Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABNORMAL PSYC363 > Sexual Dysfunction, Paraphilic Disorders and Gender Dysphoria > Flashcards

Sexual Dysfunction, Paraphilic Disorders and Gender Dysphoria Flashcards

1
Q

Milestones in Sexual Science History

A
  • “Sexual science” coined in 1906
  • Krafft-Ebing and “Psychopathia Sexualis”
  • Freud and the libido
  • Havelock Ellis and sexual variation
  • Alfred Kinsey and data
  • Masters and Johnson and sexual arousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why Do We Mate?

A
  • Parental Investment and Sexual Strategies Theory
  • Assumptions about evolution and behaviour
  • Short-term vs. long-term strategies for males and females
  • What maximizes our reproductive potential?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why Do We Have Sex?

A
  • 237 reasons broken down into 4 main factors
    • Physical reasons
    • Goal attainment
    • Emotional reasons
    • Insecurity
  • Significant sex differences (and similarities)
  • Infidelity?
    • “A man is basically as faithful as his options”

–Chris Rock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sexual Orientation

Men and Women

A
  • At least for men, sexuality appears to be very biologically based
  • Bisexuality in men and women
    • Does it exist in men? Long-standing debate
    • Current research on bisexuality in men suggests men are either homosexual or heterosexual
      • Are we looking at a paraphilic explanation? (Men who are straight may engage in homosexual actions as part of a paraphilia in order to be embarrassed)
  • Women’s sexuality occurs more on a continuum from heterosexual, bisexual and homosexual
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sexual Desire and Sexual Arousal Patterns

A
  • Men tend to have more category specific arousal patterns consistent with their self-identified sexual orientation, women show arousal to many different types of stimuli
  • Based on recent research on naked people exercising and engorged genitals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Sex Differences in Sexual Desire/Drive

Female erotic plasticity

Strength of sex drive

A
  • Female erotic plasticity
    • Individual women will exhibit more variation across time than men in sexual behaviour
    • Female sexuality will exhibit larger effects than male in response to most specific sociocultural variables
    • Sexual attitude-behaviour consistency will be lower for women than men
  • Strength of sex drive
    • Men have more frequent and more intense sexual desires than women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Human Sexual Response Cycle (4)

Masters & Johnson:

A
  • Masters & Johnson:
    • Excitement Phase (Initial Arousal)
    • Plateau Phase (at full arousal but not yet at orgasm stage)
    • Orgasm
    • Resolution Phase (after orgasm)
  • No difference between clitoral and vaginal orgasm (Freud)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sexual Dysfunction:

A

people who find it difficult to function adequately during sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dysfunction

A

Dysfunction

  • Refers to normal sexuality as opposed to paraphilias
  • Impairments or disturbances in:
    • Desire
    • Arousal
    • Orgasm
    • The presence of pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Paraphilic disorders

A

sexual deviation where sexual arousal occurs primarily in the context of inappropriate objects or individuals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Philia:

Para:

A

Philia: refers to strong attraction or liking

Para: indicates the attraction is abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Gender dysphoria:

A

incongruence and psychological distress and dissatisfaction with the gender one has been assigned at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

largest discrepancy in gender difference in sexuality

A

The frequency of masturbation (men over women)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fraternal birth order hypothesis:

A

that males are more likely to be gay if they have older brothers (the odds increase by one third for each older brother)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Biological limits

A

Almost certainly, biology sets certain limits within which social and psychological factors affect development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DSM-5 Classifications of sexual dysfunctions

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Female Sexual Interest/Arousal Disorder Diagnostic Criteria (sexual desire disorder)

A
  • A. Lack of, or significantly reduced, sexual interest/arousal, as manifested by at least three of the following:
    • Absent/reduced interest in sexual activity
    • Absent/reduced sexual/erotic thoughts or fantasies
    • No/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate
    • Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all (approximately 75% - 100%) sexual encounters
    • Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues (e.g., written, verbal, visual)
    • Absent/reduced genital or nongenital sensations during sexual activity in almost all or all sexual encounters
  • B. Symptoms in Criterion A have persisted for at least 6 months
  • C. Symptoms in Criterion A cause clinically significant distress in the individual
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Male Hypoactive Sexual Desire Disorder Diagnostic Criteria (sexual desire disorder)

A
  • A. Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity. The judgment of deficiency is made by the clinician, taking into account factors that affect sexual functioning, such as age and general and sociocultural contexts of the individuals’ life
  • B. Symptoms in Criterion A have persistent for a minimum duration of approximately 6 months
  • C. Symptoms cause clinically significant distress in the individual
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Erectile Disorder Diagnostic Criteria (sexual arousal disorder)

A
  • A. At least one of the three following symptoms must be experienced on almost all or all occasions of sexual activity:
    • Marked difficulty in obtaining an erection during sexual activity
    • Marked difficulty in maintaining an erection until the completion of sexual activity
    • Marked decrease in erectile rigidity
  • B. Symptoms have persisted for at least 6 months
  • C. Symptoms cause clinically significant distress in the individual
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Premature (Early) Ejaculation Diagnostic Criteria (orgasm disorder)

A
  • A. A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it
    • Specific duration criteria have not been established for nonvaginal sexual activities
  • B. The symptom in Criterion A must have been present for at least 6 months and must be experienced on almost all or all occasions of sexual activity
  • C. Symptom causes clinically significant distress
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Female Orgasmic Disorder Diagnostic Criteria

A
  • A. Presence of either of the following symptoms and experienced on almost all or all occasions of sexual activity
    • Marked delay in, marked infrequency of, or absence of orgasm
    • Markedly reduced intensity of orgasmic sensations
  • B. Minimum duration of approximately 6 months
  • C. Symptoms cause clinically significant distress
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Delayed Ejaculation Diagnostic Criteria (orgasm disorder)

A
  • A. Either of the following symptoms must be experienced on almost all or all occasions of partnered sexual activity, and without the individual desiring delay:
    • Marked delay in ejaculation
    • Marked infrequency or absence of ejaculation
  • B. Symptoms have persisted for minimum of 6 months
  • C. Symptoms cause clinically significant distress
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Genito-Pelvic Pain/Penetration Disorder Diagnostic Criteria (sexual pain disorder)

A
  • A. Persistent or recurrent difficulties with one or more of the following:
    • Vaginal penetration during intercourse
    • Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts
    • Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration
    • Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
  • B. Symptoms have persisted for a minimum of 6 months
  • C. Symptoms cause clinically significant distress
  • D. Sexual dysfunction not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors, not attributable to effects of substance/medication or other medical condition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vaginismus:

A

pelvic muscles in the outer third of the vagina undergo involuntary spasms when intercourse is attempted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Potential Causes of Sexual Dysfunction

Biological risk factors

Psychosocial risk factors

  • Individual
  • Relationship
A
  • Biological risk factors
    • Vascular disease
    • Diabetes, CNS diseases
    • Hormone levels
    • Alcohol use
    • Medications
    • Damage/injury to vagina
    • Age
    • Cigarette smoking
    • Chronic pain
  • Psychosocial risk factors
    • Individual
      • Psych disorders
      • Emotional issues
      • Maladaptive cognitions
      • Cultural factors
      • Lack of education
      • Sexual trauma
    • Relationship
      • Couple distress
      • Poor communication
      • Lack of physical attraction
      • Restricted sexual repertoire
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Assessing sexual behaviour (3) components

A
  1. Interviews, usually supported by numerous questionnaires because patients may provide more information on paper than a verbal interview
  2. Thorough medical evaluation, to rule out the variety of medical conditions that can attribute to sexual problems
  3. Psychophysiological assessment, to directly measure the physiological aspects of sexual arousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Medical/physical causes needed to rule out when diagnosing sexual dysfunctions

A
  • Alcoholism
  • Diabetes
  • Ageing
  • Neurological disorders
  • Illicit drugs
  • Medication side effects
  • Infections
  • Past operations
  • Past traumas
28
Q

Treatment Overview of sexual dyfunctions

A
  • Goals should not be performance-oriented
    • Primary goal should be to help couple develop more satisfying sexual relationship
  • Challenges to therapy
    • Preference for a simple pill
    • Rigid, faulty attribution for sexual difficulties
    • Noncompliance with work assignments
    • Extramarital affairs
    • Cultural or religious opposition to treatment methods
  • Methods:
    • Psychoeducation
    • Stimulus control
    • Cognitive restructuring
    • Return attention to erotic cues
29
Q

Arousal during performance demand for normal individuals and those with sexual dysfunctions

A
  • Normal functioning individuals show increased sexual arousal during “performance demand” conditions, experience positive affect, are not distracted by nonsexual stimuli and have a good idea about how aroused they are.
  • Individuals with sexual problems show decreased arousal during performance demand, experience negative affect, are distracted by non-sexual stimuli and do not have an accurate sense of how aroused they are.

These finding are particularly applicable to arousal disorders

  • Most sexual dysfunctions tend to occur together
30
Q

Psychological Treatment of Female Sexual Dysfunctions

A
  • Primary anorgasmia (never had an orgasm)
    • Sensate focus
    • Directed masturbation
  • Secondary anorgasmia (can have orgasms in some situations but not others)
    • Psychoeducation, sexual skills training, body image, communication training
  • GPPPD treatments (Genito-Pelvic Pain/Penetration Disorder)
    • Insertion training/dilation
    • Relaxation and Kegel exercises
    • Surgery
31
Q

Psychological Treatment of Male Sexual Dysfunctions

A
  • Erectile disorder
    • Systematic desensitization (used in anxiety)
    • Behavioural assignments and sex education
  • Premature (early) ejaculation
    • Squeeze/stop-start technique
32
Q

Pharmacological Treatments for sexual dyfunctions

A
  • Erectile dysfunction
    • PDE-5 inhibitors (e.g., Viagra, Cialis, Levitra)
    • Intercavernosal injections (injection straight into penis)
    • Vacuum tumescence devices
  • Hormonal treatment
    • Antidepressants and antianxiety medications
    • There is no wonder drug

  • Presently, the best treatment strategy is a combination of psychological and drug treatment*
  • A simple, effective treatment for many disorders is education*
33
Q

Paraphilia vs. Paraphilic Disorder

A
  • Paraphilia
    • Any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners
    • Paraphilias are ascertained
  • Paraphilic disorder
    • A paraphilia that is currently causing distress or impairment to the individual, or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others
    • Paraphilic disorders are diagnosed
34
Q

Categories of Paraphilic Disorders (2)

A
  • Anomalous activity preferences
    • ​Courtship disorders -> resemble distorted components of human courtship behaviour
      • Voyeuristic disorder, exhibitionistic disorder, frotteuristic disorder
    • Algolagnic Disorder -> involve pain and suffering
      • Sexual masochism disorder, sexual sadism disorder
  • Anomalous target preferences
    • Directed at humans (pedophilic disorder)
    • Directed elsewhere (fetishistic disorder, transvestic disorder)
35
Q

Paraphilic Disorders

A
  • Voyeuristic disorder
  • Exhibitionistic disorder
  • Frotteuristic disorder
  • Sexual masochism disorder
  • Sexual sadism disorder
  • Pedophilic disorder
  • Fetishistic disorder
  • Transvestic disorder
  • Other specified/unspecified
36
Q

Causes and Course of paraphilic disorders

A
  • M: F, 20: 1
  • An association between an object and sex can occur, but we don’t really understand how or why
  • Paraphilia fantasies may start in childhood/early adolescence
  • Become more pronounced in adolescence/early adulthood
  • Are recurrent and chronic
  • Can diminish with age (age-related decline in desire?)
37
Q

Fetishistic disorder

A

a person is sexually attracted to nonliving objects

38
Q

Voyeuristic Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviours
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
  • C. Individual is at least 18 years of age
  • Specify if:
    • In a controlled environment (for example, jail)
    • In full remission
39
Q

Exhibitionistic Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviours
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other
  • Specify whether:
    • Sexually aroused by exposing genitals to prepubertal children
    • Sexually aroused by exposing genitals to physically mature individuals
    • Sexually aroused by exposing genitals to prepubertal children and to physically mature individuals
  • Specify if:
    • In a controlled environment
    • In full remission
40
Q

Frotteuristic Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviours
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other
  • Specify if:
    • In a controlled environment
    • In full remission
41
Q

Sexual Masochism Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviours
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other
  • Specify if:
    • With asphyxiophilia (if individual engages in practice of achieving sexual arousal related to restriction of breathing)
    • In a controlled environment (for example, jail)
    • In full remission
42
Q

Sexual Sadism Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviours
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other
  • Specify if:
    • In a controlled environment
    • In full remission
43
Q

Pedophilic Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviours involving sexual activity with a prepubescent child or children (generally age 13 years or younger)
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other
  • C. Individual is at least 16 years of age and at least 5 years older than the child or children in Criterion A
    • Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old
  • Specify whether:
    • Exclusive type
    • Nonexclusive type
  • Specify if:
    • Sexually attracted to males
    • Sexually attracted to females
    • Sexually attracted to both
    • Limited to incest
44
Q

What We Know About Sexual Attraction to Children

Research has shown that pedophiles:

A
  • Have lower IQs
  • Have more neurocognitive impairment
  • Report more head injuries before the age of 13 (but not after)
  • Evidenced reduced grey and white matter volume in the brain
  • Show elevated rates of non-right-handedness
  • Are significantly shorter in height
  • Are more likely to have been in special education courses in schooling
45
Q

Fetishistic Disorder Diagnostic Criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from either the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviours
  • B. Individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other
  • C. Fetish objects are not limited to articles of clothing used in cross-dressing (as in transvestic disorder) or devices specifically designed for the purpose of tactile genital stimulation
  • Specify:
    • Body part(s)
    • Nonliving object(s)
    • Other
    • In a controlled environment
    • In full remission
46
Q

Transvestic Disorder diagnostic criteria

A
  • A. Over a period of at least 6 months, recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviours
  • B. (same as before)
  • Specify if:
    • With fetishism (if sexually aroused by fabrics, materials, or garments)
    • With autogynephilia (if sexually aroused by thoughts or images of self as female)
    • In a controlled environment
    • In full remission
47
Q

Other Specified Paraphilic Disorders

A
  • Bondage and dominance
  • Telephone scatologia
    • An obscene phone call, as the term is commonly used, is an unsolicited telephone call where a person derives sexual pleasure by using sexual or foul language to an unknown person
  • Necrophilia
    • corpses
  • Zoophilia
    • Animals
  • Coprophilia
    • feaces or defecation
  • Klismaphilia
  • Urophilia
    • urine or urination
  • Triolism
    • three people
  • Saliromania
  • Asphyxiophilia (restriction of breathing)

Estimates suggest that 5% to 10% of all sexual offenders are women

48
Q

History of Treatment for Sexual Disorders

A
  • Behavioural treatments
    • Aversive conditioning
    • Masturbatory satiation (satisfied to the full)
    • Vicarious sensitization
    • Covert sensitization (imagining bad consequences of actions until sexual desire disappears)
    • Orgasmic reconditioning (masturbation to usual fantasies but to switch to more desirable ones before ejaculation)
  • Cognitive interventions for empathy training
  • Surgical/medical treatments
49
Q

Current Psychological Treatments for Sexual Disorders/Offending

A
  • CBT and relapse prevention
  • Acceptance and Commitment Therapy
  • Risk-Need-Responsivity Model
  • Good Life Model
  • Self-Regulation Model
  • Online support/prevention groups
  • Consult with Association for Treatment of Sex Abusers (ATSA) for resources
50
Q

Psychopharmacological Treatment for Paraphilias

A
  • Antiandrogen medications
    • “Chemical castration”
  • SSRIs
  • Should only be used in combination with other interventions
51
Q

Gender Dysphoria

A
  • Marked incongruence between gender they have been assigned to and their experienced/expressed gender
  • Can start in either childhood or adolescence/adulthood
  • May undergo various degrees of gender reassignment
  • At increased risk for suicidal ideation, suicide attempts, and suicide
  • Prevalence:
  • Males: 0.005% to 0.014%
  • Females: 0.002% to 0.003%
52
Q

Gender Dysphoria in Adolescents and Adults Diagnostic Criteria

A
  • A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least two of the following:
    • A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
    • A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender
    • A strong desire for the primary and/or secondary sex characteristics of the other gender
    • A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
    • A strong desire to be treated as the other gender (or alternative)
    • A strong conviction that one has the typical feelings and reactions of the other gender (or alternative)
  • B. Clinically significant distress or impairment in social, occupational, or other important areas of functioning
  • Specify If:
    • With a disorder of sex development
    • e.g., a congenital adrenogenital disorder such as congenital adrenal hyperplasia or androgen insensitivity syndrome
    • Post-transition
    • The individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is preparing to have) at least one cross-sex medical procedure or treatment regimen—namely regular cross-sex hormone treatment or gender
53
Q

Male to Female: Homosexual (Androphilic) Type

A
  • Extreme form of homosexuality
  • Childhood cross-gender interests and behaviour
  • Cross-dressing in childhood not associated with sexual arousal
  • Attraction is to heterosexual men
  • Aim to be objects of desire
  • Transition at younger age
  • Less masculinized -> often quite attractive as women, “pass” well
54
Q

Male to Female: Autogynephilic Type

A
  • Paraphilic -> misdirected heterosexuality
    • Not high prevalence of gender non-conformity in childhood
    • Puberty -> cross-dressing and masturbation
    • Sexual fantasies about having female genitals and being penetrated
    • Strongest attraction is to themselves as a woman
    • More masculine
    • Transition later in life
  • Erotic target location error?
  • No good causal theory as to why this occurs
  • Many lie about their sexual orientation, tell “woman trapped in a man’s body” story
55
Q

Female-to-Male Transsexuals

A
  • “Transmen”
  • Almost exclusively attracted to females
  • Neo-phallus will never function as “normal” penis -> trans-status will always be known to sexual partners
  • Tend to pass well -> masculinizing effects of testosterone
56
Q

Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, V. 7

A
  • Created by world’s leading experts
  • Updated regularly to incorporate new data and information
  • Outlines roles and responsibilities for everyone in treatment/management group
57
Q

Good Reasons Not to Rush Into Sex-Change Treatment

A
  • Most children with GID outgrow wish to transition
  • Some carefully diagnosed persons spontaneously change their minds
  • Others make accommodations without medical interventions
  • Others give up wish to follow triadic sequence during psychotherapy
  • Some clinics have high drop out rate
  • Percentage of persons not benefitted by treatment varies significantly
58
Q

Options for Psychological and Medical Treatment of Gender Dysphoria

A
  • Changes in gender expression and role
  • Hormone therapy
  • Surgery to change primary and/or secondary sex characteristics
  • Psychotherapy
59
Q

Options for Social Support and Changes in Gender Expression

A
  • Peer support, organizations
  • Resources for family and friends
  • Voice and communication therapy
  • Hair removal
  • Breast binding/padding, genital tucking/prostheses, padding of hips/buttocks
  • Changes in name and gender marker on ID
60
Q

Effects of Hormone Therapy

A
  • Maximum physical effects may not be evident until two years of continued treatment, degree of effects varies from client to client
  • Desired effects:
    • Biological males
      • breast growth, some redistribution of body fat to approximate a female body, decreased upper body strength, softening of skin, decrease in body hair, slowing or stopping loss of scalp hair, decreased fertility and testicular size, less frequent and less firm erections
    • Biological females
      • Permanent changes -> deepening of voice, clitoral enlargement, mild breast atrophy, increased facial and body hair, male pattern baldness
      • Reversible changes -> increased upper body strength, weight gain, increased sexual interest, decreased hip fat
  • Potential negative side effects:
    • Biological males -> increased propensity for blood clotting, development of benign pituitary prolactinomas, infertility, weight gain, emotional lability, liver disease, gallstone formation, somnolence, hypertension, and diabetes
    • Biological females -> infertility, acne, emotional lability, increases in sexual desire, shift of lipid profiles to match male patterns which increase risk of cardiovascular disease, potential to develop benign and malignant liver tumors and hepatic dysfunction
61
Q

Gender Reassignment Surgery

A
  • Sex reassignment is effective and medically indicated in severe GD
  • Surgeon not merely a technician hired to perform a procedure -> part of an interdisciplinary team
  • Ideally the surgeon should have a close working relationship with the other professionals who have been actively involved in client’s psychological and medical care
  • Surgeons should personally communicate with at least one of mental health professional letters writers -> fictitious and falsified letters have occasionally been presented
62
Q

Breast Surgery

A
  • Breast augmentation and removal are common operations
  • Breast size or presence not involved in legal definitions of sex and gender
  • FTM -> mastectomy
  • MTF -> augmentation
63
Q

Surgery for MtF Clients

A
  • Genital surgery
    • Orchiectomy
    • Penectomy
    • Vaginoplasty
    • Clitoroplasty
    • Labiaplasty
  • Other surgeries
    • Reduction thyroid chondroplasty
    • Suction-assisted lipoplasty of the waist
    • Rhinoplasty
    • Facial bone reduction
    • Face lift
    • Blepharoplasty

Concerns about safety and effectiveness of voice modification surgery -> more research should be done prior to widespread

64
Q

Surgery for FtM Clients

A
  • Genital surgery
    • Hysterectomy
    • Salpingo-oophorectomy
    • Vaginectomy
    • Metoidioplasty
    • Scrotoplasty
    • Urethroplasty
    • Placement of testicular prostheses
    • Phalloplasty
    • Often requires more than one surgery
  • Other surgeries
    • Liposuction to reduce fat in hips, thighs, and buttocks
65
Q

Other

A
  • Aprox 1 -7% of people who undergo sex reassignment surgery who were available for follow up regret the surgery to some extent and 2% commit suicide after the surgery (which is higher than the rate for the general population). This could be because of misdiagnosis and assessment.
  • To qualify for surgery trans people need to live as the desired gender for 1 or 2 years, be stable psychologically, financially and socially, and then given hormones. If these are successful then sex reassignment surgery can occur.
66
Q

Charlie always felt out of place with the boys. At a young age he preferred to play with girls and insisted that his parents call him “Charlene”. He later claimed that he felt like a woman trapped in a man’s body. What disorder could Charlie have? What could be the causes of Charlie’s disorder? What treatments could be given to Charlie?

A
  • Gender dysphoria.
  • Causes could be abnormal hormone levels during development and social or parental influences.
  • Courses of action include sex reassignment surgery; psychosocial treatments to adjust to expressed or desired gender.
67
Q

Questions

A
  • After Bob’s football team won the championship, his interest in sexual activity diminished. All his thoughts and fantasies centered on football and winning again next season and his wife was threatening to leave him. Bob is probably displaying male hypoactive sexual desire disorder*
  • Kelly has no real desire for sex. She has sex only because she feels that otherwise her husband may leave her. Kelly suffers from female sexual interest/ arousal disorder*
  • Aardarsh lacks the ability to control ejaculation. The majority of the time he ejaculates within seconds of penetration. He suffers from premature ejaculation*
  • Samantha came into the office because she is unable to reach orgasm. She loves her husband but stopped initiating sex. She is most likely suffering from female orgasmic disorder*

T many physical and medical conditions and their treatments (for example, prescription medications) contribute to sexual dysfunction; however, many doctors are unaware of the connection

F (sometimes increases arousal) anxiety always decreases or even eradicates sexual arousal

T sexual dysfunctions can result from a growing dislike for a partner, traumatic sexual events or childhood lessons about the negative consequences of sexual behaviour

T a simple, effective treatment for many disorders is education

F (nondemand pleasuring, squeeze technique) all sexual dysfunctions are treated with the same psychosocial technique

T most surgical and pharmacological treatments of recent years have focused on erectile disorder

  • Mae enjoys being slapped with leather whips during foreplay. Without such stimulation, she is unable to achieve orgasm during sex sexual masochism disorder*
  • Kai has a collection of women’s panties that arouse him. He loves to look at, collect and wear them fetishistic disorder*
  • Peeping Tom loves to look through Susie’s bedroom window and watch her undress. He gets extremely excited as she disrobes. He is practicing voyeuristic disorder*
  • What peeping Tom does not know is that Susie knows he is watching. She is aroused by slowly undressing while others are watching, and she fantasizes about that they are thinking. Susie’s behaviour is called exhibitionist disorder*
  • Susie is actually Scott, a man who can become aroused only if he wears feminine clothing. Scott’s behaviour is fetishistic disorder*
  • Name some gender differences that exist in sexual attitudes and sexual behaviour*
  • More men than women masturbate and do it more often
  • Men are more permissive about casual sex
  • Women want more intimacy from sex

Which sexual preference or preferences are normal, and how are they developed?

  • Both heterosexuality and homosexuality are normal
  • Genetics seem to play some role in the development of sexual preference

ABNORMAL PSYC363 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions