Sexual Disorders And Gender Identity Disorder

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Health benefits of sex

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- immune system. People who have sex have higher levels of what defends your body against germs, viruses, and other Intruders.

- boost your libido. For women, having sex increases vaginal lubrication, blood flow, and elasticity.

- improves women's bladder control. A strong pelvic floor is important for avoiding incontinence, something that will affect about 30% of women at some point in their lives.

- lowers your blood pressure. One Landmark study found that sexual intercourse specifically not masterbation lowered systolic blood pressure.

- counts as exercise. Sex uses about 5 calories per minute for more calories than watching TV.

- lower heart attack. Besides being a great way to raise your heart rate, sex helps keep your estrogen and testosterone levels and balance. During one study men who had sex at least twice a week or half as likely to die of heart disease as men who had sex regularly.

- lessons pain. Orgasm releases a hormone that helps raise your pain threshold. Stimulation without orgasm can also do the trick.

- may make prostate cancer less likely.

- improve sleep.

- eases stress.

Front 2

The sexual response cycle

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- sexual desire is manifested in sexual thoughts and Fantasies, initiation of or participation in sexual acts, and awareness of sexual cues from others.

- the excitement phase consists of a psychological experience of arousal and pleasure, and the physical changes known as vasocongestion- feeling of blood vessels and tissues with blood, and myotonia- muscle tension.

- during the Plateau face, excitement remains at a high but stable level.

- orgasm follows the excitement and plateau phase, and involves the discharge of the built-up neuromuscular tension.

- resolution is the experience of a state of deep relaxation following orgasm, when the entire musculature of the body relaxes.

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Sexual dysfunctions

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• sexual dysfunctions occur at various stages of sexual response cycle.

• occasionally sexual problems are extremely common. To give a diagnosis of dysfunction, the sexual problems / Behavior must cause distress, impaired functioning, and occurred over six months.

• there are more studies on incidences and prevalence for men than women

• the most frequent sexual dysfunctions of women are desire and arousal dysfunction. Many women experience multiple sexual dysfunctions.

• for men, premature ejaculation and erectile dysfunction are the most common sexual dysfunctions.

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What causes sexual problems

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• common biological factors include:

- medical illness. Heart disease, diabetes, urinary tract disorders, chronic illness.

- side effects of drugs. Ssris.

- hormonal deficiencies.

• psychological factors include:

- negative attitudes about sex. Dirty or bad.

- performance anxiety.

- conflicts flash anger, distress with sexual partners.

• socio-cultural factors include:

- traumatic or stressful experiences. Job loss sexual assault loss of family member being busy

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Specifiers for sexual dysfunctions

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• lifelong or acquired. Lifelong being the person's had this dysfunction forever. Acquired is a dysfunction that they did not have in the past.

• generalized or situational

- situational only occurs in response to specific situations, Partners or forms of situations.

- generalized is overall or every situation.

• severity

- mild distress

- moderate distress

- severe distress

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Sexual desire disorder

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• low levels of Desire / interest. Most common. For 6 months or longer.

• male hypoactive sexual desire disorder.

• female sexual interest / arousal disorder.

- criteria for both include lack of or significantly reduced interest in sexual activity and low thoughts / fantasies about sexual activity.

- for females, also includes low arousal / pleasure, reduced genital Sensations during sexual activity.

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Disorders of excitement

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• premature ejaculation disorder. Ejaculation within one minute following penetration.

- treatments include stop-start technique, ssris.

• male erectile disorder. Involves the recurrent inability to attain or maintain an erection until the completion of sexual activity for 6 months or longer.

- systemic desensitization

- masturbation.

- sex education.

- communication skills.

- medication

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Orgasmic disorders

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• female orgasmic disorder: persistent and recurrent delay in or absence of orgasm and / or reduced intensity of orgasmic Sensations.

- 24% of women.

- specify if never experienced an orgasm

- ssris can cause delay or absent orgasm.

• treatment:

- directed masturbation

- directed masturbation and send Sensate Focus.

● delayed ejaculation: MALE. Involves the inability to delay ejaculation or in frequency / absence of ejaculation. Least common sexual dysfunction reported

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Sexual pain disorders

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• genital pelvic pain / penetration disorder

•persistent or recurrent difficulties with:

- vaginal penetration.

- pelvic pain.

- fear or anxiety about pain

- Pantene or tightening of pelvic floor muscles.

• prevalence of disorders unknown. 15% of women in the US report experiencing pelvic pain during intercourse.

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Treatment of sexual dysfunction

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- prefer or assessment of physiological factors.

- Mutual responsibility.

- psychoeducation.

- emotion identification.

- beliefs about sexual activities / engagement.

- addresses performance anxiety.

- increase sexual and communication skills. Sensate focus- goal orientation vs. Performance orientation.

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Paraphilia versus disorder

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• in DSM-5, paraphilias are not necessarily mental disorders.

- a a paraphilic disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia who is satisfaction and Tails personal harm, or risk of harm, to others.

- a paraphilia is a necessary but not sufficient condition for having a paraphilic disorder. A paraphilia by itself does not automatically justify or require clinical intervention.

• in the diagnostic criteria set for each of the listed paraphilic disorders, criteria a specifies the nature of the paraphilia. For example and erotic focus on children or on exposing genitals to strangers, and criteria be specified as the negative consequences of the paraphilia Flash distress, impairment or harm or risk of harm to others.

• in the DSM-5, individuals who meet both criteria a and criteria B would now be diagnosed as having a paraphilic disorder.

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Paraphilias

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• group of disorders in which the focus of the individual sexual urges and activities are:

- 1 non human

- 2 non-consenting adults

- 3 suffering or humiliation of oneself or one's partner, or..

- 4 children.

• behaviors / urges last longer than 6 months.

• variation in individuals distress. None too extreme guilt.

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Fetishistic disorder

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• A. the use of isolated body parts or inanimate objects as the preferred or exclusive source of sexual arousal or gratification.

•B. Causes distress or harm to self or other.

• transvestic fetishism: which is an individual distress in clothes of the opposite sex usually a man dressing in women's clothes in order to become sexually aroused.

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Voyeuristic disorder

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•A. Secretly watching another person undressing or doing things in the nude as a preferred or exclusive form of sexual arousal.

•B. Significant distress or impairment.

- a voyeuristic behavior is repetitive and compulsive almost all voyeurs are men who watch women.

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Exhibitionistic disorder

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•A. Obtaining sexual gratification by exposing one's genitals to involuntary observers who are usually complete strangers.

•B. Causes distress, harm, or impairment.

• the vast majority of exhibitionists are men exposing themselves to women, and sexually arouse all that usually comes from observing the woman's surprise, fear, or disgust. This behavior is often compulsive and for impulsive.

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Frotteuristic disorder

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•A. Gaining sexual gratification by rubbing against and fondling parts of the body of a non-consenting person.

•B. Causes distress or impairment to the individual or in Tales are more risk of harm to others.

• this Behavior has to be repetitive and compulsive, and has to represent a perferred way of gaining sexual gratification in order to qualify as frotteurism.

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Pedophillic disorder

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• involves seeking spiritual gratification with children.

- most pedophiles are heterosexual men engaging in sexual contact with young girls.

- many pedophiles feel intimidated when interacting sexually with adults. Some are victims of childhood sexual abuse themselves.

• treatment for the paraphilias

- antiandrogen drugs

- aversion therapy

- relapse prevention therapy

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Sexual sadism and sexual masochism

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Sadism: sexual pleasure derived from causing pain to another. May occur in the form of fantasies, urges or behaviors.

Masochism: sexual pleasure derived from experience in pain caused by another individual. May occur and the form of fantasies, urges or behavior.

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Gender dysphoria in children not a sexual disorder

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• strong and persistent identification with the other sex. In children, this is manifest by 6 or more of the following:

- required / strong desire to be, or insistence that he or she is the other gender.

- in boys, preference for crossdressing. And girls insistence on wearing only stereotypical masculine clothing.

- strong and persistent performance of cross sex rules in play and in fantasies.

- intense desire to participate in the stereotypical games and past time of the other sex.

- strong preference for Playmates of the other sex.

- dislike of one's sexual autonomy.

- rejection of typical / stereotype games of biological sex.

- desire for primary or secondary sex characteristics that match experienced gender.

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Gender dysphoria in adults and teens not a sexual disorder

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• marked and congruence with experience gender and assigned gender of at least six months with two or more of the following:

- Mart and congruence with experience gender and primary / secondary sex characteristics.

- strong desire to be rid of primary or secondary sex characteristics. Or desire to prevent development in teens.

- a strong desire to be other gender.

- a strong desire to be treated as other gender.

- strong conviction one has typical feelings and reactions to other gender.

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Gender dysphoria treatments

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• treatments for gender identity disorder.

- psychotherapy

- hormone therapy

- gender reassignment surgery. This has mixed results. Importance of pre-screening.