Exam‑Room Paraphiliac

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Medical Professional Attraction

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Most fantasies remain within one’s head. But sometimes they migrate into reality. A few patients might have a paraphiliac proclivity towards doctors or nurses that exaggerates their perception of beauty and mutual attraction. The uniform may trigger exigent sexual attraction.

Inappropriate Conduct

The American Medical Association (AMA) clearly states that sexual contact that is con­current with the doctor/patient relation­ship constitutes sexual misconduct. But it takes a fuzzier position on relation­ships that might develop later.

According to the 2020 Medscape Internal Medicine Ethics Report, 60% of more than 5,000 physicians surveyed, outright condemn a romantic or sexual relationship with a patient. Only a tiny minority (1%) give romance with current patients a green light, but a sizable share (30%) say that a romantic relation­ship with a former patient may be acceptable, at least 6 months after the profes­sional relationship terminates.

It gets murkier when some weigh the type of medical care. Eye exams are considered by some professionals to carry less weight than oncology, gynecology, or psychology. But the white-coat fetish may eschew boundaries.

A common occurrence of white-coat attraction is a patient who is flirtatious with medical professionals. They may be doctors, nurses, or dental hygienists.

A Step Beyond Sex Addict

While some medical professionals distinguish between fetishes (lifeless objects) and paraphilias (animate beings), MedicineNet categorizes fetishes as a subset of paraphilias.

The broader definition of fetishes identifies obsessions and problems with controlling impulses. These are characterized by amoral recurrent and intense sexual fantasies, urges, and behaviors involving unusual objects, activities, or situations not considered sexually arousing to others. In fact, the general public may view the behavior as distasteful or perverted.

Objects or situations can become arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. Twenty times more common among men than women, paraphiliac urges and behaviors can cause significant distress (anxiety, depression) and/or personal, social or career problems. A long list of celebrities, politicians, and athletes have gone into rehabilita­tion centers for deviant behavior.

To be most effective, professionals recommend long-term paraphiliac treatment with diligent patient compliance. There is no single unifying theory that adequately explains the pathogenesis of sexual impulse disorders.

Currently, doctors may prescribe two distinct classes of psycho­pharma­co­logical agents: anti­androgens and serotonergic anti­depressants. It is imperative that people with paraphilia of an illegal nature receive professional help before they harm others or create legal repercus­sions for themselves.

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