Gender, Sexual, And Paraphillic Disorders Flashcards
Dimensions of Sex, Gender, and Sexuality
Biological sex, Gender identity, Sexual orientation
Biological Sex
Either male or female; Categorical
Gender Identity
Scale ranging from Completely Male Completely Female
Sexual Orientation
Scale ranging from 100% Heterosexual 100% Homosexual
The vast majority of individuals identify as…
Biological Sex: Male, Gender Identity: Completely Male, Sexual Orientation: 100% Heterosexual
3 Categories of Diagnosis in DSM-5
-Sexual Dysfunctions
-Gender Dysphoria
-Paraphilic Disorders
(Homosexuality used to be included but now there is not a diagnosis for orientation)
Normal sexual behavior involves progressing through the following stages:
(The Sexual Response Cycle)
- Interest/Desire
- Arousal
- Orgasm
- Resolution (only behavior that does not cause disfunction)
A disruption in the normal cycle involves problems with regard to:
Desire, Arousal, or Orgasm (not resolution)
A 4th category of disruption in the normal cycle incluses:
Sexual Pain (for women only)
Prevalence rates of sexual dysfunction are…
Much higher than you’d think! (Must be recurrent and persistent to be diagnosed as a disorder)
What percent of men have episodes of erectile dysfunction?
13-21%
What percent of women experience female orgasmic disorder?
Up to 42% (and 10% may never have an orgasm period!)
Disorders of desire and arousal:
- Male hypoactive sexual desire disorder
- Female sexual interest/arousal disorder
- Male erectile disorder
Disorders of orgasm:
- Female orgasmic disorder
- Delayed ejaculation
- Early ejaculation
Disorder of sexual pain:
-Genito-pelvic pain/ penetration disorder which is seen in women only (Previously known as vaginismus)
Gender Dysphoria
Used to be called Transsexualism and Gender Identity Disorder, which were controversial labels…and the diagnosis still is; The term transgender is associated (but must have distress/impairment to be diagnosed with G. Dysphoria); Person could endorse any sexual orientation
GD is also not: being a “transvestite” or “intersex” individual; Involves feeling “trapped” in the body of the wrong gender
Feeling “trapped” in the body of the wrong gender (Gender Dysphoria)
Strong dissatisfaction/ disgust with one’s sexual anatomy, gender non-conformity, and overwhelming desire to be “more like” the opposite gender; Gender non-conformity in childhood often coincides (experience does not mean Disorder, only those that have clinically significant distress over it)
For gender dysphoria, the DSM-5 includes separate criteria for…
Children and Adults; 1980: Adults= Transexualism, Children= GID, 1994: All= GID, 2013: Gender Dysphoria
Etiology of Gender Dysphoria
Often manifests early in life; Neurohormonal influences likely play a role; Psychological and social influences are less clear, but may involve exposure to models and reinforcement of certain behavior
Treatment of Gender Dysphoria
A minority seek sexual reassignment surgery; Hormonal treatments and psychotherapy are common
Paraphilic Disorders: An Overview
-Fetishistic disorder
-Transvestic disorder
-Exhibitionistic disorder
-Voyeuristic disorder
-Frotteuristic disorder
-Pedophilic disorder (which can involve incest)
-Sexual sadism and maschism disorders
(There are other interesting paraphilias to consider as well…)
Fetishistic Disorder:
Sexual attraction to nonliving objects (or specific body parts) that is impairing in some way; Can include any object or body part; Rarely seen in women
Transvestic Disorder:
Does not just refer to cross-dressing behavior, Instead is a specific fetish, in which the target of arousal is clothing of the opposite gender (usually a man/women’s clothing) CAN ONLY BE DIAGNOSED IN MEN
Exhibitionistic Disorder
Strong urges and recurrent acts of exposure of genitals to unsuspecting strangers
Voyeuristic Disorder
Observing an unsuspecting individual undressing, naked, or engaging in sexual behavior
Frotteuristic Disorder
Rubbing against or sexually touching a non-consenting person
Pedophilic Disorder
Pedophiles exhibit sexual attraction to young children or adolescents (usually < age 13); Must have acted on the urges (or be clinically distressed by them) to be diagnosed; Must be at least 16 and 5 years older than the target; Specifiers: exclusive vs. non-exclusive, sexual attraction pattern, and whether limited to incest; Young females are more often targets than males; The disorder is rarer, but not unheard of, in females
Sexual Sadism Disorder
Inflicting pain or humiliation to attain sexual gratification
Sexual Masochism Disorder
Suffer pain or humiliation to attain sexual gratification
To be diagnosed with Sexual Sadism Disorder or Sexual Masochism Disorder, these behaviors must cause…
Distress or impairment for a person; Many people engage in this behavior and do not have a disorder!
Paraphilic Disorders: Etiology
Etiological theories have stressed psychoanalytic and behavioral explanations
Paraphilic Disorders: Treatment
For treatment, medication can be used, but behavior therapies are more often implemented
Behavior Therapies used to treat Paraphillic Disorders
Orgasmic reconditioning;
Aversive behavioral rehearsal (for exhibitionism); Teach self-control and risk management strategies
Orgasmic Reconditioning
Incorporating appropriate targets into masturbation behavior
Intersex
Someone born with ambiguous genitals (usually assigned to be female)
Paraphilia vs. Paraphillic Disorder
Paraphilia: Unusual pattern of sexual arousal, doesn’t make it a disorder; Paraphillic Disorder: Not enjoyed by all involved, warrants a diagnosis
Fetishistic and Transvestic Disorders involve…
Inanimate objects
Exhinitionistic, Voyeuristic, Frontteuristic, Pedophillic Disorders involve…
Non-concenting people
Sexual Sadism and Masochism Disorders involve…
Pain and suffering
