Gender Dysphoria, Sexual Dysfunctions & Paraphilic Disorders Flashcards Preview

NB 3 Dev & Psych > Gender Dysphoria, Sexual Dysfunctions & Paraphilic Disorders > Flashcards

Flashcards in Gender Dysphoria, Sexual Dysfunctions & Paraphilic Disorders Deck (25)
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describe diagnostic criteria for gender dysphoria (GD)

  • a marked incongruence between one's assigned (natal) gender and one's experienced gender
  • the incongruence results in clinically significant distress or functional impairment
  • symptoms endure at least 6 months


describe indicators of GD

  • belief that one is the opposite gender
  • desire to act as, and be treated as, the opposite gender
  • desire to be rid of one's sex characteristics and to possess those of the opposite gender
  • conviction that one has the typical feelings/reactions of the opposite gender


explain the etiology of GD

  • a transgender identity is thought to result from altered androgen exposure during critical periods of in-utero development as follows:
    • if XY and brain NOT androgenized at typical time, then a female gender identity develops
    • if XX and brain IS androgenized, then a male gender identity develops


describe sexual dysfunctions

  • problems related to the normal sexual response cycle (sexual desire, sexual arousal, orgasm)
  • problems persist for at least 6 months


describe female sexual interest/arousal disorder

problems with libido and/or physiological arousal


describe female orgasmic disorder

a delay in, the inability to, or having low-intensity orgasms


describe genito-pelvic pain/penetration disorder

difficulties with vaginal penetration or vulvovaginal/pelvic pain during intercourse/penetration attempts


what are some causes of sexual dysfunction?

  • medication (SSRIs)
  • alcohol/drug use (sedatives)
  • medical/physical problem (circulatory problems leading to erectile dysfunction)
  • normal aging (slower erections, decreased orgasm intensity, increased refractory period)


describe the snap gauge test

  • determines whether erections occur during REM
  • if REM erections occur, then the problem is not organic


describe treatment to increase libido and responsiveness

  • dual sex therapy: involves sensate focus exercise (proscribed non-sex activities progressing to coitus)


describe treatment to slow ejaculation in premature ejaculation

  • "squeeze" technique: partner squeezes the glans penis to cause discomfort
  • "start and stop" technique: partner ceases stimulation of the partner to reduce pleasure
  • SSRIs


explain PLISSIT (overall treatment strategy)

  • permission (P): give approval to discuss, fix and enjoy sex
  • limited information (LI): provide basic sex education and correct misconceptions
  • specific suggestions (SS): provide specific suggestions (sensate focus exercise, etc.)
  • intensitve therapy (IT): refer on if the above steps fail to resolve the issue


describe paraphilia

  • an intense and persistent (≥6 months) deviant sexual interest (as manifested by fantasies, urges or behaviors)
  • deviant: sexual interest OTHER THAN for genital stimulation or preparatory fondling with phenotypically normal, physically mature consenting human partners


describe diagnostic criteria for paraphillic disorder

  • a paraphilia is a disorder if any of the following 3 conditions occurs:
  • if an individual:
    • acts on the urge with a non-consenting person
    • acts on the urge with a consenting person (or acts on an urge unrelated to people) and the actions cause significant distress/functional impairment
    • does NOT act on the urge but the urge causes significant distress/functional impairment


describe exhibitionism

  • sexual arousal from exposing genitals to an unsuspecting stranger


describe voyeurism

  • sexual arousal from observing unsuspecting person either naked, in the process of disrobing or engaging in sexual activity
  • person must be at least 18 years old


describe fetishism

  • sexual arousal from nonliving objects or a highly-specific sexual focus on a non-genital body part
  • note: devices specifically designed for tactile genital stimulation don't count as a fetish


describe transvestism

  • sexual arousal by cross-dressing (wearing the opposite sex's clothing)


describe frotteurism

  • sexual arousal from touching or rubbing against a non-consenting person


describe sexual sadism vs. sexual masochism

  • sexual sadism: sexual arousal from causing psychological/physical suffering of another person
  • sexual masochism: sexual arousal from receiving psychological/physical suffering 


describe pedophilia

  • sexual arousal by a prepubescent child (usually 13 yrs or younger)
  • perpetrator must be at least 16 years old AND at least 5 years older than the child


describe the etiology of paraphilias

  • the cause of sexual deviancy is multi-factorial and largely unknown
    • suggested influences:
      • ​testosterone levels affecting sex drive (no differences have been established)
      • frontal lobe dysfunction & serotonin dysregulation affecting impulse control
      • classical conditioning 


describe aversion therapy to treat paraphilia

  • aversion therapy:
    • while engaging in (or thinking about) one's paraphilia, an ACTUAL noxious stimulus is applied to the patient
    • or
    • while fantasizing about one's paraphilia, a patient IMAGINES averise consequence (covert sensitization)


describe medication to treat paraphilic disorders

  • antidepressants: SSRIs are used to reduce libido, control impulses and reduce obsessions
  • anti-androgen (chemical castration): medroxyprogesterone acetate (aka Depo-Provera) is used to decrease testosterone levels
    • helps reduce sex drive and thus minimize deviance
    • used especially when sexual behavior is illegal, uncontrolled or dangerous
    • non-compliance is a problem


describe registration and notification of sex offenders

  • registration: states require that people convicted of certain sex crimes register as a sex offender
  • notification: personal info. about some registered sex offenders is made publically available (Megan's law)