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Chapter 14: Sexual and Gender Identity Disorders Sexual and gender identity disorder: full range of human sexual thoughts, feelings and actions that are generally regarded as abnormal and dysfunctional Gender Identity Disorder Gender identity: our sense of ourselves as male or female Characteristics of Gender Identity Disorder Transsexualism: people with gender identity disorders are sometimes referred to as this; they feel deep within themselves (usually from early childhood) that they are of the opposite sex They may want to pass as a member of the opposite sex or even have surgery In childhood associated with cross-gender behaviours dressing in opposite-sex clothes, preferring opposite-sex playmates, and engaging in play that would be more typical of the opposite sex They are usually recognized by their parents at age 2-4 GID is 6.6x more frequent in boys than girls (Zucker) factors associated with decision to seek clinical assessment o Belief that the behaviour was no longer a phase that the child would grow out of o Threshold violation (wanting to dress certain way outside of home also) o Belief that the child was experiencing intense distress about being a boy or girl o Concerns about potential or actual rejection by peers Most children with GID do not grow up to be disordered in adulthood, even without professional intervention; many demonstrate homosexual orientation GID people often experience anxiety and depression GID in childhood is linked with separation anxiety disorder Prevalence rate 1/30,000 (men) 1/100,000-150,000 (women) Causes of Gender Identity Disorder More information is needed on the cause of GID in order to resolve this debate Evidence indicates that gender identity is influenced by hormones Other research shows that human and other primate offspring of mothers who have taken sex hormones during pregnancy frequently behave like members of the opposite sex and have anatomical abnormalities Brain structures differences are also being investigated C h a p t e r 1 4 : S e x u a l & G e n d e r I d e n t i t y D i sPage 12e r s Environment may play a huge factor as well (male patients report having distant relationships with their fathers; females often report history of physical/sexual abuse) Therapies for Gender Identity Disorder There are 2 main types one attempts to alter the body to suit the persons psychology the other is designed to alter the psychology to match the persons body Body Alterations Prior to body alterations the person is required to go through 6-12 months of psychotherapy The therapy focuses on anxiety & depression as well as options available to the person on altering their body Some people may chose just to have cosmetic surgery (facial hair, adams apple removal etc), and take hormone pills Sex reassignment surgery: an operation in which the existing genitalia are altered to make them more like those of the opposite sex It is much more frequently exercised by men than by women Satisfactory factors (not regretting) of postsurgery was based on o Reasonable emotional stability o Successful adaptation in the new role for at least 1 year before surgery o Adequate understanding of the actual limitations and consequences of the surgery o Psychotherapy in the context of an established gender identity program Alterations of Gender Identity Some apparently successful procedures for altering gender identity through behaviour therapy have been reported One technique paired slides of women with slides of men, the idea being that sexual arousal from the latter might be transferred to the former this positive approach to changing the arousal properties of images and fantasies was complemented by aversion therapy to reduce the attractiveness of men The Paraphilias Paraphilias: a group of disorders involving sexual attraction to unusual objects or sexual activities that are unusual in nature These fantasies, urges or behaviours must last at least 6 months and cause significant distress or impairment The distress & impairment part has caused some problems because many people with it are neither distressed nor impaired (so its usually ignored) Most people with paraphilias are male Fetishism C h a p t e r 1 4 : S e x u a l & G e n d e r I d e n t i t y D i sPage 12e r s Fetishism: involves a reliance on an inanimate object for sexual arousal Almost always male & has recurrent and intense sexual urges toward non living objects The presence of the fetish is strongly preferred or even necessary for sexual arousal to occur Examples feet, shoes, sheer stockings, rubber products, toilet articles, fur garments, underpants The attraction felt has a compulsive quality (involuntary and irresistible) Erotic focalization: the exclusive and very special status the object occupies as a sexual stimulant The disorder begins in adolescence Fetishists often have other paraphilias (peudophilia, sadism, and masochism) Transvestic Fetishism Transvestic fetishism: or transvestism; when a man is sexually aroused by dressing in womens clothing, although he still regards himself as a man Varies from wearing womens underwear under clothes to full cross- dressing Impersonators are not considered transvestic unless the cross-dressing is associated with sexual arousal It should not be confused with cross-dressing associated with GID or with the cross-dressing preferences of some homosexuals Autogynephilia: a mans tendency to become sexually aroused at the thought or image of himself as a women (typically found in association with transvestism) Usually begins with partial cross dressing in childhood or adolescence Transvestites are heterosexual, always males, and by and large cross- dress episodically rather than on a regular basis They tend to be masculine in appearance & many are married Cross-dressing usually takes place in private and in secret and is known to few members of the family Distress & disability dont seem to apply at all to transvestics Over time it may get stronger and they may feel discomfort with their anatomical sex ( gender dysphoria ) but not to the extent of GID Its comorbid with other paraphilias like masochism Pedophilia and Incest Pedophilia: adults who derive sexual gratification through physical and often sexual contact with prepubescent children unrelated to them The offenders must be at least 16 years old and at least 5 years older than the child Occurs more frequently in males C h a p t e r 1 4 : S e x u a l & G e n d e r I d e n t i t y D i s oPage 12r s
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