(542) Artificial Intelligence and Paraphilic Interests: Emerging Challenges in Contemporary Sexual Medicine

Introduction Artificial intelligence (AI) is reshaping the relationship between sexuality and technology, inaugurating new forms of interaction and expression of human desire by creating simulation contexts capable of mirroring, modulating, or intensifying sexual fantasies. Regarding paraphilias, this technological device introduces a zone of clinical and ethical ambiguity: it can function both as a safe vehicle for the expression of atypical sexual interests and as a potential risk factor for the crystallization and escalation of such patterns of sexual arousal. Given this panorama, understanding the multifaceted role of AI emerges as a crucial discussion within contemporary sexual medicine. Objective To review the literature on the role of AI in the expression of paraphilic sexual experiences, in order to explore and analyze its operation as: (i) a safe space for the expression of non-conventional sexual interests; (ii) a risk factor for the maintenance or intensification of restrictive paraphilic experiences; (iii) a potential tool for prevention and therapeutic intervention strategies. Methods A narrative review of the literature available up to 2024 was conducted, based on databases such as PubMed, Scopus, Web of Science, and preprint repositories (arXiv). The following descriptors were used: “artificial intelligence”, “paraphilias”, “sexuality”, “cognitive-behavioral therapy”, “sex robots”, and “sexual deepfakes”. Studies addressing ethical and clinical aspects, as well as therapeutic and preventive initiatives related to the impact of AI on paraphilic sexual interests, were included. Results Recent evidence indicates that technologies such as sex robots, erotic chatbots, and generative systems may enable the symbolic experimentation of fantasies, allowing controlled catharsis as a substitute for direct human interaction. At the same time, growing attention is being given to the potential use of AI as a therapeutic tool, capable of improving screening, detection, treatment, and prevention of sexual offenses and dysfunctional sexual behaviors. Conversely, algorithmic personalization, sexualized stereotypes embedded in language models, and the circulation of non-consensual content may reinforce patterns of objectification in relationships, intensify high-risk paraphilic behaviors, and promote a new form of AI-mediated sexual violence, a field difficult to regulate legally. Conclusions Despite initial advances, significant gaps remain, such as the lack of longitudinal studies and the absence of integrative theoretical frameworks and ethical regulation. Future research should prioritize multidisciplinary approaches guided by ethical principles to optimize the use of AI in sexual experience and prevent adverse outcomes. AI should be viewed as an ambivalent device whose impact on human desire and sexual behavior will depend on contemporary sexual medicine’s ability to integrate technological innovation with ethical responsibility and clinical empathy. Disclosure No