Sexual Dysfunctions, Paraphilic Disorders & Gender Dysphoria – Key Vocabulary

Vocabulary flashcards summarizing the essential terms, disorders, diagnostic rules, assessment tools, treatment methods, biological/psychological/social contributors, and cultural/gender themes outlined in the lecture on sexual dysfunctions, paraphilic disorders, and gender dysphoria.

Normal Sexuality (clinical standard)

Sexual behavior considered acceptable unless it causes impairment in functioning or involves non-consenting individuals.

Sexual Dysfunction

Difficulty functioning adequately during sexual activity, involving desire, arousal, orgasm, or pain and producing distress/impairment.

Paraphilic Disorder

Persistent, intense sexual interests in atypical objects or situations that cause distress/impairment or involve non-consenting persons.

Gender Dysphoria

Marked distress due to incongruence between experienced/expressed gender and assigned biological sex.

Desire Phase (Sexual Response Cycle)

Stage in which sexual urges arise in response to internal or external cues or fantasies.

Arousal Phase

Stage featuring subjective sexual pleasure and physiological changes (penile tumescence / vaginal lubrication).

Plateau Phase

Brief period of heightened arousal occurring just before orgasm.

Orgasm Phase

Stage marked by ejaculatory inevitability in males and rhythmic vaginal contractions in females, culminating sexual pleasure.

Resolution Phase

Post-orgasm decrease in physiological arousal; refractory period occurs in males.

Lifelong vs. Acquired Dysfunction

Lifelong—present since first sexual experiences; Acquired—develops after a period of normal functioning.

Generalized vs. Situational Dysfunction

Generalized—occurs in all sexual situations; Situational—occurs only with certain partners, settings, or times.

Male Hypoactive Sexual Desire Disorder

Persistent lack of sexual thoughts or desire in men for ≥6 months, causing distress.

Female Sexual Interest/Arousal Disorder

Reduced interest, thoughts, initiation, excitement, or sensations during sex in women for ≥6 months.

Erectile Disorder

Recurrent inability to attain or maintain an erection adequate for sexual activity.

Delayed Ejaculation

Marked delay, infrequency, or absence of ejaculation in men despite adequate stimulation.

Premature (Early) Ejaculation

Ejaculation within ~1 minute of penetration and before the individual wishes on most occasions.

Retrograde Ejaculation

Ejaculatory fluid travels backward into the bladder rather than exiting through the urethra.

Female Orgasmic Disorder

Marked delay, infrequency, absence, or reduced intensity of orgasm in women, causing distress.

Genito-Pelvic Pain/Penetration Disorder

Persistent pain, fear, or tightening of pelvic muscles during vaginal penetration attempts.

Vaginismus

Involuntary spasms of the outer third of the vagina, often part of genito-pelvic pain/penetration disorder.

Penile Strain Gauge

Device measuring changes in penile circumference to assess male sexual arousal.

Vaginal Photoplethysmograph

Instrument that detects blood flow to vaginal walls to measure female sexual arousal.

Erotophobia

Learned negative attitudes and anxiety about sexuality that can contribute to dysfunction.

Script Theory of Sexual Functioning

Concept that people follow culturally learned ‘scripts’ guiding their sexual behavior and expectations.

Masters & Johnson Sensate-Focus

Therapeutic exercise emphasizing non-goal-oriented touching to reduce performance anxiety.

Squeeze Technique

Behavioral method in which the penis is squeezed near orgasm to delay ejaculation; used for PE.

Masturbatory Training

Structured exercises teaching women techniques to attain orgasm; used for female orgasmic disorder.

Use of Dilators

Gradual insertion of increasingly larger devices to reduce vaginismus-related pain and spasms.

Covert Sensitization

Imagining aversive consequences to reduce deviant sexual arousal (e.g., with pedophilic fantasies).

Orgasmic Reconditioning

Shifting masturbation fantasy from deviant to appropriate stimuli just before orgasm to retrain arousal.

Cyproterone Acetate

Anti-androgen medication that lowers testosterone, reducing sexual urges; a form of chemical castration.

Medroxyprogesterone Acetate (Depo-Provera)

Hormone therapy lowering testosterone to diminish deviant sexual drive in offenders.

Vacuum Device Therapy

Cylinder-pump system that creates penile blood flow and temporary erection for erectile disorder.

Penile Prosthesis

Surgically implanted device allowing mechanical erections for severe erectile dysfunction.

Frotteuristic Disorder

Sexual arousal from rubbing against or touching a non-consenting person, usually in crowded places.

Fetishistic Disorder

Sexual arousal from nonliving objects or specific non-genital body parts, causing distress/impairment.

Partialism

Subtype of fetishism focusing on a particular body part (e.g., feet, hair).

Voyeuristic Disorder

Sexual arousal from spying on unsuspecting individuals who are naked, disrobing, or engaged in sex; diagnosis requires age ≥18.

Exhibitionistic Disorder

Sexual arousal from exposing one’s genitals to an unsuspecting stranger, with thrill/risk elements.

Transvestic Disorder

Sexual arousal from cross-dressing that leads to distress or impairment; may specify with fetishism or autogynephilia.

Autogynephilia

Sexual arousal of a male from imagining or presenting himself as a female.

Sexual Sadism

Sexual arousal from inflicting pain, suffering, or humiliation on another person.

Sexual Masochism

Sexual arousal from experiencing pain, suffering, or humiliation oneself.

Pedophilic Disorder

Sexual arousal toward prepubescent children (generally ≤13 yrs) causing distress/acting on urges; perpetrator must be ≥16 and 5 yrs older.

Chemical Castration

Use of medications (e.g., anti-androgens) to suppress sexual drive in dangerous offenders.

High Sex Drive Hypothesis (Paraphilias)

Idea that paraphilic individuals often have unusually strong sex drives, making suppression difficult.

Early Sexual Conditioning

Accidental pairing of sexual arousal with atypical stimuli in childhood/adolescence, potentially leading to paraphilias.

Sambia Cultural Practice

Papua New Guinea tradition of adolescent males engaging in homosexual oral sex to ‘receive’ semen for maturation.

Peplau’s Four Gender Themes

Men have higher desire; women link sex to commitment; men’s self-concept includes power/aggression; women’s sexuality more culturally shaped.

Erotic Material Exposure Therapy

Controlled viewing of sexual stimuli to increase desire or correct arousal patterns.

Psychophysiological Sexual Assessment

Laboratory evaluation of physical sexual responses to erotic cues to map arousal patterns.

Diabetes/Kidney Disease and Sexuality

Medical conditions that can reduce genital sensitivity, contributing to dysfunctions.

Vascular Disease and Sexuality

Reduced blood flow impairs erections and vaginal engorgement, leading to arousal problems.

Psychoactive Drugs & Sexual Function

Substances altering neurotransmitters (e.g., serotonin) that can hamper desire and arousal.

Performance Anxiety Cycle

Worry about sexual performance that increases sympathetic arousal and disrupts sexual response.

DSM-5 Six-Month Rule

Most sexual dysfunctions and paraphilic disorders require symptoms to persist ≈6 months for diagnosis.

Distress/Impairment Criterion

DSM-5 requirement that sexual symptoms cause significant personal or interpersonal problems.

Non-Attribution to Substances

DSM-5 stipulation that dysfunctions can’t be explained solely by drugs, medications, or medical conditions.

Premarital Sex Approval Trend

From 1943 to 1999, approval rose from 40 %→79 % in men and 12 %→73 % in women, reflecting shrinking gender gap.

Erectile Dysfunction Prevalence (60+)

Approximately 60 % of men over age 60 experience erectile difficulties.

Female Orgasm Difficulty Prevalence

Roughly 25 % (1 in 4) women have significant trouble achieving orgasm.

Sex Reassignment Surgery (SRS)

Medical transition for gender dysphoria; ~75 % report satisfaction, with better adjustment in female-to-male cases.

Cross-Gender Role Play (Children)

Preference for roles/toys of the other gender; part of DSM-5 criteria for childhood gender dysphoria.

Incest-Limited Pedophilia

Pedophilic urges confined to one’s own children or close relatives, often influenced by availability and family dynamics.

Scripted Avoidance (PE)

Men with premature ejaculation may mentally distract themselves, inadvertently lowering ejaculatory control.

Orgasmic ‘1-Minute’ Criterion

DSM-5 operational definition for premature ejaculation during penetrative sex.

Pelvic Floor Tensing

Involuntary or anticipatory tightening of pelvic muscles contributing to penetration pain disorders.

Autogynephilia Specifier

DSM-5 specifier indicating arousal from the thought/image of oneself as a woman in transvestic disorder.

Rapists vs. Sadists

Most rapists lack paraphilic arousal patterns; a minority qualify for sexual sadism disorder.

Chemical Castration Relapse

Sexual urges often return once anti-androgen medication is discontinued.

Sensate Focus Goal

Shift attention to bodily sensations rather than orgasm, reducing anxiety in sexual dysfunction treatment.

Vacuum Device Mechanism

Creates negative pressure drawing blood into penis; ring maintains erection during intercourse.

Pedophilia Age Differential Rule

Perpetrator must be at least 5 years older than the prepubescent child for DSM-5 diagnosis.