The reasons why people desire to wear diapers and/or be treated as a baby are as diverse as the people themselves. Those with these desires are collectively called adult babies and diaper lovers (or ABDLs). As a first step towards diagnosis, let's divide the AB/DLs into four groups. There are two overlapping groups with only one symptom, a desire to wear diapers and/or be a baby. This desire is specific and persistent, and might be troubling. This group might be broadly diagnosed with paraphilic infantilism, a diaper fetish, or both. Next, there are those who might also enjoy diapers or babyhood, but don't have a deep and specific desire for them. Finally, there are those with multiple symptoms, including those desires. This first step might be the only practical one, except for those with multiple symptoms.
ABDLs with only the one symptom might have infantilism, diaper fetishism, or
both. Diaper fetishism is, of course, a fetish where the erotic focus is on
diapers. Infantilism is basically the desire to dress as and be treated as
a baby. It was briefly yet formally defined by the American Psychiatric Association in 1987[1] [2]. Both are categorized as paraphilias
.
Both infantilism and diaper fetishism are single-symptom diagnoses, like "headache" and "joint pain" were once. Since desiring diapers or babyhood isn't that serious medically, there has been little research. ABDLs seldom need or seek medical help [3] [4]. In the future, they might be divided into proper syndromes, where clusters of symptoms are used to differentiate between specific conditions. (The phrase "adult baby syndrome" was coined for a TV show script[4].)
There are some trends among ABDLs that might give some clues about their causes. That ABDLs tend to be male suggests a strong biologic influence[5]. An environmental influence is also present. This is clear from the birth order trends. For example, the second-born of three siblings is the least likely of the three to report being an ABDL, but the second-born of four is most likely[6]. ABDLs were also more likely to report having only older sisters than only older brothers[6]. Additionally, masochism (which arguably includes infantilism) is unique to the Western culture[7]. On average, an ABDL's preferred diaper is the one that was environmentally common during his early childhood, not necessarily the type he used as an infant.[8]. It is unknown whether this is the age range when the paraphilia forms, when the expression of an already-present paraphilia develops, or a mix of both.
There is, of course, no shortage of theories. One of the oldest might be Freud's proposal that fetishism was the result of castration anxiety[9]. This, like most theories from within sexology, lacks testability. However, some theories outside of sexology might be worth noting. For example, Freud's defense mechanisms might give plausible explanations even thought they aren't testable (eg "Three Things to do with a Wet Knee Brace"). Attachment theory might also shed some light on the paraphilias, especially infantilism.
In the past, stigmas against diapers and "queer" interests kept those without a driving desire from experimenting. In contrast, those with infantilism or a diaper fetish generally would be compelled to practice them. Unlike those with kinks, ABDLs with diaper fetishism or infantilism might have struggled against the desire for years or decades. They would also tend to have become interested early in life, and may have done so in isolation, thinking that they were the only ones.
For clarity, this group would include ABDLS who don't fit in the other groups. Those in the other groups may develop kinks as well.
However, there are other conditions that are disproportionately frequent among ABDLs. One example is Asperger's Syndrome, a disorder on the Autism Spectrum. 5% of ABDLs reported having been diagnosed with it[21]. They might come across as nerdy: Verbally articulate with specific interests, yet physically awkward with a difficulty reading emotions. Another would be Obsessive Compulsive Disorder, reported by 8% of ABDLs[21]. Only early-onset OCD matches the sex ratio and onset age ranges typical of ABDLs. They would have an irrational drive to act to avoid negative outcomes. Each of these conditions can be differentiated based on their other symptoms.
In contrast to the others, this group might have a more serious condition, but also might be able to expect a better-researched diagnosis and more developed treatment options.
Academic curiosity and the desire to understand one's self are great reasons to explore the roots of these desires. However, the causes might have more practical bearing on interpretations of the past and expectations for the future.
The ABDL's parents might be concerned that they did something to cause their child's desires for diapers or babyhood. In almost all cases, there is no reason to believe that the parents caused or could have prevented the development of infantilism and diaper fetishism. ( Almost all cases, that is. One exceptional surveyee reported that his father had rammed a coat hanger wire down his urethra, causing emotional trauma and incontinence. )
The ABDL, or his parents, girlfriend, etc., might be seeking a "cure." The prognosis, of course, hinges on which group the ABDL is in. A kink might be easily given up or traded in for another kink. In contrast, infantilism and diaper fetishism are persistent. They are generally lifelong, although the urges might fade in later life [22]. (The author has corresponded with one man who claims to have "outgrown" his infantilism at 53.) There is no known cure. One unfortunate patient endured chemical treatment to "cure" another paraphilia only to end up developing a desire for diapers and babyhood[23]. The best option might be to moderate damaging practices such as binge and purge cycles, and carefully evaluating the acceptability these desires in light of their situation and beliefs.
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