This document discusses sexual dysfunctions and gender identity disorders. Sexual dysfunctions are disturbances in sexual function that are caused by emotional, mental, physical or medical issues. They include problems with sexual desire, arousal, orgasm or pain. Gender identity disorders involve a strong and persistent identification with the opposite gender. The document outlines various types of sexual dysfunctions and symptoms of gender identity disorders in children and adults. Treatment options discussed include medication, therapy, education and sex reassignment surgery.

1.  Sexual
Dysfunction
 Gender Identity
Disorders
 Mr. Orlando A. Pistan
 Psychology Instructor

2.  Are disturbances in sexual
function secondary to
emotional and /or mental
causes.
 This category includes
 Sexual dysfunctions,
 Sexual perversions
(paraphilias), and
 Gender Identity
Disorders.

3.  Characterized as a
disturbance of
sexual desire,
arousal, or orgasm;
sexual pain; or
difficulties with
sexual performance.

4.  Desire disorders —lack of
sexual desire or interest in
sex
 Arousal disorders —inability
to become physically
aroused or excited during
sexual activity
 Orgasm disorders —delay or
absence of orgasm (climax)
 Pain disorders — pain
during intercourse

5. Sexual dysfunction can
affect any age, although
it is more common in
those over 40 because it
is often related to a
decline in health
associated with aging.

6.  In men:
 Inability to achieve or
maintain an erection suitable
for intercourse (erectile
dysfunction)
 Absent or delayed
ejaculation despite adequate
sexual stimulation (retarded
ejaculation)
 Inability to control the
timing of ejaculation (early
or premature ejaculation)

7.  In women:
 Inability to achieve orgasm
 Inadequate vaginal
lubrication before and
during intercourse
 Inability to relax the vaginal
muscles enough to allow
intercourse

8.  Physical causes — Many
physical and/or medical
conditions can cause problems
with sexual function. These
conditions include diabetes,
heart and vascular (blood
vessel) disease, neurological
disorders, hormonal
imbalances, chronic diseases
such as kidney or liver failure,
and alcoholism and drug abuse.
In addition, the side effects of
some medications, including
some antidepressant drugs, can
affect sexual function.


9.  Psychological causes —
These include work-related
stress and anxiety, concern
about sexual performance,
marital or relationship
problems, depression,
feelings of guilt, concerns
about body image, and the
effects of a past sexual
trauma.

10. Most types of sexual dysfunction can be corrected by treating the
underlying physical or psychological problems. Other treatment
strategies include:
 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.
 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.

11.  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.
 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.
 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.

12.  References
 American Academy of Family Physicians/American Family
Physician. Female Sexual Dysfunction: Evaluation and
Treatment Accessed 1/28/2015.
 Association of Reproductive Health Professionals. Size Up Your Sex
Life Accessed 1/28/2015.
 Planned Parenthood. Sex and Sexuality Accessed 1/28/2015.

13. Gender identity disorders
characterize individuals
who desire to be—or
insist that they are—
members of the other
sex.
Gender identity disorder
symptoms can develop
as early as ages 2 to 4.

14.  People with gender
identity disorder act
and present themselves
as members of the
opposite sex. The
disorder may affect self-
concept, choice of
sexual partners and the
display of femininity or
masculinity through
mannerisms, behavior
and dress.

15.  Children:
 Express the desire to be the
opposite sex
 Have disgust with their own
genitals
 Believe that they will grow
up to become the opposite
sex
 Are rejected by their peer
group and feel isolated
 Have depression
 Have anxiety

16.  Adults:
 Desire to live as a person of
the opposite sex
 Wish to be rid of their own
genitals
 Dress in a way that is typical
of the opposite sex
 Feel isolated
 Have anxiety

17.  A. Must persistently and
strongly identify with the
opposite gender (aside from
desiring any perceived
cultural advantage of being
the other gender).
 B. A persistent discomfort
with his or her sex or sense
of inappropriateness in the
gender role of that sex.

18. Boys:
 Disgust with own genitals
 Belief that genitals will disappear
or that it would be preferable not
to have a penis
 Rejection of male activities such as
rough and tumble play, games and
toys
Girls:
 Rejection of urinating in seated
position
 Desire not to develop breasts or
menstruate
 Claims that she will have a penis
 Strong dislike for typical female
clothing

19. In adolescents and adults, the
disturbance is manifested by
symptoms such as
preoccupation with getting
rid of primary and
secondary sex characteristics
(such as request for
hormones, surgery or other
procedures to physically
alter sexual characteristics to
simulate the other sex) or
belief that he or she was born
the wrong sex.

20. The feeling of being in the
body of the "wrong" gender
must persist for at least two
years for this diagnosis to
be made.
The cause is unknown, but
hormonal influences in the
womb and environmental
factors (such as parenting)
are suspected to be
involved.

21. Individual and family
counseling is recommended
for children, and individual
or couples therapy is
recommended for adults.
Sex reassignment through
surgery and hormonal
therapy is an option, but
severe problems may persist
after this form of treatment.
A better outcome is
associated with the early
diagnosis and treatment of
this disorder.

22.  Sources:
 Diagnostic and Statistical Manual of Mental Disorders
 National Institutes of Health - National Library of Medicine