There is considerable confusion about the definition of sexual deviation. One approach puts the primary emphasis on social disapproval, and defines it as “sexual behavior at variance with more or less culturally accepted sexual activities.” This is the definition given by the American Psychiatric Association, which cites homosexuality, transvestism, sexual sadism, and sexually violent (criminal) acts as examples.The element of social disapproval cannot be avoided because what is considered deviant in one society may not be considered deviant in another. Polygamy, prostitution, and homosexuality are acceptable in some cultures, but not in ours. There may also be wide differences even within the same society —for example, variations in sexual foreplay and coital position are generally more acceptable on higher than on lower socioeconomic levels in this country; a deviation, therefore, must be defined in terms of the total society and not simply one segment of it. Rosen and Gregory (1965) have proposed the following definition specifically for our culture: “persistent preference for a sexual object or mode other than genital heterosexual behavior with an adult.”Rosen and Gregory’s definition applies to such clear-cut deviations as sodomy, fetishism, exhibitionism, and sadism, but does not include all types of socially disapproved sexual behavior, such as promiscuity and prostitution, nor does it embrace such pathological conditions as frigidity, impotence, and nymphomania. Since these are usually included in discussions of sexual deviation, it would probably be useful to specify that sexual deviations include not only culturally unacceptable sex behavior but also sex behavior that is pathological in origin. It is also important to distinguish between sexual offenses (which only have to be unacceptable to society) and sexual deviations, although the two frequently coincide. Sexual offense is a legal distinction; sexual deviation is a psychiatric distinction with social overtones. Extramarital relations would be considered a legal offense but not ordinarily a psychiatric deviation; impotence would be a psychiatric deviation (or a physical disorder) but not a legal offense.This book will deal with all sexual deviations that can be viewed as psychological disorders. Their range is extremely wide, but they can be classified under the following categories: (1) deviations in intensity and frequency of sex activity and drive: nymphomania, satyriasis, promiscuity; impotence, frigidity; (2) deviations in the mode of gratification:excessive masturbation,voyeurism, exhibitionism, frottage, oro- genital activity (fellatio, cunnilingus), anogenital activity (sodomy), transvestism, sadism, masochism, forceable rape;(3) deviations in the object of the sexual act: homosexuality, fetishism, pedophilia, bestiality, incest, necrophilia;deviations related to a special social context: promiscuity, prostitution.Because of the private character of most sexual activity, the incidence of these deviations is hard to estimate. Probably more people engage in some form of “perverse” activity at one time or another than is generally recognized. Kinsey et al. (1949) concluded that:In spite of the many centuries in which our culture has attempted to suppress all but one type of sexual activity, a not inconsiderable portion of all the sexual acts in which the human animal engages still fall into the category which the culture rates as “perverse.” The specific data show that two thirds to three quarters of the males in our American culture, and some lesser number of females, engage in at least some “perverse” sexual behavior at some time between adolescence and old age. One half to two thirds of the males engage in such behavior with appreciable frequency during some period of their lives and a fair number engage in such behavior throughout their livesPolice figures are only partly indicative of the extent of deviation, since a great many sexual offenses are unreported and there is wide variation from state to state both in the laws and in their enforcement—for example, the penalty for sodomy in different jurisdictions ranges from thirty days to life. In Connecticut 25 per cent of the prison population have been sentenced for sexual offenses, as contrasted with 10 per cent in New York. Probably only 15 per cent of reported offenses result in actual conviction, since the reports are often false or the victim withdraws his case to avoid publicity. Also, some offenses are considered minor: a Michigan study showed that 42.5 per cent of sex offenders were voyeurs or exhibitionists who are usually given probation or suspended sentences. Other offenses which most frequently come to the attention of the police are incest, rape and assault, molesting of children, and homosexuality.About one third of all sex offenders have previous police records, and in the Michigan study, 60 per cent of offenses were directed against children. Few women are convicted of sex offenses, but when they are, it is usually for prostitution or acts against children. The highest incidence of sex crimes is among young unmarried males, and a large percentage of them have been sex delinquents during adolescence. There are, however, a number of false ideas about these offenders. Contrary to popular opinion, (a) less than 10 per cent are repeaters, and most of these commit minor offenses such as peeping; (b) only about 5 per cent inflict physical injury; these offenders are usually psychotic as well as sexually deviant; (c) very few offenders progress from minor to major sex offenses, since they usually adopt and persist in one type of satisfaction(d) most of them are not oversexed, but rather undersexed, misinformed, inadequate, and even prudish individuals.Although the origins of specific deviations are discussed under separate topics, certain general causal factors can be outlined at this point. First, personality disturbances of varying degrees of severity afflict the great majority of deviates. A large group consists of inhibited neurotics who either compensate for feelings of inadequacy by engaging in promiscuous behavior, or seek an unthreatening outlet in peeping, exhibitionism, fetishism, or homosexuality. These individuals often show some degree of impotence or frigidity. Second, psychosis affects about 2 per cent of sexual deviants, and another 8 per cent are borderline psychotics. Manic patients may be promiscuous and occasionally sadistic or assaultive. Depres- sives are usually impotent or frigid, and are sometimes masochistic as a result of guilt feelings. Schizophrenic and paranoid individuals often have no sexual feelings for others and may rely on masturbation as an outlet. Some overt schizophrenics, however, may engage in highly deviant behavior, such as rape, pedophilia, extreme fetishism, and bizarre acts of sadism or masochism.In addition, there are three other types of disorders, each of which affects about 4 or 5 per cent of deviants. Individuals suffering from organic brain disorders, often associated with senility, commit such offenses as incest, exhibitionism, and acts against children. Mild mental retardation is a factor in some cases of female promiscuity as well as male exhibitionism, and occasionally in cases of sexual assault or intercourse with animals. The antisocial personality, or sociopath, is frequently promiscuous and may resort to force, intimidation, or fraud in his sexual pursuits. Male sociopaths are often attracted to adolescent girls, and are sometimes charged with seduction, sexual assault, or rape.Sexual deviations, then, are associated with a wide variety of psychological disorders. There are certain kinds of early experiences and personality factors, however, which may give us a clearer idea of the causes. The following are most frequently cited, and studies have shown that they are most likely to lead to sexual deviation when the personality has been weakened by an unhappy home life and faulty development:(a) Sexual incidents in childhood or youth, such as seduction by an older homosexual; (b) failure to learn appropriate sex roles: a boy who has been raised as a girl or who has identified with his mother instead of his father may develop homosexual tendencies; (c) rigid upbringing, isolation from other children, and lack of sex education: this may cause a child to fear the opposite sex; he then shies away from normal relationships and may seek an outlet in voyeurism, exhibitionism, or excessive masturbation;general immaturity and fear of responsibility: this may lead to avoidance of adult heterosexual relationships and pave the way for homosexuality; (e) deprivation of normal outlets, as in prison or boarding school; may lead to homosexuality or other deviations; (f) intense feelings of hostility or resentment against parents and society; may result in a pattern of “acting out” inner tensions in the form of antisocial sex offenses; (g) arrested psychosexual development—that is, fixation at an infantile level: psychoanalysts maintain this may set the stage for orogenital or anogenital behavior as well as dependence on masturbation, voyeurism, or exhibitionism. Heredity and other biological factors have also been investigated, but the results have been largely negative. It is true that families of deviates show a higher than normal rate of neurosis, psychopathic behavior, and other deviations—but today the difference is usually attributed to environmental rather than hereditary factors. The physical constitution and endocrine functions of homosexuals are practically always the same as for heterosexuals,and no hereditary basis for homosexuality has yet been proven. As pointed out above, sexual deviates—even nymphomaniacs and satyriasists—are rarely if ever physiologically oversexed. Except in rare cases, deviates do not differ from normal individuals in sex chromosomes or sex hormones.Treatment procedures vary considerably for the different deviations, but certain general points can be made here. Sexual deviants are frequently prone to either anxiety or depression, and in these cases tranquilizing drugs or antidepressants are likely to be administered. Tranquilizers are also used to reduce the sex drive, particularly in older men who molest children. In some cases female hormones are administered to suppress sex activity in males, and castration is permitted or even mandatory in some localities. However, these physical measures do not alter the structure of the personality or the character of the sex impulse.Psychotherapy is rarely successful with long-standing deviations, but is sometimes effective with cases of recent onset, or where the patient is basically heterosexual even though his behavior is occasionally homosexual or deviant in some other respect. As to the specific kind of psychotherapy, psychoanalysis is usually more difficult with deviates than with typical neurotics because they derive so much pleasure from their sexual activities that they resist change. More direct techniques often fare better; for example, providing the misinformed deviate with accurate sexual information, or helping the inhibited deviate abandon his prudish attitudes toward normal relations. A therapist can sometimes shift a patient toward more normal behavior by a step-by-step approach: a homosexual male may be encouraged to develop friendships with boyish-looking females as a bridge to relationships with more feminine women. Hypnotic suggestion has also been tried, but the results have usually been disappointing.One of the most promising techniques is reconditioning therapy. In one experiment, male transvestites were given a nauseating drug, and were then shown photographs of themselves wearing feminine clothing. In most of the cases this brought about a lasting aversion to transvestism. A somewhat similar technique has been used with homosexuals. Desensitization techniques have also been applied in cases of exhibitionism and voyeurism. See BEHAVIOR THERAPY, HOMOSEXUALITY (MALE).Finally, group therapy has been effectively employed in helping sexual deviates gain insight into their motivations, and in encouraging them to alter basic attitudes and develop more acceptable behavior patterns. Currently, group techniques are being combined with rehabilitation procedures in treating sex offenders in mental hospitals instead of putting them in prison. In a significant experiment in California, Cabeen and Coleman (1962) used a variety of approaches: group discussions led by patients, patient self-government, psychodrama, mental health films, talks by staff members, more formal group psychotherapy, and meetings with legislators, judges, educators, clergymen, physicians, and other members of the community at large. An independent organization of ex-patients was also established. Of 126 offenders, 79 were found to improve enough to return to society, and a follow-up study showed that only three of them were later arrested for sex offenses. Similar approaches have also been tried in prisons, although many psychiatrists do not consider the prison setting conducive to effective psychotherapy.There is evidence that society is moving in the direction of the procedure outlined by the Committee on Forensic Psychiatry of the Group for the Advancement of Psychiatry, which has recommended that every person convicted of a sexual offense should be given a psychiatric examination, and “If we diagnose this sex offender as mentally disordered he should be treated as a mental case in a facility for that purpose . . . If the offender is curable he can be eventually released to society; if not, he should never be released.”

Cite this page: N., Pam M.S., "SEXUAL DEVIATIONS (GENERAL)," in, November 28, 2018, (accessed October 12, 2019).