Chapter 10
- Gender Identity and Sexual Disorders
I. Important Definitions
A. gender identity
B. sex roles/gender roles
C. sexual orientation
D. normal vs. abnormal sexuality
1.
lack of choice
2.
lack of others’ consent
3.
harm to others
4.
mismatch with partner’s desire
5.
other distress/interference
II. Gender Identity
Disorder (aka transsexualism)
A. psychological issues AND political
issues in dx
1.
IS it a disorder? Transsexual vs transgendered?
2.
does NOT apply to intersex
individuals
B. etiology: how do we develop gender identities?
1. biological factors
a. the role of
genetics
b. the role of
hormones
c. the case of
John/Joan
2. psychosocial factors
a. environmental
pressures to conform to sex roles
b. the Janey/Joey study
C. treatment
1.
sex-reassignment
2.
alternative:
sex-reassignment minus surgery (full or part)
3.
behavioral tx to
alter gender identity
III. Sexual Response
Cycle Disorders (Sexual Dysfunction)
A.
Sexual desire disorders
1.
hypoactive
2.
aversion
B.
Sexual arousal disorders
1.
women:
lubrication problems (female sexual arousal d/o)
2.
men:
erectile problems (male erectile d/o)
C.
Orgasmic Disorders
1.
women:
not obtaining orgasm given “sufficient” sexual stimulation
a. preorgasmic
vs. anorgasmic
2.
men:
lack of orgasm/ejaculation (male orgasmic d/o) less common;
premature ejaculation much more
common
D.
Sexual Pain Disorders
1.
dyspareunia
2.
vaginismus
E.
Etiological and Related Factors in Sexual Dysfunction
1. biological: disease, hormone, meds, etc
2. alcohol/drug use, past and present
3. performance anxiety/
spectatoring
4.
sole focus on intercourse
5. partner of nonpreferred gender (or other demog)
6. sexual trauma
7. sociocultural
(e.g. strict or negative beliefs about sex)
8. masking other
problems/secondary gain
F.
Treatment for Sexual Dysfuntions
1.
addressing anxiety/relational concerns
2.
masturbatory training
3.
sensate focus (Masters and Johnson)
4.
biological approaches: estrogen, erectile aids (pump/meds), psych
meds
IV. Paraphilias
A. sexual attraction TO objects, or
needing the objects in the situation to become aroused, or attraction to specific sexual situations
B.
Inc. fetishes, tranvestic fetishism,
voyeurism, exhibitionism, s/m, etc
(C. pedophilia/incest and possibly rape)
D. Etiology
1. conditioned
associations
2.
“safer” outlets for sexual expression
3. self-serving
distorted thoughts
4. the role of
androgens
E.
Treatment:
1. orgasmic
reorientation (reconditioning)
2.
aversive conditioning
3.
cognitive therapy
4.
impulse control training, relapse prevention
5.
castration, medication