The hallmark of fetishism is long-standing compulsive sexual interest in non-living objects that are used to generate sexual excitement. Fetishism is an exaggeration of normal sexual interest (DSM-IV code 302.81; ICD-10 code F65.0).(34) Males without fetishistic interests report sexual interest and attraction to objects worn by their sexual partners such as brassières, panties, garter belts, hose, shoes, and boots. Typically, they purchase these objects for their sexual partners because it adds to their sexual arousal. However, fetishism is an extreme exaggeration of an attachment to objects. Fetishists can become sexually aroused to unusual acts, such as blowing up balloons or imagining triangles turning in space, and may go to extremes to obtain fetishistic objects (e.g. breaking into homes to steal, touch, and masturbate with women's underwear). In some cases, fetishists will become excited by specific parts of their partner's anatomy (e.g. feet or breasts); this variant of fetishism is called partialism. In other cases the fetishist is excited by the sight of a person with an amputation (apotemnophilia). It has been reported that, rarely, the person may even request an amputation/.7)

Fetishism begins at an early age and does not require the active participation of a partner. Consequently, fetish objects can be paired and associated with masturbation and orgasm hundreds of times before others become aware of their influence over an individual's sexual interest. As the fetish object becomes more ingrained in an individual's sexual arousal pattern, the fetishist finds it difficult to relate sexually without the inclusion of the object. Sexual partners are initially naive to the extent of the fetishist's attachment to these objects. As relationships progress, however, fetishists' interests in fetish objects become more dominant, with conflict usually erupting over the extent to which use of the fetish object intrudes into the relationship.

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