Fetishism is not a sexuality or sexual orientation. It's a paraphilia.
https://icd.who.int/browse/2025-01/mms/en
Chapter 17 of the ICD 11:
'Gender incongruence is characterised by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex. Gender variant behaviour and preferences alone are not a basis for assigning the diagnoses in this group.
Exclusions
Paraphilic disorders(6D30-6D3Z)'
Paraphilic disorders are chapter 6, Mental, behavioural or neurodevelopmental disorders:
'Paraphilic disorders are characterised by persistent and intense patterns of atypical sexual arousal, manifested by sexual thoughts, fantasies, urges, or behaviours, the focus of which involves others whose age or status renders them unwilling or unable to consent and on which the person has acted or by which he or she is markedly distressed. Paraphilic disorders may include arousal patterns involving solitary behaviours or consenting individuals only when these are associated with marked distress that is not simply a result of rejection or feared rejection of the arousal pattern by others or with significant risk of injury or death.'
And under 6D36:
'Boundary with Gender Incongruence of Adolescence or Adulthood:
Individuals who have a focused and intense pattern of sexual arousal involving cross-dressing might qualify for the diagnosis of Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals if they are markedly distressed by having this pattern of arousal. A history of sexual excitement in association with cross-dressing can sometimes be a feature of Gender Incongruence that develops in adolescence or adulthood, but such a history is not a sufficient basis for diagnosing Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals.'