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Chapter 14

PSYB32H3 Chapter Notes - Chapter 14: Anger Management, Charlotte Selver, Relationship Counseling


Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis
Chapter
14

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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 Disorder
Sexual identity our sense of ourselves as male or female
Sexual Orientation our preference for the sex of a partner
Characteristics of Gender Identity Disorder (GID)
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
Transvestism cross-dress for sexual pleasure but do not identify themselves as of opposite sex (GIDNOS)
They may want to pass as a member of the opposite sex or even have surgery
GID is different from GIDNOS (gender identity disorder not otherwise) since that involves symptoms that meet
GID but there are some symptoms that do not
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:
Social factors associated with disorder and many factors determine 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
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 or they
necessarily do not have abnormal gender identity but they sometimes did exhibit some cross-sex behaviours
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)
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, Adam’s 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 female-to-male surgery were more successful than male-to-female
It is much more frequently exercised by men than by women
Preoperative factors that resulted in postsurgery success was based on:
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oReasonable emotional stability
oSuccessful adaptation in the new role for at least 1 year before surgery
oAdequate understanding of the actual limitations and consequences of the surgery
oPsychotherapy 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
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) they may also choose not to seek clinical intervention
Most people with paraphilias are male
Pedophilia someone who has repeatedly had sex with young children
Fetishism
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 women’s clothing,
although he still regards himself as a man
Varies from wearing women’s 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 as it does not involve gender identity dilemma
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 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; violence is not involved but they often threaten the child
The offenders must be at least 16 years old and at least 5 years older than the child
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Occurs more frequently in males & can be hetero or homo
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 pathological)
The incest taboo has adaptive evolutionary significance (negative biological effects)
It is more present when mothers is absent or disabled or in patriarchal or traditional families
Incest is listed in DSM as a subtype of pedophilia
Difference between incest & pedophilia
oIncest is by definition between members of the same sex
oIncest 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 partner
Plethysmograph measures have been described as phallometric tests and they have been used to identity males –
both adults and adolescents with pedophilic interests
History of exposure to pornography is a cause of sexual offending but this remains inconclusive
Pedophiles generally know the children they molest (ie. Neighbours, friends of family)
There is correlation b/n negative mood of pedophile and sexual fantasies about children
Pedophiles are low in social maturity, self-esteem, impulse control, & social skills; are often married
Alcohol use and stress increases the likelihood that a pedophile will molest a child
1 ½ 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 support; many were sexually abused as kids
Cluster analyses of scores on California Psychological Inventory have identified 4 types of offenders
oAntisocial/impulsive – more pathological characteristics
oUnusual/isolated – more pathological characteristics
oOvecontrolled/reserved
have a more + orientation toward others and overly shy
oConfident/aggressive
The adolescence have relatively + orientation toward others, but can be narcisstic and hostile at times
Screening scale for Pedophilic Interests (SSPI): screening instrument that is quite successful in distinguishing
pedophilic child molesters and non child molesters who have abused older victims
Voyeurism
Voyeurism: involves a marked preference for obtaining sexual gratification by watching others in a state of
undress or having sexual relations
There is seldom contact with the observer and he/she may masturbate while watching or later when recollecting
Almost always a man
The voyeur is excited by the anticipation of how the women would react if she knew he was watching
Voyeurs are most often charged with loitering rather than with peeping itself
Onset - adolescence
It’s thought that they are more fearful of more direct sexual encounters with others, because they may lack social
skills
Exhibitionism
Exhibitionism: recurrent, marked preference for obtaining sexual gratification by exposing one’s genitals to an
unwilling stranger, sometimes a child
Onset – adolescence
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