For thousands of years, people have gotten body modifications like tattoos and piercings for a variety of reasons. Sometimes it’s tied to specific cultural practices, like the face tattoos of the Maori and Inuit people. Other times, people use tattoos and piercings to share their personal stories and experiences, like a semicolon tattoo for mental health awareness or an engagement piercing.

All to say that tattoos are pretty common and have been for a long time—as has being attracted to those who have them. Research has shown that cis women, for example, tend to find tattooed men healthier and more “masculine” than men without body modifications, and a 2017 survey conducted by the UK dating app Type reportedly found that two-thirds of female respondents were attracted to men with tattoos.

However, some folks get sexual gratification from the tattoo (or piercing) itself. What is this sexual interest, and what does it entail? Here’s a look into stigmatophilia and how to navigate this sexual interest in relationships.

What is stigmatophilia?

If you get sexually aroused from body modifications, you may have stigmatophilia. According to Kendra Capalbo, LICSW, a licensed sex and couples therapist at Esclusiva Couples Retreats, stigmatophilia is “sexual paraphilia in which sexual pleasure and arousal [are] related to a partner having tattoos, piercings or scars.” Paraphilias, in case you aren’t familiar with the term, are recurring and persistent sexual interests or behaviors that are considered “atypical” by societal standards. They generally aren’t considered a mental health condition, with some exceptions if the paraphilia is distressing the person who has it, or if it requires harming another person. (Not typically the case with stigmatophilia.)

A person with stigmatophilia can be aroused by someone else’s tattoos or scars, or gets aroused from getting tattooed themselves. “[Stigmatophilia] can be displayed by feeling turned on at, say, a tattoo shop seeing people with tattoos or knowing you are about to get one,” says Lyndsey Murray, an AASECT-certified sex therapist at Relationship Matters Therapy.

“[A person with stigmatophilia] may be someone who only chooses partners that have art—tattoos or piercings—on their body, or they may be someone who has a lot of art on their body because it turns them on if they look that way,” Murray adds.

Stigmatophilia originally referred to people who were aroused by scarification (intentional cutting to create patterns or different skin textures) but has since been expanded. “Recently, this definition [of stigmatophilia] has been expanded to account for those who are sexually aroused by tattoos, piercings, and any other body modifications, especially on the genitals and nipples,” says Rebecca Alvarez Story, a certified sexologist and the CEO and co-founder of Bloomi.

How common is stigmatophilia?

There’s limited research on stigmatophilia, but Story says that paraphilias in general are more common among men than women: “Since sex drive is on average higher in men, it can fuel the motivation to seek out a higher variety of sexual activities, interests, and partners.” (Unclear how that plays out among trans and genderfluid folks—there just isn’t enough data to say.)

However, some tattoo artists say they have encountered stigmatophilia in their own shops. John Johnson, the owner of New Flower Studio in Long Beach, California, and an online education administrator for the Association of Professional Piercers, has had a few instances where his clients became erect or made sexual comments during the piercing experience. “I don’t know if this is specifically a result of them being aroused or just a biological reaction to being handled, cleaned for the procedure, and being examined,” says Johnson.

“Different people enjoy and appreciate different things sexually, and I think that’s just human.” —John Johnson, owner, New Flower Studio

Johnson also mentions that couples have kissed or had sexual conversations during a piercing appointment. Still, he’s okay with them creating a sexual environment if it doesn’t cross his boundaries. “I communicate my boundaries very clearly, and like all piercers, I maintain control of the piercing room.”

Emmanuel Fortunato, a tattoo artist at Mad Rabbit in New York City, says he hasn’t had a client confess to becoming sexually aroused from getting a tattoo but understands that a tattoo “is something very personal, where you submit your trust and make a compromise for the rest of your life, which is exactly why it would not surprise me if someone felt more intense feelings.”

“I would think [stigmatophila] is very normal,” says Johnson. “Different people enjoy and appreciate different things sexually, and I think that’s just human.”

Can stigmatophilia ever be a cause for concern?

Story reiterates that stigmatophilia “isn’t considered to be [a] perversion or mental illness” and is not “an uncontrollable desire that can only be satisfied by performing a sexual act.”

However, Capalbo notes that if a person requires continuous body modifications to feel aroused, their stigmatophilia can “reach the level of a disorder and thus [be] a legitimate health concern.”

For example, Capalbo mentions that a person with stigmatophilia may have the urgent and repetitive need to touch or get several body modifications. This compulsivity may lead to a person “risking getting infections and regretting a decision at a later stage,” says Capalbo. (If the tattoo artist doesn’t use sterile equipment, there’s an increased risk of developing infections like hepatitis C or HIV.)

“It’s okay if someone wants to have their entire body covered in body art, just make sure the needles and material are clean, legitimate, and not shared with others if you decide to do so,” says Murray.

Additionally, if someone is experiencing signs of distress or discomfort from stigmatophilia, they should seek help from a mental health professional.

Navigating stigmatophilia in romantic and sexual relationships

If you have stigmatophilia, being open about it with your partner(s) can certainly benefit your romantic and sexual relationships. According to Capalbo, it can “add sexual excitement and pleasure both for an individual as well as partners and ‘spice up’ their sex lives, make you feel close to other like-minded people, and allow them to explore your sexuality.” Sharing these desires, and exploring them with your partner(s), can also encourage self-confidence, she says.

“As with every relationship, it is important for all partners to be honest with each other and communicate their sexual wants and needs,” adds Story.

Having a conversation about sexual interests can be nerve-wracking, but it’s important to be open and honest. “Provide some context to your partner as to what triggered this in the first place and what exactly you like or dislike,” Capalbo suggests. “A mutual understanding and direct and honest conversation with your partner will help you in navigating through incorporating or not incorporating new elements into your relationship and sex lives.”

If your partner(s) cannot meet your sexual interests, Murray says you should “explore other ways to meet your needs, perhaps including watching ethical pornography together that involves individuals who do have tattoos and piercings.

The bottom line: Stigmatophilia is part of the vast mosaic of the human sexual experience. If getting inked gets you off, then by all means explore it (safely).