PSY 223 - Chapter 9 Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunctions

Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunctions

Learning Outcomes

• By the end of the class, students should be able to:

  • Identify and describe key definitions and classifications.

  • Understand gender dysphoria.

  • Describe types of paraphilic disorders and sexual dysfunctions.

  • Discuss related theoretical perspectives.

  • Identify approaches to treatment.

Gender Dysphoria

• Definition: Dysphoria is a state of generalized unhappiness, restlessness, dissatisfaction, or frustration, which can be symptomatic of several mental health conditions.

• Gender Assignment: Refers to the initial classification of individuals as male or female at birth based on external anatomy; also known as natal gender.

• Cognitive Disconnect: Dysphoria arises from a cognitive disconnect between one’s gender identity and gender assignment.

Components of Gender Dysphoria

• Gender Identity: One's psychological sense of being male, female, intersex, transgender, nonbinary, etc.

• Disorder Characteristic: Gender dysphoria is diagnosed when individuals experience significant distress or decreased functioning due to the incongruence between anatomical sex and gender identity.

• Equation: Gender Identity + Distress = Gender Dysphoria

Development and Symptoms of Gender Dysphoria

• Age of Onset: Usually begins in childhood, but may start in adolescence or early adulthood. Rare after late adulthood.

• Childhood Signs:

  • Desire to associate with gender-identified peers.

  • Engaging in imaginary play reflecting identified gender roles.

  • Boys may avoid rough play; girls may avoid feminine clothing.

• Puberty Effects: Unease with developing gender characteristics.

  • Boys may tape genitals to reduce noticeability; girls may avoid feminine clothing to reduce prominence of breasts.

Prevalence and Identification

• Demographics: More prevalent in males than females, with early signs often reported by parents.

• Cultural Influences: Gendered clothing and play can be influenced by cultural standards.

Treatment Approaches for Gender Dysphoria

• Interventions:

  • Hormone therapy.

  • Living as the identified gender.

  • Sex reassignment surgery.

  • Psychotherapy.

• Psychotherapy Focus: Help clients cope with stigma and acceptance, often emphasizing support through community engagement.

• Caution on Conversion Therapies: Conformity therapies have been shown to be ineffective and harmful, leading to calls for legal bans.

Paraphilic Disorders

• Definition: Characterized by recurrent sexual urges and fantasies involving nonhuman objects, nonconsenting partners, or causing humiliation or pain, which can lead to significant distress or acting upon the urges.

• Demographics: Majority of those affected are men.

Types of Paraphilic Disorders

• Exhibitionistic Disorder:

  • Urges to expose genitals to unsuspecting strangers for shock value.

• Fetishistic Disorder:

  • Sexual urges focused on inanimate objects or specific body parts; typically harmless.

• Transvestic Disorder:

  • Urges related to cross-dressing for sexual arousal; distinct from dysphoria.

• Voyeuristic Disorder:

  • Urges to watch unsuspecting individuals in sexual situations.

• Frotteuristic Disorder:

  • Urges involving rubbing against nonconsenting individuals, often in crowded places.

• Pedophilic Disorder:

  • Urges concerning sexual activity with prepubescent children; diagnosis considers fantasies or urges, not necessarily actions.

Theoretical Perspectives on Paraphilic Disorders

• Psychoanalytical View: Individual may revert to early sexual habits.

• Behavioral View: Paraphilias may arise from conditioning, linking nonsexual objects with pleasurable sexual activity.

Treatment Options for Paraphilic Disorders

• Possible Interventions:

  • Cognitive-Behavioral Therapy to address distorted beliefs regarding sexual behaviors.

  • Aversive therapy and biomedical treatments include SSRIs and antiandrogen drugs to reduce testosterone.

Sexual Dysfunctions

• Definition: Involves issues with sexual interest, arousal, or response; affects over 40% of women and 20-30% of men.

Types of Sexual Dysfunctions (DSM-5)

• Disorders related to sexual interest/arousal, orgasmic response, or pain during intercourse.

• Notable disorders include:

  • Female/Male Sexual Interest/Arousal Disorders

  • Orgasm Disorders

  • Genito-Pelvic Pain/Penetration Disorder

Treatment Approaches

• Options for Treatment:

  • Psychotherapy and sex therapy.

  • Relaxation techniques, masturbation, stop-and-go techniques.

  • Biological treatments like Viagra and Cialis.

Conclusion

• Class Outcomes:

  • Understanding of gender dysphoria, paraphilic disorders, sexual dysfunctions, their treatment, and theoretical perspectives.