Transcript Sexual and Gender Identity Disorders

Sexual and Gender
Identity Disorders

What Is “Normal” vs. “Abnormal” Sexual
Behavior?
 Cultural
considerations
 Gender differences in sexual behavior and
attitudes
 Complex interaction of biopsychosocial
influences

Including partner’s characteristics
Sexual and Gender
Identity Disorders
Gender Identity Disorder
 Sexual Dysfunctions
 Paraphilias
 Not Sexual Orientation (Homosexuality)

Gender Identity Disorder


Difference between sex and gender
Key feature: sense of being trapped in the body
of the wrong sex
 Assume
the identity of the desired sex
 Goal is not sexual

Causes are unclear
 Gender
identity develops between 18 months and 3
years of age
Gender Identity Disorder

Transsexualism
 Goal
is Not Sexual
 No Physical Abnormalities
 Independent of Sexual Arousal Patterns


NOT Transvestism
Homosexuality
 Unrelated
Gender Identity Disorder

Sex-reassignment as a treatment
is a candidate? – Basic prerequisites before
surgery
 75% report satisfaction with new identity
 Female-to-male conversions adjust better
 Who

Psychosocial treatment
 Realign
psychological gender with biological sex
 Few large scale studies
Sexual Dysfunctions



Involve desire, arousal, and/or orgasm
Pain associated with sex can lead to additional
dysfunction
Men and Women experience parallel versions of
most dysfunctions
 Affects
about 43% of all women and 31% of men
 Most prevalent class of disorder in the United States
Classification of Sexual
Dysfunctions




Lifelong vs. acquired
Generalized vs. situational
Psychological factors alone
Psychological factors combined with medical
condition
Sexual Response Cycle
Sexual Dysfunctions

Desire
 Hypoactive
Sexual Desire
 Sexual Aversion Disorder

Arousal
 Male
Erectile Disorder
 Female Sexual Arousal Disorder
Sexual Dysfunctions

Orgasm
 Inhibited
Orgasm
 Premature Ejaculation

Pain
 Dyspareunia
 Vaginismus
Sexual Dysfunctions

Causes?
 Medical
Conditions
 Medications
 Alcohol and Other Drugs
 Traumatic and/or Negative Experiences
 Performance Anxiety and Distraction
 Interpersonal Factors
 Cultural Factors
Sexual Dysfunctions

Biological Treatments
 Medications and Injections
 Surgery and Implants
 Vacuum Device Therapy
Sexual Dysfunctions

Psychosocial Treatments
 Education
 Eliminate Performance Anxiety (Spectator Effect)
 Relationship Enhancement
 Gradual Building of Intimacy
 Sensate focus and nondemanding pleasuring
 Squeeze technique (Premature ejaculation)
 Masturbation training (Female orgasm disorder)
 Use of dilators (Vaginismus)
 Exposure to erotic material (Desire problems)
Paraphilias
Definition
 Often multiple paraphilic patterns of
arousal
 High comorbidity with anxiety, mood, and
substance abuse disorders

Paraphilias
Pedophilia
 Fetishism

 Transvestic
Voyeurism
 Exhibitionism
 Sadism and Masochism
 Frotteurism

Other Paraphilias
Scatologia -- Obscene Calls
 Klismaphilia -- Enemas
 Coprophilia -- Feces
 Zoophilia -- Animals
 Necrophilia -- Corpses

Paraphilias

Biological Treatments (Medication)
 Anti-Androgen

Reduces Testosterone Levels
 Reduces
Sexual Desire / Fantasy
 Used for Sex Offenders
 Seen as Only a Temporary Solution
Paraphilias

Psychosocial Treatment
 Suppression

Paradoxically Backfires
 Covert
Sensitization
 Orgasmic Reconditioning
 Family and Marital Therapy
 Relapse Prevention
Clarifications
Homosexuality is not considered a
disorder
 Homosexuality is unrelated to gender
identity disorder
 “Cross-dressing” could be due to:

 Transvestic
fetish
 Transsexualism
 “Being a Drag Queen”