Sexual and Gender Identity Disorders

Gender Identity Disorder The Paraphilias Sexual Dysfunctions

A) A strong and persistent cross-gender identification manifested in children by four or more of the following: Repeatedly stated desire to be the other sex Preference for wearing opposite-sex clothing Strong and persistent preference for cross-sex roles in make- believe play or fantasies of being opposite sex Intense desire to participate in games or pastimes of opposite sex Strong preference for playmates of opposite sex (In adolescents and adults, desire to live or be treated as opposite sex, or conviction that he or she has feelings and reactions of opposite sex) B) Persistent discomfort with his or her sex or sense of inappropriate- ness in the gender role of that sex (e.g., feeling disgusted with one’s sexual organs) Gender Identity Disorder (Transexualism)

Gender Identity Disorder Etiology –Hormonal or chromosomal abnormalities? –Social reinforcement? Treatment –Hormone therapy –Sex Reassignment Surgery –Behavioral therapy (aversion conditioning)

The Paraphilias Recurrent, intense, sexual fantasies, urges, or behaviors generally involving –Nonhuman objects –Suffering or humiliation of self or partner –Children or other non-consenting persons Condition must be present for at least six months Condition must cause significant distress or impairment in social or occupational functioning

The Paraphilias Fetishism Transvestic fetishism Pedophilia Exhibitionism Voyeurism Frotteurism Sexual masochism Sexual sadism Paraphilias NOS

Paraphilias Not Otherwise Specified (NOS) Telephone scatalogia (obscene phone calls) Necrophilia (sexual urges toward corpses) Partialism (exclusive focus on a part of the body) Zoophilia (sexual urges toward animals) Coprophilia (sexual attraction to feces) Klismaphilia (sexual gratification from enemas) Urophilia (sexual attraction to urine) Apotemnophilia (sexual interest in being an amputee) Acrotomophilia (sexual attraction to amputees)

Etiology Behavioral paraphiliac behavior is modeled and later compensated operant conditioning Compensation unable to have normal sexual relations so seek gratification elsewhere Physiological Androgen abnormalities during fetal development Childhood sexual abuse or distorted parent-child relationship may result in low level of self-esteem or social skills however Maletzky (1993): only 1/3 of pedaphiles were CSA The Paraphilias

Treatment –Behavioral orgasmic reorientation aversion therapy social skills training –Biological castration medroxyprogesterone accetate (Depo-Provera) –lowers testosterone –inhibits sexual desire

Sexual Abuse Childhood sexual abuse (CSA) Rape