Pathological Sexual Stereotype Caused by Masturbation Using Porn Videos with Participation of Transsexuals/Transvestites

Male patient K, 21, had been living for 1 year with his 22-year-old girl. He sought our medical advice on October 8, 2021. He presented complaints about a periodical appearance of a desire to masturbate using porn with participation of transsexuals/transvestites (“non-normative masturbation”). The rate of development of such a desire depended upon the length of the period when he did not have sex with his girl as well as was associated with the state of his health: if he felt well he wanted to have sex with her; but when he was depressed, underconfident and jaded he developed a desire to make non-normative masturbation. He used the following porn plots: a “girl” with a penis or strapon made sex with a man, disguised as a woman, whom she inserted her penis or strapon into his rectum. And it was that girl who excited him. He did not have any sexual intercourses with transsexuals/transvestites in real life. He made the point that everything in having sex with his girl was normal, but an active enquiry managed to reveal that his sexual excitement and orgasm were more expressed in masturbation with use of the above porn rather than in sexual life with the girl. Four times (3–4 months before) that girl put on a strapon, inserted it into the patient’s rectum, but he disliked it (no pleasant sensations were felt) and gave up that practice. Non-normative masturbation began from the age of 14–15, but was not constant. When in February of 2020 the patient’s father died, his condition became grave and he intensively made non-normative masturbation. Then twice he masturbated directly via videolink looking at a man with his naked penis, who looked like a woman, and told his girl about it (he did not know why). Her reaction to it was stormy and she became jealous of him that brought her to a psychologist and later to a psychotherapist. Later during masturbation he resorted to the above porn plots. At the time of referral his sexual activity with his girl was once a week, since she did not want to live sexual life as often as he did (both because she worked much and because of the jealousy she developed). Our investigations made it possible to conclude that the patient’s long-term masturbation using non-normative porn video plots with involvement of transsexuals/transvestites resulted in formation of his pathological sexual stereotype, which manifested with decreased sexual excitement and weakening of orgasm in heterosexual intercourses. Also the patient developed a drive to the above non-normative masturbation. The following treatment was provided: a talk directed at explanation of causes of his disorder; a ban was imposed on making masturbation, including non-normative one; 10 sessions of hypnosuggestive therapy, which played a key role in therapy. During hypnotic sessions we made suggestions directed at (1) getting rid of the desire to masturbate and the drives to masturbation, which also included use of transsexual/transvestite porn plots; (2) increasing of sexual desire to women in general and his sexual partner in particular; (3) programming of the normal course of coitus with his girl. We also used suggestion, which programmed good mood. The treatment, which lasted 1 month, resulted in recovery: the desire to masturbate using the above non-normative porn video plots absolutely disappeared, the expression of sexual excitement and orgasm in sexual life with his girl achieved maximum. The patient characterized that sex as “roarsome”