Sexual and Identity Disorders Flashcards
Sociocultural Influences on Sexual Practices and Standards
- Some aspects of sexuality are universal; others are quite variable
- Sexual attitudes vary greatly across cultures and across time
Degeneracy Theory (1750s)
Case 1
• In the 1750s, degeneracy theory held that loss of semen caused men to lose masculine characteristics
Abstinence Theory (1830s)
Case 1
• Masturbation and patronizing prostitutes were seen as problematic
• In the 1830s, abstinence theory held that masturbation threatened public health and caused insanity
Ritualized Homosexuality in Melanesia
Case 2
• Ritualized homosexuality is practiced in some societies in Melanesia
• Male initiation rituals
• Young males exchange semen with each other
• Ingested semen protective against “female pollution”
Homosexuality and American Psychiatry
- Up to 1970, homosexuality widely regarded as sickness
- Current evidence shows that homosexuality is compatible with psychological normality
- Homosexuality is no longer listed as a disorder in the DSM-5
- Significant status of homosexuality during last half-century
Gender Dysphoria
• Discomfort with assigned gender or sex-relevant physical characteristics
• Common outcomes
- Boys – Homosexuality
- Girls – May lead to homosexuality but only small studies done
• Transsexuals
- Adults with gender dysphoria who want to change their sex
• Autogynephilia
• Paraphilia characterized by man’s sexual arousal at thought of being a woman
Treatment
• Psychotherapy is usually not effective
• Surgical sex reassignment typically effective
Childhood Sexual Abuse
- Prevalence depends on definition but ranges from less than 5% to over 30%
- Short- and long-term negative consequences
- Controversies include children’s testimony and recovered memories of sexual abuse
Pedophilia
- Adult has recurrent, intense sexual urges or fantasies about sexual activity with prepubescent child
- Almost all pedophiles are male; 2/3 of victims are female
- In recent years, many scandals involving priests have involved pedophilia
Incest
• Culturally prohibited sexual relations between family members
• Prevalence and incidence
- Universal taboo
- Incidence unclear due to non-reporting
Rape
• Sexual activity involving actual or threatened forcible coercion
• Prevalence
- Depending on the definition used, prevalence figures run from 5% to 13%
• Potential consequences
- Physical trauma
- Psychological trauma
- Post-traumatic stress disorder
• Strangers commit only a small fraction of all rapes
• Most rapes are committed by someone known to the victim
• 60% of all rapists are under 25
Treatment and Recidicism of Offenders
• Sex offenders with deviant sexual preferences (e.g., those most attracted to children) have high rates of recidivism
• Recidivism rates for rape and sexually deviant behavior decrease with age
• Sex offenders’ therapy goals
- To modify patterns of sexual arousal
- To modify cognitions and social skills to allow more appropriate sexual interactions with adult partners
- To change habits and behavior that increase the chance of re-offending
- To reduce sexual drive
Psychological Therapies for Sexual Abuse Offenders
- Aversion therapy
- Covert sensitization/assisted covert sensitization
- Cognitive restructuring
- Social-skills training
Treatment for Sexual Abuse Offenders
Biological and surgical treatments may include:
• Antidepressant medications
• Castration (surgical or “chemical” via hormones)
• Many treatment programs use a combination of hormone therapy and cognitive-behavioral treatments
Sexual Dysfunctions
• Impairment in desire for sexual gratification and/or ability to achieve it
Four human sexual response phases
- Desire phase
- Excitement phase
- Orgasm
- Resolution