Sexual Dysfunction in Individuals with Paraphilic Interests: Findings from a Large Matched Cross-Sectional Study

Paraphilic interests are common in nonclinical populations, yet their relationship with sexual dysfunction remains underresearched. Understanding this association may support clinical assessment and treatment planning in sexual health settings.

To examine the associations between paraphilic interests/disorders and DSM-5 sexual dysfunctions in a large nonclinical adult sample, using sociodemographic matching.

An online survey of 8,282 participants (aged 18-35) classified individuals into paraphilic disorder, paraphilic interest, and control groups based on DSM-5 criteria. A 1:1 manual sociodemographic matching procedure was applied. Sexual dysfunctions were assessed according to DSM-5 criteria A-C.

Compared with matched controls, paraphilic interests were associated with higher rates of erectile dysfunction (OR = 3.10), premature ejaculation (OR = 1.60), and female orgasmic disorder (OR = 1.59) (all p < .05). Paraphilic disorders showed even higher likelihoods of erectile dysfunction (OR = 4.47), premature ejaculation (OR = 4.47), male hypoactive sexual desire disorder, and female sexual interest/arousal disorder (all p < .05). These associations were independent of sociodemographic factors.

Screening for sexual dysfunction may be warranted when paraphilic interests or related distress are disclosed in clinical contexts. Awareness of potential comorbidities may support earlier recognition.

Paraphilic interests and disorders were significantly associated with multiple sexual dysfunctions in a nonclinical population. These findings highlight clinically relevant comorbid patterns.