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psycopathology > Gender Dysphoria, Sexual Dysfunction And Paraphilias > Flashcards

Gender Dysphoria, Sexual Dysfunction And Paraphilias Flashcards

1
Q

What does cisgender mean?

A

Someone’s sex assigned at birth and gender identity correspond in the expected way

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2
Q

What does cross dresser mean?

A

A person who dresses as the binary opposite gender expression for relaxation and fun. Generally refers to a man who occasionally wears clothes of the opposite sex, wears makeup and accessories associated with women.

They are usually heterosexual

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3
Q

What does gay mean?

A

Experiencing attraction solely to some members of the same gender

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4
Q

What is gender expression?

A

External display of one’s gender, combination of clothing, grooming, demeanor, social behavior, scales or masculinity and femininity

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5
Q

What is gender identity?

A

Internal perception of one’s gender, how they label themselves. A person’s internal deeply held sense of their gender. Refers to an individual’s identifications man, woman, both or neither

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6
Q

What is gender nonconforming ?

A

A gender identity label that indicates a person who identifies outside of the gender identity

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7
Q

What does gender queer mean?

A

An umbrella term for many gender non-conforming or non-binary identifies (e.g., agender bigender, genderfluid)

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8
Q

What does queer mean?

A

Umbrella term for persons who do not identify as straight +/- cisgender

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9
Q

What is sexual orientation?

A

Type of sexual, romantic, emotional attraction one has to capacity to feel for some others, based on gender relationship between the person and the people they are attracted to. The physical, romantic +/- emotional attraction to another person. Not the same as sexual preference

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10
Q

What is sexual preference?

A

Types of sexual intercourse, stimulation and gratification one likes to receive and participate in

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11
Q

What is transgender?

A

An umbrella term for anyone whose sex assigned at birth and gender identity do not correspond in the expected way. A gender description for someone who has transitioned( or transitioning) from living as one gender to another. Used as an adjective, not a noun

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12
Q

What is a transsexual?

A

A person who identifies psychologically as a gender/sex other than the one to which they were assigned at birth. Transexuals often wish to transform their bodies hormonally and surgically to match their inner sense of gender/sex. Many transgender people do not identify as transsexual - ask which term + pronoun a person prefers

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13
Q

Contrast gender identity and gender role/expression

A

Gender identity: who you are on the inside

Gender role/expression: your expression of gender in society

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14
Q

What is gender dysphoria?

A

When gender identity and gender role don’t match

-feels trapped in the wrong, e.g., biologically (sex assigned at birth) male, gender role male, gender identity female, attracted to male

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15
Q

When do you know gender role and gender identity don’t match?

A

3-4 years

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16
Q

When do you know your sexual preference or sexuality?

A

Puberty

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17
Q

When do cross dresser behaviors become appearent?

A

Parents report cross gender behaviors were appearent before 3 years

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18
Q

What are the diagnostic criteria of gender dysphoria?

A

A marked incongruence between one’s gender assigned at birth and one’s experienced gender

The incongruence results in clinically significant distress or functional impairment

Symptoms endure 6 month

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19
Q

What is the etiology of sexual dysfunction ?

A

Psychological factors are the primary cause

  • anxiety
  • guilt
  • body image

A medical condition may co-exist but in sufficiently explains the symptoms

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20
Q

How can sexual therapy be used took treat sexual dysfunction?

A

Dual sex therapy- emphasis is on treating the couple when the person is in a relationship

Short term with behavioral focus

Sex education

Communication skills

Anxiety reduction through senate focus exercises (e.g., non-coital activities progressing not coital activities

21
Q

How can sexual dysfunction be treated, aside from sexual therapy?

A

Psychotherapy- feelings of guilt, poor self-esteem, anxiety, fear

Orgasm-
1. Squeeze-squeeze coronal ridge of the glans penis to cause discomfort (premature ejaculation)

  1. Stop and go- partner ceases stimulation of the partner to reduce pleasure

Pain

  • dilators
  • relaxation

Pharmacotherapy

22
Q

How can pharmacotherapy be used to treat sexual dysfunction?

A

Pharmacotherapy- medications may be useful adjunct to behavioral therapy

  • Vasodilating substances such as Viagra for erectile disorder
  • SSRI to slow ejaculation in premature ejaculation
23
Q

What is a paraphilia ?

A

Sexual stimuli or acts that are deviations from “normal” sexual behaviors but are necessary for some persons to experience arousal and orgasm

  • intense and persistent
  • at least 6 months
  • manifested by fantasy, urges and behaviors
24
Q

When does paraphilia become a disorder?

A

Paraphilia becomes a disorder if any of the following are present:

  • Someone acts on the urge with a non-consenting person OR
  • someone acts on the urge with a consenting person (or thing) and the actions cause significant distress/functional impairment OR
  • Someone does not act on the urge, but the urge causes significant distress/functional impairment
25
Q

What is exhibitionism?

A

Type of paraphilia disorder

Sexual arousal from exposing genitals to unsuspecting stranger

Typical features:

  • female victim
  • masturbation during act
  • no attempt to involve the observer
26
Q

What is voyeurism?

A

A type of paraphilia disorder where sexual arousal from observing unsuspected person naked or in the process of disrobing or engaging in sexual identity.

Person is Atleast 18 years old

Typical features:

  • female victim
  • masturbation during act
  • no attempt to further involve the stranger
27
Q

What is fetishism?

A

A paraphilia disorder where sexual aroudal is derived from objects (shoes, gloves, stockings) or highly specific sexual focus on non-genital part

Devices used for tactile stimulation do not qualify as fetish

Typical features:

  • Masturbation accompanies a multi sensory fondling of the object
  • Object May be required in order to get aroused
28
Q

What is transvestism?

A

Sexual arousal by cross dressing -wearing clothing of the opposite sex

Typical features:

  • unrelated to gender dysphoria
  • cross dressing may involve a single article of clothing or complete dressing as opposite sex
  • Distress May be manifested as “purging and acquisition” behavior
29
Q

What is frotteurism?

A

-sexual arousal From touching or rubbing against a non consenting person

Typical features:
-Occurs in crowded places

  • Frottuer fantasies about a relationship
  • frottage tends to be their sole sexual outlet
30
Q

What is sexual sadism?

A

Sexual arousal from causing the physical and psychological suffering of another person

31
Q

What is sexual masochism ?

A

Sexual arousal from receiving physical and psychological suffering —> humiliation, beaten, bound, asphyxia

32
Q

What are the typical features of sexual masochism and sadism?

A

S and M acts (simulation) May occur between consenting partners as normal variety

  • True S and M acts are NOT simulated. If they occur between non-consenting partners or if distress/harm results, then acts are diagnosable
  • Actions tend to increase in severity over time for both sadist and masochist to achieve arousal
33
Q

What is pedophilia?

A

Sexual arousal from prepubescent child

The child typically is less than 13 years old (depends on whether they have reached puberty)

-Perpetrator is at least 16 years old AND at least 5 years older than the child

34
Q

What are the typical features of pedophilia?

A

Involves viewing, fondling, oral sex(cunnilingus or Felatio)

Lack of remorse, and use of rationalization to justify actions

35
Q

What is the epidemiology of pedophilia?

A

People with paraphilic disorders are:

  • rare and almost exclusively males
  • frequent offenders
36
Q

Give onset and course of pedophilia

A
  • urges typically start in childhood/teens with actions becoming better defined with age
  • disorders are chronic and associated with a high recidivism rate after treatment/ prison release
37
Q

Give the etiology of paraphilias

A

Multifactorial and unknown

Theories: psychological factors
-improper identification with opposite sex parent

  • exhibitionism and voyeurism —> calm anxiety about castration
  • fetishism —> shoe fetishism, the shoe symbolizes the female penis
  • pedophilia and sadism —> compensation for powerlessness
  • masochism —> overcome fear of injury and sense of powerlessness by showing they are impervious to harm
  • Early childhood abuse —>spanking, enemas, verbal humiliation (classical conditioning)
38
Q

Give the THEORIES of paraphilia

A

Biological factors:
-Abnormal hormone levels—> testosterone levels affecting sex drive

-Neurological —> frontal lobe dysfunction, serotonin Dysregulation affecting impulse control

Psychological-environmental factors:

Classical conditioning (e.g., in fetishism) 
  -the object /situation was paired with sexual excitement in the past

Imitation(e.g., in pedophilia)
-the person imitating abuse that was sustained in the past (I.e., the person is “identifying with the aggressor”)

39
Q

Summarize methods of paraphilia disorders

A

Behavioral therapy - aversion and CBT

reduction of sexual drives

Treatment of comorbid conditions

External control

40
Q

How can behavioral therapy be used to treat paraphilic disorders?

A

Aversion therapy
-when engaging in paraphilia, a noxious stimulus is applied to the patient

-when fantasizing about the paraphilia, the patient imagines an aversive consequence —> covert sensitization

CBT
-social skills, sex education, development of victim empathy, cognitive restructuring

41
Q

How can we reduce sexual drives to treat paraphilic disorders?

A

Antiandrogens (Depo-provera)

  • decreased serum testosterone levels —> decrease sex drives
  • Chemical castration
  • Non-compliance is a problem
42
Q

How can comorbid conditions of paraphilias be treated?

A

Depression , anxiety

SSRI —> decrease libido, control impulse and reduce obsessions

43
Q

How can external controls be used to treat paraphilia?

A

Eliminate opportunities for the perpetrator to act on the urges

44
Q

How does registration on the sex offenders list occur?

A

Person convicted of certain sex crimes must register in the jurisdiction in which they work or attend school

  • update information: annually, every 6 months or every 3 months
  • duration : 15 years, 25 years or for life
45
Q

What law allows for the sex offenders list to be made publicly available ?

A

Notification: this information is made publicly available

-Megan’s law- Megan Kanka was raped and murdered by a repeat sex offender

46
Q

What legal issues have involved the registered sex offenders list?

A

Sex offenders have challenged the registration and notification laws

  • they cannot be punished twice
  • the registry is punitive

US Supreme Court rejected their argument

47
Q

When was being gay, ceased being considered an ailment ?

A

DSM eliminated homosexuality as a disorder in 1973; it was not listed after DSM-II

48
Q

When and how is sexual orientation determined?

A

Sexual orientation is not alterable. It is established in-utero after a subtle difference in hormone exposure changes brain development.

Conversion therapies

psycopathology (23 decks)

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