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Hello sir! I can understand it sounds bit awkward to see your friend behaving sexually different for which he has no regrets for. Issues are: 1.tendency to expose genitalia in public oftenly. 2. Lost of conflicts between their relationship with girlfriend 3. Behaving for pleasure and excitement . Before giving you some suggestions. Let me help you to understand the problem he's going through. Dear, this problem is exhibitionism which comes under sexual paraphalia. This is more prominent in males, having tendency to expose genitals in public and strangers. As u mentioned too,these clients doesn't take help themselves because they find pleasure in it, they only seek help when they have problem in sexual life with partners. Probable causes: 1. Hormonal excitement like testestrone which urges to seek pleasure by exposing 2. Victim of emotional abuse in childhood like separation from mother or family members. My suggestions for your friend would be 1. Firstly, talk to your friend and try to talk over him related to his childhood insecurities and fear 2. Involve his girlfriend, let her understand the problem and visit sexologist to know the insight of problem as she can only insists for the same. 3. As he himself don't want to go to the doctor, an online voice chat can be encouraged. 4. Medicines and hormonal therapy works in combating the hormonal Disturbance. 5. Therapies like Reality THERAPY,cognitive behavioural therapy, aversion therapy can bring result. 6. Sometimes the person feels guilty inside, but can't leave the learning so empathy training can be given. 7. Sexual counselling, couple counselling are recommended. 8. 12-step sexual deaddiction programme along with group therapy can be given for the same. You are doing big help to your friend. Once he will be fine,he will be thankful to you. Keep doing great .