Male who maintains a collection of female clothing that he intermittently utilizes for cross-dressing describes the condition of Transvestic Fetishism (TF). This occurs in heterosexual males and is not part of Gender Identity Disorder. These heterosexual males may have very few sexual partners and have occasional homosexual relationships. When not cross-dressing, they may behave in stereotypic male fashion but this behavior may be quite feminine when wearing women's clothing. The actual wearing of an article, which may not be visible to the casual onlooker, It may be a means of reducing anxiety or depression. In in some cases, it may also give rise to gender dysphoria (discontent with one's own gender). Thus, the motivation for cross dressing may change over time. Clinically significant problems in social and occupational roles are most often the result.

Repeatedly for at least 6 months, a heterosexual male has intense sexual desires, fantasies or behavior concerning  cross-dressing.

This causes clinically important distress or impairs work, social or personal functioning.
    

Specify if With Gender Dysphoria. The patient is persistently uncomfortable with gender identity or role.

Associated Features:

Generally there is a moderate to severe coexisting personality disturbance. Frequently the person experiences considerable anxiety and depression, which he or she may attribute to the inability to live in the role of the desired sex.

Differential Diagnosis

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Gender Identity Disorder Not Otherwise Specified - Those who wish to belong to the other sex and to be rid of their own genitals.
Transsexualism.
Schizophrenia

Cause:
   

There is little understanding of the cause of TF, some therapists have theorized that, for some reason, a particular item or object, a pair of gloves, shoes, becomes associated with sexual gratification. This, for the person forms a permanent mental connection that may persist for years. Some therapist consider that one of the causes of this disorder is an avoidance response; or fleeing from the demands of human intimacy and find it less anxiety-provoking to engage in their paraphilia.
  

Treatment:
  

The major form of treatment revolves around psychotherapy although drugs are used in some cases.
  

Counseling and Psychotherapy [ See Therapy Section ]:
  
Cognitive, behavior, and psychoanalytic therapies are used to treat individuals with paraphilia's.
  

Pharmacotherapy [ See Psychopharmacology Section ] :
  

Some prescription medicines have been used to help decrease the compulsive thinking associated with the paraphilia's. Hormones may be prescribed occasionally for individuals who experience intrusive sexual thoughts, urges, or abnormally frequent sexual behaviors. Almost always the treatment must be long-term if it is to be effective.