Sex and Gender

Question 1

Three Types of Assessments for Sexual Functioning

Answer 1

Clinical Interview
Medical Examination
Psychophysiological assessment (e.g. penile strain gauge)

Question 1

What are the four types of sexual dysfunction?

Answer 1

Sexual desire disorders
Sexual arousal disorders
Orgasm disorders
Sexual pain disorders

Question 2

What is sexual desire disorder?

Answer 2

Reduced desire must be present for at least 6 months and cause clinically significant distress

Question 3

Is Asexuality a sexual desire disorder?

Answer 3

NO

Asexuality is the lack of sexual attraction to others or interests/desire for sexual activity
People who identify as asexual would not be diagnosed with a sexual desire disorder (lack of distress)

Question 4

What is sexual arousal disorder?

Answer 4

Erectile disorder
Difficulty obtaining or maintaining rigid erection for at least 6 months (and that causes distress)
People can have erectile dysfunction but not have distress

Question 5

3 types of orgasm disorder

Answer 5

Premature ejaculation
Very fast orgasm phase (<1 min)
Presenting complaint in 60% seeking help for sexual dysfunction
Affects 9% of men

Delayed Ejacualtion
5% of male population
Orgasm phase is significantly longer

Female Orgasmic Disorder
11% report of women report sexual dysfunction related to orgasm
Important to distinguish whether orgasm is “never or almost never” since only 50% of women experience orgasms regularly during intercourse
Disorder equally present across ages

Question 6

Criteria for Genito-Pelvic Pain/Penetration Disorder
(hint: it’s a sexual pain disorderand for only women)

Answer 6

Recurrent difficulties with one or more of the following
Vulvovaginal or pelvic pain during vaginal intercourse
Fear or anxiety
Tensing or tightening of the pelvic floor muscles

Question 7

What are some medical interventions for sexual disorders?

Answer 7

Medication for ER (Viagra)
Hormone therapies for low sexual desire (e.g. testosterone)
Other devices, procedures and surgeries can be used to manage ED

Question 8

What are some psychosocial interventions for sexual disorders?

Answer 8

Sex therapy can be highly effective for managing low sexual desire, orgasmic concerns and pain disorders
Involves cognitive-behavioural techniques, learning specific skill, relationship issues and facilitating open communication between partners,
Lifestyle changes (e.g. smoking)

Question 9

Who decides what is normal and what is a paraphilia?

Answer 9

DSM, the paraphilic disorder needs to cause distress or impair oneself or harm others

Question 10

Can a paraphilia be changed in the future?

Answer 10

Yes, depending on how cultural norms is changed, harm is done and how consent is determined.

Question 11

List the Paraphilic Disorders

Answer 11

Fetishistic Disorder

Voyeuristic and Exhibitionistic Disorders
Consent is not possible or unlikely

Transvestic Disorder

Sexual Sadism and Masochism Disorder

Frotteuristic Disorder
Consent is possible or unlikely

Pedophilic Disorder
Consent is impossible

Question 12

Explain the debate on pedophilia?

Answer 12

Some fear that less stigma will normalize pedophilic acts. However, others argue that more stigma creates more distress and leads to more people committing acts related to pedophilia.

Question 13

How to treat paraphilic disorders?

Answer 13

Covert sensitization (imagining consequences of certain behaviors repeatedly)
Orgasmic reconditioning (re-pairing pleasurable orgasms with other stimuli)
Relapse prevention programs (similar to substance use programs)
Drug interventions (e.g., antiandrogens which is effectively chemical castration)

Question 14

What are the treatment guidelines for the gender reassignment of adults?

Answer 14

APA recommends starting with reversible steps and progressing to non-reversible
Evaluation and education
Partially reversible steps (e.g. hormone therapy)
Non-reversible: surgery

Question 15

What are the treatment guidelines for the gender reassignment of children?

Answer 15

There is none, it’s a controversial topic
For the most part, a “wait and see” approach is used, delaying non-reversible interventions as much as possible until adulthood

More research and clinical guidelines are needed. This research is hard to do for a variety of reasons (methodological, political, funding, etc).

Question 16

Satisfaction results of gender reassignment surgery

Answer 16

The majority of people (about 90%) who receive gender reassignment surgery are satisfied with the results (Johannson et al., 2010)
About 1-7% report regretting the surgery; up to 2% attempt suicide after surgery
Legal cases have popped up in the UK and US relating to when youth can consent to procedures and what to do when parents consent, but youth later wish to reverse interventions.