Exhibitionistic Disorder

Exhibitionistic Disorder is also known as Exhibitionism, is a paraphilic disorder. It is characterized by the achievement of sexual excitement and gratification through the act of exposing one’s genitals to others (usually to non-consenting people). It may also include a strong urge to show one’s sexual activity to other people.  

Overview

Exhibitionistic Disorder is more common in men compared to women. The disorder usually begins in early adulthood. About 30% of men charged with a sexual crime also enjoy, or are, exhibitionists. The person may become sexually aroused or masturbate when revealing their genitals. Typically the individual has no intention of engaging in a sexual act with the non-consenting spectator.  In the world of technology, there is a trend of sending sexually explicit pictures (of genitals) online to strangers through various methods. Exhibitionistic Disorder includes the continuous, strong, and abnormal sexual arousal patterns that may go along with clinically notable suffering or distress, but there is a good prognosis for the exhibitionism treatment.

Exhibitionistic Disorder Symptoms & Signs

The most common and specific exhibitionistic disorder symptom is a frequent and strong sexual arousal that is achieved by the exposure of one’s genitals to an unknown person.

An individual with Exhibitionistic Disorder is typically only able to achieve sexual excitement and gratification when they expose themselves to someone.  

Getting exhibitionistic impulses, or attempts for at least 6 months.

Satisfying exhibitionistic urges with an unknown person.

Sexual urges or fantasies cause disruption at work or within social relationships.  

The individual becomes excited by exposing genitals to either adults, adolescence, children, or all age groups. 

A man is caught in Exhibitionistic Disorder

Types of Exhibitionist Disorder:

  • There are different types of exhibitionism:

    Pure exhibitionists are people who show their sexual organs to other people at a distance. They do not touch or physically harm the people to whom they expose their body.

    Exclusive exhibitionists they are individuals who struggle with being involved in a romantic relationship and they are unable to have sexual relations normally. Exposing themselves is their way to get the sexual satisfaction. This type of exhibitionistic disorder is less common.

Exhibitionistic Disorder Causes

Exhibitionistic Disorder usually develops during young adulthood. The exact Exhibitionistic Disorder causes are unknown but it is thought that one or multiple factors such as antisocial personality disorder,  substance abuse, or other paraphilic disorders may play a role.  There have been some schools of thought that there is an association between the disorder and childhood sexual abuse and/or hyper-sexuality as a potential risk factor for developing the disorder, but there is no proven data for the triggers and Exhibitionistic Disorder causes. 

Exhibitionistic Disorder Effects

  • Negative implications for the individual as it can cause feelings of shame, guilt, and other emotional turmoil. 
  • Social isolation. 
  • Trouble communicating in sexual relationships
  • Partners of the affected individuals also go through emotional distress. For example, they can feel unattractive or inadequate.
  • Sexual dysfunction such as delayed ejaculation or erectile dysfunction may occur

Exhibitionistic Disorder Diagnosis

Criteria:

  • The individual is strongly and repeatedly aroused by revealing their genitals to an unknown person or being seen by someone while they are engaged in a sexual act. 
  • The individual satisfies sexual urges with an unknown and non-consenting person. If the urge is not satisfied the individual could develop distress or day-to-day functioning can be impaired. 
  • The individual’s behavior has occurred for more than 6 months.

Exhibitionistic Disorder Treatment

Exhibitionistic Disorder Treatment usually is accomplished through psychotherapy with a clinician who specializes in sexual disorders. It may also include prescribed psychotropic medications if the urges are severe and cannot be controlled through self-motivation and therapy alone. 

Cognitive Behavioral Therapy (CBT) is a type of therapy that may be helpful to recognize triggers that lead to urges and teach different and appropriate ways to deal with exhibitionistic urges.  

Medications such as SSRIs (Selective serotonin reuptake inhibitors) like Fluoxetine can help with complications such as depression, anxiety, and lower the individual’s sex drive. 

Antiandrogens:  Cyproterone acetate and Medroxyprogesterone acetate are medicines that can be used to reduce testosterone levels which in turn, decrease hypersexuality. 

If these medicines are not helpful, drugs like Anti-androgens are used which include:

  • Depot medroxyprogesterone acetate
  • GnRH (Gonadotropin-releasing hormone) agonists i.e. elagolix, degarelix etc.

These medications decrease the production of follicle-stimulating hormones and luteinizing hormones from the pituitary gland and ultimately will decrease the production of testosterone.