Sexual/Identity Disorders
SEXUAL AND GENDER IDENTITY DISORDERS
Sexual Dysfunction is a disruption in sexual response cycle or by pain associated with sexual intercourse. The sexual response cycle can be divided into four phases: desire (e.g. fantasies about sexual activity); excitement (e.g. sense of sexual pleasure and accompanying physical changes); orgasm (e.g. peaking of sexual pleasure with release of tension and rhythmic contraction) and resolution (e.g. sense of muscular relaxation and well-being).
Sexual Desire Disorders
Premature Ejaculation is the constant onset of orgasm and ejaculation with very little stimulation before or shortly after penetration and before that person wishes it. Majority of the time, delayed orgasm can occur during self-masturbation or considerably longer that sexual intercourse.
Vaginismus is the involuntary contraction of the outer muscles of the vagina when penetration (I.e. penis, finger, tampon or speculum) is attempted. Sometimes just the thought of vaginal insertion can result in muscle spasms. These contractions can range from mild, causing some tightness , to severe, preventing penetration or causing pain. Often the diagnosis is made during routine gynecological checks although there instances when Vaginismus occurs during sexual activity but not during a gynecological exam. The disorder is more commonly found in younger than in older females, in females with a negative attitude toward sex and in females who have a history of being sexually abused or traumatized.
Hypoactive Desire Disorder is when the sexual fantasies and desire for the fantasies do not occur. The individual does not usually initiate sexual activity or may be reluctant to engage in it when it is initiated by a partner.
Sexual Aversion Disorder is the active avoidance of genital contact with a sexual partner. It is usually accompanied by fear or disgust when confronted by a sexual opportunity. Some people are even revolted by kissing or touching. In severe cases panic attacks, faintness, nausea, palpitations, dizziness and breathing difficulties can occur.
Sexual Arousal Disorders
Female Sexual Arousal Disorder is a recurrent inability to maintain an adequate lubrication-swelling response during sexual activity. Individuals with this disorder may have little or no sense of sexual arousal and can result in painful intercourse, sexual avoidance, and the disturbance of relationships.
Male Erectile Disorder is a recurrent inability to maintain an adequate erection during sexual activity. Some people report never having an adequate erection and others will complain of experiencing an adequate erection but losing tumescence when attempting penetration or during thrusting. Many people experience sexual anxiety, fear of failure, concerns about performance and decreased excitement and pleasure.
Orgasmic Disorders
Female Orgasmic Disorder is a recurrent delay or absence of an orgasm after a normal sexual excitement. It may be caused by how the individual feels about their body image, self-esteem or relationship satisfaction.
Male Orgasmic Disorder is a recurrent delay or absence of an orgasm after a normal sexual excitement. In the most common form, orgasms are not reached during intercourse but can ejaculate from manual or oral stimulation.
Sexual Pain Disorders
Dyspareinia is a pain that is most commonly experienced during sexual intercourse but may also occur before or after in both males and females. The pain may be described as superficial during insertion or as deep during thrusting and the intensity can range from mild discomfort to sharp pain.
Sexual Dysfunction Due to a Medical Condition is the presence of significant sexual dysfunction that is an exclusive result of the direct effects of a general medical condition. The sexual dysfunction can involve pain associated with intercourse, hypoactive sexual desire, male erectile dysfunction and other forms of sexual dysfunction.
Substance Induced Sexual Dysfunction is a significant sexual dysfunction due to the use of substances(I.e. drugs, alcohol, medication). Depending on the substance involved, the dysfunctions can include impaired desire, arousal, orgasm or sexual pain. The dysfunction only occurs during the use of a substance.
Paraphilias are intense sexually arousing fantasies, urges or behaviors to objects, situations or individuals that is not part of normal stimulation. Individuals may act out their fantasies with unwilling victims.
Exhibitionism involves the exposure of one’s genitals to strangers. Once the urges are acted upon there is usually no further attempt at sexual activity with a stranger. Onset usually occurs before 18 but becomes less severe after age 40.
Fetishism involves the use of nonliving objects. A person usually has recurrent sexually arousing fantasies, urges or behavior involving the desired fetish (I.e. women’s underpants, bras, stockings, shoes boots or other apparel). These fantasies can cause significant distress in social, occupational and other areas of functioning.
Frotteurism involves touching or rubbing of one’s genitalia on a nonconsenting person. This behavior usually occurs in crowded places where the individual can easily escape arrest. He may rub his genitals against her thigh or buttocks or fondles her genitalia or breasts with his hands while fantasizing about an exclusive, caring relationship with the victim.
Pedophilia is intense sexually arousing fantasies, urges or behavior involving sexual activity with a prepubescent child or children. Some individuals with pedophilia are only sexually attracted to children and some are attracted to adults and children. Activities with these children are commonly explained with excuses or rationalizations like the have “educational value” for the child, that the child derives “sexual pleasure” from them, or that the child was “sexually provocative.” Often, the Pedofile will try to gain the child’s affection, interest and loyalty to prevent the child from reporting the sexual activity.
Sexual Masochism involves intense sexually arousing fantasies, urges or behaviors involving the act of being humiliated, beaten, bound or otherwise made to suffer. Some individuals are bothered by their fantasies but do not act upon them, others do act upon the fantasies either by themselves or with a partner. Masochistic acts with a partner include restraint, blindfolding, spanking, whipping, beating and humiliation. Individuals may have the desire to be treated like a helpless infant and clothed in diapers(“infantilism”) and in the most dangerous cases an individual may have the desire to be deprived of oxygen (“hypoxyphilia”) sometimes resulting in death.
Sexual Sadism involves acts in which an individual is aroused from the psychological or physical suffering of a victim. In these cases the person fantasizes about having complete control over the no consenting victim who is terrified by the sadistic act. Others act on theses urges with a consenting partner who willingly suffers pain or humiliation. The acts can include restraint, blindfolding, spanking, whipping, beating, burning, rape, stabbing, strangulation, torture, mutilation or killing. In severe cases, an individual with Sexual Sadism may actually kill the victim.
Transvestic Fetishism is only present in heterosexual males and involves cross dressing in women’s attire. The fantasies can range from being a woman with female genitalia to a view of one’s self fully dresses as a woman with no attention to genitalia. Some males wear a single item of women’s clothing under their masculine attire. Others dress entirely as a female and wear makeup. Although the basic preference is heterosexual, he may have engaged in homosexual acts. The disorder typically emerges in childhood or early adolescents and in most cases the cross dressing is not done in public until adulthood.
Voyeurism involves observing, or watching, unsuspecting individuals, usually strangers, undress or engage in sexual activity. The purpose of this is to achieve sexual excitement, and generally no sexual activity with the person is sought but is fantasized about to achieve orgasm through masturbation. The onset of this behavior is usually before age 15 and tends to be chronic.
Gender Identity Disorder
Gender Identity Disorder is a strong and persistent cross-gender identification, desire to be or insistent that one is of the other sex. The individual is uncomfortable about one’s assigned sex. In boys, there is a preference for cross-dressing and a strong attraction for stereotypically girl activities (I.e. playing house, drawing pictures of princesses, playing with Barbie dolls or playing house). Typically they avoid rough and tumble play and completive sports. They sometimes pretend to not have a penis, pushing it between their legs and in rare cases find their penis and testes disgusting expressing a want to remove them and wishing to be a girl. Girls display intense negative reactions to wear dresses or other feminine attire and sometimes avoid school or social events where such clothes may be required preferring to wear boys clothing and short hair. They may occasionally refuse to urinate in the sitting position and insist that she has or will grow a penis. Adolescents and adults may express and intense desire to adopt the social role of the opposite sex and/or acquire the physical appearance through hormones or surgery.
