the person per se not being the reason for the excitement but the fact of surprise. In fact, it is not uncommon for the exhibitionist to escape if the victim corresponds positively to their reaction. However, reactions of indifference or mockery can be extremely painful for these subjects, due to their low level of self-esteem.

Psychological profile of the exhibitionist

The typical exhibitionist subject is a generally heterosexual male , often with difficulties in establishing contact with the sex he desires, although it is also common for him to appear in subjects with a partner and even married subjects having apparently normal relationships.

In general, the exhibitionist subject presents a high level of withdrawal and introversion, with a high lack of self-confidence that pushes him to carry out his action, probably as a defense mechanism. This type of subjects, therefore, are not usually a real threat, and there is no aggressiveness or intention of doing harm in their actions.

Legal treatment

As mentioned above, some paraphilias may constitute serious crimes punishable by imprisonment.

In the case of exhibitionism, we would be facing a paraphilia classified as a crime against sexual freedom , which can be punished with a prison sentence of six months to a year or with a fine of one to two years, assessing the circumstances of the exhibitionist in question.

It should be borne in mind that when assessing the possibility of creating a diagnostic category to refer to a mental disorder, it is not only considered whether the disorder impairs the quality of life of the person experiencing it in his or her own flesh. It also takes into consideration the discomfort and inconvenience generated to third parties , and this is precisely what happens in the case of exhibitionism.

Exposing one’s genitals to another person, with the intention of feeling pleasure about it, makes the dignity of others be attacked and, in many cases, produces fear, being interpreted as the beginning of a rape.

Etiology (causes) of exhibitionism

The causes of this type of paraphilic behavior is widely debated in the psychological literature.

Many of the theories in this regard indicate the participation of learning processes in the acquisition of these behaviors, proposing that they are behaviors learned by accidentally conditioning between sexual arousal and an atypical stimulus, conditioning reinforced by the repetition of situations and the beginning of the application of the stimulus in the imagination during masturbation.

The imitation of models observed in childhood has also been explored as a possible cause , due to the presence of patterns of violence and abnormal sexual behaviour in some cases of individuals with little socialisation, domestic violence and excessively repressive education of sexuality.

Similarly, the presence of deficits in social and communication skills has also been explored, due to the presence of difficulties in courtship in many of the cases studied. In these subjects we have observed the existence of a high inferiority complex, low self-esteem, impulsiveness and poor communication skills, which may lead to the performance of behaviors considered immoral, unethical, surprising or bizarre as a defense mechanism.

Another of the hypotheses considered is that of McConaghy’s behavioural termination, according to which if a behaviour is very habitual a mechanism is created in the brain which is activated when stimuli associated with the behaviour in question are perceived , producing a high level of tension. This means that the individual does not stop the action, so that the tension does not appear. It presents a certain similarity with the mechanism of action of obsessive-compulsive disorder.

Caution: not everything is paraphilia

Exhibitionism is a paraphilia that can be a serious problem for those who suffer it, both because of the discomfort it generates and because of the effects it can cause in different vital areas such as socialization, the emotional area.

Exhibitionism as a paraphilia should not be confused with sexual fantasies and behaviours occasionally used as sexual stimuli. Erotic games and fantasies with the partner such as striptease or the use of one’s own anatomy to provoke the desire of the partner will not be encompassed as paraphilia, which implies the need to present this type of behaviour in a compulsive manner in order to obtain sexual gratification, at least for six months and producing discomfort or significant alterations in normal life.

Thus, what characterizes exhibitionism is that the action of undressing in the sight of others, on the one hand, is done simply with the intention of being seen by others, and on the other, is not consensual , besides being born from an irrepressible need.

Similarly, neither are behaviors such as toplessness or claiming use in demonstrations classifiable as paraphilic behavior, since they do not involve compulsive sexual gratification.

Nor can this disorder be diagnosed if the display behavior is due to and occurs only during an altered state of consciousness or other disorders, such as in cases of manic episodes, psychotic break, intoxication, or dementia.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Belloch, Sandín and Ramos (2008). Manual of Psychopathology. McGraw-Hill. Madrid.
  • Cáceres, J. (2001). Paraphilias and rape. Madrid: Editorial Síntesis.