Exhibitionism

In 1824 indecent exposure was first specified as a criminal offence. Indecent exposure remained firmly in the realm of crime for another fifty years until Lasegue (1877) made the first of a series of medical attempts to have the behaviour recategorized ( Indecent Exposure ana Exhibitionism by Rooth in British Journal of Hospital Medicine, April 1971). The term exhibitionism is confined to those exposers for whom genital display to a member of the opposite sex is an end in itself. They are distinguished from those other exposers in whom the behaviour simply expresses a wish for intercourse or masturbation, or is the preliminary to an intended sexual assault (Rooth, 1971). "Indecent exposure of the male person with intent to insult a female is the statutory definition of the offence colloquially known as flashing". (Gunn and Taylor 1995). Clinically, it is the urge to expose the genitals, usually in front of strangers in a public place. It is one of the most common of heterosexual offences (Gunn and Taylor). Diagnostic Criteria: ICD-10 Code F65.2 WHO 1992 states: Exhibitionism is " a recurrent or persistent tendency to expose the genitalia to strangers ( usually of the opposite sex) or to people in public places, without inviting or intending closer contact. There is usually, but not invariably, sexual excitement at the time of the exposure and the act is commonly followed by masturbation." Diagnostic Criteria for DSM- IV Code No 302.4 Exhibitionism are as follows: "(A) Over a period of at least six months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviours involving the exposure of one's genitals to an unsuspecting stranger". "(B) The fantasies, sexual urges, or behaviours cause clinically significant distress or impairment in social, occupational, or other important areas of functioning". (DSM-IV of the American Psychiatric Association 1994 ). Despite its superficially innocuous nature, exhibitionism is a form of sexual disturbance that can be extremely persistent and disruptive. Sometimes the act is a crude form of sexual invitation used by the mentally impaired. (Gunn an Taylor 1995). Conviction rate for indecent exposure per one million males in England and Wales ( figures from Home Office) shows that adult conviction rate remained steady from 1948 to 1969 whereas the rates for those under 21 years of age have doubled since 1948 (Rooth 1971). Exhibitionism is mainly a disorder of males, but women sometimes indecently expose their genitals too. This may be done to please inmates, for exemple, during a prison visit (Gunn and Taylor 1995). The " flash" or "flash-up" may occur during prison visiting when a wife, girlfriend or even paid prostitute will briefly expose her breasts or lift her skirt having gone to the prison without the relevant items of underclothing (Morris and Morris 1963). The fantasies which accompany acts of exhibitionism, or during masturbation to memory of the scene of exbibitionism, give some clue to the complex inner meaning of this superficially irrational behaviour. If the victims appear shocked, or at least impressed by the act, this gives a feeling of sexual power and control, even though at a safe distance, and thus compensates for feelings of inferiority and inadequacy in real life ( Rooth 1971) . According to Gunn an d Taylor (1995): The conditioning effect resulting from constant repetition of their ritual act"may permit these men to attain maximal sexual arousal more easily in these situations than in what are for them nore threatening personal relationships". Gebhard et al. (1965) found that the majority of exhibitionists do not resort to violence, but 10% attempt or contemplate rape.