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Exhibitionistic disorder is a condition marked by the urge, fantasy, or act of exposing one’s genitals to non-consenting people, particularly strangers.

This condition is considered a paraphilic disorder, which refers to persistent and intense atypical sexual arousal patterns that are accompanied by clinically significant distress or impairment.

People with exhibitionistic disorder may have a preference to show their genitals to prepubescent children, adults, or both. Some people may deny that they show their genitals to unsuspecting others or deny that this act causes them distress; if they have indeed exposed themselves repeatedly to non-consenting people, they may still receive a diagnosis of exhibitionistic disorder.

The prevalence of exhibitionistic disorder is unknown, but it is thought to affect approximately 2-4 percent of the male population. This condition is less common in females, although prevalence estimates among females are unknown.

Acts of exhibitionism and having exhibitionistic disorder can be distinct. While exhibitionism involves exposing the genitals to become sexually excited or experiencing urges to be observed by other people during sexual activity, exhibitionistic disorder involves acting on those urges or fantasies and being distressed by or unable to function because of them.

Symptoms

A diagnosis of exhibitionistic disorder can be made if the following criteria are met, according to the DSM-5:

  • Over a period of at least six months, a person has recurrent and intense sexually arousing fantasies, behaviors, or urges that involve exposing the genitals to an unsuspecting person.
  • The person has acted on these sexual urges with a non-consenting person, or the urges or fantasies cause marked distress or interpersonal difficulty in the workplace or in everyday social situations.

Exhibitionistic disorder is categorized into subtypes based on whether a person prefers to expose him or herself to prepubescent children, adults, or both.

Like many other paraphilias, individuals can exhibit exhibitionistic urges or engage in exhibitionistic acts sporadically or occasionally without having exhibitionistic disorder.

What is an example of exhibitionism?

One of the classic examples of exhibitionism is the phenomenon of streakers at sporting events, those who get naked and run onto the field during play, exposing themselves to those in the stands (as well as those watching on television). Another example would be a man on public transportation or in another public place exposing himself to those around him.

Is sending nudes a form of exhibitionism?

It depends on the circumstances and the intention behind sending the nudes. In some cases, it might be, while in other cases there could be other social or psychological forces at work. Because those who send non-consensual explicit images typically have some kind of relationship with the target, it is not a direct analog. 

The research on sending nudes focuses primarily on men who send unsolicited nude pictures of themselves (or parts of themselves) to women. While unsolicited nude pictures may be an example of exhibitionism, other factors may play into the act as well, including gender power dynamics, a feeling of entitlement, or an earnest desire to begin a romantic relationship (what some call a “distortion of the normal courtship process”).

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Causes

While little is known about the risk factors for the development of exhibitionistic disorder in males, they can include antisocial personality disorder, alcohol abuse, and an interest in pedophilia. Other factors that may be associated with exhibitionism include sexual and emotional abuse during childhood and sexual preoccupation in childhood.

Some people who display exhibitionistic behavior engage in other paraphilias as well, and are consequently considered hypersexual.

The theory of courtship disorder as applied to paraphilias postulates that exhibitionists perceive their victims' shocked response to their behavior as a form of sexual interest. In the exhibitionists' mind, he is engaging in a form of flirting. However, the behavior is not harmless, and some exhibitionists go on to commit sexual crimes such as rape.

The onset of this condition typically occurs sometime in late adolescence or early adulthood. Similar to other sexual preferences, exhibitionistic sexual preferences and behavior may lessen as people get older.

Approximately one-third of sex crimes reported to the police involve incidences of exhibitionism.

Do exhibitionists typically suffer from other psychiatric disorders as well?

There is little research on the causes of exhibitionistic disorder, and what research does exist comes predominantly from men in the criminal justice system who have been convicted of sexual misconduct. Therefore, it is difficult to know about the psychiatric states of those in the general population. 

Conditions that occur along with exhibitionistic disorder can include depressive, bipolar, anxiety, and substance use disorders; hypersexuality; attention-deficit/hyperactivity disorder; other paraphilic disorders; and antisocial personality disorder.

What is the average age of onset for exhibitionistic disorder

Adult males with exhibitionistic disorder often report that they became aware of their sexual urge during adolescence, typically after the onset of puberty.

Treatment

Most people with exhibitionistic disorder do not seek treatment on their own, and don't receive treatment until they are caught and are required to do so by authorities. If you or someone you care about may have an exhibitionistic disorder, early treatment is strongly advised. The treatment for exhibitionism typically includes psychotherapy and medication.

Research suggests that therapeutic treatments can be effective in treating exhibitionistic disorder by providing individuals with tools to control their impulses and find more acceptable ways of coping with their urges than showing their genitalia to others.

Cognitive-behavioral therapy may help individuals identify the triggers that cause their urges and then manage these urges in healthier ways. Other psychotherapy approaches include relaxation training, empathy training, coping skills training, and cognitive restructuring (identifying and altering the thoughts that lead to exhibitionism).

Medications that may be helpful in treating exhibitionistic disorder include those that inhibit sexual hormones, resulting in a decrease in sexual desire. Some medications that are commonly used to treat depression and other mood disorders, such as SSRIs, can also reduce sexual desire.

What can I do if I have exhibitionist thoughts or urges?

If you have exhibitionist thoughts or urges, it’s important to seek help from a trained therapist who can help you find healthier ways to cope with your urges before you act on them, which can be damaging to those whom your actions affect.

Is exhibitionism illegal?

Yes. Each state has its own penal code, where punishments can range from a fine for a first offense to a felony for a repeat offense.

References
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
First, M. B. (2014). DSM-5 and paraphilic disorders. Journal of the American Academy of Psychiatry and the Law Online, 42(2), 191-201.
SexInfo Online, The University of California at Santa Barbara
Hayes, R. M., & Dragiewicz, M. (2018). Unsolicited dick pics: Erotica, exhibitionism or entitlement? Women’s Studies International Forum, 71, 114–120. https://doi.org/10.1016/j.wsif.2018.07.001
Clark, S. K., Jeglic, E. L., Calkins, C., & Tatar, J. R. (2014). More Than a Nuisance. Sexual Abuse, 28(1), 3–19. https://doi.org/10.1177/1079063214525643
Last updated: 03/22/2022