Modules in Abnormal Psychology First Semester S.Y.

2020-2021

ABNORMAL
PSYCHOLOGY
UNIT FOUR
This chapter deals with sexual
CHAPTER 3 dysfunctions, gender dysphoria, and paraphilias.
The diagnoses of sexual dysfunctions, gender
dsyphoria and paraphilic disorders are mostly
descriptive; no diagnosis-specific tests or
examinations are usually available. The
3.1 Objectives
classification of sexual dysfunctions was
3.2 Self-Assessment # 15 historically based on the notion of connected yet
separate and clearly defined phases of the
3.3 Lesson Three: Sexual,
sexual response cycle—desire, arousal/
Gender, and Paraphilic
Disorders excitement, orgasm, and resolution.

3.3.1 Sexual Dysfunctions

3.3.2 Gender Dysphoria 3.1 Objectives
3.3.3 Paraphilias
After reading this chapter, you will be able to:
3.3.4 Self-Test # 17
1. Define sexual dysfunctions and paraphilia.
2. Describe the different types of these
3.4 Learning Insights disorders;

3.5 Chapter Questions 3. Explain the etiology (causes) of these

disorders; and
3.6 Suggested Readings
4. Describe the different types of treatment for
these disorders.

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3.2 Self-Assessment # 15
Disruptive, Impulse-Control, and Conduct Disorders
Read the following account and reflect on the questions below.

Case 11
Gener is a 24-year-old, healthy male, who seems a little shy and
withdrawn. He never really knew that he had a problem and was not sure if
he can explain. He had only one girlfriend before now – Janet—and she
never complained. Gener was her first partner, and we would make love
once or twice a week purely by his initiation. In fact, this was the reason they
broke up. Shortly after, he met Donna, who he is with now. The first time
they made love Gener was nervous and it was all over very quickly. She was
very understanding and although a little disappointed, she gave him the
impression that they just needed to get used to each other. Unfortunately,
this happened consistently over the next few weeks, and Gener could sense
her frustration. They spoke about the problem, and he told her that he had
never been able to go for more than five minutes. He simply could not
control his ejaculation, and although some love-making sessions lasted
longer than others, the problem has been with him from the first time that he
made love. Donna was very open-minded, and they tried to treat the
problem using various products that they bought from sex shops and on-line.
They tried sprays and numbing creams, rubber rings and even a few
techniques that Donna had read about. Although all of these seemed to
initially help, Gener never was able to gain control, and he sensed that
Donna was starting to lose patience with him.

Thought Questions:
1. Based on what has been stated above, what must be your preferred diagnosis of
the case?
2. What could be your treatment options?
3. What do you think would be the best predictors of a good case outcome
(prognosis)?

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3.3 LESSON 3: Sexual,

Gender and Paraphilic Disorders

This chapter focuses on sexual dysfunctions that describe sexual issues linked to
the sexual response cycle or pain as well as paraphilias that are chronic, sexually
arousing hallucinations, desires, or actions involving individuals and/or objects that
are non-conventional or non-consent. Gender identity disorder, renamed gender
dysphoria in the DSM-5, is covered in another chapter. This chapter includes
epidemiology; assessment; etiology; course and treatment for sexual dysfunction
problems and paraphilias.

3.3.1 Sexual Dysfunctions

Sexual dysfunction happens when you have an
condition that prevents you from having sexual
intercourse or trying to have it. It can happen at any
given moment. Sexual dysfunction is encountered by
men and women of all ages and the chances increase
as you age.

Stress is a common cause of sexual dysfunction. Other

causes include:

• sexual trauma
• psychological issues
• diabetes
• heart disease or other medical conditions
• drug use
• alcohol use
• certain medications

Categories of Sexual Dysfunctions

Four categories of sexual dysfunction exist. It’s normal not to be in the mood
sometimes. None of these should be considered a disorder unless it happens regularly
and significantly affects your sexual life:

• Desire disorder is when you have little or no interest in sexual relations on an

ongoing basis.
• Arousal disorder means you’re emotionally in the mood, but your body isn’t into it.
• Orgasm disorder means you’re emotionally in the mood, but you have an inability
to climax that leaves you frustrated.
• Pain disorder involves having pain during intercourse.

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Two disorders reflect

problems with the desire
1. Sexual Desire Disorder
phase of the sexual response
cycle. These two disorders are
characterized by little or no
interest in sex that is causing significant distress in the
individual. In males this disorder is called male
hypoactive sexual desire disorder. In females low
sexual interest is almost always accompanied by a
diminished ability to become excited or aroused by erotic
cues or sexual activity. Thus, deficits in interest or the ability
to become aroused in women is combined in a disorder
called female sexual interest/arousal disorder.

Males with hypoactive sexual desire disorder

Male Hypoactive Sexual and females with sexual interest/arousal disorder
Desire Disorder & have little or no interest in any type of sexual activity.
It is difficult fto assess low sexual desire, and a great
Female Sexual Interest/ deal of clinical judgment is required. You might
Arousal Disorder gauge it by frequency of sexual activity—say, less
than twice a month for a married couple. Or you
might determine whether someone ever thinks about
sex or has sexual fantasies. Then there is the person who has sex twice a week but
really doesn’t want to and thinks about it only because his wife is on his case to live
up to his end of the marriage and have sex more often. This individual might have no
desire, despite having frequent sex. Consider the following:

CASE SAMPLE:

M
rs. C., a 31-year-old successful businesswoman, was married to a 32-year-old lawyer. They had two
children, ages 2 and 5, and had been married 8 years when they entered therapy. The presenting
problem was Mrs. C.’s lack of sexual desire. Mr. and Mrs. C. were interviewed separately during the
initial assessment, and both professed attrac-tion to and love for their partner. Mrs. C. reported that she
could enjoy sex once she got involved and almost always was orgasmic. The problem was her lack of
desire to get involved. She avoided her husband’s sexual advances and looked on his affection and
romanticism with great skepti-cism and, usually,
anger and tears. Mrs. C. was raised in an upper-
middle-class family that was supportive and
loving. From age 6 to age 12, however, she had
been repeatedly pres-sured into sexual activity by
a male cousin who was 5 years her senior. This
sexual activity was always initiated by the cousin,
always against her will. She did not tell her
parents because she felt guilty, as the boy did not
use physical force to make her comply. It
appeared that romantic advances by Mr. C.
triggered memories of abuse by her cousin.

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Erectile disorder is a
2. Sexual Arousal Disorder specific disorder of arousal. The
problem here is not desire. Many
males with erectile dysfunction
have frequent sexual urges and fantasies and a strong desire to have sex. Their
problem is in becoming physically aroused.For females who are also likely to have
low interest, deficits in arousal are reflected in an inability to achieve or maintain
adequate lubrication.
Erectile dysfunction (impotence) is the inability to get and
Erectile keep an erection firm enough for sex. Having erection trouble
Dysfunction from time to time isn't necessarily a cause for concern. If
(ED) erectile dysfunction is an ongoing issue, however, it can cause
stress, affect your self-confidence and contribute to
relationship problems.

CASE SAMPLE:

B
ill and his wife agreed that despite marital
problems over the years, they had always
maintained a good sexual relationship until the
onset of the current problem and that sex had kept them
together during their earlier difficulties. Useful information
was obtained in separate interviews. Bill masturbated on
Saturday night in an attempt to control his erection the
following morning; his wife was unaware of this. In
addition, he quickly and easily achieved a full erection
when viewing erotica in the privacy of the sexuality clinic
laboratory (surprising the assessor). Bill’s wife privately
acknowledged being angry at her husband for an affair
that he had had 20 years earlier.At the final session, three specific recommendations were made: for Bill to
cease masturbating the evening before sex, for the couple to use a lubricant, and for them to delay the
morning routine until after they had had sexual relations. The couple called back 1 month later to report that
their sexual activity was much improved.

3. Sexual Orgasm Disorder The orgasm phase of the sexual

response cycle can also become
disrupted in one of several ways. As
a result, either the orgasm occurs at
an inappropriate time or it does not occur. An inability to achieve an orgasm despite
adequate sexual desire and arousal is commonly seen in women and less commonly
seen in men. Males who achieve orgasm only with great difficulty or not at all meet
criteria for a condition called delayed ejaculation. In women the condition is
referred to as female orgasmic disorder. A far more common male orgasmic
disorder is premature ejaculation, ejaculation that occurs well before the man and
his partner wish it to, defined as approximately 1 minute after penetration in DSM-5.

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Delayed ejaculation — sometimes called

Delayed Ejaculation impaired ejaculation — is a condition in which it takes
& Female Orgasmic an extended period of sexual stimulation for men to
reach sexual climax and release semen from the
Disorders penis (ejaculate). Some men with delayed ejaculation
are unable to ejaculate at all. Anorgasmia in
women, is a medical term for regular difficulty
reaching orgasm after ample sexual stimulation. The lack of orgasms distresses you
or interferes with your relationship with your partner.

CASE SAMPLE:

G
reta, a teacher, and Will, an engineer, were an attractive couple who
came together to the first interview and entered the office clearly
showing affection for each other. T hey had been married for 5
years and were in their late 20s. When asked about the problems that
had brought them to the office, Greta quickly reported that she didn’t
think she had ever had an orgasm—“didn’t think” because she wasn’t
really sure what an orgasm was. She loved Will and occasionally
would initiate lovemaking, although with decreased frequency over the
past several years. Will certainly didn’t think Greta was reaching orgasm.
In any case, he reported, they were clearly going in “different directions”
sexually, in that Greta’s interest was decreasing. She had progressed
from initiating sex occasionally early in their marriage to almost never
doing so, except for an occasional spurt every 6 months or so, when
she would initiate two or three times in a week. But Greta noted that it
was the physical closeness she wanted most during these times rather
than sexual pleasure. Further inquiry revealed that she did become
sexually aroused occasionally but had never reached orgasm, even
during several attempts at masturbation mostly before her marriage. Both
Greta and Will reported that the sexual problem was a concern to them
because everything else about their marriage was positive.Greta had been brought up in a strict but loving
and supportive Catholic family that more or less ignored sexuality. T he parents were always careful not to
display their affection in front of Greta, and when her mother caught Greta touching her genital area, she was
cautioned rather severely to avoid that kind of activity.

Premature ejaculation occurs when a man ejaculates

Premature Ejaculation sooner during sexual intercourse than he or his partner
(PE) would like. Premature ejaculation is a common sexual
complaint. Estimates vary, but as many as 1 out of 3 men
say they experience this problem at some time.

As long as it happens infrequently, it's not cause for concern. However, you might
be diagnosed with premature ejaculation if you:

• Always or nearly always ejaculate within one minute of penetration

• Are unable to delay ejaculation during intercourse all or nearly all of the time
• Feel distressed and frustrated, and tend to avoid sexual intimacy as a result.

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CASE SAMPLE

G
ary, a 31-year-old sales representative, engaged in sexual activity with his wife three or four times a
month. He noted that he would have liked to have had sex more often but his busy schedule kept
him working about 80 hours a week. His primary difficulty was an inability to control the timing of his
ejaculation. Approximately 70% to 80% of the time he ejaculated within seconds of penetration. This pattern
had been constant since he met his wife approximately 13 years earlier. Previous experience with other
women, although limited, was not characterized by premature ejaculation. In an attempt to delay his
ejaculation, Gary distracted himself by thinking of nonsexual things (scores of ball games or work-related
issues) and sometimes attempted sex soon after a previous attempt because he seemed not to climax as
quickly under these circumstances. Gary reported masturbating seldom (three or four times
a year at most). When he did masturbate, he usually attempted to reach orgasm quickly, a
habit he acquired during his teens to avoid being caught by a family member.
One of his greatest concerns was that he was not
pleasing his wife, and under no circumstances did
he want her told that he was seeking treatment.
Further inquiry revealed that he made many
extravagant purchases at his wife’s request, even
though it strained their finances, because he wished
to please her. He felt that if they had met recently, his
wife probably would not even accept a date with him
because he had lost much of his hair and she had
lost weight and was more attractive than she used to be.

A sexual dysfunction specific to

women refers to difficulties with
4. Sexual Pain Disorder penetration during attempted
intercourse or significant pain during
intercourse. This disorder is called
genito-pelvic pain/penetration disorder. For some women, sexual desire is
present, and arousal and orgasm are easily attained, but the pain during attempted
intercourse is so severe that sexual behavior is disrupted. In other cases severe anxiety
or even panic attacks may occur in anticipation of possible pain during intercourse.

But the most

Genito-Pelvic Pain/ usual presentation of
Penetration Disorder this disorder is referred
& Vaginismus to as vaginismus, in
which the pelvic muscles
in the outer third of the
vagina undergo
involuntary spasms when intercourse is attempted. The
spasm reaction of vaginismus may occur during any
attempted penetration, including a gynecological exam or
insertion of a tampon. Women report sensations of
“ripping, burning, or tearing during attempted intercourse.

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CASE SAMPLE

J
ill was referred to our clinic by another therapist because she had not consummated her marriage of
1 year. At 23 years of age, she was an attractive and loving wife who managed a motel while her
husband worked as an accountant. Despite numerous attempts in a variety of positions to engage in
intercourse, Jill’s severe vaginal spasms prevented penetration of any
kind. Jill was also unable to use tampons. With great reluctance, she
submitted to gynecological exams at infrequent intervals. Sexual
behavior with her husband consisted of mutual masturbation or,
occasionally, Jill had him rub his penis against her breasts to the
point of ejaculation. She refused to engage in oral sex. Jill, an
anxious young woman, came from a family in which sexual matters
were seldom discussed and sexual contact between the parents had
ceased some years before. Although she enjoyed petting, Jill’s
general attitude was that intercourse was disgusting. Furthermore,
she expressed some fears of becoming pregnant despite taking
adequate contraceptive measures. She also thought that she would
perform poorly when she did engage in intercourse, therefore
embarrassing herself with her new husband.

Treatment

Most types of sexual dysfunction can be corrected by treating the underlying

physical or psychological problems. Other treatment strategies include:

1. Medication — When a medication is the cause of the dysfunction, a change in the

medication may help. Men and women with hormone deficiencies may benefit from
hormone shots, pills, or creams. For men, drugs, including sildenafil (Viagra), tadalafil
(Cialis), vardenafil (Levitra, Staxyn), and avanafil (Stendra) may help improve sexual
function by increasing blood flow to the penis.
2. Mechanical aids — Aids such as vacuum devices and penile implants may help men
with erectile dysfunction (the inability to achieve or maintain an erection). A vacuum
device (Eros) is also approved for use in women, but can be costly. Dilators may help
women who experience narrowing of the vagina.
3. Sex therapy — Sex therapists can be very helpful to couples experiencing a sexual
problem that cannot be addressed by their primary clinician. Therapists are often good
marital counselors, as well. For the couple who wants to begin enjoying their sexual
relationship, it is well worth the time and effort to work with a trained professional.
4. Behavioral treatments — These involve various techniques, including insights into
harmful behaviors in the relationship, or techniques such as self-stimulation for
treatment of problems with arousal and/or orgasm.
5. Psychotherapy — Therapy with a trained counselor can help a person address
sexual trauma from the past, feelings of anxiety, fear, or guilt, and poor body image, all
of which may have an impact on current sexual function.
6. Education and communication — Education about sex and sexual behaviors and
responses may help an individual overcome his or her anxieties about sexual function.
Open dialogue with your partner about your needs and concerns also helps to
overcome many barriers to a healthy sex life.

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3.3.2 Gender Dysphoria

Gender Dysphoria involves a conflict between a person's physical or assigned
gender and the gender with which he/she/they identify. People with gender dysphoria
may be very uncomfortable with the gender they were assigned, sometimes described as
being uncomfortable with their body (particularly developments during puberty) or being
uncomfortable with the expected roles of their assigned gender.

People with gender

dysphoria may often
experience significant distress
and/or problems functioning
associated with this conflict
between the way they feel and
think of themselves (referred to
as experienced or expressed
gender) and their physical or
assigned gender.

The gender conflict

affects people in different
ways. It can change the way a
person wants to express their gender and can influence behavior, dress and self-image.
Some people may cross-dress, some may want to socially transition, others may want to
medically transition with sex-change surgery and/or hormone treatment. Socially
transitioning primarily involves transitioning into the affirmed gender’s pronouns and
bathrooms.

Symptoms

In adolescents and adults gender dysphoria diagnosis involves a difference

between one’s experienced/expressed gender and assigned gender, and significant
distress or problems functioning. It lasts at least six months and is shown by at least two
of the following:

1. A marked incongruence between one’s experienced/expressed gender and primary

and/or secondary sex characteristics
2. A strong desire to be rid of one’s primary and/or 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
5. A strong desire to be treated as the other gender
6. A strong conviction that one has the typical feelings and reactions of the other
gender

In children, gender dysphoria diagnosis involves at least six of the following and an
associated significant distress or impairment in function, lasting at least six months.

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1. A strong desire to be of the other

gender or an insistence that one is the
other gender
2. A strong preference for wearing clothes
typical of the opposite gender
3. A strong preference for cross-gender
roles in make-believe play or fantasy
play
4. A strong preference for the toys, games
or activities stereotypically used or
engaged in by the other gender
5. A strong preference for playmates of the
other gender
6. A strong rejection of toys, games and
activities typical of one’s assigned
gender
7. A strong dislike of one’s sexual anatomy
8. A strong desire for the physical sex
characteristics that match one’s
experienced gender

Treatment

The goal is not to change how the

person feels about his or her gender. Instead,
the goal is to deal with the distress that may
come with those feelings. Talking with a
psychologist or psychiatrist is part of any
treatment for gender dysphoria. "Talk" therapy is one way to address the mental health
issues that this condition can cause. Beyond talk therapy, many people choose to take at
least some steps to bring their physical appearance in line with how they feel inside. They
might change the way they dress or go by a different name. They may also take medicine
or have surgery to change their appearance. Treatments include:

• Puberty blockers. A young person in early puberty with gender dysphoria might ask
to be prescribed hormones (testosterone or estrogen) that would suppress physical
changes. Before making that decision, the young person should talk with a
pediatrician and sometimes a psychiatrist about the pros and cons of taking these
hormones, especially at a young age.
• Hormones. Teens or adults may take the hormones estrogen or testosterone to
develop traits of the sex that they identify with.
• Surgery. Some people choose to have complete sex-reassignment surgery. This
used to be called a sex-change operation. But not everyone does. People may
choose to have only some procedures done in order to bring their looks more in line
with their feelings.

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3.3.2 Paraphilia

Paraphilia (formerly known as sexual perversion and sexual deviation is the

perception of extreme sexual desire to atypical artifacts, circumstances, desires,
activities, or individuals. No agreement was found on any clear distinctions between
uncommon sexual and paraphilic interests.

Types of Paraphilia

Exhibitionism ("Flashing")
1. Exhibitionism involves someone exposing his
or her genitals to an
unsuspecting stranger. The
individual with this problem, sometimes called a "flasher," feels a
need to surprise, shock, or impress his or her victims. The
condition is usually limited to the exposure with no other harmful
advances being made. Nevertheless, "indecent exposure" is
illegal. Actual sexual contact with the victim is rare. However, the
person may masturbate while exposing himself or while
fantasizing about exposing himself.

People with
Fetishism have
2. Fetishism sexual urges
associated with non-
living objects. The
person becomes sexually aroused by wearing or
touching the object. For example, the object of a fetish
could be an article of clothing, such as underwear,
rubber clothing, women's shoes, women's underwear,
or lingerie. The fetish may replace sexual activity with
a partner or may be integrated into sexual activity with
a willing partner. When the fetish becomes the sole object of sexual desire, sexual
relationships often are avoided. A related disorder, called partialism, involves becoming
sexually aroused by a body part, such as the feet, breasts, or buttocks.

With this problem, the focus of the

person's sexual urges is on
3. Frotteurism touching or rubbing his or her
genitals against the body of a non-
consenting, unfamiliar person. In most cases of frotteurism, a male
rubs his genital area against a female, often in a crowded public
location. The contact made with the other person is illegal.

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People with pedophilia have

4. Pedophilia fantasies, urges, or behaviors
that involve illegal sexual
activity with a child or children.
The children involved are generally 13 years of age or younger.
The behavior includes undressing the child, encouraging the child
to watch the abuser masturbate, touching or fondling the child's
genitals, and forcefully performing sexual acts on the child.

Individuals with this

5. Sexual Masochism disorder use the act --
real, not simulated -- of
being humiliated,
beaten, or otherwise made to suffer in order to achieve sexual
excitement and climax. These acts may be limited to verbal
humiliation, or they may involve being beaten, bound, or
otherwise abused. Masochists may act out their fantasies on
themselves by such acts as cutting or piercing their skin or
burning themselves. Or they may seek out a partner who
enjoys inflicting pain or humiliation on others. Activities with a
partner include bondage, spanking, and simulated rape.

Sadomasochistic fantasies and activities are not uncommon among consenting

adults. In most of these cases, however, the humiliation and abuse are acted out in
fantasy. The participants are aware that the behavior is a "game" and actual pain and
injury is avoided. A potentially dangerous, sometimes fatal, masochistic activity is
autoerotic partial asphyxiation. With this activity, a person uses ropes, nooses, or
plastic bags to induce a state of asphyxia (interruption of breathing) at the point of
orgasm. This is done to enhance orgasm, but accidental deaths sometimes occur.

Individuals with
this disorder have
6, Sexual Sadism
p e r s i s t e n t
fantasies in which
sexual excitement results from inflicting psychological
or physical suffering (including humiliation and terror)
on a sexual partner. This disorder is different from
minor acts of aggression in normal sexual activity -- for
example, rough sex. In some cases, sexual sadists are
able to find willing partners to participate in the sadistic
activities.

At its most extreme, sexual sadism involves

illegal activities such as rape, torture, and even murder,
in which case the death of the victim produces sexual excitement. It should be noted that
while rape may be an expression of sexual sadism, the infliction of suffering is not the

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motive for most rapists, and the victim's pain generally does not increase the rapist's
sexual excitement. Rather, rape involves a combination of sex and gaining power over
the victim. These individuals need intensive psychiatric treatment and may be jailed for
these activities.

Transvestitism , or transvestic
7. Transvestitism fetishism, refers to the practice by
heterosexual males of dressing in
female clothes to produce or
enhance sexual arousal. The sexual arousal usually does not involve
a real partner but includes the fantasy that the individual is the female
partner as well. Some men wear only one special piece of female
clothing, such as underwear, while others fully dress as female,
including hair style and make-up. Cross-dressing as a transvestite is
not a problem unless it is necessary for the
individual to become sexually aroused or
experience sexual climax.

This disorder involves

achieving sexual arousal by
8. Voyeurism observing an unsuspecting and
non-consenting person who is
undressing or unclothed or
engaged in sexual activity. This behavior may conclude with
masturbation by the voyeur. The voyeur does not seek sexual
contact with the person he or she is observing. Other names for
this behavior are "peeping" or "peeping Tom."

Treatment for Paraphilias

Treatment combining cognitive and behavioral elements appear relatively more

successful in treating this condition.

Aversion therapy is another treatment technique that seems to work effectively for this
condition. That is, aversive conditioning to deviant sexual fantasies.

Assisted covert sensitization:

This therapy involves having the
patient imagine a deviant sexual
arousal scene. At the point where
arousal is high, the patient imagines
aversive consequences and a foul
odor is introduce via an open vial to
help condition a real aversion to
these deviant ones.

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Name: Year & Section:

3.3.3 SELF-TEST # 17

I. DIAGNOSTICS: Label the disorder that the client had experience

______ 1. After Bob’s football team won the championship, his interest in sexual activity
diminished. All his thoughts and fantasies centered on football and winning again next season
and his wife was threatening to leave him.

_______ 2. Kelly has no real desire for sex. She has sex only because she feels that otherwise
her husband may leave her.

_______ 3. Alden lacks the ability to control ejaculation. The majority of the time he ejaculates
within seconds of penetration.

_______ 4. Samantha came into the office because she is unable to reach orgasm. She loves
her husband but stopped initiating sex.

_______ 5. Mae enjoys being slapped with leather whips during foreplay. Without such
stimulation, she is unable to achieve orgasm during sex.

_______ 6. Kai has a collection of women’s panties that arouse him. He loves to look at, collect,
and wear them.

_______ 7. Sam finds arousal in walking up to strangers in the park and showing them his
genitals.

_______ 8. Tom loves to look through Susie’s bedroom window and watch her undress. He gets
extremely excited as she disrobes.

_______ 9. What Tom does not realize is that Susie knows that he is watching. She is aroused
by slowly undressing while others are watching, and she fantasizes about what they are thinking.

_______ 10. What Tom will be shocked to find out is that “Susie” is actually Scott, a man who can
become aroused only if he wears feminine clothing.

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3.4 LEARNING INSIGHTS

Sexual, Gender and Paraphilic disorders according to this provided algorithm can
be diagnosed:

Sexual, Gender and Paraphilic

Disorders
Presenting symptoms: inhibited sexual desire, impaired arousal, delayed orgasm,
premature ejaculation, pain during sex, gender-incongruent conditions, and
paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others.

1. Consider sexual pain or a disturbance in one or more SEXUAL

phases of the sexual response cycle, approximately 6 DYSFUNCTIONS
months

Male Hypoactive Sexual

A. If sexual dysfunction is related to low sexual desire or Desire Disorder
avoidance of all general sexual contact.
Female Sexual Interest/
Arousal

B. If sexual dysfunction is related to sexual arousal Erectile Disorder

Delayed Ejaculation

C. If sexual dysfunction is related to orgasm Premature Ejaculation

Female Orgasmic Disorder

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Sexual, Gender and Paraphilic

Disorders
D. If sexual dysfunction is related to related to pain during Genito-Pelvic Pain/
intercourse Penetration Disorder

GENDER DYSPHORIA
2. If an individual experiences significant discontent with
the sex they were assigned at birth and/or the gender roles Gender dysphoria in children
associated with that sex. Gender dysphoria in
adolescents and adults

PARAPHILIC DISORDERS
3. If an individual is in a condition in which sexual arousal
Voyeuristic Disorder
and gratification depend on fantasizing about and engaging
in sexual behavior that is atypical and extreme. Exhibitionistic Disorder
Frotteuristic Disorder
Sexual Masochism Disorder
Sexual Sadism Disorder
Pedophilic Disorder
Fetishistic Disorder
Transvestic Disorder

3.5 CHAPTER QUESTIONS

1) What are sexual dysfunctions? Why did they occur?

2) What are the various classifications of sexual dysfunctions?

3) What are the different types of paraphilias?

4) Enumerate the symptoms and treatment of gender dysphoria.

5) What are the treatments for paraphilias?

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Modules in Abnormal Psychology First Semester S.Y. 2020-2021

3.6 SUGGESTED READINGS

Hickey , Eric, W. (2005). Sex Crimes and Paraphilia Sage Publicartion, NY.

Holmes, R.M. (2007). Sex Crimes and Paraphilia. Prentice Hall, London.

Medline World Health Organisation. The International Statistical Classification of

Diseases and Health Related Problems, Tenth Revision. 2nd ed. World Health
Organisation; 2004.

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