sexual disorders

Gender Dysphoria

• Gender Identity: Innermost concept of self as male, female, neither, or a mix of both.

• Gender Expression: The means through which individuals communicate their gender; includes clothes, hairstyles, mannerisms, and use of names that reflect their gender identity.

Sexual Orientation

• Sexual Orientation: Refers to feelings of emotional, romantic, or sexual attraction to others; distinct from gender identity.

• Key Vocabulary:

  • Gender Identity

  • Transgender

  • Gender Dysphoria

  • Gender Non-conforming

  • Non-binary

  • Cisgender

  • Sex Assigned at Birth

  • Transition

  • Gender Binary

  • Sexual Orientation

  • Gay

  • Lesbian

  • Bisexual

  • Pansexual

  • Asexual

Terminology

• Terms to Avoid:

  • Born a female

  • Male-to-female

  • Sex change/Pre operation

• Terms to Use:

  • Transgender male

  • Transgender female

  • Transition

  • Equality

• Key Concepts:

  • Gender Dysphoria: Persistent identification and distress caused by a mismatch between gender identity and physiology.

  • Gender Non-Conforming: Can be persistent or transient; does not cause distress.

Theories of Gender Dysphoria

• Biological Factors: Alterations in sex hormones and neurological development can contribute.

• Psychological Factors: Attachment issues in early childhood and learned responses to inappropriate role models.

• Social Challenges: Individuals may experience shame, discrimination, embarrassment, and social isolation; counseling may be beneficial.

Types of Dysphoria

• Social: Discomfort presenting as one’s birth-gender.

• Body: Discomfort with one's body not reflecting their gender identity.

• Mind: Discomfort with emotions not aligning with gender identity.

Transgender - Sex Reassignment

• Procedures:

  • Psychotherapy

  • Living as desired gender for 1-2 years

  • Surgical interventions

Life after Transgender Reassignment

• Example: Lia Thomas, Transgender Olympic Swimmer.

• Transgender Nursing Care: Focuses on physiological stability post-surgery and psychosocial elements.

Clinical Case Study: Sam and Terri

• Both in a committed relationship and in the process of gender reassignment.

• Exploring feelings of having children before reassignment completion.

  • Options available for transgender couples wanting children.

  • Psychosocial considerations for each choice.

Psychological Implications in Case Study

• Possibility for breastfeeding and psychological implications of such choices.

• Consideration of potential gender dysmorphia during reassignment transition.

Sexual Dysfunction

• Types:

  • Desire: Lack of sexual interest.

  • Arousal: Inability to become aroused.

  • Orgasm: Delayed or absent orgasm.

  • Pain: Pain during intercourse.

• Paraphilias: Sexual acts or fantasies deviating from social norms; can lead to clinical disorders if they cause distress or harm.

Theories Related to Paraphilias

• Biological: Disorders due to brain developmental issues, TBIs, or inappropriate sexual behavior links.

• Psychological: Attachment failures or learned responses can contribute.

Coercive Paraphilias

• Examples:

  • Exhibitionism

  • Voyeurism

  • Pedophilia

  • Necrophilia

  • Bestiality

• Note on rape: Defined as a crime of violence and aggression, not sexual satisfaction.

Effects of Paraphilic Disorders

• Impact individuals, families, and society; significant harm when involving unwilling or underage partners.

• Addressing recidivism rates among untreated offenders is critical.

Nursing Involvement

• Nursing Diagnoses may include:

  • Anxiety

  • Fear

  • Spiritual distress

• Expected Outcomes:

  • Reducing problematic sexual acts.

• Interventions:

  • Support and connect patients with benefits from peers and professionals.

  • Maintain appropriate interpersonal boundaries.

Self-Care for Nurses and Treatment Options

• Acknowledge personal biases and build trusting relationships.

• Medications: Hormonal interventions and other psychopharmaceuticals.

• Therapies: Group therapy, cognitive behavioral therapy, and behavioral desensitization approaches.

Evaluation

• Monitor recidivism and ongoing therapy engagement.

• Ensure compliance with reporting laws regarding personal circumstances post-treatment.