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The British Journal of Psychiatry (1970) 117: 173-185. doi: 10.1192/bjp.117.537.173
© 1970 The Royal College of Psychiatrists
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Sexual Deviants Two Years after Electric Aversion

ISAAC MARKS M.D., D.P.M.1, MICHAEL GELDER M.D., M.R.C.P., D.P.M.2, and JOHN BANCROFT M.B., M.R.C.P., D.P.M.3

1 Senior Lecturer, Institute of Psychiatry, De Crespigny Park, London, S.E.5
2 Professor of Psychiatry, University of Oxford, Warneford Hospital, Oxford
3 First Assistant, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford

1. Twenty-four sexual deviants were treated by electric aversion for 2 to 3 weeks as inpatients and were followed up for two years. The patients comprised 12 transvestites and fetishists, 7 transsexuals and 5 sadomasochists. Nearly all patients were co-operative and well motivated; 9 were married, and 17 had some previous heterosexual experience.

2. Progress was assessed on ratings made after regular interviews with patients and their relatives by psychiatrists and a psychiatric social worker. Patients also filled in semantic differential scales at intervals.

3. After treatment, deviant acts and fantasies diminished considerably in transvestites, fetishists and sadomasochists. Deviant attitudes changed correspondingly. Improvement was usually maintained throughout follow-up, despite minor relapses. When normal before treatment, heterosexual behaviour continued so after treatment, Where heterosexual behaviour had been absent before treatment, improvement after treatment occurred more in heterosexual fantasies than in overt behaviour.

4. Improvement was transient or absent in the patients who had strong transsexual feelings.

5. Specific changes in attitudes occurred only in 'deviant concepts' related to treatment. Other concepts changed very little.

6. When marked depression, marital and interpersonal problems were present before treatment, these continued during follow-up, but improvement in sexual deviance was not accompanied by symptom substitution.

7. Evidence of conditioned anxiety was uncommon.

8. Improvement was not related to the amount of treatment: those who improved usually showed evidence of change early in treatment.

9. Sexual deviants who remained untreated changed less during 14 months follow-up.

10. Electric aversion produced worthwhile improvement in most patients who did not have strong transsexual feelings, but had to be part of a careful plan of clinical management.

Submitted on March 31, 1969




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