Sexual Dysfunctions

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Sexual Dysfunctions

Sexual dysfunctions prevent or reduce an individual's enjoyment of normal sex and prevent
or reduce the normal physiological changes brought on normally by sexual arousal.1 These
dysfunctions can be classified by the phase of the sexual cycle in which they occur. It is
important to keep in mind that the diagnosis of sexual dysfunction is made only when the
disability persists.1 Any of them could occur occasionally or be caused by a temporary factor
such as fatigue, sickness, alcohol, or drugs.

The Desire Phase


There are two types of dysfunctions that can occur during the desire phase. One
is hypoactive desire, which is basically a disinterest in sexual activity. It results in a
complete or almost complete lack of desire to have any type of sexual relation. This can
often result in the participation in intercourse as a simple marital duty. 1
The second type is an aversion to sex. This is different from simple hypoactive sexual desire
in that sexual activity actually repulses the person or makes them unusually apprehensive.
This is most often the result of a traumatic sexual experience, such as molestation as a child
or rape.

The Arousal Phase


Erectile dysfunction is the inability of males to attain or sustain erection long enough for
coitus. The inability of females to become sexually aroused is sexual arousal disorder.

The Orgasm Phase


When males are unable to control ejaculation so that it occurs before satisfying sexual
relations can take place with the partner, it is known aspremature ejaculation. Ejaculatory
incompetence is the lack or delay of reaching orgasm in males. The female version of this
is inhibited female orgasm, the lack or delay of reaching orgasm in females.

Sexual Pain Disorders


There are two sexual pain disorders. Dyspareunia is when pain occurs during intercourse.
This is predominantly a female complaint, but it does occur in males
occasionally. Vaginismus is a female disorder in which involuntary spasmodic muscle
contractions occur at the entrance to the vagina when an attempt is made to insert the
penis. If intercourse is attempted despite these contractions, a painful sexual experience
results.

Paraphilia
Paraphilias are sexual behaviors in which unusual objects or scenarios are necessary to
achieve sexual excitement.1 Eight paraphilias are recognized which are grouped into 3 broad
catergories.

Preferences for Nonhuman Objects


There are two types of preferences for nonhuman objects: fetishism and transvestism.
Fetishism
A fetish exists when a person is sexually aroused by a nonliving object. It can manifest in
two ways, one more extreme than the other. One form associates coitus with some object
(most frequently women's panties or other undergarments 1 ). It is relatively harmless if the
action is taken playfully and is acceptable to the person's partner. Focus on certain parts of
the body (feet, hair, ears, etc) aside from those part of the pleasurable foreplay, can
become fetishistic in its hold on the individual.
The more extreme form of fetishism is when a nonliving object completely substitutes for a
human partner, such as underwear, boots, and shoes or such textured objects as velvet or
silk. Here, orgasm is achieved when the person is alone, fondling the object.

Transvestism
This paraphilia exists when the person achieves sexual excitement by cross-dressing. This is
very rarely found in females so the male side of this paraphilia will be used as the example.
Two different purposes seem to be associated with this act in different individuals. In one
aspect the person seeks to intensify sexual excitement in intercourse with a partner by only
partially dressing as a woman. In the other form, the male moves about in full female
regailia, which suggests some type of gender identity problem but not necessarily
homosexuality.

Preferences for Situations Causing Suffering


Sadism and Masochism
The term sadist is derived from the reported violent sexual exploits of the Marquis de Sade.
"Sadist" is applied to those who derive sexual excitement from the pain of others. The term
masochist was derived from the writing of Leopold von Sacher-Masoch whose characters
sought out women who would beat them. "Masochist" is applied to those who derive sexual
excitement through their own pain. Hence, sadists and masochists go hand in hand, one
depending on the need of the other. The danger of these needs is that each may need
succesively more brutal treatment to satisfy their sexual needs.

Preference for Nonconsenting Partners


The three types of this catergory of paraphilia are exhibitionism, voyeurism, and pedophilia.
All three are considered crimes in this country and are almost entirely male crimes.
Exhibitionism
Exhibitionism is the exposure of one's genitals in a public place. It is the most prominent
sexual offense leading to arrest and makes up one third of all sexual crimes.1 From the
psychological point of view, there are three characteristic features of the exhibition. First, it
is always performed for unknown women; second, it always takes place where sexual
intercourse is impossible, for example in a crowded shopping mall; and third, it must be
shocking for the unknown woman or it seems to lose its power to produce sexual arousal in
the individual. Exhibitionists are not assaultive and are considered more of a nuisance than
an actual danger.

Voyeurism
Looking at sexually arousing pictures or situations is a relatively common, apparently
normal activity. The difference between this and voyeurism is that in normal watching, the
viewing is a prelude to normal sexual activity. In the voyeur or "Peeping Tom" the
experience replaces normal sexual activity. Nevertheless, voyeurism may exist in a person
who also engages in normal heterosexual activity.1

Pedophilia
Pedophilia is the act of deriving sexual excitement through the physical contact of children.
This paraphilia is radically different from exhibitionism and voyeurism in its severely
damaging impact on the nonconsenting partner, a child. Ordinarily, the pedophiliac is
someone who has ready access to the child. The child or parent would have no reason to
suspect that the individual has a pedophilic orientation.

Gender Identity Disorder


A gender identity disorder exists when a person, male or female, experiences confusion,
vagueness or conflict in their feelings about their own sexual identity. 1 There is a struggle
between the individual's anatomical sex gender and subjective feelings about choosing a
masculine or feminine style of life.
Children can distinguish the difference between males and females by the age of two and by
their fourth birthday can recognize the different roles that each sex plays in society. By the
age of fifteen or so a person can relate to what arouses sexual feelings in themselves. Those
with a gender identity disorder may have a problem with one or all of these aspects of
identity.

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