Week 6 - Gender Dysphoria & Paraphilias Flashcards
Biological Sex
Chromosomes & physical anatomy
Gender
Social construct, referring to norms, behaviors and roles associated with being male/female/other in a society or culture
Gender role
A (subjective) set of behaviors, interests, personality traits that a society/culture relates to a certain gende
Gender identity
The subjective feeling to belong to a gende
Gender expression
How one expresses their gender identity
AFAB/AMAB
Assigned female / male at birth
Gender incongruence
Gender identity does not align with assigned sex
The gender unicorn
- Gender identity
- Gender expression
- Physically attracted to
- Emotionally attracted to
Challenges in daily life
- Figuring yourself out in a cis-normative world
- Coming out and coming in
- Figuring out your gender expressions / possible social or medical transition
- Minority stress and internalized transphobia
- Gender incongruence and gender dysphoria
Medical treatment gender dysphoria
Medical interventions can sometimes reduce gender dysphoria and improve quality of life becauseof that.
Options include:
* Variations in cross-sex hormones
* Various surgical options
* Various less invasive referrals (hair removal, speech therapy)
* Fertility preservation
Development in recent years
Greater diversity
* in gender identity, gender expression and dysphoria
* in treatment wishes (no longer binary / whole package)
* in gender development and psychological comorbidity
Evolutions / changes in patient treatment wishes along the way
Cross-sex hormones
Feminization
* Adding a form of estrogen (e.g. breast development, fat distribution)
* Blocking testosteron (e.g. easier hair removal, decrease muscle mass, decrease sexual function / desire)
Masculinization
* Adding a form of testosteron (e.g. easier muscle gain, increased body and facial hair, clitoral (=penis) growth, lowering of voice, increase sexual desire)
Surgery options AMAB
- Adam’s apple reduction
- Breast augmentation
- Facial Feminization Surgery
- Voice surgery
Genital surgery
* Vaginoplasty (vulva + vaginal cavity)
* Vulvaplasty (only vulva, no cavity)
* Orchidectomy (only removal testicles)
Surgery options AFAB (transmen, transmasculine, nonbinary, etc)
- Breast removal
- Removal of uterus, ovaries, or vaginal cavity
Genital surgery
* Metaidoioplasty (reconstructing existing area into a small penis)
* Phalloplasty (using skin from elsewhere to construct a ne-phallo)
Role of the mental health profesional
- Diagnosing
- Counselling
- Communication assistance
Diagnostic themes
- Genderidentity
- Social functioning
- Cognitive functioning
- Psychosexual functioning
- Mental functioning
- Physical functioning
- Informational knowledge
Paraphilia
- An atypical experience of recurring/intensesexual arousalto objects, situations, fantasies, behaviors, or individual
- Asexual interest in anything other than a consenting human partn
The 4 d’s of abnormal behavior
- The behavior is highly deviant
- The behavior is dysfunctional
- The behavior causes emotional distress
- The behavior is dangerous
What may be a cause of paraphilias
It is not very well understood. It is probably something with the interplay between hormonal development and sexual development and socialisation
Measures you can take for paraphilia
- Deconditioning
- Masturbatory reconditioning
- Drugs that decrease sexual arousal [e.g., cyproterone acetate]
- (chemical) Castration [offenders + IC]
- Cognitive techniques (mindfulness,impulse control, cognitive restructuring)
- Interpersonal (skills) techniques
- Psychoeducation
Types of paraphilias
- Fetishism
- Transvestism
- Exhibitionism
- Voyeurism
- Pedophilia
- Sadomasochism
- Frotteurism
- Necrophilia
- Zoophilia
Types of paraphilic disorders
- Exhibitionistic disorder
- Voyeuristic disorder
- Pedophilic disorder
- Coercive sexual sadism disorder
- Frotteuristic disorder
With non-consenting individuals
* Necrophilia
* Zoophilia
With consenting individuals
* Sadomasochism
* Fetishistic transvestism
* Fetishism
