sexuality and sexual dysfucntion

delayed ejaculation

A.Either of the following symptoms must be experienced on almost all or all occasions (approximately 75%-100%) of partnered sexual activity (in identified situational contexts or, if generalized, in all contexts), and without the individual desiring delay:

1. Marked delay in ejaculation.

2. Marked infrequency or absence of ejaculation.

B.The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.

C.The symptoms in Criterion A cause clinically significant distress in the individual.

D.The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

delayed ejaculation Specify if:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

•Generalized (not limited to specific situations, partners, forms of stimulation)

•Situational (specific to situations, partners, forms of stimulation)

premature ejaculation

A.A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it.

B.The symptom in Criterion A must have been present for at least 6 months and must be experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts).

C.The symptom in Criterion A causes clinically significant distress in the individual.

D.The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

premature ejaculation specifcy if:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

•Generalized (not limited to specific situations, partners, forms of stimulation)

•Situational (specific to situations, partners, forms of stimulation)

Specify severity:

•Mild: 30-60 seconds

•Moderate: 15-30 seconds

•Severe: prior or within 15 seconds

erectile disorder

A.At least one of the three following symptoms must be experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts):

1.Marked difficulty in obtaining an erection during sexual activity.

2.Marked difficulty in maintaining an erection until the completion of sexual activity.

3.Marked decrease in erectile rigidity.

B.The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.

C.The symptoms in Criterion A cause clinically significant distress in the individual.

D.The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

erectile disorder specify if:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

•Generalized (not limited to specific situations, partners, forms of stimulation)

•Situational (specific to situations, partners, forms of stimulation)

male hypoactive sexual desire disorder

A.Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity. The judgment of deficiency is made by the clinician, taking into account factors that affect sexual functioning, such as age and general and sociocultural contexts of the individual's life.

B.The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.

C.The symptoms in Criterion A cause clinically significant distress in the individual.

The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition

male hypoactive sexual desire disorder specify if:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

•Generalized (not limited to specific situations, partners, forms of stimulation)

•Situational (specific to situations, partners, forms of stimulation)

female orgasmic disorder

A.Presence of either of the following symptoms and experienced on almost all or all (approximately 75%-100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts):

1.Marked delay, marked infrequency of, or absence of orgasm.

2.Markedly reduced intensity of orgasmic sensations.

B.The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.

C.The symptoms in Criterion A cause clinically significant distress in the individual.

D.The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

female orgasmic disorder specifiy if:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

•Generalized (not limited to specific situations, partners, forms of stimulation)

•Situational (specific to situations, partners, forms of stimulation)

•Never experienced orgasm

female sexual interest/arousal disorder

A.Lack of, or significantly reduced, sexual interest/arousal, as manifested by at least three of the following:

1.Absent/reduced interest in sexual activity.

2.Absent/reduced sexual/erotic thoughts or fantasies.

3.No/reduced initiation of sexual activity, and typically unreceptive to a partner's attempts to initiate.

4.Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all (approximately 75%-100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts).

5.Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues (e.g., written, verbal, visual).

6.Absent/reduced genital or nongenital sensations during sexual activity in almost all or all (approximately 75%-100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts).

B.The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.

C.The symptoms in Criterion A cause clinically significant distress in the individual.

D.The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

female sexual interest/arousal disorder specifiers:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

•Generalized (not limited to specific situations, partners, forms of stimulation)

•Situational (specific to situations, partners, forms of stimulation)

Genito-Pelvic Pain/Penetration Disorder

A.Persistent or recurrent difficulties with one (or more) of the following:

1.Vaginal penetration during intercourse.

2.Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.

3.Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration.

4.Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration.

B.The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.

C.The symptoms in Criterion A cause clinically significant distress in the individual.

D.The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

genito-pelvic pain/penetration disorder specifier:

•Lifelong (since sexually active)

•Acquired (after a period of normal functioning)

gender dysphoria (adults and adolescents)

A.A marked incongruence between one's experienced/expressed gender and assigned gender, of at least 6 months' duration, as manifested by at least two of the following:

1.A marked incongruence between one's experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics).

2.A strong desire to be rid of one's primary and/or secondary sex characteristics because of a marked incongruence with one's experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics).

3.A strong desire for the primary and/or secondary sex characteristics of the other gender.

4.A strong desire to be of the other gender (or some alternative gender different from one's assigned gender).

5.A strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender).

6.A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one's assigned gender).

B.The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.

gender dysphoria specifiers

•With a disorder/difference of sex development (e.g., congenital adrenogenital disorder)

Specify :

•Posttransition (i.e., living in the experienced gender and has had or is preparing to have gender-affirming medical procedure)

voyeuristic disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors.

B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The individual experiencing the arousal and/or acting on the urges is at least 18 years of age

voyeuristic disorder specifer

•In a controlled environment

In full remission (5 years)

Exhibitionistic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of one's genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.

The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

exhibitionistic disorder specifier

•Exposing to prepubertal children

•Exposing to physically mature individuals

•Exposing to both

Specify if:

•In a controlled environment

•In full remission (5 years)

Frotteuristic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.

B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

frotteuristic disorder

Specify if:

•In a controlled environment

•In full remission (5 years)

sexual masochism disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors.

B.The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

sexual machismo disorder specifier

Specify if:

•With asphyxiophilia

Specify if:

•In a controlled environment

•In full remission (5 years)

sexual sadism disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from the physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviors.

B.The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Pedophilic Disorder

A.Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger).

B.The individual has acted on these sexual urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

C.The individual is at least age 16 years and at least 5 years older than the child or children in Criterion A.

Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13-year-old

pedophilic disorder specifiers

•Exclusive type (attracted only to children)

•Nonexclusive type

Specify if:

•Sexually attracted to males

•Sexually attracted to females

•Sexually attracted to both

Specify if:

•Limited to incest

fetishistic disorder

Specify:

•Body part or parts

•Nonliving objects

•Other

Specify if:

•In a controlled environment

•In full remission (5 years)

Transvestic Disorder

A.Over a period of at least 6 months, recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviors.

B.The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

tranvestic disorder specifier

Specify if:

•With fetishism

•With autogynephilia

Specify if:

•In a controlled environment

In full remission (5 years)