PART E

Sexual Disorders and Gender Identity Disorders

Paraphilias include the following:

• voyeurism – receiving gratification by watching others without their knowledge • fetishism – sexual desire for objects such as leather, feathers, lace
• transvestic fetishism – sexual obsession for women’s clothes (cross-dressing in men)
• sexual sadism – experiencing orgasm through inflicting pain
• sexual masochism – experiencing orgasm through receiving pain or humiliation
• exhibitionism – intense sexual arousal from exposing genitals in a public setting
• pedophilia – powerful desire for sexual contact with children (prepubescent individuals)
• others – (e.g., frotteurism, coprophilia, necrophilia)


More detailed information regarding the paraphilias is beyond the scope of this course. You may obtain information from your nearest library or the Internet.

The second category of sexual disorders is sexual dysfunctions. People with sexual dysfunctions have difficulty performing adequately when having sex. They can experience problems with either desire or arousal. From male erectile disorder (inability to achieve or maintain an erection) and female sexual arousal disorder (inability to achieve or maintain sufficient lubrication) to inhibited orgasm and dyspareunia (persistent or frequent pain before, during, or after intercourse), the range of problems is wide. For the purposes of this course, orgasm is defined as an intense pleasurable sensation resulting from sexual arousal. Orgasm is usually accompanied by the ejaculation of semen in the male and by vaginal contractions in the female.

Sexual dysfunctions can result from psychological factors, physical and/or biological factors, and/or the interaction of psychological factors with physical and/or biological factors. A few examples are listed in Table 11.1.

Table 1.1:
Factors Linked to Sexual Dysfunction

Psychological Factors
Physical/Biological
Factors
- fear of inadequacy
- fear of pregnancy
- depression
- sexual trauma
- fear of AIDs
- low attraction to partner		 - neurological damage to the genitals
- inadequate blood flow to the penis resulting from vascular disease
- chronic congestive diseases (heart or lung diseases)
- side effects from prescription medication
- alcoholism


Depending on the type and cause of the sexual dysfunction, treatment can involve medication alone or in combination with cognitive exercises. Some disorders have high recovery rates while others may persist over the lifetime of the individual. As with the paraphilias, more information on specific sexual dysfunctions can be obtained from the Internet, libraries, and specialized health care professionals.

Please note that the following information, a preamble to gender identity disorder, is reprinted with permission from the American Psychological Association.