Can we use unusual sexual fantasies to identify sexual deviancy? Is there a link between what people fantasize about and how they actually behave?
Psychiatry’s two main diagnostic manuals list certain sexual interests - such as voyeurism, exhibitionism, fetishism, sadism and masochism - as “anomalous” or “unusual”. But, our study shows that some of these fantasies are not all that unusual.
To find out what defines an unusual sexual fantasy, we recently conducted an online survey of 1,516 adults (799 females and 717 males) about the nature and intensity of their sexual fantasies. Because the handful of studies examining sexual fantasies used college aged participants, the people in our study had a mean age of 30.
The results, published in the Journal of Sexual Medicine, question the definition of typical and atypical sexual fantasies used in psychiatric manuals.
Our survey had 55 questions about specific sexual fantasies, that people ranked on a scale of zero to seven. There was also one open question where participants were asked to write down their favorite sex fantasy. The benefit of this type of study is that we can use objective, statistical criteria to define usual and unusual fantasies.
Diversity is the norm
In the realm of sexual fantasies, diversity is normal. Most of the fantasies on our survey were not found to be rare or unusual, and only a few were found to be typical.
Out of the 55 fantasies on our survey, only two were rare. Bestiality and pedophilia were reported by less than 2.4% of the sample.
Nine fantasies were statistically unusual. Seven of these were rare in women. These included urinating on partner or being urinated on (reported by 3.5% of the sample), wearing clothes of the opposite gender (6.9%), forcing someone to have sex (10.8%), abusing a person who is drunk, asleep, or unconscious (10.8%), having sex with a prostitute (12.5%) and having sex with a women who has very small breasts (10.8%).
Interestingly, even among men, just four fantasies are less common: urinating on their partner (8.9%), being urinated on (10.0%), having sex with two other men (15.8%), or having sex with more than three other men (13.1%).
More typical fantasies
Five fantasies were statistically typical, endorsed by about 84.1% of participants. These fantasies involved feeling romantic emotions, fantasies in which atmosphere and location are important and fantasies involving a romantic location. Both genders reported fantasies in romantic locations in similar numbers.
For men, typical fantasies included receiving oral sex and having sexual intercourse with two women.
Second, submission and domination themes are common, both in men and women. These themes were reported by approximately 30% to 60% of the sample. It is worth noting that no difference between genders emerged for either theme, so men actually reported submissive fantasies in comparable proportions of women, and vice versa for domination. This refutes the belief that men necessarily fantasize about domination.
Third, submission and domination themes are correlated. Many people with submissive fantasies also reported domination fantasies.
Some so-called paraphilic, or atypical, sexual fantasies involving consenting adult partners are noteworthy, especially fetishism, sadism, and masochism. These sexual fantasies are far from uncommon.
All this means that we should refrain from listing fantasies and interests involving consenting adults and non-criminal behaviors in psychiatric manuals as disorders.
Fantasy ≠ real behavior
The key point is that fantasies should not be confused with wishes or behaviors. For instance, while many women acknowledged fantasies about domination, approximately half specified they would never want to experience it in real life. The mere presence of a fantasy, even if intense and recurrent, is not sufficient to describe a real-life sexual interest.
Thus, fantasies are not necessarily good indicators of real-life interests.
We should worry less about sexual fantasies that involve consenting adults in non-criminal situations and more about the effect of the fantasy, whatever the content is. As soon as a sexual fantasy induces distress or suffering or involves non-consenting partners, it should be considered pathological. Any sexual fantasy that inflicts distress to a person should be categorized as a sexual preference disorder.
Assertions of what is common or normal for sexual fantasies should be based more on data and less on judgment.
Surprisingly, however, to date neither of the major diagnostic manuals lists any studies or research to back up their definition of unusual sexual fantasies.