Thanks to the work of a few selected historians, we now know quite a lot about the history of masturbation. This paper shows that the history of masturbation from a medical standpoint can be divided into three main periods. The first period, the “pathological” period, started in 1758 up until the end of the 19th century, before moving into the “depathological” period when it was no longer considered to be a pathology, and finally the “therapeutic” period where masturbation was used as a form of treatment, including treatments used on perpetrators of sex-abuse, particularly in North America. This article will focus on the use of masturbation in therapies proposed to this population. After a presentation of two techniques – satiation therapy and orgasmic reconditioning – two forms using masturbation in order to facilitate access to sexual fantasies, this article will suggest that masturbation still remains medicalised today, despite no longer being considered to be a disease. By making a comparison with the treatment for imagination by physicians in the 19th century, it is argued that the real target of this medicalisation is the “pathology” of sexual fantasies.