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Lecture 8

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Psychology 2030A/B
David Vollick

Chapter 10: Sexual Disorders and Gender Identity Disorder  Sexual Disorders and Gender Identity Disorder: An Overview  What is “normal” vs. “abnormal” sexual behaviors? o Cultural considerations (i.e. only about 50% of societies accept premarital sex) o Sexuality and the elderly o Gender differences in sexual behavior and attitudes- no difference between males and females re: number of sexual partners in the past year  Development of Sexual Orientation o Complex interactions of bio-psycho-social influences- no single factor can account for orientation  The Nature of Gender Identity Disorder  Clinical Overview o Trapped in the body of the wrong sex o Assume the identity of the desires sex, but the goal is not sexual (i.e. not sexually aroused be wearing opposite clothing)  Causes are Unclear o Postulations include abuse as a child and genetics o Biological- testosterone/estrogen? o GI develops between 18 months and 3 years of age  Sexual Reassignment as a Treatments of Gender Identity Disorder o Changing physiology; 75% report satisfaction with new identity o Female to male adjustment is better than male to female o Need to dress in the opposite gender and act like the opposite gender for a certain period of time to be able to qualify  Psychosocial Treatment of GI Disorder o Realigning the persons psychosocial gender with the biological sex o Few large scale studies  Sexual Dysfunctions: An Overview  The Normal Cycle- Figure 10.2  Sexual dysfunction involve desire, arousal, and/or orgasm  Males and females experience parallel versions of most dysfunctions o Affects 43% of females and 31% of males o Most prevalent class of disorders in the US  Most persons suffer from more than one dysfunction  Classification of Sexual Dysfunction o Lifelong vs. acquired: Lifelong= for as long as you can remember, never had the desire Acquired: were “normal” then suddenly can no longer be aroused o Generalized vs. Specific o Due to psychological factors alone or in combination with medical condition; need to first eliminate medical condition before treating  Sexual Desire Disorder  Hypoactive Sexual Desire Disorder o Little or no interest in any type of sexual activity o Masturbation, sexual fantasies, and intercourse are rare in this disorder o Accounts for half of all complaints at sexual clinics o 11% of women and 5% of men suffer from this disorder  Sexual Aversion Disorder o Little interest in sex o Extreme fear, panic, or disgust related to physical or sexual contact o 25% of patients met criteria for panic attacks (Kaplan)  Sexual Arousal Disorders  Male Erectile Disorder o Difficulty achieving and maintaining an erection  Female Sexual Arousal Disorder o Difficulty achieving of maintaining adequate lubrication  Associated Features of Sexual Arousal Disorders o Problem if arousal, not desire o Problem affects about 5% of males and 14% of females (hard to estimate females- lack of arousal often not considered a problem o Males are more troubled by the problem than females o Erectile problems are the main reason males seek help o Women report low arousal but have normal vaginal responses to erotica= problem: current definition focuses on “genital events” (lubrication difficulties – not enough in subjective arousal  Orgasm Disorders: An Overview  Inhibited Orgasm: Female and Male Orgasmic Disorder o Inability to achieve orgasm despite adequate sexual desire and arousal o Rare in adult males (also retarded and retrograde [goes back into bladder] ejaculation) o Most common complaint for adult females o 25% of adult females report significant difficulty reaching orgasm; at one point it was thought to be normal o 50% of adult females report experiencing regular orgasms during intercourse  Premature Ejaculation o Ejaculation occurring before the man or partner wishes to o 9% or all Canadian adult males meeting criteria for premature ejaculation o Most prevalent sexual dysfunction in adult males o Most common in younger, inexperienced males, and declines with age o How soon is too soon? Perhaps perception of lack of control better criterion  Sexual Pain Disorders  Dyspareunia o Associated with depression and anxiety o Extreme pain during intercourse adequate sexual desire, and ability to attain arousal and orgasm o Must rule out medical reasons for pain o Affects 1-5% of males and abou
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