Sexual and Gender Identity Disorders Flashcards
name 8 sexual dysfunctions
hypoactive sexual desire dis female arousal ./ pain dis males erectile dis male orgasmic dis feamle orgasmic dis premature ejaculation dyspareunia genito/pelvic pain dis
differences between males and females
females -XX chromosomes - estrogen hormones -vagina -ovaries males -XY chromosomes -androgen hormones -penis -testes
gender
psychosocial meaning of maleness or femaleness
gender identity
psychological sense of being male or female
gender role
cultural norms for male and female behaviour
masculine and feminine expectations of the sexes
case of john / joan
circucision mishap one twin had sex-reassignment surgery raised as a female given hormonal replacement therapy in teens was used as a case for enviornment influences as being strong enough to develop appropriate gender identity -was miserable as a teenager -sex re-reassignment -married a woman, adopted her children -committed suicide in may 2004 aged 38 nurture is not enough
summary of normal sexual behaviours accross different genders
by in large gender gap is decreasing for everything men -masturbate more -better premarital sex attitudes -more sexual partners women -more love and intimacy -more negative core beliefs equal views on homosexuality
cultural differences in normal sexual behaviour example
sambia new guinea
younger boys give blowjobs to older boys
older boys did not engage in masturbation
then older boys marry and stay with one wife, younger boys become the older boys etc
no increased incidene of homosexuality
normal behaviour in the cultural context
what is normal sexual behaviours
not
-by default - ie haven’t met the right girl yet
-seduction - ie gay teacher leading astray
-contagion - ie same sex couple adopting (no increased incidence of gay kids, more accepting kids)
-parentsv- ie mum over nurtures boys, but is true gay men more often report having strained relationships with their father = maybe unaccepting father, men are much harsher at enforcing gender roles than women
may be based on
-genetics (50% concordance in mz twins)
-hormones - gay men = women finger thing
-structural (brain) - hypothalamus smaller in women and in gay men more similar to women
-gene-environment interaction (Bem’s exotic becomes exotic, no evidence simply boys who are girly play with girls, then when puberty hits joins in the girls looking at boys and starting to find them attractive)
DSM 5 gender dysphoria
incongrunence between experienced gender and primary / seconday sex characteristics
stated desire to gte rid of primary / secondary characteristics because of above point
desire for sex characteristics of other gender
desire to be the other gender
conviction of other gender feelings
lasts at least 6 months
gender dysphoria stats and background
rare
more ocmmon in natal males (3:1)
different to transvestic fetishism
not due to physical abnormalities (as with intersex)
goal is to live life as the opposite gender; not sexual
independent of sexual orientation
causes are unknown, 62% genetic concordance
sex reassignment surgery as treatment for gender dysphoria
surgery to alter physical anatomy to conform to their psychological gender identity
must live in the opposite sex role 1-2 years before surgery (can seem too long so go abroad)
must be stable psychologically, financially and socially
outcomes of sex reassignment surgery as treatment
75% satisfied
female to male conversions abdjust better than male to female (upgrade idea)
7% regret surgery
can maintain erection with added surgical options eg pump a balloon, titanium rod
explain the sexual response cycle and where problems can occur
(X)desire phase - sexual urgers occur in response to sexual cues or fantasies, parasympathetic nervous system
(X)arousal stage - subjective sense of sexual pleasure and physiological signs of arousal
plateau phase - period before orgasm
(X)orgasm phase - in males feelings of inevitability of ejaculation followed by ejaculation; in females contractions of the walls of the lower third of the vagina
resolution phase - decreased arousal occurs after orgasm (particularly in men)
back to desire phase
physiological signs of arousal
males
-penile tumescence (increased flow of blood into penis)
females
-vasocongestion (blood pools in the pelvic area) leading to vaginal lubrication and breat tumescence (erect nipples)
overview of sexual dysfunctions
pain may be associated with sexal functioning - in men is entirely medically explained
males and females experience parallels of most disorders
may be lifelong, chronic or aquired
may be generalized or specific
43% females
31% males
female sexual interest / arousal disorder
low sexual interes and recurrent inability to become excited
maintain adequate lubrication and maintain arousal from erotic cues until completion of sexual activity
at leat 3 of the following:
-absent / reduced interest
-absent/ reduced erotic thoughts
-no/ reduced and unreceptive to partner attempts
-absent/ reduced excitement during sex
-absent/ reduced response to sexual cues
-absent/ reduced genital sensation
female orgasmic disorder
recurrent dealy or absence of orgasm in some women following normal sexual excitement phase, relative to prior experience and current stimulation
delay, infrequency or absence of orgasm
reduced intensity of orgasmic sensation
5-10% females never orgasm (only 50% females experience reasonably regular orgasms)
causes are typically situational or cultural
symptoms for 6 months
genito-pelvic pain / penetration disorder
specific to women
pain / anxiety, tensions associated with sexual activity muscle spasms in the vagina that interefere with penetration
persistent difficulties with:
-vaginal penetration during intercourse
-vulvovaginal or pelvic pain during intercourse (or attempts)
-marked anticipatory fear or anxiety about genital pain
-marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
-symptoms present for 6 months
male hypoactive sexual desire disorder
lack of interest in sexual activity or fantasy that wouldn’t be expected considering the persons age and life situation
persistent or recurrently deficient or absent sexual fantasies and lack of desire for sexual activity
may be associated with another dysfunction
may masturbate or have sex even with low desire
typically stop initiating
erectile disorder / erectile dysfunction
inability in some men to attain or maintain adequate penile erection until completion of sexual activity
increases as you get older - normal part of the ageing process
