I've have recently realised something that must be the same (or at least common) for masochistic fetishes. Whereas the fetishes are often a sexualization of an experience of overwhelming psychological distress or trauma, as a means to be able to cope with the experience if it happens again, or rather a "coping mechanism". An interesting thing is that in the newly sexualized framework, the psychological distress remains but is obscured due to its connection to arousal. So the subject is given the impression that the object of which was once distressing, is a soley positive enjoyable object, due to its correlation with arousal, or as it is often the case early in life where one is unable to recognise arousal, the object of distress is simply experienced as a positive fixation or curiosity. In parrallel to this, what confuses the subject is the presence of narratives of which are recognisably psychologically distressing (aka humiliation). These "humiliating" fantasies are simply a narrative elaboration (or maniphestation) of the underlying psycholgical distress, but to the extent that it is drawn out from the obscuring cloak of its connection to arousal, in a fully recognisable form.

From my perspective (Autogynephilia aka Crossdreaming), much of the community struggles to reconcile the positively constructed affinity of the thought of oneself as feminine(often the symbol(s) of the female body), with the social masochism of many fantasies. The biggest problem with the communities, and I imagine many others is how powerfully the subjects internalize that which they have an affinity with, and the will to distance themselves from socially unacceptable "perversions". The self-amputation fetishist claims that they feel they were always meant to be without the bodypart which they are aroused by removing, that it is the "real me", that they are "finally complete". The baby/youth fetishist claims that they really are a child, or that they didn't have the oppertunity to be a kid, so now as an adult, being aroused by being young is a psychological means for them to live out the assumed necessary developmental period. With the feminization fetishist there is the claim that they are really are a woman on the inside, and that sexual arousal is a means of expressing oneself.