Sex and Gender Issues

Question 1

Definition sexual dysfunction

Answer 1

clinically significant disturbance in person’s ability to respond sexually or to a experience sexual pleasure

Question 2

medications that can cause sexual dysfunction

Answer 2

antipsychotics thru dopamine blocking
antidepressants thru serotonergic activity
antiHTN

Question 3

sexual dysfunction must meet criteria through

Answer 3

causing subjective, clinically significant distress

Question 4

main male sexual dysfunctions

Answer 4

premature ejaculation
delayed ejaculation
erectile dysfunction
male GPPPD

Question 5

main female sexual dysfunctions

Answer 5

female sexual interest/ arousal disorder
female orgasmic disorder
female GPPPD

Question 6

Tx for female sexual interest arousal disorder

Answer 6

sensate focus exercises

sildenafil

Question 7

Tx for male hypoactive sexual desire disorder

Answer 7

psychotherapy
testosterone
bupropion

Question 8

Tx for genito-pelvic-pain penetration disorder

Answer 8

medical and/or gynecological workup

psychotherapy

Question 9

Tx for delayed ejaculation

Answer 9

sensate focus exercises
couples therapy
sildenafil

Question 10

Tx for erectile disorder

Answer 10

sensate focus exercises
PDE5 inhibitors
vasoactive injections
vacuum devices

Question 11

Tx for premature ejaculation

Answer 11

delay techniques

couples therapy

Question 12

Tx for female orgasmic disorder

Answer 12

masturbation
accessory equipment
couples therapy

Question 13

ground rules for gender dysphoria

Answer 13

address individual consistently with what gender they identify
do not project own ideas

Question 14

genetic sex

Answer 14

determinied at conception

Question 15

gender identity

Answer 15

individuals perception and self awareness of being male or female

Question 16

gender role

Answer 16

behavior of an individual that identifies him/her as male/female

Question 17

sexual orientation

Answer 17

erotic attraction to males, females or both

sexual orientation is not a disorder

Question 18

complaint of patients with gender dysphoria

Answer 18

“trapped” in wrong body

Question 19

Dx criteria for gender dysphoria for all ages

Answer 19

marked incongruence between ones experienced gender and assigned
6+ mo
can occur with/without a disorder of sex development
must cause significant distress or impairment in social/occupational/other functioning

Question 20

additional gender dysphoria criteria for children

Answer 20

strong desire to be other gender with insistence and at least 5:

• want attire other gender
• cross gender roles in play
• likes toys games sterotypic to other gender
• playmates of other gender
• rejection assigned toys
• dislike own anatomy
• desire for primary or secondary sex characteristics matching ones experienced gender

Question 21

Tx gender dysphoria in children

Answer 21

rule out psychosis and adjustment disorders
hormone and surgery not appropriate
individual and family psychotherapy

Question 22

additional gender dysphoria critera for adults and adolescents

Answer 22

at least 2:

• marked incongruence
• strong desire to rid of ones own primary secondary characteristic
• desire characteristics other gender
• strong desire to be gender other than assigned
• strong desire to be treated as gender other than assigned
• strong conviction that one has typical feelings/reactions of gender other than assigned

Question 23

helpful information for dx gender dysphoria

Answer 23

collateral info like from family and friends

Question 24

steps if reassignment surgery requested for gender dysphoria

Answer 24

engage in psychotherapy first

Question 25

what is criteria for reassignment surgery

Answer 25

patient lived 1-2 years in cross gender role and begun to alter physical appearance
-hormone Tx for 1-2 years
then surgery

Question 26

after surgery feelings in reassignment

Answer 26

happy with decision

Question 27

post surgical complications gender dysphoria reassignment

Answer 27

genetic males: urethral stenosis, misdirected urinary streams, vaginal strictures and rectovaginal fistulas
genetic females: chest wall scars and polycystic ovarian disease

Question 28

side effect E therapy

Answer 28

DVT, inc BP, thromboembolic disorders, weight gain, impaired glucose tolerance, liver abnormalities, depression

Question 29

side effect T therapy

Answer 29

impaired liver function, acne, Na retention– edema

Question 30

paraphilic disorders in general

Answer 30

> 6 mo
intense persistenc sexual interest
M»>W
person must experience distress/impairment as result of paraphilia or pursuit of paraphilia resulted in harm to others

Question 31

requirement for paraphilic disorder

Answer 31

recurrent intense sexual arousal from 1+ of the types

Question 32

exhibitionism

Answer 32

exposure of genitals to unsuspecting stranger

Question 33

transvestic fetishism

Answer 33

urges fantasies involving cross dressing

Question 34

pedophilia

Answer 34

urges fantasies involving prepubescent children “generally 5 yr older than target

Question 35

frotteurism

Answer 35

touching rubbing against nonconsenting person

Question 36

voyeurism

Answer 36

observing an unsuspecting person naked, disrobing, or having sex

Question 37

fetishism

Answer 37

non living object

Question 38

partialism

Answer 38

focus on one part of body

Question 39

telephone scatalogia

Answer 39

obscene telephone ccalls

Question 40

sexual masochism

Answer 40

being humiliated, beaten, bound or otherwise made to suffer

Question 41

sexual sadism

Answer 41

pyschological or physical suffering of another person

Question 42

necrophilia

Answer 42

contact with corpses

Question 43

urophilia

Answer 43

urine

Question 44

zoophilia

Answer 44

animals

Question 45

klismaphilia

Answer 45

enemas

Question 46

pyschotherapy for paraphilic disorders

Answer 46

CBT

aversive conditioning

Question 47

biological Tx for paraphilic disorders

Answer 47

SSRI

hormonal (dec sex drive)