15. Sexuality and Gender

Question 1

Define: Gender dysphoria (1)

Answer 1

• the distress that may coincide with conflict between one’s experienced/expressed gender and one’s assigned gender

Question 2

Describe typical presentation: Gender dysphoria (7)

Answer 2

• strong and persistent cross-gender identification
• desire to be rid of current primary/secondary sex characteristics and to gain the primary/secondary sex characteristics of their identified gender
• repeated stated desire or insistence that one is of the opposite sex
• preference for cross-dressing, cross-gender roles in make-believe play
• strong desire to participate in the stereotypical games and pastimes of the opposite sex
• strong preference for playmates of the opposite sex
• significant distress or impairment in functioning and persistent discomfort with his or her sex or gender role

Question 3

Describe tx: Gender dysphoria (3)

Answer 3

• psychotherapy
• hormonal therapy
• gender affirming surgery (old term: sexual reassignment surgery)

Question 4

Define: Paraphilic Disorders (7)

Answer 4

• intense and persistent sexual arousal that is elicited by something other than genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners
• paraphilic disorder: paraphilia that causes distress or functional impairment to the individual, or a paraphilia whose realization entails personal harm, or risk of harming others
• subtypes
• rarely self-referred; come to medical attention through interpersonal or legal conflict
• person usually has more than one paraphilia; 5% of paraphilias attributed to women
• typical presentation: begins in childhood or early adolescence; increasing complexity and stability with age
• chronic, decreases with advancing age but may increase with stress

Question 5

Name subtypes of paraphilic disorders (10)

Answer 5

• voyeuristic
• exhibitionistic
• frotteuristic
• sexual masochism
• sexual sadism
• pedophilic
• fetishistic
• transvestic
• other specified paraphilic disorder
• unspecified paraphilic disorder

Question 6

Describe tx: Paraphilic disorders (3)

Answer 6

• anti-androgen drugs
• behaviour modification
• psychotherapy