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Learn more about disorders of sexual preference
Disorders of sexual preference, referred to in the DSM-5 as paraphilic disorders, are conditions involving intense, persistent sexual interests that cause significant personal distress or that involve behaviour that harms or risks harming others. The DSM-5 draws a deliberate distinction between a paraphilia (an atypical sexual interest that causes neither distress nor harm) and a paraphilic disorder (where distress or harmful behaviour is present). Many people with atypical sexual interests do not have a disorder; the clinical threshold is reached when those interests cause suffering or involve risk to others. Therapy in this area is focused on psychological wellbeing and, where relevant, behaviour, not on pathologising sexuality.
People seek support in this area for a range of reasons. The following experiences are among the most common.
Signs you might benefit from support
- Sexual thoughts or urges that feel intrusive, distressing, or in conflict with your values
- Difficulty managing sexual impulses that you do not want to act on
- Shame, anxiety, or confusion about your sexual interests that significantly affects daily life
- Concerns that certain sexual interests or behaviours are causing harm to yourself or others
- A pattern of sexual behaviour that feels out of control or inconsistent with who you want to be
- A desire to understand your sexuality more clearly with the support of a professional
Therapeutic work in this area is tailored to the individual's specific concerns, whether these involve distress about unwanted thoughts, questions about sexual identity, or behaviour management.
- Psychotherapy Psychotherapy provides a non-judgmental space to explore the psychological dimensions of sexual interests, including their origins, emotional meaning, and relationship to identity and values.
- Clinical psychology Clinical psychologists can assess presentations systematically, provide a diagnostic formulation, and design a treatment plan suited to the specific clinical picture.
- Psychiatry Psychiatrists can assess for co-occurring conditions and, where appropriate, consider medication as part of a broader treatment plan for paraphilic disorder presentations.
- CBT (Cognitive Behavioural Therapy) CBT can help with intrusive sexual thoughts, impulsive behaviour, and the shame and distress that often accompany unwanted sexual interests, using structured cognitive and behavioural techniques.
It's Complicated is a therapist-founded mental health platform connecting clients with verified practitioners across Europe and globally, in over 60 languages. We work with over 2,500 vetted therapists, with in-person availability in Berlin, Amsterdam, Barcelona, Lisbon, Vienna, and other major cities, alongside online sessions worldwide. It's Complicated is free to use, and you pay your chosen therapist directly at rates they set.
Finding a therapist who approaches questions of sexual preference without judgement, and who has relevant clinical experience, requires more than a standard search. Our matching service is built to remove that friction. You complete a short survey, our psychologists combine data-driven insights with human judgement to identify the right therapists for your situation, and you choose from a shortlist of strong candidates. You can also browse our directory directly if you'd prefer to choose yourself.
Get matched with a therapist who specialises in disorders of sexual preference, or browse the directory.
