Week 11: Gender Dysphoria, Paraphilic Disorders, And Sexual

Week 11 Gender Dysphoria Paraphilic Disorders And Sexual Dysfunctio

Week 11 Gender Dysphoria Paraphilic Disorders And Sexual Dysfunctio

This week's topics include gender dysphoria, paraphilic disorders, and sexual dysfunction. The diagnosis of female orgasmic disorder is characterized by a persistent or recurrent delay in, or absence of, orgasm following normal sexual excitement phase. To meet the DSM-5 criteria, the disturbance must have persisted for at least six months, cause significant distress, and not be better explained by a medication, other psychiatric condition, or relationship issues. These criteria highlight the importance of understanding both the clinical symptoms and contextual factors involved in diagnosis.

Evidence-based psychotherapy for female orgasmic disorder includes cognitive-behavioral therapy (CBT) and sensate focus exercises. CBT aims to modify maladaptive thoughts and beliefs contributing to sexual difficulty, while sensate focus involves gradually increasing physical intimacy without pressure to achieve orgasm, fostering relaxation and body awareness. Psychopharmacologic treatments, such as the use of selective serotonin reuptake inhibitors (SSRIs), are sometimes prescribed to address underlying anxiety or mood components, though they may also potentially cause sexual side effects like decreased libido or delayed orgasm (American Psychiatric Association, 2013; Sadock et al., 2014).

Comparison of Differential Diagnostic Features of Gender/Sexual Disorders

Gender dysphoria primarily involves incongruence between assigned sex and experienced gender, often accompanied by significant distress or impairment in social or occupational functioning (American Psychiatric Association, 2013). It is distinct from paraphilic disorders, which are characterized by recurrent, intense sexual urges or behaviors involving non-consenting persons, non-human objects, or suffering/humiliation (Gabbard, 2014). Sexual dysfunctions, including female orgasmic disorder, involve disturbances in the normal sexual response cycle, which can be caused by psychological, physiological, or relational factors. These disorders are differentiated based on their core symptoms, onset, duration, and the presence of distress.

Gender dysphoria is diagnosed based on a persistent incongruence lasting at least six months, with associated distress. Paraphilic disorders are distinguished by the presence of specific repetitive behaviors or urges that are abnormal in nature, such as exhibitionism or voyeurism, and often require a focus on the person's sexual interests or fantasies. Sexual dysfunctions, like female orgasmic disorder, are identified by specific difficulties during the sexual response phases, supported by clinical interviews and assessments. Proper differential diagnosis requires detailed history-taking, understanding of the patient's subjective experiences, and consideration of possible comorbidities.

Support for these distinctions is grounded in the DSM-5 framework and current literature (Sadock et al., 2014; Gabbard, 2014). Recognizing the differences enables clinicians to tailor treatment approaches effectively, whether through psychotherapy, pharmacotherapy, or combined interventions. Understanding these diagnostic nuances also helps in destigmatizing these conditions and providing compassionate care to affected individuals.

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  • Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
  • Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
  • Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
  • Johnson, L., Shipherd, J., & Walton, H. M. (2016). The psychologist’s role in transgender-specific care with U.S. veterans. Psychological Services, 13(1), 69–76. doi:10.1037/ser
  • Levenson, J. S., & Grady, M. D. (2016). The influence of childhood trauma on sexual violence and sexual deviance in adulthood. Traumatology, 22(2), 94–103. doi:10.1037/trm
  • Hawes, S. W., Boccaccini, M. T., & Murrie, D. C. (2013). Psychopathy and sexual deviance as predictors of sexual recidivism: Meta-analytic findings. Psychological Assessment, 25(1), 233–243. doi:10.1037/a
  • Johnson, S. (Producer). (n.d.). Emotionally focused therapy with same-sex couples [Video file]. Mill Valley, CA: Psychotherapy.net.
  • Other references can include the most recent articles from peer-reviewed journals related to sexual dysfunction diagnosis and treatment modalities.

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