Sexual and Gender Identity Disorders:
At the outset: four terms
1. Anatomic sex: biological sex, based on XX or XY chromosomes
2. Gender Identity: internal feelings as to whether one is male or female (I am male/ I am female)
3. Gender role: external behavior (particularly social behavior but can include sexual behavior) how one wishes to be seen by others (or oneself) as a male or female
4. Sexual orientation: preference for sexual partners
Sexual dysfunctions
- sexual desire, sexual arousal, orgasmic, sexual pain
Paraphilias
Gender Identity Disorders
Human sexual response cycle
1. desire/appetitive- fantasies about sexual activity and the desire (libido) to have it
2. excitement: subjective sense of sexual pleasure with accompanying physiologic changes (male-erection, female- vaginal lubrication) swelling of the external genitalia) called excitement and plateau by masters and Johnson
3. orgasm- the peaking of sexual pleasure an the release of sexual tension. Mediated by the sympathetic nervous system (males- ejaculation, females- contraction of outer third of vagina)
4. Resolution- generalized muscular relaxation. Males have refractory periods (refractory to erection or orgasm) females can respond immediately to additional stimuli.
Sexual dysfunctions: disturbance in response phases (first 3 phases)
Subtypes: lifelong or acquired, generalized or situational, psychological or combined factors)
Five etiological factors in sexual dysfunction
1. intrapsychic- performance anxiety, guilt, low self esteem, denial, undue self-monitoring (spectatoring)
2. interpersonal: intimacy issues, fear of abandonment, power struggles, lack of trust, failure to explicitly inform partners about open’s particular sexual needs and specific pleasures, a sex manual mentality, displaced anger.
3. Cultural” sexual myths, insufficient or incorrect information, negative attitudes about sex learned from