ICD-116D34	FROTTEURISTIC DISORDER Frotteuristic disorder
ICD-10F65.8	Other disorders of sexual preference
DSM-5-TRF65.81	Frotteuristic Disorder

1. Definition and nosology

Frotteuristic disorder (ICD-11: 6D34; DSM-5-TR: F65.81) — persistent and intense sexual arousal from touching or rubbing one's genitals against a non-consenting person. The patient has acted on the fantasies or experiences significant distress/functional impairment. Typical context — crowded public transport and crowds.

2. History

• “Frotteur” — from the French word for “to rub”.
• DSM-IV (1994) — ‘Other Specified Paraphilia’; DSM-5 (2013) — separate category.

3. Epidemiology

• Prevalence: frotteuristic acts may occur in as many as 30% of adult males; 10–14% of adult males seen as outpatients for paraphilic disorders and hypersexuality meet the diagnostic criteria (DSM-5-TR).
• Comorbid other paraphilic disorders.

4. Aetiology and pathogenesis

General etiology for paraphilia; comorbid hypersexuality and impulsivity.

5. Clinical features

• Touching an unwilling person in crowded public places (bus, metro, crowd)
• Patient escapes — victim cannot complain immediately.
• Legal consequences (sexual harassment, sexual crime).

6. Diagnosis

6.1 Unified diagnostic criteria

A. ≥6 months persistent and intense sexual arousal from touching or rubbing against a non-consenting individual.

B. The patient has acted on fantasy or experiences significant distress.

6.2 Differences between sources

DSM-5-TR / ICD-11 — same; WFSBP 2020.

6.3 Diagnostic algorithm

1. Clinical interview.
2. Risk assessment.
3. Comorbidity.

6.4 Differential diagnosis

7. Examination and assessment

• Forensic clinical interview.
• Risk scales.

8. Treatment

1. WFSBP 2020 step‑by‑step:
   • CBT and prevention of relapse;
   • SSRI high dose;
   • Antiandrogen / GnRH in severe cases.
2. Legal-medical coordination.

8.1 Treatment methods

1. CBT and SSRIs + WFSBP 2020 protocol — same as 6D30/6D31/6D32 tiered.

9. Prognosis

Reduction of relapse with WFSBP intervention.

10. Myths and misconceptions

Myth 1: “Frotteurism is harmless”

Evidence: Trauma for victim; sexual crime and legal consequences.

Myth 2: “Just an impulse — does not require clinical intervention”

Evidence: repeated pattern requires clinical diagnosis.

Myth 3: “Only legal punishment”

Evidence: Clinical intervention reduces relapse.

11. Sources

1. WHO. ICD-11. 6D34 Frotteuristic disorder. 2024.
2. APA. DSM-5-TR. 2022.
3. Thibaut F., Cosyns P., Fedoroff J.P. et al.; WFSBP Task Force on Paraphilias. The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders. World J Biol Psychiatry 2020;21(6):412–490.