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 It has also been seen in older, reserved, and socially withdrawn men.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% of adult males seen by clinicians for paraphilic disorders meet the diagnostic criteria for frotteuristic disorder.
According to 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.
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.
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 managing inappropriate sexual impulses and behaviors.