Hypersexual Desire in Males: An Operational Definition and Clinical Implications for Males with Paraphilias and Paraphilia-Related Disorders

The longitudinal history and temporal stability of total sexual outlet (TSO) in a group of outpatient males with paraphilias (PA) and paraphilia-related disorders (PRD) was assessed. Based on extant normative data from contemporary population-based surveys of sexual behavior, it was hypothesized that a persistent TSO of 7 or more orgasms/week for a minimum duration of 6 months be considered as the lower boundary for hypersexual desire in males. In almost all statistical analyses, the PA (n = 65) and PRD (n = 35) groups were not statistically different. The mean current TSO (PA, 7.4 ± 5.7; PRD, 8.0 ± 4.2) as well as the current average time consumed in all unconventional sexual behaviors (1–2 hr/day) were not statistically different. Unconventional sexual behaviors (i.e., related to PAs or PRDs) leading to orgasm constituted 77% of current TSO. In the combined group (n = 100), 72% (n = 72) reported a hypersexual TSO of 7 or greater. Age of onset of hypersexual TSO in the PAs (19.2 ± 6.8 years; range 10–43) and the PRDs (21.0 ± 8.6; range 10–46) and the duration of hypersexual TSO (PA, 11.1 ± 11.2 years; PRD, 10.5 ± 9.1) were not significantly different. Fifty-seven males (57%) reported a TSO of 7 or more for a minimum duration of 5 years. Clinical implications of reconceptualizing PAs and PRD as sexual desire disorders are discussed.