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Chapter 14

chapter 14 textbook note

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Mark Schmuckler

Chapter 14- Sexual and Gender identity disorders 1. Gender identity disorder 2. The paraphilias 3. Rape 4. Sexual dysfunctions Characteristics of GID Actions that are generally regarded as abnormal and dysfunctional are listed as sexual and gender identity disorders in the DSM-IV-TR Gender identity disorder: -sometimes referred to as transsexualism -know from early childhood that they are of the opposite sex -they have an aversion to same-sex clothing and activities. The evidence of their autonomy= normal genitals and the usual secondary sex characteristics doesnt persuade them that they are what others see them to be -the majority of GID cases are diagnosed as GIDNOS (gender identity disorder not otherwise specified) ;the person has symptoms that meet much of the description of GID, but there are some unique features that dont fit the criteria -when GID begins in childhood, it is associated with cross gender behaviours ie. Cross- dressing, preferring opposite-sex playmates and engaging in play that is usually more typical of the opposite sex (boy playing with barbies) -GID is usually recognized by parents when the child is 2-4 years old -GID is about 6.6 times more frequent in boys than girls -factors to seek clinical treatment.. 1. a belief that the behaviour was no longer a phase that the child would grow out of 2. a threshold violation 3. belief that the child was experiencing intense distress about being a boy or girl 4. concerns about potential/ actual rejection by peers www.notesolution.com -most children with GID do not grow up to be disordered in adulthood, even without professional intervention. However many demonstrate a homosexual orientation. -excluded from GID are ppl with schizophrenia who on very rare occasions claim to be of the other sex, as well as hermaphrodites, so called intersexed individuals, who have bothe female and male organs. A male with GID experiences his sexual interest in males as if he was a normal womanthey often experience discrimination in employment -GID in childhood is linked with separation anxiety disorderprevalence rates of 1/30,000 for men and 1/100,000-150,000 for women Causes of GID Children who experience a sense of inappropriateness in the culturally prescribed gender role of their sex but who do not experience discomfort with their biological sex shd be considered to have GID Classifying GID as a mental disorder may add to the stigma who go on to be gay Evidence indicates that gender identity is influenced by hormones Interviews with the parents of children who show signs of GID often reveal that they did not discourage, and in many instances clearly encouraged, cross-dressing behaviour in their atypical children. This holds true especially for feminine boys. Female relatives found it cute when the boys dressed in the mothers old dresses and high heels. The childs attractiveness is a factor that may contribute to this pattern of parental behaviour. Boys with GID have been rated as more attractive than control children and girls with GID less attractive. Male patients with GID report having distant relationships with their fathers, females often report a history of physical/sexual abuse A hypothesis is that stereotypically feminine behaviour in boys is encouraged by mothers who, prior to the childs birth, wanted very much to have a girl Our society has a low tolerance for boys who engage in feminine activities, where as girls can play games and dress up like boys and still conform to society Therapies for GID Body alterations: generally required to do 6-12 months of psychotherapy. The therapy typically focuses not only on the anxiety and depression that the person has likely www.notesolution.com been experiencing, but also on available options for altering his/her body. May have electrolysis to remove facial hair, surgery to reduce the size of their adams apple.. ,it is estimated more than 1,000 transsexuals are surgically altered -Sex reassignment surgery: made more frequently by men, is an operation in which the existing genitilia are altered to make them more like those of the opposite sex Preoperative factors that seemed to predict favourable-post surgery adjustment were 1) reasonable emotional stability 2)successful adaptation in the new role for at least one year before the surgery 3)adequate understanding of the actual limitations and consequences of surgery 4) psychotherapy in the context of an established gender identity program The Paraphilias Paraphilias: are a group of disorders involving sexual attraction to unusual objects/ sexual activities that are unusual in nature. There is a deviation (para) in what the person is attracted to (philia). The fantasies, urges, or behaviours must last at least 6 months and cause impairment. -The DSM diagnostic criterion of distress or impairment has created some problems b/c many ppl with their behavioural features of paraphilia are neither impaired or distressed -People often exhibit 1+ paraphilias Fetishism: involves a reliance on an inanimate object for sexual arousal. Almost always male, has recurrent and intense sexual urges toward non-living objects, and the presence of the fetish is strongly preferred or even necessary for sexual arousal to occur. Usually begins in adolescence. The attraction has a compulsive quality, it is experienced as involuntary and irresistible Transvestic fetishism: when a man is sexually aroused by dressing in womans clothing, although he still regards himself as a man. They are not considered transvestic unless the cross-dressing is associated with sexual arousal. Usually begins with partial cross-dressing in childhood/ adolescence. Transvestites are heterosexual, always male- many are married and may be accompanied by gender dysphoria: discomfort with ones anatomical sex -Autogynephilia: refers to a mans tendency to become sexually aroused at the thought or image of himself as a woman. www.notesolution.com
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