From Onanism to Masturbation—A Comprehensive Overview on Matters of Behavioral Specificity, Hypotheses of Function and Associated Aspects of Pathology

Objectives This review concentrates on the solitary sexual activity of masturbation in adult males and females. Specifically, it incorporates its historical trajectory, matters of specification, hypotheses of function, and associated aspects of pathology within the framework of sexual science. A synthesis of the aforementioned is presented and narratively discussed.Methods A comprehensive literature search was conducted, leading to a narrative overview of masturbation that consists of sources spanning a period range from the early 20th century to the present. A majority (70%) of these sources fall within the 2009–2025 timeframe, and all sources referenced were published in English.Results Influenced by a wide range of biological, socio-cultural, and individual variables, masturbation emerges as a multifaceted sexual behavior. The evolution from onanism to masturbation reflects a rich history marked by pivotal moments, involving contributions from various fields—such as medicine, epidemiology, ethology, sexology, and psychology—each challenging longstanding misconceptions surrounding the act, ultimately advancing a more comprehensive understanding of the full spectrum of human sexuality. Through this holistic examination and its critical synthesis, masturbation manifests as an integral aspect of human behavior. Understudied and unexplored dimensions, as well as avenues for further empirical investigation are identified.Conclusion Masturbation is recognized as a normal, widespread, and prevalent sexual behavior, consistently associated with various aspects of sexual health and overall well-being. However, its impulsive-compulsive, ego-dystonic, and atypical manifestations have been systematically associated with various aspects of pathology. A need to revisit understudied hypotheses about its function is identified, along with the imperative for greater behavioral specificity in empirical enquiry. Ultimately, the term ‘masturbation’ is reconsidered upon a final reflection, and discussed alongside a proposed alternative term, ‘sexual autostimulation.’