The diagnosis of Transvestic Fetishism applies to heterosexual males who fantasize or use female garments to fulfill a sexual fetish that dominates their character. Thus, it is not applicable to FTMs. This information has been provided as a general TG reference.
Transvestic Fetishism is a fairly common mental health diagnosis within the transgender community. Transvestic Fetishism is often paired with the diagnosis of Gender Identity Disorder because the two carry several similarities such as a recurrent urge to cross-dress. The main aspect of Transvestic Fetishism is the fetish of cross-dressing whether it be wearing a single garment or a whole outfit. This disorder is more commonly apparent in the male sex, although females are theoretically just as likely to have suffer from similar disorders. Please note that this disorder is only diagnosed in heterosexual males. Therefore women and homosexual males are excluded from the diagnosis.
The American Psychiatric Association as well as psychologists from around the globe define a disorder as an illness that cause significant distress or impairment within ones life. A disorder is not classified when the symptoms are present, but there is no distress. It is possible for a heterosexual male to have a fetish for womens undergarments, and for him to participate in masturbatory or cross-dressing behaviors while not actually having a disorder because no distress is present.
The American Psychiatric Association has pinpointed the exact diagnoses and criteria for Transvestic Fetishism. This criteria is what all psychiatrists and most therapists use to diagnose the condition.
The paraphiliac focus of Transvestic Fetishism involves cross-dressing. Usually the male with Transvestic Fetishism keeps a collection of female clothes that he intermittently uses to cross-dress. While cross dressed, he usually masturbates, imagining himself to be both the male and the female object of his sexual fantasy. This disorder has been described only in heterosexual males. Transvestic Fetishism is to be diagnosed when cross-dressing occurs exclusively during the course of Gender Identity Disorder.
Transvestic phenomena range from occasional solitary wearing of female clothes to extensive involvement in a transvestic subculture. Some males wear a single item of women’s apparel (e.g., underwear or hosiery) under their masculine attire. Other males with Transvestic Fetishism dress entirely as females and wear makeup. The degree to which the cross-dressed individual successfully appears to be a female varies, depending on mannerisms, body habits, and cross-dressing skill.
When not cross-dressed, the male with Transvestic Fetishism is usually unremarkably masculine. Although his basic preference is heterosexual, he tends to have few sexual partners and may have engaged in occasional homosexual acts. An associated feature may be the presence of Sexual Masochism. The disorder typically begins with cross-dressing in childhood or early adolescence. In many cases, the cross-dressing is not done in public until adulthood. The initial experience may involve partial or total cross-dressing; partial cross-dressing often progresses to complete cross-dressing.
A favored article of clothing may become erotic in itself and may be used habitually, first in masturbation and later in intercourse. In some individuals, the motivation for cross-dressing may change over time, temporarily or permanently, with sexual arousal in response to the cross-dressing diminishing or disappearing. In such instances, the cross-dressing becomes an antidote to anxiety or depression or contributes to a sense of peace and calm.
In other individuals, gender dysphoria may emerge, especially under situational stress with or without symptoms of depression. For a small number of individuals, the gender dysphoria becomes a fixed part of the clinical picture and is accompanied by the desire to dress and live permanently as a female and to seek hormonal or surgical reassignment. Individuals with Transvestic Fetishism often seek treatment when gender dysphoria emerges. The subtype with Gender Dysphoria is provided to allow the clinician to note the presence of gender dysphoria as part of Transvestic Fetishism.
diagnostic criteria for 302.3 transvestic fetishism
A. Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if: With Gender Dysphoria: if the person has persistent discomfort with gender role or identity.