1. Sexual Disorders
Rebecca Sposato MS, RN

2. Normal Sexuality
Necessary for procreation of species, continuation of family heritage
Contributes to sense of well-being
Desire, arousal/excitement, climax, resolution
An abnormality occurs when one of the steps deviates from natural pattern or is a source of pain or distress for the individual

3. Abnormalities related to Desire
Hypoactive libido – low motivation to initiate, respond to or maintain sexual activity
Etiology – endocrinal, psychological, relational
Sexual Aversion – revulsion and active avoidance of sexual activity, which lacks pleasure and is marked by anxiety

4. Abnormalities related to arousal
Arousal/Erectile disorders – delayed, reduced or abnormal physiological response to sexual stimuli, mechanics controlled by the spinal cord
Dyspareunia, vaginismus,
Erectile dysfunction
Hypersexual – increased or inappropriate sexual behavior beyond accepted social norms
Paraphilia – sexual arousal resulting from atypical stimuli
Fetishism – nonliving objects, >6 months
Situations – exhibitionist, voyeurism
BDSM – abnormal if non-simulated
Non-consenting partner– frotteurism, pedophilia

5. Pedophilia
Persistent or exclusive attraction to prepubescent girls and/or boys
Not all adults who commit an act of sexual abuse on a child are pedophiles
90% of child victims knew the abuser, over 60% are within the child’s extended family
<5% involve abduction/coercion by a stranger
Only a small minority of pedophiles use force, most groom the child with praise, treats and companionship prior to initiating sexual contact
Most pedophiles seek compliance in the victim
20% relapse w/i 5 years of completing treatment ( 2011)

6. Transsexuals/Gender Dysphoria
The identity of self as opposite gender
Prefers mannerisms of opposite gender
The size of bed nucleus of the stria terminalis (BST) found in the hypothalamus is switched in transsexuals
A) heterosexual male
B) heterosexual female
C) homosexual male
D) MTF transsexual
High rate of depression, anxiety and suicide
Kruijever, Zhou, Pool, Hofman, Gooren, & Swaab, 2000

7. Nursing Interventions
Protect and prevent patient and others from harm and victimization
Maintain matter-of-fact and supportive composure
Nonjudgmental in professional role
Therapy : psychoanalysis, CBT, REBT
Support Groups
Law enforcement if sexual abuse is disclosed

8. References
Association for the Treatment of Sexual Abusers (2011). Retrieved from
Kruijver, F., Zhou, J., Pool C., Hofman, M. Gooren L., Swaab D. (2000) Male-to-female transsexuals have female neuron numbers in limbic nucleus. Journal of Clinical Endocrinology and Metabolism. 85(5)