Though not necessary, this disorder can occur with fetishism (the person is sexually aroused by materials, garments, or fabrics) or with autogynephilia (the person is sexually aroused by thoughts or images of oneself as a female).Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
If a person has had a history of this disorder but it has not caused distress or impairment within the past 5 years, the person would be considered “in remission”
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