The Psychology of Gay Sexual Fetishes: A Gay Men’s Therapist Explains

Michael Pezzullo
Aug 18
4 min read

When it comes to sex, few topics spark as much curiosity—and confusion—as fetishes. In today’s culture, we casually throw around terms like kink and fetish, but many people don’t fully understand what they mean, where they come from, or how to approach them in a healthy way.

As a gay men’s therapist, I often work with clients who feel conflicted about their sexual desires. Some worry their fetish is “too weird,” while others wonder if it’s unhealthy or a sign that something is wrong. My goal is to reframe fetishes as a natural part of human sexuality, while also helping gay men explore them with intention and self-compassion.

In this article, I’ll break down the psychology of fetishes—what they are, where they come from, how to decide whether they’re healthy, and what they mean for gay men in particular.

What Is a Fetish?

A fetish is typically defined as sexual arousal linked to an object, material, body part, or activity that isn’t inherently sexual. Common examples include feet, leather, underwear, or specific role-play scenarios like pup play.

Think of it this way: while sex organs are “naturally” sexualized, fetishes take something outside of that category and infuse it with erotic charge. For instance, leather itself is just a material—but in the gay community, it’s strongly associated with power, masculinity, and erotic authority.

It’s also important to remember that fetishes exist on a spectrum. Some are relatively mainstream (like feet), while others may be more niche or symbolic. The diversity of human sexuality means there’s no single “right” or “wrong” fetish.

What Causes Fetishes?

The origins of fetishes remain somewhat mysterious. Science hasn’t pinpointed a single explanation, but several theories exist:

Neurological wiring: Some studies suggest foot fetishes may be linked to overlapping neural pathways in the brain between sensory areas for feet and genitals.
Taboo and secrecy: Fetishes often involve the thrill of what is hidden, forbidden, or socially transgressive. This “taboo factor” can amplify arousal.
Psychological dynamics: Many fetishes involve power, submission, and dominance—core dynamics that naturally evoke strong emotional and erotic responses.
Early experiences: While not always the case, some people link their fetish to early memories or exposures during formative years of sexual development.

Ultimately, we don’t fully know why one person is drawn to feet while another is drawn to leather. What’s clear, however, is that fetishes are both common and deeply human.

Are Fetishes Healthy?

A common concern I hear as a gay men’s therapist is: “Is my fetish normal? Is it unhealthy?”

The short answer: most fetishes are completely healthy. The key is how they’re expressed and integrated into your broader sexual identity.

Here are a few reflective questions to ask yourself:

Does this fetish feel affirming and exciting, or does it cause me shame?
Is it mutually enjoyable with my partners, or does it create conflict or discomfort?
Am I practicing safety, consent, and clear boundaries as I explore it?
Is this fetish just one part of my sexuality, or has it become the only way I can feel aroused?

If your fetish is affirming, consensual, and part of a diverse sexual life, then it’s likely healthy. If it begins to feel compulsive, isolating, or limiting, that may be a signal to explore it further in therapy.

Fantasy vs. Reality

One of the biggest questions around fetishes is whether they should stay in the realm of fantasy or be acted out in real life.

Interestingly, many people discover that a fetish is most satisfying in their imagination. The fantasy can feel erotic, mysterious, and thrilling, but when brought into reality, it may not live up to expectations. For example, someone who fantasizes about leather play may find that the actual experience feels less intense than the fantasy version.

That doesn’t mean fetishes shouldn’t be explored in real life—it just means to approach them with curiosity rather than rigid expectations. If you decide to act on a fetish:

Prioritize safety above all else.
Communicate clearly with your partner(s).
Keep expectations neutral. Sometimes “trying it out” is more about curiosity than chasing ultimate pleasure.

Do Gay Men Have More Fetishes?

The short answer: not necessarily. Fetishes exist across all genders and sexual orientations. But gay men may feel freer to express them.

Here’s why:

Cultural permission. The gay community often creates space to explore sexuality outside of rigid norms. Straight men, in contrast, are often discouraged from expressing sexual curiosity beyond “vanilla” sex.
Community and subcultures. Gay men have built communities around fetishes—such as leather culture, pup play, and kink networks—that normalize exploration.
Internalized shame. At the same time, gay men must be cautious about self-judgment. Many of us unconsciously filter our desires through guilt or moral judgment, instead of curiosity and openness.

In other words, gay men may not have more fetishes than others—but we often have more visible subcultures that support their expression.

The Deeper Meaning: Look for the Theme

Behind almost every fetish is a psychological or symbolic theme. Understanding this theme can help you connect with your fetish in a more integrated way.

For example:

A foot fetish might reflect themes of vulnerability, intimacy, or taboo.
A leather fetish may embody power, authority, or protection.
Pup play might symbolize surrender, belonging, or freedom from control.

When you look beyond the surface, you often find that fetishes are less about the object or act itself, and more about the feelings, emotions, and dynamics they evoke.

Embracing Fetishes as a Gay Men's Therapist

At the end of the day, fetishes are just one facet of human sexuality. For gay men especially, embracing them with curiosity rather than shame is a powerful act of self-acceptance.

As a gay men’s therapist, I encourage clients to view fetishes not as problems to be “fixed,” but as opportunities for exploration. With reflection, communication, and safe practice, fetishes can enrich your sex life, deepen your relationships, and reveal new insights about your erotic self.

So if you’ve ever wondered about your own fetish, try asking: What theme does this represent for me? What emotions or dynamics are at play? And how can I explore it in a way that feels safe, joyful, and affirming?

The more we approach fetishes with openness, the more we realize they’re not strange or shameful—they’re simply part of the endlessly diverse ways humans experience desire.

If you’d like to learn more about my practice, you can book a complementary consultation. You can also read more about my psychotherapy work with gay men.