Sexual Dysfunction, Paraphilias and Gender Dysphoria

Question 1

Gender Dysphoria

Answer 1

DSM-IV-TR: ‘Gender Identity Disorder’ (GID)

Aversion to same-sex clothing & activities

Childhood-onset

*Emphasize gender incongruence not
pathologize cross-gender identification

• Evidence of hormonal involvement in some cases
• Experience significant identity-related distress
• Causes are not well understood

Question 2

Interventions for gender identity issues

Answer 2

• Sex-reassignment surgery and hormonal therapy
• More frequent male to female
• Post-surgical adjustment can be predicted by:
• Psychological stability
• Advance knowledge of surgery limitations
• Psychological intervention

Question 3

Transvestic Disorder

Answer 3

Transvestism or transvestic disorder (a paraphilia)

• Intense sexual arousal when cross dressing
• Usually male and heterosexual
• Usually no cross dressing/behaviour in day-to-day life
• May start with partial or occasional cross-dressing in childhood or adolescence
• May be accompanied by gender dysphoria but it usually isn’t

Question 4

Paraphilias

Answer 4

atypical sexual behaviors- conditions involving sexual arousal to unusual objects or sexual
activities

• May involve fetishism
• Last at least six months
• Cause significant distress or impairment

Question 5

DSM-5 differentiates between Paraphilia and Paraphilic disorders

Answer 5

• Paraphilias (no distress about having atypical attractions AND no potential for harm to self or others-no disorder)
• Paraphilic disorders (distress about atypical attractions or potential for
  harm to self or others

Question 6

Paraphilic Disorders

Answer 6

• Transvestic disorder
• Voyeuristic disorder
• Exhibitionistic disorder
• Frotteuristic disorder
• Sexual masochism disorder
• Sexual sadism disorder
• Pedophilic disorder
• Fetishistic disorder (body parts, non-living objects specifiers)

Question 7

Psychological Interventions for Paraphilic Disorders

Answer 7

Behaviour Therapy
* Orgasmic reorientation

Cognitive Treatment
*Challenge distorted thinking
* Empathy training (re: consequences for victims)
* Relapse prevention

Question 8

Sexual Dysfunctions Categories

Answer 8

• Sexual desire disorders
• Sexual arousal disorders
• Orgasmic disorders
• Sexual pain disorders- dyspareunia

Question 9

Sexual Dysfunctions Examples

Answer 9

• Delayed Ejaculation
• Erectile Disorder
• Female Orgasmic Disorder
• Female Sexual Interest/Arousal Disorder
• Genito-Pelvic Pain/Penetration Disorder
• Male Hypoactive Sexual Desire Disorder
• Premature Ejaculation
• Substance/Medication Induced Sexual Dysfunction
• Other Specified Sexual Dysfunction
• Unspecified Sexual Dysfunction

Answer 10

Treatments for Sexual Dysfunctions
* Sensate Focusing (anxiety reduction)
* Extratherapy Sensuality Activities
* Cognitive Restructuring
* Sensory-awareness procedures (e.g., sensate focusing)
* Skills and Communication Training
* Couples Therapy
* Physical/Medical Procedures (e.g., lubricants, medication)