The type of stimuli for which people experience sexual interest varies greatly. Some are attracted to their own sex, the other or both, and this configures the first level of sexual attraction (the orientation of sexual desire). At a second level, specific sexual preferences emerge, determining that homosexual people do not feel attracted to absolutely all people of their own sex or heterosexuals to those of the opposite sex. These preferences are configured around physical characteristics (such as height, complexion, and physiognomy), the concept of beauty, social status, race, power, personal characteristics (such as charisma or social skills), and especially around age (typically, individuals feel attraction for people from a similar age). The most common is that these preferences conform to what is socially desirable (i.e., normophilic sexual attraction). However, sometimes the object of sexual desire deviates from what is socially acceptable (i.e., paraphilic sexual attraction).

For the diagnosis of paraphilia, the person must experience, for at least 6 months, sexual fantasies, impulses, or behaviors deviated from the normal object of sexual desire. The DSM-5 manual currently includes the following paraphilic disorders:

• Voyeurism: sexual arousal derived from the observation of an unsuspecting person who is naked, undressing, or engaging in some type of sexual activity.
• Exhibitionism: sexual arousal derived from exposing genitals to someone unsuspecting.
• Frotteurism: excitement from touching or rubbing against a person without their consent.
• Sexual masochism: arousal from being humiliated, beaten, or subjected to suffering.
• Sexual sadism: excitement derived from the exercise of physical or psychological violence.
• Pedophilia: sexual attraction to prepubertal children (generally under 13 years of age).
• Fetishism: sexual arousal derived from the use of inanimate objects or fixation on specific non-genital areas of the body.
• Cross-dressing: sexual arousal derived from dressing in clothing of the other sex.
• Other unspecified paraphilic disorders: attraction to any sexual stimulus that is considered socially deviant and that has not been previously listed.

The severity of the clinical picture is determined by aspects such as the degree of exclusivity of the paraphilic attraction (can you become aroused with some type of normophilic stimulus?) Or the nature of the paraphilia (due to its consequences, pedophilia is considered the most serious condition). Depending on its severity, treatment is aimed either at reconditioning the sexual interest or to control sexual response in order to avoid the commission of any type of sexual offense.