Sexual healing: A brief examination of medical fetishism‬

I’m sure most of us can remember playing ‘doctors and nurses’ when we were kids but there are some people who never seem to grow out of it and engage in what has been termed ‘medical fetishism’. The fetish appears to be quite inclusive and wide ranging because the activity can comprise those (i) individuals who are sexually attracted to people in the medical profession, (ii) people (usually heterosexual males) who derive sexual pleasure from their female sexual partners to dress up in a nurse’s uniform, and/or (iii) individuals who derive sexual pleasure and arousal from actually being the recipients of a medical or clinical procedure (usually some kind of bodily examination). Some of these behaviours may be paraphilias or specialized fetishes such as klismaphilia (i.e., sexual pleasure from the receiving of enemas) that I examined in a previous blog. There are also those whose fetish only concerns a very particular branch of medicine (such as dentistry).

The types of activity that have been reported as medical fetishes include genital and urological examinations (e.g., a gynecological examination), genital procedures (e.g., fitting a catheter or menstrual cup), rectal procedures (e.g., inserting suppositories, taking a rectal temperature, prostate massage), the application of medical dressings and accessories (e.g., putting on a bandage or nappy, fitting a dental retainer, putting someone’s arm in plaster), and the application and fitting of medical devices (e.g., fitting a splint, orthopedic cast or brace).

Some of these activities such as having a nappy, catheter, or orthopedic brace fitted may overlap with other sexual paraphilias listed in Dr. AnilAggrawal’ Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, such as infantilism (i.e., deriving sexual pleasure from being an adult baby), catheterophilia (i.e., deriving sexual pleasure from catheters), and apotemnophila (i.e., deriving sexual pleasure from the thought of being an amputee). In the most extreme cases of medical fetishism, more invasive medical acts may be performed for sexual pleasure including giving injection, anaesthesia, and actual surgery. The sexual pleasure and arousal may occur in the giver and/or receiver, and much of the activity may be in the form of sexual role-play. As one online essay on medical fetishism noted:

“People with an extreme medical fetish use torturous medical devices, speculums, mouth and anal spreaders, enema kits, probes etc. They may even consent to false operations where they are surgically opened, and with nothing fixed or removed, sutured closed. An extreme medical fetish can be a dangerous thing…A medical fetish can include a sexual attraction to medical people. Doctor and nurse porn movies, people receiving medical examinations and so on. Most are simply role play”.

There are also sub-branches of medical fetishism that may have overlaps with sadomasochism and BDSM where (for instance) a female dominatrix may inflict a medical procedure on their willing submissive individual. Such activity often centres on sexual and/or sensitive body parts including the penis, testicles, nipples and anus. The instruments used may also be heated or cooled to heighten the pain/pleasure sensations. Given the potential danger involved in some of the activities performed and the fact the person administering the procedure (e.g., anaesthesia, surgery) may not have any formal medical training, the risk of permanent body damage – or in extreme cases, death – is a possibility. Here, the risk of something going wrong may also be sexually stimulating to the person, and there appears to be both physical and psychological overlaps with paraphilias such as hypoxyphilia (i.e., deriving sexual pleasure from restricting oxygen supply to heighten sexual arousal).

Medical fetishism within sadomasochistic activity would therefore constitute ‘edgeplay’. This is a term used within the BDSM community that refers to sexual activities that push the boundaries of safety and are sometimes referred to as RACKs (Risk-Aware Consensual Kinks). Those involved in edgeplay are fully cognizant of the fact that their sexual behaviour may result in serious bodily harm and permanent damage.

In the Encyclopedia of Unusual Sex Practices, Dr. Brenda Love notes that some people are sexually aroused by exposing themselves to medical practitioners, and that this is called ‘iatronudia’.  She claims that such people will pretend to be ill just so that they can undress in front of a doctor. This echoes with some online sources claim that those with medical fetishes may also feign injury and illness, or give themselves self-inflicted wounds just so that they can receive genuine medical help. Such activity would appear to have psychological overlaps with Factitious Disability Disorders such as Munchausen Syndrome (i.e., feigning illness to draw attention or sympathy from others). This type of behaviour may be considered somewhat safer for the medical fetishist (as the procedures would be carried out by someone who is medically trained) but is an abuse of others’ time and expertise.

Although there is almost no empirical research on medical fetishism, it would appear that most fetishes – particularly when they are very specific and specialized – are rooted in early childhood experiences and most likely caused by behavioural conditioning processes. For instance, those individuals who are only sexually turned on by being anaesthetized not only enjoy the act itself but will usually be sexually aroused by the sight of all the aneasthetic equipment and accessories (e.g., black rubber anaesthetic masks).

As with many other fetishes, the internet has fostered whole online communities of medical fetishists (such as the Gynecology and Medical Examination Fetish Forum or the My Male Medical Fetish; please be warned that these are sexually explicit sites). There is little scientific research on the etiology and psychology of medical fetishism although Dr. Brenda Love speculates that sexual games involving medicine are popular because of the anxiety connected with visiting a GP that “leads to a natural increase in energy in a sexual experience”. I can’t say I’m overly convinced by this explanation, but in the absence of anything more empirical, it’s one of the few views that a clinician has put forward.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Bizarre Magazine (2010). Medical fetishism. December 1. Located at: http://www.bizarremag.com/fetish/fetish/10393/medical_fetish.html?xc=1

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Midori (2005). Wild Side Sex: The Book of Kink Educational, Sensual, And Entertaining Essays. Daedalus Publishing.

Streetsie (2011). Disability fetish and medical fetish. August 19. Located at: http://www.streetsie.com/disability-fetish-medical-fetish/

Wikipedia (2012). Medical fetishism. Located at: http://en.wikipedia.org/wiki/Medical_fetishism