Human Sexuality . Common Definitions

Sex and Sexuality Defined

SEX - the characteristics that differentiate males and females in most plants and animals. The biological male and female status and describe specific sexual behavior (r)

SEXUALITY - the state of having sex - the collective characteristics that mark the differences between the male and the female or the constitution and life of an individual as related to sex; all the dispositions related to intimacy, whether associated with sex organs or not. (r)

Common Definitions

• Sexual Identity: based on the person’s sexual characteristic, such as external and internal genitalia, hormonal characteristics and secondary sexual characteristics.
  
  Gender Identity: based on the person’s sense of maleness or femaleness, established by the age of 3 years and believed to have been determined by parents. Brain perception of either a boy or a girl is established by age 3 years.
  
  Sexual Orientation: based on the person’s choice of a love object, may be heterosexual (opposite sex), homosexual (same sex), bisexual (both sexes), or asexual (no sex).
• Masturbation: Normal precursor of object-related sexual behavior, both men and women do it, beginning by 15 months to 19 months with no sexual fantasies. It increases by puberty. Males learn it earlier and practice more often.
  Adolescents have sexual fantasies while masturbating, commonly seen among adolescents, married couples and elderly. Excessive only if it interferes with daily functioning.
• Homosexuality: not a mental illness, not pathologic.  Freud believed it was an arrest of psychosocial development.  It may be due to genetic and biological causes.  Male-male relationships may be less stable than female-female relationships.

Alteration in Sexual Behavior:

• Transexualism - feeling that one’s sex is inappropriate and desiring to acquire sexual characteristics of the opposite sex.
• Exhibitionism - Sexual urges and fantasies and exposing one’s genitalia to strangers.
• Fetishism - Using nonliving objects for sexual gratification (female’s shoes).
• Pedophilia - Desiring sexual activity with a child under the age of 13 years (most common paraphilia).
• Frotteurism - Recurrent urge or behavior involving touching or rubbing against a non-consenting partner (e.g., in the subways).
  Voyeurism - Recurrent urges or behavior involving the act of observing an unsuspecting person who is engaging in sexual activity or disrobing, etc. it is an earlier paraphilia to develop.
• Masochism - recurrent urge or behavior involving acts of humiliation, the victim, the victim likes to receive pain through sexual performance.
• Sadism - recurrent urge or behavior involving acts in which physical or psychological suffering of a victim is exciting to the patient. Loves to inflict pain on his victim.
• Transvetic fetishism - recurrent urge or behavior involving cross-dressing, usually found in heterosexual men.

Sexual Dysfunctions

• Phase: Desire
  Characteristics: Focuses on drives, motivation, and desires
  Disorder: Hypoactive sexual desire, decreased fantasies, decreased desire Sexual aversion
  Treatment: Individual Psychotherapy.  Feelings, guilt, self esteem, Homosexual impulse, Marital conflicts
• Phase: Arousal
  Characteristics: Sense of sexual pleasure with physiological changes
  Psychological: fear of failure Disorder
  Female: failure to achieve adequate lubrication during the act
  Male: persistent or recurrent inability to attain/sustain erection until completion of the act.  Selective impotence: erection with girlfriend, not with wife
  Treatment: individual psychotherapy to deal with guilt, anxiety and fear.  Medication for vaginal dryness, Marital conflict resolution.
  Must rule organic vs.. psychological, plethysmography or postage stamp test, Couples therapy to resolve conflict
• Phase: Orgasm
  Characteristics: Physiologic state in which sexual tension is released and contractions are produces in various organs.
  Disorder: Female anorgasmia - recurrent or persistent inability to achieve an orgasm either through masturbation or sexual intercourse.
  Premature ejaculation - ejaculation before the man wishes to do so, before penetration, or just after penetration.
  Treatment: Individual Psychotherapy to deal with issues of guilt fear of impregnation.., vibrators, education, & fantasy, Couples marital conflict resolution.  Behavioral techniques, e.g., squeeze & stop-and-go.
  Pharmacology: SSRI, Prozac retards premature ejaculation, The partner squeezes.
• Phase: Pain
  Characteristics: Subjective sense of pain associated with sexual act.  Most likely due to dynamic factors.
  Disorder: Dyspareunia - pain associated with sexual intercourse in either male or female. No diagnosis is there is organic cause, e.g., UTI, and lack of vaginal lubrication
  Vaginismus - involuntary construction of the outer one third (1/3) of the vaginal wall that interferes with the sexual act.
  Treatment: Individual therapy to help the woman deal with issues of anxiety & tension about sexual intercourse Treat marital conflict,  Behavior therapy, e.g., dilators,  Individual therapy to deal with issues of fear of impregnation, strict upbringing or religious beliefs,
• Gender Identity Disorder
  Persistent discomfort and sense of inappropriateness regarding the patient’s assigned sex. Seen more frequently in men than women. Cause is unknown. ? Hormonal problems.
  Presenting Symptoms
  children will have preference for friends of the opposite sex.
  Preoccupied with wearing opposite gender’s clothes.
  Refusal to urinate sitting down if a girl or standing up if a boy.
  Believe they were born with the wrong body.
  Routinely request medications or surgery to change their physical appearance.
  Women may bind their breast, have mastectomies, take testosterone to deepen the voice.
  Men may have electrolysis to remove body hair & take estrogens to change the voice. May have surgeries to remove penis & create vagina.

 

 

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