1. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 0

2. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 1 Chapter 26 Sexual Responses and Sexual Disorders

3. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 2 Sexuality Genetic identity—A person’s chromosomal gender Gender identity—A person’s perception of his or her own maleness or femaleness Gender role—The cultural role attributes of one’s gender, such as expectations regarding behavior, cognitions, occupations, values, and emotional responses Sexual orientation—The gender to which one is romantically attracted

4. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 3 Criteria for Adaptive Sexual Responses Between two consenting adults Mutually satisfying to both Not psychologically or physically harmful to either Lacking in force or coercion Conducted in private

5. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 4 Figure 26-2 Phases of the nurse’s growth in developing awareness of human sexuality.

6. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 5 Behaviors Related to Sexual Responses Heterosexuality—Sexual attraction to members of the opposite sex; the predominant sexual orientation among people in American society Homosexuality—Sexual attraction to members of the same sex; the term gay is used to refer to male and female homosexuals; some use the term gay to refer only to male homosexuals and use the term lesbian to refer to female homosexuals Bisexuality—Sexual orientation or attraction to both men and women

7. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 6 Behaviors Related to Sexual Responses (Cont.) Transvestism—Cross-dressing, or dressing in the clothes of the opposite sex Transsexualism—A condition in which one has a profound discomfort with his or her own sex and a strong and persistent identification with the opposite gender; a transsexual lives as a member of the opposite sex either part-time or full-time and may seek to change his or her sex through hormone therapy and sex reassignment surgery

8. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 7 Stages of the Sexual Response Cycle Stage 1: Desire Stage 2: Excitement Stage 3: Orgasm Stage 4: Resolution

9. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 8 Figure 26-4 The Stuart Stress Adaptation Model as related to sexual responses.

10. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 9 Primary Nursing Diagnoses Related to Variations in Sexual Response Sexual dysfunction Ineffective sexuality pattern

11. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 10 Primary Medical Diagnoses Related to Variations in Sexual Response Sexual dysfunctions Paraphilias Gender identity disorders

12. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 11 Evidence-Based Treatments for Sexual Disorders Disorder: Paraphilias Treatment: Cognitive, behavioral, and cognitive-behavioral treatments reduce rates of recidivism. Somatic treatments that lower testosterone levels, such as medroxy-progesterone and cyproterone acetate, also are somewhat effective.

13. Copyright © 2005 Mosby, Inc. All rights reserved. Slide 12 Evidence-Based Treatments for Sexual Disorders (Cont.) Disorder: Sexual dysfunction Treatment: Pharmacological therapies for erectile disorders (sildenafil) and rapid ejaculation (SSRIs: fluoxetine, sertraline, clomipramine, paroxetine) are successful in reversing sexual dysfunction. There is less efficacy for the sense of sexual satisfaction and couple interaction. The evidence concerning pharmacological treatment of female sexual disorder is very limited.