Joyal · Sexual medicine 2015 · cross-sectional survey · n=1501

Defining "Normophilic" and "Paraphilic" Sexual Fantasies in a Population-Based Sample: On the Importance of Considering Subgroups.

Cited 58 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional survey using cluster analysis

PubMed 26797067 · doi:10.1002/sm2.96 · record verified 2026-08-27

What was done

Researchers administered a revised version of the Wilson Sex Fantasy Questionnaire to 1,501 adults recruited from the general population. Multiple correspondence analysis (MCA) was used to identify distinct participant subgroups and profiles based on the nature and self-reported intensity of "normophilic" and "paraphilic" sexual fantasies according to DSM-5 definitions.

What was found

Across the total sample, the mean intensity of the most common normophilic fantasy (oral sex) was significantly higher than the top paraphilic fantasies (being sexually dominated for women; watching two women have sex for men). However, cluster analysis identified four distinct subgroups (two predominantly female, two predominantly male) where participants reported at least one paraphilic fantasy with an intensity equal to or greater than their top normophilic fantasy. Overall, 57% of the general population sample met DSM-5 criteria for paraphilia based on fantasy intensity.

Why it matters

These findings suggest that DSM-5 criteria based on fantasy content and intensity overpathologize normal variations in sexual interest. The study underscores the necessity of distinguishing common sexual fantasies from pathological paraphilic disorders.

Limits

The study relied on cross-sectional self-report questionnaires, which are susceptible to reporting bias. The abstract does not report exact numerical means, standard deviations, or demographic characteristics, nor did the analysis measure clinical distress, functional impairment, or actual sexual behaviors.

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