Patient Presentation
After seeing several adolescents in an afternoon, some residents and an attending were having a general discussion about adolescent sexuality. The attending noted it was important to gain the appropriate trust from the teen or young adult. “I try to be open to anything an adolescent may tell me and not to be surprised. Sometimes they will say something just to see if they can shock you, but most are saying something that is important to them or have questions because they just want to know about it. Often they are wondering if their bodies or their thoughts they are normal,” the attending said. He also stated that it was important to keep in mind that just because a person has sexual thoughts, feelings or performs certain sexual acts, these do not necessarily define the sexual orientation or sexual practices of an individual. He went on, “There is a difference between someone being curious or seeking novelty and more consistent or less common sexual practices.” One of the residents said, “I grew up around a lot of farms, and it was always the high school joke that some of the boys had their first sexual experiences with some of the animals on the farm. While it might have happened because of the opportunity, I don’t know how common it actually was or is.”

Discussion
Teens may also have normal curiosity and thoughts about sexuality and various sexual practices. They may also have the opportunity to explore or engage in some practices in person or through the Internet. For example, a teen inadvertently or purposefully watches sexual intercourse between his/her parents or between peers at a party. This is not a paraphilia or an atypical sexual interest.

“Paraphilias are defined as intense and persistent sexual interests outside of foreplay and genital stimulation with phenotypically normal, consenting adults.” Examples of paraphilias are voyeurism, exhibitionism, and fetishism. Most people with paraphilias do not have a mental disorder and people with paraphilias may or may not act on the interest. Paraphilic disorders are distinct from paraphilias. Paraphilic disorders occur when the atypical sexual interest causes distress or is bothersome to the individual, or in some way causes distress or injury to another individual. There are numerous paraphilias and paraphilic disorders that are named based on the sexual interest.

Learning Point
Zoophilia is a persistent sexual interest in animals. Bestiality is “the legal term for the criminal offense of engaging in sexual relations with an animal or animals.” Bestiality laws are common because of the harm to animals who obviously cannot provide consent. There is not a great deal of medical professional literature on the subject and overall the practice appears to be rare.

Three of the studies below (Holoyda and Newman, Ranger and Fedoroff, and Satapathy et.al.), cited the 1948 Kinsey report where he “…reported that 8 percent of males had participated in some form of sexual activity with animals and that 40-50 percent of boys growing up on a farm had sex with an animal at least once. Kinsey also reported that 1.5 percent of females had contact with animals before adolescence….”

Some limited data has found zoophilia/zoophilic disorder among people who were sexually abused, or are violent or sex offenders. One 2016 case report discusses an adolescent male who was illiterate, who had experienced childhood sexual abuse and lived near a farm. A meta-analysis by Seto and Lalumiere found a 14% rate of bestality among juvenile sex offenders (JSOs). In another study of JSOs, rates for bestiality was 3.9-38% for JSO in the literature the authors reviewed. Their own data showed 37.5% self-reported bestiality which increased to 81.3% when the JSOs underwent polygraph examination.

Questions for Further Discussion
1. What are treatment options for paraphilic disorders?
2. What are special health needs of incarcerated youth?
3. How common is teen violence?

Related Cases

Disease: Paraphilias | Sexual Health Issues | Teen Sexual Health

Symptom/Presentation: Health Maintenance and Disease Prevention

Specialty: General Pediatrics | Psychiatry and Psychology

Age: Teenager

To Learn More
To view pediatric review articles on this topic from the past year check PubMed.

Evidence-based medicine information on this topic can be found at SearchingPediatrics.com, the National Guideline Clearinghouse and the Cochrane Database of Systematic Reviews.

Information prescriptions for patients can be found at MedlinePlus for these topics: Sexual Health and Teen Sexual Health.

To view current news articles on this topic check Google News.

To view images related to this topic check Google Images.

To view videos related to this topic check YouTube Videos.

Kinsey A, Wardell C, Pomeroy B, Martin CE. Philadelphia: W.B. Saunders; 1948. Sexual Behavior in the Human Male.

Hensley C, Tallichet SE, Dutkiewicz EL. Childhood bestiality: a potential precursor to adult interpersonal violence. J Interpers Violence. 2010 Mar;25(3):557-67.

Seto MC, Lalumiere ML. What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis. Psychol Bull. 2010 Jul;136(4):526-75.

Holoyda B, Newman W. Zoophilia and the law: legal responses to a rare paraphilia. J Am Acad Psychiatry Law. 2014;42(4):412-20.

Ranger R, Fedoroff P. Commentary: Zoophilia and the law. J Am Acad Psychiatry Law. 2014;42(4):421-6.

Schenk AM, Cooper-Lehki C, Keelan CM, Fremouw WJ. Underreporting of bestiality among juvenile sex offenders: polygraph versus self-report. J Forensic Sci. 2014 Mar;59(2):540-2.

Satapathy S, Swain R, Pandey V, Behera C. An Adolescent with Bestiality Behaviour: Psychological Evaluation and Community Health Concerns. Indian J Community Med. 2016 Jan-Mar;41(1):23-6.

Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa Children’s Hospital