Sexuality, Gender Identity, and Sexual Disorders

Sexuality, Gender Identity, and Sexual Disorders

Learning Objectives
  • Differentiate sexuality from gender identity.
  • Explain how self-awareness influences client care involving sexuality and gender identity, including the impact of personal biases and societal norms.
  • Use patient-centered terminology when discussing sexuality and gender identity, promoting understanding and respect.
  • Describe the continuum of human sexual responses, including desire, arousal, and orgasm across different populations.
  • Explain how sexuality and gender identity are expressed through each life stage, recognizing the fluidity and changes that can occur.
  • Compare sexual dysfunction with a sexual disorder, providing examples of each and understanding their implications for treatment.
  • Apply the nursing process to the care of a client with a sexual disorder, ensuring comprehensive assessment and intervention.
Patient-Centered Terminology: Sexuality

  • Sexual orientation: The emotional, romantic, or sexual attraction one feels toward others.

    • Heterosexuality: Attraction to the opposite gender.
    • Homosexuality: Attraction to the same gender (includes Gay and Lesbian).
    • Bisexual: Attraction to both genders.
    • Pansexual: Attraction regardless of gender.
    • Asexual: Lack of sexual attraction to others.
    • LGBTQIA2+: A spectrum including various sexual orientations and gender identities.
    • Other terms include 2+ [two spirited] which can denote a mix of gender identities.

  • Sex vs. Sexuality vs. Intersex:

    • Sex: Biological attributes (chromosomes, hormones, reproductive/sexual organs).
    • Sexuality: Complex interplay of biological, emotional, erotic, social, and spiritual factors.
    • Intersex: Variations in sex characteristics that do not fit typical binary notions.
Patient-Centered Terminology: Gender Identity
  • Gender Identity Terms:
    • 2+: Includes individuals identifying with more than one gender.
    • Cisgender: Individuals whose gender identity aligns with their natal sex.
    • Gender dysphoria: Distress experienced when an individual's gender identity does not align with their sex assigned at birth.
    • Gender expression: The external presentation of one's gender, which may include clothing, hairstyle, and behavior.
    • Genderfluid: Gender identity that may change over time.
    • Genderqueer: Nontraditional genders that may fall outside the binary.
    • Nonbinary: Identities that do not exclusively fit male or female categories.
    • Transgender: Individuals whose gender identity differs from their sex assigned at birth.
Influences on Sexuality & Gender Identity
  • Cultural, societal, legal, and religious influences: Explores how cultural norms and laws can impact individual experiences and expressions of sexuality.
  • Adaptive behaviors: Include respecting the rights and wishes of others, and consensual sexual behaviors.
  • Maladaptive behaviors: These involve harm to self or others, such as coercive acts or violations of consent.
Self-awareness, Sexuality, and Gender Identity
  • Importance of self-awareness in nursing practice, including recognition of one’s biases, values, and how they affect client care. Encourages reflection and fostering an open, supportive atmosphere.
Sexuality and Gender Identity Throughout the Life Cycle

  • Childhood:

    • Natal sex is often used for naming and identity formation.
    • Identification of gender roles commonly develops between ages 2-3, potentially leading to assumptions in traditional gender norms.

  • Adolescence and Young Adulthood:

    • Time of exploration and understanding of sexual orientation and gender identity, influenced by peers and societal pressures.
    • Education around sexual health is crucial, emphasizing safe practices.

  • Adulthood:

    • Varies widely, recognition of diverse relationship structures.
    • Sexual expression may adapt due to circumstances such as health or age-related changes.
    • Availability of gender-affirming surgeries and additional support during the coming out process.
Sexual Disorders

  • Categories of sexual dysfunctions include:

    • Male: Delayed ejaculation, erectile disorder, male hypoactive sexual desire disorder, premature ejaculation.
    • Female: Genito-pelvic pain disorder, female orgasmic disorder, female sexual interest/arousal disorder.
    • Both genders: Substance/Medication-induced sexual dysfunction.

  • Paraphilias: Consist of atypical sexual interests, some illegal, including exhibitionism, voyeurism, and others like pedophilia and sexual sadism.

Therapeutic Interventions

  • Treatment approaches:

    • Approaches depend on the specific disorder, ranging from therapy (group or individual) to medications (SSRIs, hormonal therapies).
    • Addressing illegal behaviors may require legal interventions.

  • Psychosexual assessment:

    • Approach must be sensitive to client comfort, including informed consent.
    • Focus on understanding each client’s unique sexual functioning.
Nursing/Therapeutic Process
  • Establish problem statements based on client concerns.
  • Emphasizing non-judgmental and accepting interactions is vital in creating a therapeutic environment.
  • Activities must include assessment, treatment planning, advocacy for the client, and