Diagnostics (Sexual Dysfunctions, Paraphilias and Gender Dysphoria)

sexual dysfunction can take place in any stage of the sexual cycle

desire, excitement, orgasm

prevalence of sexual dysfunction

four out of ten women- low sexual desire, problems with arousal, pain during intercourse

three out of ten men- premature ejaculation, erectile dysfunction, low desire

what could erectile dysfunction be caused by?

medication, age and physical fitness and decrease circulation

criteria for diagnosis of sexual dysfunction

lasts 6 months, experience symptoms in all of almost all sexual encounters (persistent/reoccurrence), cause distress

what is female sexual interest/arousal disorder?

-persistent lack of interest or desire for sexual activity

absent or reduced pleasure in sexual activity

absent or reduced genital sensations

-causes distress

female sexual interest/arousal disorder is associated with...

depression, poor body image, relationship problems and exhaustion

sexual aversion disorder

extreme and irrational fear of sexual activity

what is male hypoactive sexual desire disorder?

male doesn't think much about sex and lasts for 6 months

arousal disorder: erectile disorder

-marked difficulty in obtaining an erection during sex

-difficulty in maintaining an erection until completion of sex

-marked decrease in erectile ridgity

-symptoms last 6 months and cause distress

rule outs for erectile disorder

NOT illness or medication

prevalence of erectile disorder

unknown- however it is reported more as male gets older

associated features of arousal disorders: erectile disorder

poor body image, problematic cognitive structures about sexuality, performance anxiety, relational difficulties, medical problems, lack of sexual knowledge

orgasmic disorders: female orgasmic disorder

marked delay or absence of orgasm following sexual excitement phase, reduced intensity of orgasm

associated features of female orgasmic disorder

younger women

once resolved does not come back unless relationship problems, poor sexual communication, traumatic experience, mood disorder, general medical condition

for female orgasmic disorder it is important to rule out

clitoral stimulation to orgasm

prevalence of female orgasmic disorder

varies 10-42%, masturbation rate reaching orgasm is higher, 10% women don't reach orgasm in lifetime

orgasmic disorders: male orgasmic disorder

persistent or recurrent delay or absence of orgasm following normal sexual excitement phase

orgasmic disorders: premature ejaculation

persistent, recurrent ejaculation occurring during sexual activity within 1 minute

associated features of premature ejaculation

youth and drinking

prevalence of premature ejaculation

only 1-3% meet diagnosis

genito-pelvic pain/penetration disorder

persistent difficulties with the following

-pain during vaginal penetration

-fear or anxiety about pain

-tensing or tightening of pelvic floor muscles

-must last 6 months

genito-pelvic pain/penetration disorder is not diagnosed if

consequence of relational distress

gender dysphoria

strong desire to be rid of own gender sexual characteristics

have desire to have other gender characteristics

wants to be treated as other genders

causes distress

what are paraphillic disorders?

recurrent intense sexually arousing fantasies involving non-human objects, suffering or children

paraphillic disorders must cause

client or other person distress

exhibitionistic disorder

sexual gratification attained by exposing genitals to unsuspecting strangers

fetishistic disorder

attracted to non-human objects

frottueristic disorder

rubbing against non-consenting person

pedophilic disorder

sexual interest in children

sexual masochism disorder

sexual interest in behaviors that involve pain/ humiliation

sexual sadism disorder

inflicting suffering on others.

transvestic disorder

dress as another gender

voyeuristic disorder

watch someone when they don't know

children are NOT allowed to

give consent

can't be diagnosed with pedophilia until what age?

16 and at least 5 years older than the child