This is the 2007 version. Click here for the 2017 chapter 16 table of contents.

Summary: Sex Disorders and Sex Therapy

Psychologists use the word gender to refer to a person's psychological identification as male or female. Gender disorders occur when a person's inner feelings of gender do not match the external body. This could occur due to a hormonal abnormality during embryological development.

In the 1960s and 1970s many sex-change operations were performed. Follow-up studies showed they did not produce consistent benefits, compared to living as a transsexual without an operation. The frequency of the operations dropped. They are still performed, but only after a lengthy evaluation period.

Paraphilias are unusual sexual attractions. Transvestitism is considered a paraphilia when cross-dressing is a source of sexual arousal. This seems to be unique to men; women who cross-dress are not aroused by it. Exhibitionism is the most common paraphilia, and it is resistant to treatment. Women exhibitionists are accepted in some subcultures and are not necessarily regarded as abnormal.

Masochism is sexual arousal from pain, physical abuse, or humiliation. Sadism is sexual arousal from inflicting pain. Masochists are often men who occupy positions of high status, for whom masochistic tendencies are normally forbidden.

The two most common sexual disorders are premature ejaculation or impotence (in men) and anorgasmia (in women). Treatment of these problems is usually successful over the short term. As therapies for these common problems became widely known, therapists began seeing people with more complex sexual problems. Often these required treatment of the whole person. Now it is common for regular therapists (not specialized sex therapists) to deal with sexual problems that present themselves in the context of a marriage or similar relationship.

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