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Chapter 14

PSYB32H3 Chapter Notes - Chapter 14: Transvestic Fetishism, Female Sexual Arousal Disorder, Gender Dysphoria

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
Gender identity disorder or transsexualism: 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
When GID begins in childhood it’s 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
GID is associated with a developmental lag in achieving a sense of gender constancy or
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
Belief that the behaviour was no longer a phase that the child would grow out of
Threshold violation (wanting to dress certain way outside of home also)
Belief that the child was experiencing intense distress about being a boy or girl
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
Excluded from GID are schizophrenics (who very little report being the opposite sex or
having both male and female reproductive organs)
A male with GID experiences his sexual interest in men as a conventional heterosexual
preference, since he considers himself a woman
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
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)
Attractiveness is also a factor, males with GID tend to be more attractive and females with
GID less attractive (males also report being distant with father and females report a history of
physical or 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

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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, while others go further to surgery
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
Reasonable emotional stability
Successful adaptation in the new role for at least 1 year before surgery
Adequate understanding of the actual limitations and consequences of the surgery
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—this resulted in the man thinking of himself as a man and not a
woman and finding women sexually attractive
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
A person can have the behaviours, fantasies, and urges that a person with a paraphilia has but
not be diagnosed with a paraphilia if the fantasies or behaviours are not recurrent or if he or
she is not markedly distressed by them
The distress & impairment part has caused some problems because many people with it are
neither distressed nor impaired (so it’s usually ignored)—such as a pedophile having sex
with young children
Most people with paraphilias are male
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,
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 (distinguishes fetishisms from ordinary attraction)
The disorder begins in adolescence
Fetishists often have other paraphilias (pedophilia, sadism, and masochism)
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 man
Varies from wearing women’s underwear under clothes to full cross-dressing
These 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

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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
Often comorbid with mood and anxiety disorders, substance abuse, and other paraphilias
The use of internet has made it easier for them to acquire a child
A minority of pedophiles, who might also be classified as sexual sadists or antisocial
(psychopathic) personalities, inflict serious bodily harm on the object of their passion (they
wish to hurt the child physically at least as much as they wish to obtain sexual gratification)
Homicidal child molesters show greater physiological response to and preference for
descriptions of assaults on children
Incest: sexual relations between close relatives for whom marriage is forbidden
Most common between brothers and sisters, then father-daughter (considered more
The incest taboo has adaptive evolutionary significance (negative biological effects)
It is more prevalent when mothers is absent or disabled
Incest is listed in DSM as a subtype of pedophilia
Difference between incest & pedophilia
Incest is by definition between members of the same sex
Incest victims tend to be more older than pedophile’s victims they desire
Incest is usually when they are mature physically whereas in pedophile is when they are
sexually immature
Gynephile: an adult who is incestuous with a child in the absence of a mature, adults sex
Plethysmograph measures have been described as phallometric tests and they have been
used to identity males – both adults and adolescents with pedophilic interests
Alcohol use and stress increases the likelihood that a pedophile will molest a child
1 ! of all child molestations (also within families) are committed by adolescent males (50%
of adult offenders began in early teens). Their homes often lacked structure and positive
pedophiles generally know the children they molest
Cluster analyses of scores on California Psychological Inventory have identified 4 types of
Antisocial/impulsive – more pathological characteristics
Unusual/isolated – more pathological characteristics
have a more + orientation toward others and overly shy
The adolescence have relatively + orientation toward others, but can be narcisstic and hostile
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