Paraphilic disorder: The sickness of men exposing private parts in public, understanding it

CEBU CITY, Philippines – At around 8 a.m. on March 25, 2024, just after the students had settled into their classes, a commotion happened near the Tejero Elementary School in Cebu City when a 32-year-old woman reported to a security guard that she had been the victim of a disturbing incident of sexual misconduct.

She described how a man had engaged in inappropriate behavior behind her, performing a sexual act and ejaculating onto her back “without her consent.”

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A 57-year-old man, the offender, was arrested.

He admitted to having committed the act. Not only did he acknowledge his actions, but he also confessed to a prior occurrence of similar behavior.

In his defense, he said he did not know what he was doing.

Not an isolated case

The case involving the man at the Tejero school is not an isolated incident. Instances of public sexual misconduct among men have been reported not only locally but also worldwide.

In Cebu alone, such cases are no longer uncommon, as apprehensions of offenders like that man from Tejero school have been repeatedly covered by news outlets.

Last March 10, 2024, a Japanese national was arrested for allegedly committing a lewd act while on a plane to Cebu. He was released after he posted bail of P3,000.

On January 28, 2024, a 39-year-old sex offender was arrested after he was allegedly seen playing with his private parts in front of two minors in Barangay Tinaan, City of Naga.

The victims were 12-year-old and 17-year-old girls, who were both residents of the said place.

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Offenders are usually apprehended and charged for the violation of Republic Act 11313, or the Anti-Bastos Law, and these offenses are bailable.

However, most reports on these cases are limited to the knowledge of apprehension and the legal basis of the violation.

It is rare to find an understanding that there could be a medical explanation for why these things happened.

What is Paraphilia, or paraphilic disorder?

In an exclusive interview with Dr. Regie Afroilan, a medical specialist from the Department of Health (DOH) and the chairman of the Psychiatric Department at Capitol Medical Center in Quezon City, Manila, he explained that this phenomenon is known as paraphilia or having a paraphilic disorder.

“When we say exposing your genitalia to other people without consent, (this) is considered to be a part of a sexual problem called paraphilia,” he said.

Paraphilia is a term used to describe unusual or atypical sexual interests, fantasies, or behaviors that differ from what is considered typical or culturally accepted.

How they behave

Dr. Afroilan said that paraphilia involves frequent, intense, sexually arousing fantasies or behaviors that may include inanimate objects, children, nonconsenting adults, or the suffering or humiliation of oneself or a partner.

“It is a psychological disorder kasi once you have this kind of paraphilic disorder, it’s against the rule of society. When they are exposing their body part to non-consenting individuals, they become more excited and more aroused to be observed by other people. And it is indecent,” he said.

He added that these behaviors are usually more commonly found in men than in women.

Exhibitionism and Frotteurism

According to Dr. Afroilan, among the most common paraphilic disorders are Exhibitionistic disorder and Frotteuristic disorder.

Exhibitionism or exhibitionistic disorder, Afroilan said, involves exposing the genitals to become sexually excited or having a strong desire to be observed by other people during sexual activity.

Exhibitionists expose their genitals, usually to unsuspecting strangers, and become sexually excited when doing so. They may be aware of their need to surprise, shock, or impress the unwilling observer.

The victim is almost always a woman or a child of either sex.

“Usually sa mga lalaki, they usually do it in the window, public transportation, or public grounds just for people, non-consenting ha, to see. Mas lalo silang na-arouse kapag may nakikita sila ng confusion from people,” he said.

(Usually for male persons, they usually do it in the window, public transportation, or public grounds just for people, non consenting, to see. They become more aroused if they see the confusion from people.

On the other hand, Afroilan defined Frotteurism, or Frotteuristic Disorder, as intense sexual arousal from touching or rubbing against a non consenting person.

According to him, it is characterized by recurrent and intense sexual arousal from such actions and may include acting on these urges. 

This behavior typically occurs in crowded areas such as buses, elevators, sporting events, or other crowded public events.

Potential causes of paraphilic disorder

When asked about the factors contributing to paraphilic disorders, Afroilan cited several potential causes.

These are a history of sexual abuse, exposure to exhibitionist behavior, substance abuse, mental disorders like psychosis or antisocial personality disorder, and a strong self-admiration as potential contributing factors.

“Kapag may history ng sexual abuse kasi, na-expose sila dun sa mga taong nag e-exhibit ng mga organs nila, and that led them to mimic o gayahin yung ginagawa nung tao na yun para at least mapansin sila,” Afroilan said.

(If there is a history of sexual abuse because they are exposed to the people who exhibit their organs, and that (would) lead them to mimic or do the same thing that that person did before so that they can be noticed.)

‘Plain excuse’ debunked, treatment options

Afroilan also debunked the notion that individuals engaging in such behaviors were unaware of their actions and dismissed it as a “plain excuse.”

“It’s just a plain excuse, kaya nga nila ginagawa ‘yan for people to admire them, for people to see them, and to boost their desire. They have the confidence to show themselves. Wala silang pakialam basta mas lalo silang ma-satisfy,” he said.

(It’s just a plain excuse, that is why they do that (and) that is for people to admire them, for people to see them, and to boost their desire. They have the confidence to show themselves. They don’t care as long as they can satisfy themselves.)

When discussing treatment options, Afroilan said that individuals are often placed in communities with others who share similar experiences, a practice known as isolation or asylum treatment.

He also mentioned the existence of “naked communities,” where individuals could receive specialized treatment and connect with others who understand their struggles.

Afroilan further discussed medical interventions, mentioning the use of medications to decrease libido and reduce desire.

However, he noted that simple psychoeducation and therapy might not always be effective, as the primary motivation for these individuals would be to often desire for attention and validation.

They need help

Despite receiving advice or warnings, their urge to exhibit themselves to others persists, leading to a shift in behavior toward aggression.

“They really need help, pero mali yung sinasabe nila na hindi nila alam kasi alam nila ‘yun. Kaya lang, they are driven by instinct and that sexual gratification,” Afroilan said.

(They really need help, but it is wrong to say that they do not know what they are doing because they know what they are doing. It is just that they are driven by instinct and that sexual gratification.) / with reports from Futch Anthony Inso

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