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Chapter 14

PSYB32H3 Chapter Notes - Chapter 14: Anorgasmia, Prostaglandin E1, California Psychological Inventory

Course Code
Konstantine Zakzanis

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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
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
oBelief that the behaviour was no longer a phase that the child would
grow out of
oThreshold violation (wanting to dress certain way outside of home
oBelief that the child was experiencing intense distress about being a
boy or girl
oConcerns 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
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
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
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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
person’s psychology the other is designed to alter the psychology to
match the person’s 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
oReasonable emotional stability
oSuccessful adaptation in the new role for at least 1 year before
oAdequate understanding of the actual limitations and consequences
of the surgery
oPsychotherapy in the context of an established gender identity
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 it’s usually ignored)
Most people with paraphilias are male
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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
Transvestic Fetishism
Transvestic fetishism: or transvestism; when a man is sexually aroused
by dressing in women’s clothing, although he still regards himself as a
Varies from wearing women’s underwear under clothes to full cross-
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 man’s 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 don’t 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
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