Brief Answer: Different factors could be causatory... Detailed Answer: Hello and welcome to Healthcare Magic. Thanks for your query. I understand that you are curious to know why you seem to be having certain sexual preferences, which may not be considered normal. From the description of your fantasies, it appears that you may be having what we call, in medical terms - a "sexual deviation" or "paraphilia". This, in simple words, means that a person derives sexual arousal through situations which are normally considered "atypical". Though the usually heard of sexual deviations are fetishism, cross-dressing, etc., the fantasy or sexual behaviour which you are describing would also fall into this spectrum of sexual deviations. Now, though it is quite common for most people to have sexual fantasies (which may or may not be enacted in reality), it is called a sexual deviation or a paraphilia if it becomes the only or most predominant mode of sexual arousal. The exact cause of such sexual deviations are not known, but from the research evidence we have and my clinical experience, I would say that it can be caused by the following few factors. Childhood trauma, such as sexual abuse is very often found to be associated with sexual deviations. Sometimes, objects or situations can become sexually arousing if they are frequently and repeatedly associated with a pleasurable sexual activity. In other words, initially, these fantasies may have cropped up unconsciously from previous memories or pornography, but as the person starts finding it more sexually arousing, and as he keeps thinking about then more and more, this may slowly become a "learned" or a "re-inforced" behaviour. In some people, emotional stress can be one of the precipitating factors for such sexual deviations. Many people, in fact, report an increase in such deviant sexual behaviour during times of increased stress. In order to gain a proper understanding into why you have developed such a specific sexual fantasy or deviation, you would need an in-depth psychological exploration. Psychoanalysis would be one option for doing this, but it usually requires a long time (usually months). However, if you are distressed by these fantasies / thoughts and would like to overcome them, there are short term psychotherapies available, which can help you "re-structure" your thoughts. One such effective therapy is called Cognitive Behavioural Therapy (CBT). This type of therapy targets both your thoughts and behavious in order to bring about the desired change. So, if you are interested in the above mentioned therapies, you can contact a psychiatrist or psychologist in your area. Regards, Dr. Jonas Sundarakumar Consultant Psychiatrist

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