Gregg has a successful career and is in a happy and healthy relationship with his girlfriend of ...

Gregg has a successful career and is in a happy and healthy relationship with his girlfriend of three years, Janelle. He also happens to have a high heel shoe fetish.
 
  Although his sexual relationship with Janelle is fulfilling and she accepts his shoe fetish, Gregg can only orgasm during masturbation while fantasizing about a high heel shoe. What factor would prevent Gregg's shoe fetishism from being diagnosed as a paraphilia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)?
 
  a. Gregg's sexual behavior is noncoercive.
  b. Gregg's actions are not causing him psychological distress or interfering with his life.
  c. Gregg's sexual partner is aware of and accepts his fetish.
  d. Gregg's sexual behavior is not causing him any physical harm.