Sexual and Gender Identity Disorders

Question 1

name 8 sexual dysfunctions

Answer 1

hypoactive sexual desire dis
female arousal ./ pain dis
males erectile dis
male orgasmic dis
feamle orgasmic dis
premature ejaculation
dyspareunia
genito/pelvic pain dis

Question 2

differences between males and females

Answer 2

females
-XX chromosomes
- estrogen hormones
-vagina 
-ovaries
males
-XY chromosomes
-androgen hormones
-penis
-testes

Question 3

gender

Answer 3

psychosocial meaning of maleness or femaleness

Question 4

gender identity

Answer 4

psychological sense of being male or female

Question 5

gender role

Answer 5

cultural norms for male and female behaviour

masculine and feminine expectations of the sexes

Question 6

case of john / joan

Answer 6

circucision mishap
one twin had sex-reassignment surgery
raised as a female
given hormonal replacement therapy in teens
was used as a case for enviornment influences as being strong enough to develop appropriate gender identity
-was miserable as a teenager
-sex re-reassignment
-married a woman, adopted her children
-committed suicide in may 2004 aged 38
nurture is not enough

Question 7

summary of normal sexual behaviours accross different genders

Answer 7

by in large gender gap is decreasing for everything
men 
-masturbate more
-better premarital sex attitudes 
-more sexual partners
women
-more love and intimacy
-more negative core beliefs
equal views on homosexuality

Question 8

cultural differences in normal sexual behaviour example

Answer 8

sambia new guinea
younger boys give blowjobs to older boys
older boys did not engage in masturbation
then older boys marry and stay with one wife, younger boys become the older boys etc
no increased incidene of homosexuality
normal behaviour in the cultural context

Question 9

what is normal sexual behaviours

Answer 9

not
-by default - ie haven’t met the right girl yet
-seduction - ie gay teacher leading astray
-contagion - ie same sex couple adopting (no increased incidence of gay kids, more accepting kids)
-parentsv- ie mum over nurtures boys, but is true gay men more often report having strained relationships with their father = maybe unaccepting father, men are much harsher at enforcing gender roles than women
may be based on
-genetics (50% concordance in mz twins)
-hormones - gay men = women finger thing
-structural (brain) - hypothalamus smaller in women and in gay men more similar to women
-gene-environment interaction (Bem’s exotic becomes exotic, no evidence simply boys who are girly play with girls, then when puberty hits joins in the girls looking at boys and starting to find them attractive)

Question 10

DSM 5 gender dysphoria

Answer 10

incongrunence between experienced gender and primary / seconday sex characteristics
stated desire to gte rid of primary / secondary characteristics because of above point
desire for sex characteristics of other gender
desire to be the other gender
conviction of other gender feelings
lasts at least 6 months

Question 11

gender dysphoria stats and background

Answer 11

rare
more ocmmon in natal males (3:1)
different to transvestic fetishism
not due to physical abnormalities (as with intersex)
goal is to live life as the opposite gender; not sexual
independent of sexual orientation
causes are unknown, 62% genetic concordance

Question 12

sex reassignment surgery as treatment for gender dysphoria

Answer 12

surgery to alter physical anatomy to conform to their psychological gender identity
must live in the opposite sex role 1-2 years before surgery (can seem too long so go abroad)
must be stable psychologically, financially and socially

Question 13

outcomes of sex reassignment surgery as treatment

Answer 13

75% satisfied
female to male conversions abdjust better than male to female (upgrade idea)
7% regret surgery
can maintain erection with added surgical options eg pump a balloon, titanium rod

Question 14

explain the sexual response cycle and where problems can occur

Answer 14

(X)desire phase - sexual urgers occur in response to sexual cues or fantasies, parasympathetic nervous system
(X)arousal stage - subjective sense of sexual pleasure and physiological signs of arousal
plateau phase - period before orgasm
(X)orgasm phase - in males feelings of inevitability of ejaculation followed by ejaculation; in females contractions of the walls of the lower third of the vagina
resolution phase - decreased arousal occurs after orgasm (particularly in men)
back to desire phase

Question 15

physiological signs of arousal

Answer 15

males
-penile tumescence (increased flow of blood into penis)
females
-vasocongestion (blood pools in the pelvic area) leading to vaginal lubrication and breat tumescence (erect nipples)

Question 16

overview of sexual dysfunctions

Answer 16

pain may be associated with sexal functioning - in men is entirely medically explained
males and females experience parallels of most disorders
may be lifelong, chronic or aquired
may be generalized or specific
43% females
31% males

Question 17

female sexual interest / arousal disorder

Answer 17

low sexual interes and recurrent inability to become excited
maintain adequate lubrication and maintain arousal from erotic cues until completion of sexual activity
at leat 3 of the following:
-absent / reduced interest
-absent/ reduced erotic thoughts
-no/ reduced and unreceptive to partner attempts
-absent/ reduced excitement during sex
-absent/ reduced response to sexual cues
-absent/ reduced genital sensation

Question 18

female orgasmic disorder

Answer 18

recurrent dealy or absence of orgasm in some women following normal sexual excitement phase, relative to prior experience and current stimulation
delay, infrequency or absence of orgasm
reduced intensity of orgasmic sensation
5-10% females never orgasm (only 50% females experience reasonably regular orgasms)
causes are typically situational or cultural
symptoms for 6 months

Question 19

genito-pelvic pain / penetration disorder

Answer 19

specific to women
pain / anxiety, tensions associated with sexual activity muscle spasms in the vagina that interefere with penetration
persistent difficulties with:
-vaginal penetration during intercourse
-vulvovaginal or pelvic pain during intercourse (or attempts)
-marked anticipatory fear or anxiety about genital pain
-marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
-symptoms present for 6 months

Question 20

male hypoactive sexual desire disorder

Answer 20

lack of interest in sexual activity or fantasy that wouldn’t be expected considering the persons age and life situation
persistent or recurrently deficient or absent sexual fantasies and lack of desire for sexual activity
may be associated with another dysfunction
may masturbate or have sex even with low desire
typically stop initiating

Question 21

erectile disorder / erectile dysfunction

Answer 21

inability in some men to attain or maintain adequate penile erection until completion of sexual activity
increases as you get older - normal part of the ageing process

Question 22

delayed ejaculation

Answer 22

achieve orgasm with great difficulty or not at all

delay, infrequency, or absence of orgasm following normal desire and arousal phases, relative to prior experience

Question 23

premature ejaculation

Answer 23

recurring ejaculation within 1 minute following penetration and before the person wishes it (1-3% all adult males)
-note 75% college males note that they ejaculate sooner than they wished; cultural expectations associated with porn as primary method of sex education

Question 24

DSM 4 categoris of sexual dysfucntions

Answer 24

secual desire disorders - lack of interest in sex or aversion to sexual contact
sexual arousal disorders - failure to become adequately sexually aroused to engage in or sustain sexual intercourse
orgasmic disorders - difficulty reaching orgasm or reaching orgasms more rapidly than one would like
sexual pain disorders - persistent or recurrent experience of pain during coitus

Question 25

risk factors for sexual dysfunction

Answer 25

* Occur in women more than men * Occurs after age of 30 * Old age increases the chance * Painful intercourse * Cardiovascular disease, depression, diabetes * Alcohol abuse * Some medications (e.g., antidepressants) * Estrogen deprivation (postmenopausal) * Emotional or stress related problems * Decreased libido * Delay/absence of orgasm * Inability to attain vaginal lubrication/swelling * Inability to maintain erection * Lost of interest in sexual activity

Question 26

bio causes of sexual dysfunction

Answer 26

``` medical conditions -neuro diseases -diabetes -vascular disease -chronic illness reaction to medications -beta blockers (anti-performance anxiety) -tricyclics -SSRIs recreational drugs ```

Question 27

psych causes of sexual dysfunctions

Answer 27

``` cognitive -low expectations -avoid sexual cues physiologically -underestimated their arousal emotionally -experience sexual situation more negatively and experience negative emotion in the process ```

Question 28

social and cultural causes of sexual dysfunctions

Answer 28

erotophobia = learned early that sexuality is negative and threatening negative or traumatic sexual experiences (orgasmic disorder) close interpersonal relationships - poor communication and sexual skills script theory of sexual functioning - guided by scripts reflecting social and cultural expectations interaction - negative attitudes may predispose one toward performance anxiety leading to sexual dysfunction

Question 29

psychosocial sexual dysfunction treatments

Answer 29

masters and johnsons treatment - male and female therapist to facilitate communication in a couple (daily for 2 weeks); goal is to eliminate anxiety. not used muhc now as expensive but ideas are the core of most therapies -education about sexual functioning (altering myths, fostering communication) -sensate focus, couples approach, naked touching without arousal -non-demand pleasuring - don't have to react to touching removes anxiety and pressure

Question 30

medical treatments for sexual dysfunctions

Answer 30

viagra + CBT = more effective than drug alone vasodilating drugs - injecting into the penis when they want to have sex, this produces and erection penile prostheses - surgical option vacuum device therapy

Question 31

masters and johnson treatments for | premature ejaculation

Answer 31

squeeze technique - establish erection and the partner squeeze the penis near the top to quickly reduce arousal teaches man to be aware and control his arousal but have to top it up ie effects diminish

Question 32

masters and johnson treatments for | female orgasmis disorder

Answer 32

masturbatory training procedures

Question 33

masters and johnson treatments for | vaginismus

Answer 33

dilator insertion (with relaxation techniques)

Question 34

masters and johnson treatments for | low sexual desire

Answer 34

reeducation and communication masturbatory training introduction of erotic material

Question 35

paraphilia

Answer 35

``` sexual attraction or arousal directed at innappropriate people and or objects that causes significant distress or harm common comorbities -mood -anxiety -substance abuse ```

Question 36

11 types of paraphillias and in their subgroups

Answer 36

``` noncoercive -fetishistic -transvestic coercive -voyeurism -exhibitionism -frotteurism -pedophilia -zoophilia (beastiality) -telephone scatologia -necrophilia S&M -sexual sadism -sexual masochism ```

Question 37

fetishism

Answer 37

recurrent, intense, sexually arousing fantasies, urges or behaviours involving the use of nonliving objetcs symbolic transformation - the object is part of the essence of its owner so that the child responds to the object as he might react to the actual person operatn condition + incredibly strong sex drive (OCD)

Question 38

transvestic disorder

Answer 38

recurrent and intense sexual arousal from cross-dressing (fantasies, urges, behaviours) males may show highly masculinized compensatory behaviours many are married and the behaviour is known to spouse/ partner majority are heterosexual

Question 39

voyeurism

Answer 39

the practice of observing an unsuspecting person undressing to become aroused = and the risk associated with it

Question 40

exhibitionism

Answer 40

sexual arousal and gratification by exposing ones genital to unsuspecting stranger the shock of other is the bit that causes arousal

Question 41

frotteurism

Answer 41

sexual arousal and gratification through ribbing the body parts on unsuspecting strangers (usually in crowded areas)

Question 42

pedophilia

Answer 42

sexual attraction to young children (incest = to ones own children) both may involve male and or female children or veyr young adolescence (ie 14 = illegal but past puberty wouldn't be pedophilia) in women is rare but not unheard of incestous males are more aroused by adult women most molestors are not physically abusive to their victims rationalize behaviour loving the child or teaching almost never consider the psych damage to their victims often highly religious

Question 43

warning signs of pedophilia

Answer 43

* Vast majority are males and heterosexual * Sexual urges geared towards prepubescent child * Sexual fantasies with prepubescent child * Record of prior sexual conviction * Lack of intimate partners * Never being married * Poor relations with own mother * Overly touchy and affectionate with kids * Being alone with kids a lot * Being a victim of child abuse at a younger age * Excessive use of alcohol * Low self-esteem * Repeated lying

Question 44

causes of pedophilia

Answer 44

no classic profile of the pedophile offender exists pedophilia is assciated with sexual and social problems and deficits pattterns of inappropriate arousal and fantasy may be learned early in life the role of high sex drive, coupled with suppression of urges

Question 45

sexual sadism

Answer 45

sexually arousing fantasies, urges or behaviours involving acts involving the suffering of another

Question 46

sexual masochism

Answer 46

``` sexually arousing fantasies, urges or behaviours involving act of being humiliated, beaten bound or otherwise made to suffer development -need for heightened arousal -escape from self-awareness -guilt relief ```

Question 47

treating paraphilia - psychosocial treatments

Answer 47

covert sensitization family / marital therapy orgasmic reconditioning coping ad relapse prevention

Question 48

results of psychosocial treatments for paraphillia

Answer 48

70-100% effective men who rape have the second to lowest success rate those with multiple paraphillias have the lowest success rate (multiple paraphillias are unfortunately more common than single) clinicians expertise appears important

Question 49

predictors of failure of treatment of paraphillias

Answer 49

``` unstable social relationships unstable employment history strong denial history of multiple victims continues to live with victim chronic course with high rates of recurrence ```

Question 50

drug treatments of paraphillias

Answer 50

anti-androgen medications to reduce testosterone reduces desire, but not funcitoning only successful while on medication

Question 51

excpetions 2 dis there isnt another gender version ie only effects one gender

Answer 51

vaginismus | premature ejaculation

Question 52

understanding arousal study

Answer 52

men say yes to porn more both men and women = aroused when watching (women only slightly less so then men) women consistently said no didn't arouse me, men said yes it did women = taught to ignore their internal cues for arousal

Question 53

pneumonic mainstream sex therapists use

Answer 53

``` PLISSIT P ermission L imited I nformation S pecific S suggestions I ndividual T herapy ```