Culturally, of course, it's deemed non-standard and again, older versions of the DSM lumped it in with Transvestic Fetishism. The person may change their lifestyle to more closely fit their needs, and may act on their desires. For example, a male who is aroused by a woman's breasts does not have a breast fetish in the clinical sense of the word. A transgender or transsexual person is someone who undergoes surgical, hormonal, and psychological procedures to shift their sex to the opposite sex. Referred to as "standard", "optional", and "low level". Many psychologists try to find patterns of behavior to distinguish between "levels" of paraphilia, to measure how much the paraphilia affects the individual. Safe words and other tools are used to make sure consent is always given, though some members of paraphilia groups have reported and written articles where they claim to feel ashamed if they use their safe word. There is research indicating that paraphiliacs have higher libidos than normal people, and are more likely to experience sexual addictions related to their paraphilia. Here is my hypothesis: In fact, love, sex, pain and violence all stimulate the release of similar chemicals and hormones in the human body. This means that some paraphilias are not clinical paraphilias but do not qualify as fetishes either, particularly "action" based paraphilias like biastophilia or lust murder. Mental health issues[ edit ] Aside from mental health issues caused by negligence in supervising someone's mental health in a relationship, or identity crisis and shame caused by a paraphilia being illegal, a person can have mental health issues that stem from the paraphilia itself. The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life. A 25 year old male engaging in sexual contact with a 15 year old female is not pedophilia. They are incapable of arousal except through the subject of their paraphilia. Normal human biological response actually supports the complex and mysterious link between pain and pleasure, which we see in the runner's high and the facial expressions during orgasmic release. Alternate terms for the condition have included Biastophilia,  Coercive Paraphilic Disorder,  and Preferential Rape.