[2] A sexual fetish may be regarded as a mental disorder if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life.

[6] Originally, most medical sources defined fetishism as a sexual interest in non-living objects, body parts or secretions.

This is dangerous due to the issue of hyperactive pleasure seeking which can result in strangulation when there is no one to help if the device gets too tight and strangles the user.

In several experiments, men have been conditioned to show arousal to stimuli like boots, geometric shapes or penny jars by pairing these cues with conventional erotica.

[12] Imprinting seems to occur during the child's earliest experiences with arousal and desire, and is based on "an egocentric evaluation of salient reward- or pleasure-related characteristics that differ from one individual to another.

In order to be diagnosed as fetishistic disorder, the arousal must persist for at least six months and cause significant psychosocial distress or impairment in important areas of their life.

In the DSM-IV, sexual interest in body parts was distinguished from fetishism under the name partialism (diagnosed as Paraphilia NOS), but it was merged with fetishistic disorder for the DSM-5.

[1] The ReviseF65 project campaigned for the International Classification of Diseases (ICD)’s fetish-related diagnoses to be abolished completely to avoid stigmatizing fetishists.

[19] On 18 June 2018, the WHO (World Health Organization) published ICD-11, in which fetishism and fetishistic transvestism (cross-dressing for sexual pleasure) are now removed as psychiatric diagnoses.

Moreover, discrimination against fetish-having and BDSM individuals is considered inconsistent with human rights principles endorsed by the United Nations and The World Health Organization.

[20] According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress.

Aversion therapy and covert conditioning can reduce fetishistic arousal in the short term, but requires repetition to sustain the effect.

Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain.

Some hospitals use leuprorelin and goserelin to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens.

A number of studies support the use of selective serotonin reuptake inhibitors (SSRIs), which may be preferable over antiandrogens because of their relatively benign side effects.

[21] Relationship counselors may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing.

If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).

[23] Another study found that 28% of men and 11% of women reported fetishistic arousal (including feet, fabrics, and objects "like shoes, gloves, or plush toys").

[29] Richard von Krafft-Ebing and Havelock Ellis also believed that fetishism arose from associative experiences, but disagreed on what type of predisposition was necessary.

Today, Hirschfeld's theory is often mentioned in the context of gender role specific behavior: females present sexual stimuli by highlighting body parts, clothes or accessories; males react to them.