(178) AN OVERVIEW OF ASSISTANCE PROGRAMS FOR PATIENTS WITH PARAPHILIC DISORDERS
Authors: Torres De Sá Urtiga Rego KF , Vidal Medeiros J , Morais Braga C , Sampaio M , Sousa Luz JH , Lemos Bremberger L , Vasconcelos Dos Santos LA , Becher G 
Published: December 2024

Abstract

Introduction
Sexual health is a fundamental aspect of individuals’ quality of life. To enjoy this dimension of life depends, among other factors, on access to qualified sexual healthcare services if needed. However, specialized healthcare spaces for individuals with paraphilic disorders (PD) are scarce. The development of rehabilitation programs for individuals with PD requires a combination of clinical interventions tailored to individual needs, promotion of accountability, behavior change, and attention to the overall well-being of participants.

Objective
To discuss, through a descriptive review, the importance of promoting specialized assistance programs for individuals with PD within sexual healthcare services.

Methods
This work was constructed using a descriptive and review method.

Results
To have access to non-discriminatory sexual healthcare services, that offer active listening, guidance, prevention, and clinical management of sexual issues, is fundamental for promoting healthy exercise of sexuality. In general, such services address conditions such as sexual dysfunctions, reproductive health, sexual violence, sexually transmitted infections, and gender affirmation processes. However, they are unprepared to assist individuals with PD, due to the social stigma surrounding unconventional sexuality. There is evidence that specialized monitoring can reduce the recurrence of sexual crimes. However, when it comes to PD, legal interventions take precedence over sexual healthcare. Such care requires an ethical, humanistic, multidisciplinary, and patient-centered approach and should include: (1) Comprehensive psychological and psychopathological diagnostic assessment; (2) Education and awareness regarding healthy and pathological sexual experiences, consent, empathy, communication, and identification and prevention of triggering situations; (3) Individual or group psychotherapeutic intervention, focusing on individual sexual thoughts, emotions, and behaviors; (4) impulsivity control and psychiatric comorbidities; (5) Social rehabilitation to promote responsibility, empathy, social skills, and, for individuals convicted of sexual crimes, preparation for social reintegration after serving their sentence; (6) Post-treatment follow-up, providing support for relapse prevention and community reintegration; (7) Interdisciplinary approach among professionals from different areas of clinical and social care; (8) Respect for Human Rights. To deal with individuals with PD, it is necessary, initially, to differentiate PD from paraphilias and other healthy manifestations of sexual desire, which requires knowledge typically absent from academic training in healthcare. This emphasizes the importance of creating assistance programs for individuals with PD, according to the aforementioned guidelines.

Conclusions
While scietific literature suggests that monitoring individuals with PD, who have a history of sexual crimes, may reduce its recurrence, proposals for policies addressing PD as a healthcare situation are limited. This highlights the improbability of healthcare provision for these individuals, as a result of protocols poorly grounded in technical and scientific knowledge. Conversely, the expansion of existing programs and the implementation of new, accessible sexual healthcare services prepared to offer clinical and psychological support for individuals with PD are recommended.

Disclosure
No.