Sexual and Gender Identity Dysphoria - McIntyre

Question 1

disturbance in persons ability to experience sex pleasure or respond sexually

Answer 1

sex dysfunction

must meet criteria - clinically significant distress
rule out med causes

meds - strong affect of medications

• antipsych - DA
• anti depressants - serotonin

Question 2

male sex dyxfxn

Answer 2

premature ejaculation 27%

delayed ejac - 10%
ED - 10%
male GPPPD - 3%

Question 3

female sex dysfxn

Answer 3

female sexual interest/arousal disorder - 33%

female orgasmic disorder - 25%
female GPPPD 15%

Question 4

female sexual interest/arousal disorder

Answer 4

sensate focus exercises - foreplay

sildenafil

Question 5

GPPPD

Answer 5

genito-pelvic pain/penetration disorder

Question 6

male hypoactive sex desire disorder

Answer 6

psychotherapy
testosterone
bupropion - DA reuptake inhibitor

Question 7

delayed ejac

Answer 7

sensate focus exercise
couple therapy
sildenafil

Question 8

premature ejac

Answer 8

delay techniques
couples therapy
topicals, TCAs

Question 9

ED

Answer 9

PDE-5 inhibitor
vasoactive injection
vacuum devices

Question 10

female orgasm disorder

Answer 10

masturbation
accessory equipment
couples therapy

Question 11

gender dysphoria

Answer 11

tx with respect

there is no such thing as gender denial disorder

address consistently - as pt identifies

Question 12

genetic sex

Answer 12

determined at conception
fetal androgen - testosterone
-to become phenotypic male

fetal androgen in genetic female - male genital develop

fetal androgen missing genetic male - female genital develop

Question 13

gender identity

Answer 13

individuals perception of their sex

complex process

Question 14

gender role

Answer 14

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

Question 15

sexual orientation

Answer 15

erotic attractions to males, females, or both

not disorder

Question 16

gender dysphoria diagnosis

Answer 16

criteria for all ages

incongruence ones experienced expressed gender and assigned gender

at least 6 months

with or without disorder of sex development

most cause significant distress or impair social fxn

Question 17

children gender dysphoria diagnosis

Answer 17

strong desire to be other gender

5 of following strong desires

• attire of other gender
• cross-gender roles in play
• toy/game of other sex
• playmates of other gender
• reject gender assigned toy/games
• dislike ones sex anatomy
• desire for primary and secondary sex characters of other gender

Question 18

tx gender dysphoria

Answer 18

rule out psych condition

tx - psychotherapy

Question 19

gender dysphoria diagnosis of adolescents

Answer 19

2 of following

-things about desire being opposite sex

Question 20

tx adult and adolescent gender dysphoria

Answer 20

rule out psych illness

surgery requested - psychotherapy first

surgery indication

• 1-2 year living cross gender role
• hormone therapy 1-2 years

Question 21

side effects E and T

Answer 21

E - DVT, increased BP, weight gain

T - impaired liver fxn, acne, edema

Question 22

medicare

Answer 22

2014 - lifted ban on sex reassignment surgery

Question 23

paraphilic disorder

Answer 23

> 6 months
sex interest in something other than mature consenting human partner

must experience distress as result of this

men > women

does not always involve sex offense

Question 24

pedophilia

Answer 24

fantasy of pre-pubescent children -

Question 25

klismaphilia

Answer 25

enemas

Question 26

urophilia

Answer 26

urine

Question 27

necrophilia

Answer 27

corpses

Question 28

sadism

Answer 28

suffering of other person

Question 29

fetishism

Answer 29

non-living object

Question 30

partialism

Answer 30

one part of body

Question 31

tx of paraphilic disorder

Answer 31

psychotherapy
averse conditioning

SSRIs, hormonals (if risk to others)

Question 32

frotteurism

Answer 32

touching consenting against nonconsenting person