Co-Ending Paraphilias: A Case Study

Other paraphilias have a co-occurrence with transvestic fetishism (Lawrence, 2009). There is also co-occurrence of non-paraphilic hypersexuality (Langstrom, 2005). Lawrence reminds clinicians that non-homosexual male transgenderism can be understood to be an outgrowth of autogynephilia, however, the increased prevalence of the other paraphilic sexual interests in these men is predictable (2009). Predicting the possible presence of co-occurring paraphilias will give clinicians and psychiatrists information to develop a more effective treatment plan.
Treatment for paraphilias did not begin until the late 19th century and was initially treated with surgical castration (Gordon, 2008). The idea behind surgical and physical castration is to reduce sexual interest and performance (Beech & Harkins, 2012). Drugs that can be utilized in chemical castration are cyproterone acetate, medroxyprogesterone,
The United States first used medroxyprogesterone acetate and more recently luteinizing hormone release hormone (LHRH) agonists are used (Gordon, 2008). This began when sexual deviance was labeled as a medical condition (Gordon, 2008). Research was conducted on testosterone and paraphilias, namely looking at antiandrogen drugs such as cyproterone acetate (CA), medroxyprogesterone acetate (MPA), and gonadotropin-releasing hormone antagonist (GnRH) (Fromberger, Stolpmann, & Müller, 2011). These drugs are used to decrease testosterone levels, but findings have either been moderate or inconsistent (Fromberger, Stolpmann, & Müller, 2011). The benefit and risk ratio is not in favor of the use of medroxyprogesterone acetate (Garcia &