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Flashcards in Sexual Disorders Deck (25):

Sexual orientation: disordered or not?

Not disordered
Homosexuality is no longer considered by the DSM to be a disorder


Gender dysphoria characteristics

Mismatch between one's perceived gender and actual gender (feel as if born into wrong body)
Strong desire to be rid of one's own sex characteristics
Can begin in childhood- puberty is torture as person develops into gender that he/she doesn't want to be


Gender dysphoria is not...

Sexual orientation
Sexual attraction
Cross dressing in and of itself
Desire for privilege/esteem that accompanies other sex
Intersex (presence of indiscriminate sex organs)


Gender dysphoria epidemiology

0.01% lifetime prevalence: very rare disorder
2:1 male to female
Age of onset: puberty or earlier
30-50% project into adulthood: other 50-70% are either going through phase or suppress their feelings


Gender dysphoria causes/contributors

Vastly unknown (perhaps too much testosterone in girls or not enough in boys?)
Possibly genetics or social factors


Gender dysphoria treatment

Most common: sex-reassignment
3 steps:
1. Must undergo evaluation to determine that this isn't just a phase and that person is ready to change gender
2. Hormone therapy: spend about 2 years living as opposite gender while taking hormones
3. Surgical alteration
75% report satisfaction (relief rather than elation), but other 25% still struggle with identity


Sexual dysfunctions: desire-related

Female sexual interest/arousal disorder: woman has either fear of sex or lack of interest
Male hypoactive sexual desire disorder: man has lack of interest in sex


Sexual dysfunctions: arousal-related

Female sexual arousal disorder: woman can't achieve or maintain lubrication
Male erectile disorder: man can't achieve or maintain an erection


Sexual dysfunctions: orgasm-related

Female orgasmic disorder: woman can't orgasm
Delayed ejaculation disorder
Premature ejaculation


Sexual dysfunctions: pain-related

Genito-pelvic pain/penetration disorder
Genital pain during sex


Paraphilic disorders

Person gains arousal from things that don't normally cause arousal
Can have multiple paraphilic arousals, but usually 1 is primary
Can sometimes achieve arousal without object/activity, but often need it for arousal
People with these disorders often feel guilt for their activities


Frotteuristic disorder

Person gains sexual arousal by touching or rubbing against a non-consenting (or unknowing) person
Often occurs when person is in a crowded place and person ends up rubbing another person nearby
Often considered sexual assault
More common in males than females


Voyeuristic disorder

"Peeping Tom" disorder
Person gains sexual arousal by observing an unsuspecting individual who is naked, disrobing, or engaged in sexual behavior for arousal
Must be at least 18 years old
More common in males than females


Exhibitionistic disorder

Person gains sexual arousal by exposing their genitals to unsuspecting strangers (flashing)
Driving forces: sense of showing off, sense of developing relationship with person who sees genitals
More common in men than women


Sexual masochism disorder

Person is aroused by having pain inflicted upon him/her
Specifier: with asphyxiophilia (arousal through being choked)
More common in males than females


Sexual sadism disorder

Person is aroused by inflicting pain upon another person (must be real- not faked)
Can be consensual, but not always (considered sexual abuse if not)
Most sex offenders don't actually have this disorder


Fetishistic disorder

Person gains sexual arousal through either non-living things or highly specific non-genital body parts
Object of fetish must be present to be aroused
Tactile and olfactory properties are important
Doesn't include cross-dressing
Almost exclusively males


Transvestic disoder

Person gains sexual arousal through cross-dressing
Potential mechanisms: fetishism (sexual arousal brought on by feeling of clothes) or autogynephilia (sexual arousal due to fantasies of being the opposite sex)
More common in men (many are married)


Pedophilic disorder

Sexual arousal through sexual activity with pre-pubescent children (can be attracted to either gender)
Can be exclusive (only attracted to kids) or non-exclusive (attracted to adults, too)
More common in males
Rationalization ("She was coming on to me!") or compensation (do something good to help kids to compensate for guilt/shame) common
People with this disorder can recognize that what they're doing is wrong


Rarer paraphilic disorders

Scatologia: sexual arousal from poop
Necrophilia: sexual arousal from corpses
Zoophilia: sexual arousal from animals


Risk factors for paraphilic disorders

Early inappropriate sexual associations
Limited consensual adult arousal (lack of sex; not much evidence for this)
Poorly developed social skills (can't develop normal relationships)


How paraphilic disorders are reinforced

Attempts to suppress undesired arousal


Treatment for paraphilic disorders

Behavioral interventions (not extremely effective): covert sensitization and orgasmic reconditioning
Medications: chemical castration (reduce testosterone and suppress sex drive)


Covert sensitization

Method of treating paraphilic disorders
Person goes with fantasy, but then thinks about the worst possible outcomes of acting out on fantasy


Orgasmic reconditioning

Method of treating paraphilic disorders
Person masturbates to fantasy object, but switches to more appropriate object right at climax