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Sexual Dysfunction & Disorders Outline
Carolyn R. Fallahi, Ph. D.
What is considered normal sexual behavior? Males versus females.
High risk sexual behavior.
Gender differences & sexual behavior.
 Masturbation
 Permissive attitudes
 Premarital intercourse
 Number of sexual partners
 Frequency of intercourse
 The desire for sex to be associated with love
 Self-schemas
Cultural Differences
 Sambia in New Guinea
The development of sexual orientation
 Homosexuality runs in families
 MZ versus DZ twins
 Is it biological?
 Bem – temperament to behave in a certain manner.
Gender Identity Disorder (GID) or transsexualism
 More common with males
 Transvestic fetishism – clothes
 GID differs from intersex individuals (e.g. hermaphrodites)
 GID does not = homosexual arousal patterns
 Make sure to specify, e.g. sexually attracted to males; females both;
neither.
 Biological contributions?
 Levels of testosterone or estrogen
 When is gender identity in place?
Sexual Dysfunction
Three stages of sexual response cycle, e.g. desire, arousal, orgasm.
 Sexual dysfunctions can be lifelong or acquired.
 Generalized or specific.
 Psychological factors or psych factors + medical factors.
 43% females; 31% males
 Warning signs of sexual dysfunction.
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Sexual Desire Disorders
 Hypoactive sexual desire disorders. 22% women; 5% men.
 Sexual aversion disorder: the role of panic disorder. Specify type.
 Warning signs.
 Sexual arousal disorders. Outdated terms. Specify type.
o 40% males = occasional erectile & ejaculatory difficulties; 63%
women. Relationship to sexual satisfaction?
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Erectile dysfunction 5% males; increases with age.
Female arousal disorders – difficult to estimate; maybe 14%
Orgasm Disorders:
 Inhibited orgasm (female & male orgasmic disorder). 25% women; 50%
men = who seek therapy for sexual problems. Specify type.
 Premature ejaculation: 21% men. Issue – difficult to define “premature”.
Surveys 1 to 2 minutes after penetration. Issue = lack of control. Specify
type.
Sexual Pain Disorders:
 Dyspareunia: 1% to 5% men; 10% to 15% women. Specify type.
 Warning signs.
 Vaginismus: 5% women who seek treatment; higher rates in
conservative countries. Specify type.
Assessing Sexual Behavior
 Psychophysiological assessment.
 Nocturnal penile tumescence (NPT)
 Penile strain gauge
 Vaginal photoplethysmograph
Causes of Sexual Dysfunction:
 Biological contributions
 Prescription medications
 Psychological issues, e.g. performance anxiety, cognitive issues,
physiological issues, emotional issues, social & cultural contributions,
relationship issues, script theory of sexual functioning. The final word?
Paraphilia: What is it? Comorbid problems?
Fetishism
Partialism
Voyeurism
Exhibitionism
Transvestic Fetishism
Sexual sadism & masochism
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Sadistic rape
Pedophilia
Warning signs of pedophilia
Telephone scatologia
Frotteurism
Causes of pedophilia