Sexual preferences and associated disorders: toward an extended model for description

The notion of human sexual preferences relates to relatively stable patterns of sexual response and to directing sexual behaviors toward specific arousing stimuli, which are also important for sexual satisfaction. The preferences may pertain to the properties of the object or the sexual activity itself. Diagnosing sexual preferences, in its basic form, is conducted with the use of disorder criteria defined in diagnostic classifications (ICD-10, DSM-5). However, while employing these criteria enables the categorization of the patient's sexual preferences as normal or pathological, they seem clearly insufficient for describing complex sexual interest patterns in a comprehensive manner. The goal of this article is to present a detailed dimensional model for describing sexual preferences. This proposal assumes the description of two aspects of preference: a contentual aspect, defining the individual hierarchy of sexually attractive and aversive stimuli, and a formal aspect. The latter involves four dimensions: the diversity of stimuli falling within the pattern of the patient's sexual interest, preference changeability in time, the coherence between individual components of responding to sexual stimuli, and insight into one's own preferences. The proposed model supplements the basic description of sexual preferences conducted on the basis of diagnostic criteria. The model can be a tool useful for diagnostic practice, particularly in precise characterization of various difficulties experienced by patients in relation to the properties of their sexual interests. It can also inspire new research on features of human sexual response patterns which have been neglected in previous analyses.