The answer that seems to emerge from all of this is more or less; "Lady, that's a tough one and we don't really have an answer." Perhaps one or the other suggestion might, in practice, work, but the question then is, what else do I have to give up to go that route? My independent judgement? My propensity for making my own decisions? And the point is not whether these objections are real or not, but that I feel that they do apply to me.
So if you do not want to go Val's very cautiously suggested medical route, the only answer is to go within, because, after all, that is where the fetish is rooted, not in some operable cells somewhere that can be removed without extinguishing other faculties that we need to function as a human being.
So, to me the first question again is the motive for change. Is it because you are embarassed by it, or because you do not trust youorself to control it sufficiently to not be a danger to yourself, your reputation, your significant relationships?
If it is because of embarassment, then think again, because embarassment is a result of our vanity, our need to feel better than we really are, and we will never fundamentally change any aspect of ourselves as long as we have not accepted ourselves just as we are, because anything else is really based on illusion.
If it is fear of losing control, then the first question is not how to get rid of it, but how to learn to control it, and that can certainly be done. I do not believe that anyone in my environment would ever realise that I had this fetish. I have myself only come to recognise it as such on the internet. Before that it lived only in my fantasies and occasional, inconspicuous tickles in uncompromising situations. My wife knew I liked it, but never what a controlling force it was. And for me the most painful part has been that my own desires have caused me to find other people attractve from the point of view of the fetish, and so, without necessarily acting on this, nevertheless lose interest in my significant relationships.
So, it is controlled, but not overcome, and if I had the choice today, I should go the route that many have suggested on this forum, and not try to hide it, but be open about it and try to make it a part of my relationships.
Don't think this is a moan. I am really not all that unhappy about it, but have adjusted to it. It is merely an attempt to approach an answer from a less metaphysical point of view, as the other did not meet the need.