Exhibitionism

Exhibitionism is characterized by achieving sexual gratification by exposing one's genitals, usually to unsuspecting strangers. It may also manifest itself in a strong desire to be observed during sexual activity.

The exhibitionist (usually a man) may masturbate while displaying his genitals or fantasizing about it. He may be aware of his need to surprise, shock, or impress the unwitting observer. The victims are almost always adult women or children of both sexes. There is almost never a search for actual sexual contact. The age of onset is about 25 years; rarely, the first episode occurs in prepuberty or middle age. About 30% of male sex offenders are exhibitionists. They have the highest recidivism rate of all sex offenders; 20 to 50% are rearrested. Most exhibitionists are married, but marriage is often complicated by poor social and sexual relationships, including frequent sexual dysfunction. Women are rarely diagnosed with exhibitionism, although there is social sanction for some forms of exhibitionistic behavior in women (through videos and entertainment).

In some people, exhibitionism manifests itself as a strong desire to have others watch their sexual acts. This action is not aimed at surprising the audience, but rather at being watched by a willing audience. People with a compulsive attraction to this form of exhibitionism may make pornographic films or participate in adult entertainment. They are rarely concerned with their sexual needs.

Treatment of exhibitionism

If legal boundaries are crossed and sexual offences are at issue, treatment usually begins with psychotherapy, support groups and SSRIs. If these drugs are ineffective, antiandrogens may be prescribed with full informed consent and appropriate monitoring of liver function and blood testosterone levels.

Exhibitionism and the Law

Indecent exposure, or exhibitionism, is not an indictable offence. Most men convicted of this offence do not reoffend, as the mere appearance in court is considered to have a deterrent effect. If a conviction and punishment follow, the risk of reoffending increases considerably. In the past, offenders of indecent exposure were classified according to the condition of their penis at the time of exposure, whether it was erect or not. However, as with other sexual offences, there is no satisfactory classification or theory of the etiology of this behaviour. Most offenders of indecent exposure do so during periods of personal stress, are more likely to be married, and lack the characteristics of other sex offenders. Abel & Rouleau conducted a longitudinal study of 561 sex offenders. According to their data, these offenders had several different paraphilias. More than 80% of exhibitionists had two or more other paraphilias, and one in three had five or more. In addition, 28% of sexual predators reported a sexual interest in exhibitionism. The effectiveness of treatment for perpetrators of indecent exposure decreases as the frequency of the act increases.

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