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2025 ICD-10-CM code F65.1

Transvestic fetishism is a paraphilic disorder characterized by recurrent and intense sexual arousal from cross-dressing, causing significant distress or impairment.

The diagnosis should not be made if the cross-dressing behavior is solely for reasons other than sexual arousal, such as performance art or cultural expression. Differentiate from gender dysphoria.

Medical necessity for treatment is established by the presence of clinically significant distress or impairment in social, occupational, or other important areas of functioning due to the transvestic behavior.

Clinicians diagnose transvestic fetishism based on patient history and psychiatric evaluation. Treatment may include psychotherapy to help reduce symptoms and address associated distress or impairment.

In simple words: Transvestic fetishism is a condition where someone experiences sexual excitement from dressing in clothes of the opposite gender. This causes distress or problems in their life.

Transvestic fetishism, also known as transvestic disorder, primarily affects men. It typically begins in childhood or adolescence and involves persistent urges to cross-dress for sexual gratification. Individuals may wear a single item of clothing associated with the opposite sex or a complete outfit, sometimes including makeup and hairstyling.Shame, guilt, and anxiety may result from societal disapproval or personal conflicts. A diagnosis requires symptoms to be recurrent for at least six months and cause significant distress or impairment in social or occupational functioning. Transvestic fetishism is distinct from gender dysphoria, although other paraphilias or mental health/substance use disorders may coexist.

Example 1: A 30-year-old male experiences intense sexual arousal from wearing women's lingerie. He engages in this behavior secretly and feels significant shame afterward, impacting his relationships and self-esteem., A 20-year-old female experiences sexual gratification from dressing in men's clothing. She has been doing this since adolescence and it causes her significant distress due to fear of judgment from others., A 45-year-old male is court-ordered to undergo evaluation due to concerns about his cross-dressing behavior. He acknowledges deriving sexual pleasure from wearing women's clothing but does not feel distressed by the behavior itself.

Documentation should include a detailed patient history, including the onset, frequency, and nature of cross-dressing behavior.The patient's subjective experience of arousal, distress, and impact on functioning should be documented.Any associated mental health or substance use disorders should also be noted.

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