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Chapter 14

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Konstantine Zakzanis

Chapter 14: Sexual and Gender Identity Disorders GENDER IDENTITY DISORDER Gender identity disorder (GID) or transsexualism: feel deep within themselves, usually from early childhood, that they are the opposite sex  dressing in opposite-sex clothes, preferring opposite-sex playmates…  GID is usually recognized when the child is between 2 and 4 years old  6.6x more likely in boys than girls many demonstrate homosexual orientation Causes of GID: Children of mothers who have taken sex hormones during pregnancy frequently behave like members of the opposite sex and have anatomical abnormalities Parents who encouraged it (unknowingly) dressed up little boys in dresses because it was cute 2 main types of therapy for GID: Body alterations  6-12 months of psychotherapy  Some only choose to have cosmetic surgery (male to female- remove facial hair, reduce size of chin and adams apple)  Take hormones to bring their bodies physically closer to their beliefs about the gender  Sex-reassignment surgery: existing genitalia are altered to make them more like those of the opposite sex  Each year in USA, more than 1000 transsexuals are surgically altered to the opposite sex Alterations of gender identity  Shaping various specific behaviours (mannerisms and interpersonal behaviour- how to talk to young women) PARAPHILIAS Paraphilias: group of disorders involving sexual attraction to unusual objects or sexual activities that are unusual in nature distorted parent-child relationship will create lack of empathy towards women alcohol and negative affect are often triggers Types of paraphilias: Fetishism- reliance on an inanimate object for sexual arousal (women’s shoes, sheer stockings…)  usually begin in adolescence and even during childhood  often have other paraphilias such as: pedophilia, sadism, and masochism Transvestic fetishism- when a man is sexually aroused by dressing in women’s clothing, although he still regards himself as a man Pedophilia- adults who derive sexual gratification through prepubescent children  offender is at least 16 years old and at least 5 years older than the child  often comorbid with mood and anxiety disorders, substance abuse…  child is usually a neighbour or friends of the family  about 50% of adult offenders began their illegal behaviour in their early teens  offenders are more socially isolated and have poorer social skills than their peers  don’t know what they are doing is wrong, think they are doing something good for the child Incest- sexual relations between close relatives for whom marriage is forbidden  most common between brother and sister, and father and daughter  not related to pedophilia Voyeurism- marked preference for obtain sexual gratification by watching others in a state of undressing or having sexual relations  Electronic voyeurism: videotaping another person while voyeurism occurs  For some men, voyeurism is the only sexual activity in which they engage, for others it is preferred but not absolutely essential for sexual arousal  Voyeur fantasizes about having sexual contact with the observed person , but it remains a fantasy  Element of risk is important for the voyeur, doesn’t want the women to know that he is there, but is excited by how the women would react if she saw him Exhibitionism- preference for obtaining sexual gratification by exposing one’s genitals to an unwilling stranger, sometimes a child  Typically begins in adolescence  Rarely tries to have actual contact with the stranger  Desire to shock or embarrass the observer Frottuerism- sexually oriented touching of an unsuspecting person  Attack usually occurs in places that provide an easy escape (crowded bus or sidewalk) Sexual sadism & sexual masochism- obtaining sexual gratification by inflicting pain or psychological suffering on another (humiliation) is sadism, obtaining or increasing sexual gratification through subjecting oneself to pain or humiliation is masochism  Both are found in heterosexual and homosexual relationship  20-35% of sadomasochistic clubs are female  Begin in early adulthood  Majority establish relationships with masochists to derive mutual sexual gratification (blindfolding one’s partner, spanking, whipping, electric shocks, cutting…)  Sadistic offends are more likely to impersonate police officers, commit serial murders, tie up their victims, and conceal corpses Other paraphilias:  Necrophilia- sex with dead people  Zoophilia- bestiality (more in rural areas among men with lower levels of intelligence)  Telephone scatalogia- repeated urge to make obscene phone calls  Coprophilia- use of feces for sexual excitement Therapies for Paraphilias: Aversion therapy- used to change behaviours (a man who is sexually attracted to children will receive an electric shock when he is shown a picture of a child) Orgasmic reorientation- help client learn to become more aroused by conventional sexual stimuli (photo of a woman) Cognitive treatment- training in empathy toward others, teaching offende
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