# Is a fetish a mental disorder? What the DSM keeps and the ICD dropped

> No. A fetish, sexual arousal tied to an object, a material or a non-genital body part, is not a mental disorder in either current diagnostic manual. The DSM-5-TR diagnoses fetishistic disorder only when the pattern has lasted six months and causes clinically significant distress or impairment. The ICD-11, in force since January 2022, removed fetishism as a diagnosis altogether.

Published 2026-09-27. 7 min read. KINKSpec, https://www.kinkspec.com/blog/is-a-fetish-a-mental-disorder

The word *fetish* lives in two places at once. In a survey it names a preference, and the preference is common: in [Joyal and Carpentier's 2017 survey](https://pubmed.ncbi.nlm.nih.gov/26941021/) of 1,040 adults weighted to match the population of Quebec, interest in fetishism passed the 15.9% line that marks a fantasy as statistically unusual, in men and in women, with no significant difference between the sexes. In a diagnostic manual the same word names a disorder, and for most of the twentieth century the interest and the disorder were one thing.

They came apart in stages. Fetishism entered medicine in 1887, gained a second clinical requirement in 1994, left the national classifications of Sweden, Norway and Finland between 2009 and 2011, and left the World Health Organization's classification in 2022. The American manual still names a disorder, and the door into it is narrow. The wider question of whether any kink counts as a disorder has [its own article](https://www.kinkspec.com/blog/is-my-kink-normal); this one follows the fetish.

## What the American manual diagnoses

The [DSM-5-TR](https://www.psychiatry.org/psychiatrists/practice/dsm), the American Psychiatric Association's manual in its 2022 text revision, names fetishistic disorder among its eight specific paraphilic disorders. The [fetishism](https://www.kinkspec.com/entry/fetishism) entry records its three criteria.

- Criterion A: for at least six months, recurrent and intense sexual arousal from nonliving objects or from a highly specific focus on one or more non-genital body parts, shown in fantasies, urges or behaviour.
- Criterion B: the fantasies, urges or behaviour cause clinically significant distress or impairment in social, occupational or other important areas of functioning.
- Criterion C: the objects are not limited to clothing used in cross-dressing, which belongs to [transvestic disorder](https://www.kinkspec.com/entry/transvestic-disorder), or to devices designed for genital stimulation, such as a vibrator.

Criterion A describes the interest. **Criterion B is the disorder, and a person untroubled by the interest does not meet it.** The manual separates the two in its own vocabulary: a *paraphilia* is the atypical interest, a *paraphilic disorder* is a paraphilia that causes distress or impairment or harms someone else, and the first is a necessary condition for the second but not a sufficient one.

The diagnosis carries specifiers that record the focus (body parts, nonliving objects, or other) and two states: in a controlled environment, and in full remission. The body-part specifier is the trace of an argument about [partialism](https://www.kinkspec.com/entry/partialism), a focus on a part of the body, which the manual treated as a separate category for twenty-six years before folding it back in.

## What the WHO classification removed

The [ICD-11](https://icd.who.int/browse11), adopted by the World Health Assembly in 2019 and in force since January 2022, has no fetish diagnosis. Its predecessor, the ICD-10, coded fetishism as F65.0 and fetishistic transvestism as F65.1. Both are gone, and so is sadomasochism, F65.5.

The working group that recommended the change set out its reasoning in [a 2017 paper by Krueger and colleagues](https://pmc.ncbi.nlm.nih.gov/articles/PMC5487931/) in *Archives of Sexual Behavior*. The three categories, it wrote, described consensual or solitary sexual activity that does not involve inherent harm to self or others. The ICD is a public-health reporting tool, which member states use to define their obligations to provide free or subsidised healthcare, and the group asked which arousal patterns mattered from the perspective of a public-health agency. Keeping the three categories, the paper argued, stigmatised the people who had it, which it called inconsistent with the human rights principles the United Nations and the WHO endorse.

What remains are the disorders that involve other people who have not consented (exhibitionistic, voyeuristic, pedophilic, coercive sexual sadism and frotteuristic disorder, plus a category for other paraphilic disorders involving non-consenting individuals) and one residual category, other paraphilic disorder involving solitary behaviour or consenting individuals. A fetish could land there in only two ways: the person is markedly distressed by the nature of the arousal pattern, or the behaviour carries a significant risk of injury or death.

| | DSM-5-TR (2022) | ICD-11 (2022) |
|---|---|---|
| Named fetish diagnosis | Fetishistic disorder | None |
| Body-part focus | A specifier of fetishistic disorder | Not named |
| Route to a diagnosis | Six months plus distress or impairment | Marked distress or risk of injury or death |
| Distress caused only by others' disapproval | Left to the clinician | Excluded explicitly |

## How the diagnosis narrowed

The erotic sense of *fetishism* is a coinage of 1887. The psychologist Alfred Binet, drawing on cases Charcot and Magnan had published in 1882, borrowed a word from the study of religion, where [*fétichisme*](https://www.kinkspec.com/entry/anthropological-fetishism) named the worship of objects, and used it for arousal attached to shoe nails, nightcaps and white aprons. Krafft-Ebing's *Psychopathia Sexualis* had catalogued such cases a year earlier as a pathology of association. Freud, in 1905, placed fetishism on a continuum with ordinary erotic life, and Havelock Ellis treated it as an exaggeration of normal selectivity. The manuals of the next century took the first reading, and the revisions since 1994 have moved them toward the second.

Before 1980 the American manual filed the interests under *sexual deviation*; the [DSM-III](https://en.wikipedia.org/wiki/Paraphilia) of 1980 introduced the word *paraphilia* and restricted fetishism to nonliving objects, excluding body parts. The DSM-III-R of 1987, as [Martin Kafka's 2010 review](https://link.springer.com/article/10.1007/s10508-009-9558-7) recounts, cleaved partialism from fetishism and placed it in the paraphilia-not-otherwise-specified category. The DSM-IV of 1994 then added the clinical significance criterion, criterion B, to the paraphilias, and with it the idea that an interest alone is not a disorder.

Kafka argued that once criterion B existed, the line between an object and a body part was no longer clinically meaningful, and recommended folding partialism back into fetishism as a specifier. The DSM-5 did so in 2013, and made the distinction between a paraphilia and a paraphilic disorder explicit. The DSM-5-TR of 2022 kept both.

### The Nordic countries went first

Four countries removed the categories from their own versions of the ICD-10 before the WHO did, and Krueger's paper lists them. Denmark removed sadomasochism in 1995. Sweden in 2009, Norway in 2010 and Finland in 2011 removed fetishism, fetishistic transvestism, sadomasochism and the category for multiple disorders of sexual preference. The Norwegian group that campaigned for the removals, [ReviseF65](https://www.revisef65.org/), took its name from the ICD-10 code block. ReviseF65 describes the ICD-11 as the WHO following the Nordic countries, and on fetishism the dates bear it out: the last national removal came seven years before the WHO released the new classification in 2018.

## What counts as distress

Distress is the only route into the American diagnosis for a person whose fetish involves no one else. The ICD-11 guidance defines it by excluding a cause: the distress must not be only a consequence of rejection, or feared rejection, by other people. **A person who is unhappy because a partner or a community disapproves of the interest is not, by that fact, disordered.** The working group's guidance directs clinicians to a counselling code for that case instead.

The DSM-5-TR leaves that judgement to the clinician who applies criterion B. In the catalog's reading of the clinical literature, what tips a fetish into the disorder is usually rigidity: the object becomes required for arousal in a way that distresses the person or disrupts a relationship, work or daily life. The content of the interest is not a criterion. A preference for [leather](https://www.kinkspec.com/entry/leather-fetish) and a preference for an object few people have heard of meet the same test, and neither becomes a disorder without distress or impairment.

The catalog's [fetishism](https://www.kinkspec.com/entry/fetishism) entry describes treatment in the same terms. Where someone seeks help, clinical care aims at the distress and the relationship strain around the interest, and at helping the person integrate it. Eliminating a harmless preference is not the goal.

## What the catalog records

Three of the catalog's eleven families hold what most people mean by a fetish: [Body Parts & Partialism](https://www.kinkspec.com/category/body-parts-partialism) with 42 entries, [Clothing & Garments](https://www.kinkspec.com/category/clothing-garments) with 32, and [Objects & Materials](https://www.kinkspec.com/category/objects-materials) with 30. Every one of the 104 carries a `clinical_status` field written from the two manuals. None states that the interest is a disorder in itself. Each says the interest is a normal variation, or a disorder only with distress, impairment or a non-consenting person.

The most common of them are common by any measure. [Foot fetish](https://www.kinkspec.com/entry/foot-fetish) sits fifth on the whole index of 486 entries, at an estimated 14% of adults. [Lingerie](https://www.kinkspec.com/entry/lingerie-fetish) follows at 12%, [shoes](https://www.kinkspec.com/entry/shoe-fetish) at 7%, [leather](https://www.kinkspec.com/entry/leather-fetish) at 6% and [latex](https://www.kinkspec.com/entry/latex-fetish) at 4%. Across the three families, four entries are estimated at 8 to 20% of adults, 32 at 2 to 8%, and 30 below 0.5%. The [methodology](https://www.kinkspec.com/methodology) explains how each estimate is made and from which survey.

One of the 104 is flagged as harmful. [Crush fetish](https://www.kinkspec.com/entry/crush-fetish) has a lawful form involving objects and a second form that is animal cruelty, and the flag belongs to the second.

The disorder has its own pages. The fetishism entry sits in the Clinical Paraphilias family, at an estimated 8% and rank 41, and covers both the broad interest and the narrow diagnosis that shares its name. [Cross-dressing](https://www.kinkspec.com/entry/cross-dressing) and transvestic disorder are split the same way: the manual names a disorder, the interest is common and benign, and one page cannot hold both meanings without blurring them. [Object sexuality](https://www.kinkspec.com/entry/object-sexuality), in which an object is experienced as a partner, is filed apart from fetishism and described in the literature as an orientation toward objects.

## Common questions

### Is a foot fetish a mental disorder?

No. A foot fetish is partialism, a focus on a non-genital body part, and the DSM-5-TR records it as a specifier of fetishistic disorder, diagnosed only with six months of the pattern plus clinically significant distress or impairment. The ICD-11 has no such diagnosis. The catalog estimates that 14% of adults share the interest, fifth on its index.

### What is the difference between a fetish and fetishistic disorder?

A fetish is the interest: arousal tied to an object, a material or a non-genital body part. Fetishistic disorder is the DSM-5-TR diagnosis for that interest when it has lasted at least six months and causes clinically significant distress or impairment. Most people with a fetish meet the first description and not the second.

### Is fetishism still in the ICD?

No. The ICD-10 coded fetishism as F65.0 and fetishistic transvestism as F65.1; the ICD-11, in force since January 2022, dropped both, along with sadomasochism. Sweden, Norway and Finland had already removed them from their national versions between 2009 and 2011, and Denmark had removed sadomasochism in 1995.

### How common is it to have a fetish?

Common. Joyal and Carpentier's 2017 survey of 1,040 Quebec adults found interest in fetishism above the 15.9% threshold for a statistically unusual fantasy, in men and women alike. On the KINKSpec index, foot fetish is estimated at 14% of adults and lingerie at 12%.

### Can a fetish be cured?

No, because the manuals do not diagnose the interest itself. They diagnose the distress or impairment, and clinical care, where someone seeks it, aims there. In the catalog's reading of the literature, treatment helps the person integrate the interest and reduce the shame or conflict around it, and removing a harmless preference is not its aim.

### Is cross-dressing a fetish?

No, not in the manuals' sense. The DSM-5-TR's fetishistic disorder excludes clothing used in cross-dressing, which belongs to a separate diagnosis, transvestic disorder, with the same requirement of distress or impairment. The ICD-11 removed fetishistic transvestism in 2022. Cross-dressing itself, for arousal or for expression, is a lawful interest the catalog documents as common.

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Entries this article is about: https://www.kinkspec.com/entry/fetishism, https://www.kinkspec.com/entry/partialism, https://www.kinkspec.com/entry/transvestic-disorder, https://www.kinkspec.com/entry/cross-dressing, https://www.kinkspec.com/entry/foot-fetish, https://www.kinkspec.com/entry/lingerie-fetish, https://www.kinkspec.com/entry/shoe-fetish, https://www.kinkspec.com/entry/leather-fetish, https://www.kinkspec.com/entry/latex-fetish, https://www.kinkspec.com/entry/crush-fetish, https://www.kinkspec.com/entry/object-sexuality, https://www.kinkspec.com/entry/anthropological-fetishism