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Frotteuristic disorder, or frotteurism, is one of several paraphilias, or sexually arousing disorders. It is the act of touching or rubbing one's genitals up against another person in a sexual manner without their consent, in order to derive sexual pleasure or reach orgasm. Those who practice frotteurism enjoy experiencing a private sexual experience in a public setting. Although it can occur at any age, the problem is most often seen in young, seemingly shy males between the ages of 15 and 25. It has also been seen in older, reserved, and socially withdrawn men. Frotteurism is thought to be rare among females. The prevalence of the disorder is unknown, although approximately 10-14 percent of adult males seen by clinicians for paraphilic disorders meet the diagnostic criteria for frotteuristic disorder.

Symptoms

According to the DSM-5, frotteuristic disorder involves intense fantasies, urges, and keen sexual arousal centering on the act of touching an unsuspecting and non-consenting person’s breasts, legs, buttocks, or genitals, or rubbing one’s own pelvic area or erect penis against that person, generally from behind. Frotteuristic behavior is repetitive and usually occurs in crowded public places, such as trains, buses, elevators, or even crowded streets. Aside from being a criminal activity because it is a form of nonconsensual sex, frotteurism is diagnosed as a mental health disorder when the behavior continues for more than six months, or when the fantasies and urges cause significant distress or dysfunction in personal relationships and daily activities.

How common is frotteurism?

Frotteurism and other paraphilias are generally considered deviations from "sexually normal" urges and behaviors. They are often connected with childhood trauma and the development of an abnormal understanding of sex and romantic relationships. Frotteurism is unusual, but it’s not rare: It is estimated to occur in up to 30 percent of adult males, according to the DSM-5.

What is the difference between frotteurism and toucherism?

While it is not recognized in the DSM-5, the concept of toucherism is closely related to frotteurism. Both behaviors involve touching strangers without their consent, generally in public places. But whereas frotteurism involves rubbing one’s pelvic area against another person, toucherism occurs when someone uses their hands to touch erotic parts on a stranger’s body (e.g., buttocks, breasts, or genitals) without permission. A subtype of toucherism, called hyphephilia, associates sexual pleasure with touching or rubbing someone’s skin, hair, fabric, leather, or fur.

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Causes

Some theories as to the root cause of frotteuristic disorder focus on social issues that result in a lack of consenting partners, and others on an inability to control one's sex drive—but ultimately, what causes the disorder remains unknown. Risk factors may include a preoccupation with sex or hypersexuality issues, such as unusually frequent and intense sexual urges.

Co-existing conditions may include hypersexuality or other paraphilic disorders—most commonly, voyeurism and exhibitionism—as well as nonsexual antisocial personality disorder, conduct disorder, depression, anxiety, substance use disorders, or brain injury. A history of sexual abuse may play a role in the development of frotteuristic disorder, especially when signs of the disorder appear at an early age.

Treatment

Individuals with frotteuristic disorder generally do not pursue treatment on their own and only receive help after they are arrested for sexual assault and treatment is mandated by the courts. And since those with frotteuristic tendencies tend to act quickly in crowded, public places, and often are able to successfully disappear or blend into a crowd without getting caught, there is little reliable information on either prevalence or treatment success rates. Standard treatments for frotteuristic disorder include medication and psychotherapy. Medications such as hormones and certain antidepressants may be used to help diminish sexual desire. Behavioral or cognitive-behavioral therapy and relaxation training can help manage sexual urges and redirect thoughts to more appropriate ways of dealing with inappropriate sexual impulses and behaviors.

Can frotteuristic disorder be cured?

There is no known cure for frotteuristic urges and fantasies. However, there are treatments that can help those with frotteurism develop healthier ways to behave sexually, including medication and therapy. People with frotteuristic disorder are considered in remission if they don’t act on their inappropriate sexual urges or experience any distress or impairment of normal functioning for at least five years, per the DSM-5.

What are the psychological consequences of frotteurism?

Frotteuristic thoughts and urges can be distressing for the person who experiences them even if they are never acted out in real life. Acts of frotteurism are a type of sexual assault that can cause great emotional distress and acute or long-term trauma for the victim.  

References
American Psychiatric Association. Understanding Mental Disorders: Your Guide to DSM-5. 2015. American Psychiatric Publishing
Frotteurism. SexInfoOnline. University of California, Santa Barbara. Updated 3 Apr 2014. Accessed 13 Jul 2017
Patra APP, Bharadwaj B, Shaha KK, et al. Impulsive frotteurism: A case report. Medicine, Science and the Law. August 8, 2013;53(4):235-238
Mark Griffiths, PhD. Wordpress. Rubbing someone up the wrong way: A beginner’s guide to frotteurism.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Last updated: 03/28/2019