Lesson 10: Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria


Attention

Probably no group of disorders in the DSM-V is more difficult to define than those related to sexual functioning. Given that “normal” sexual behavior is incredibly difficult to determine, how is it possible, then, to identify that which is abnormal? How much sexual arousal is too much? How much sexual behavior is not enough? How long should intercourse last? What is sexual activity exactly? When does a sexual fantasy become a disorder?


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Discuss the difference between gender and sex.
  • Correctly identify the diagnostic criteria for Gender Identity Disorder, Sexual Dysfunctions and Paraphilias.
  • Discuss the sociopolitical issues surrounding Megan’s Law and mandated sex offender registration.

Teaching

Chapter 10-Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria

Probably no group of disorders in the DSM-V is more difficult to define than those related to sexual functioning. Given that “normal” sexual behavior is incredibly difficult to determine, how is it possible, then, to identify that which is abnormal? How much sexual arousal is too much? How much sexual behavior is not enough? How long should intercourse last? What is sexual activity exactly? When does a sexual fantasy become a disorder?

This chapter will introduce you to the current definitions of abnormality in sexual or gender functioning. I should caution you that the language and themes of this chapter are “adult” in nature and meant to be purely educational. Some students may be disturbed by part of the content. I have given three discussion questions, one of which deals with the issue of pedophiles and Megan’s Law.

The content and discussions of this chapter can be challenging for some of you. It is important to come to terms as to why this is the case and contend with it. If there are activities that you find too challening to do, please contact your instructor in order to work out a solution.

Gender

Sociology defines gender and more than simply the "sex" or "male/female" physical qualities that we have. Gender connotes the social norms and values associated with a person's behavior...including attraction and sexuality. There are many different genders now defined by the field.

While some of these may be hard to understand, click HERE to view a Wikipedia source on list of "Nonbinary Identities." As you can see there is a LOT of diversity out there.

With all of this diverstity it is becoming increasingly difficult to discern bewteen "diversity" and problematic behavior requiring intervention.

Sexual Dysfunction

Regardless of the gender or sexual orientation of someone, there may be issues that arise related to sexual dysfunction (the book discusses these in terms of heterosexual relationships but they can be applied to any relationship.)

Many of the sexual disorders discussed in the text have to be viewed in terms of degree along with the nature of the disorder. Keep in mind that "abnormal behavior" is defined in three ways:

  • Statitisticaly rare
  • Violates social norms
  • Interferes with functioning

Keeping these in mind we can see that certain behaviors (such as transvestite and sadomasochism) can be engaged in to a degree that falls into a new "normal." These behaviors become "disorders" when they begin to interfere with someone's functioning and/or their social groups and expectations.

For instance. If a person you work with engaged in transvestite behavior (cross dressing) but did so in private, there may be no problem. Depending on the degree of openness of the workplace and the type of work, cross dressing at work may not be a problem either. However, if the workplace does not allow for that or it interferes with the function of the person or workplace, the issue could be opproached as a problem

Psychosocial Treatments

On p. 373 in your text you will find a section on Psychosocial Treatments for sexual behavior problems. While this is not always a comfortable issue to discuss with clients, sexuality is a part of their lives.

Coordinating the availablity of basic sexual education, alterning myths associated with sexuality, and information about contraception are important aspects of treatment planning for our clients.


CLASS ACTIVITIES

Lesson 10 Assignment - Case Study

Open the Case Study labeled “Terrance” Read the attached case and answer the questions given in the assignment.

Lesson 10 Discussion A

Pretend you wake up tomorrow and you are the "opposite" sex: 

  • What will be different?
  • What things will you miss?
  • What will some advantages be?
  • How will society treat you differently or make different assumptions about you?
  • How is sex different from gender?

This is an examination of the norms associated with your sex and gender.

Lesson 10 Discussion B

One of the more difficult paraphilias to discuss is pedophilia. It is generally defined as a primary sexual attraction to children, usually under 13 years of age. While there are multiple types of pedophiles, most do not respond well to treatment and are highly likely to reoffend.

As a result, all 50 states are required to keep a database of registered sexual offenders (not: any felony sex offense is grounds for inclusion in this database, not just sex crimes involving children). This was mandated by “Megan’s Law.” Maine does not allow people to search this database online, while California does.

I want you to go to http://www.meganslaw.ca.gov/ Once in the site, click on the link at the bottom of the page to enter the database. From there, it will ask you to agree to abide by the conditions listed. On the next page, you will be asked to select how you want to view the database.

I would like you to select “by City” and then enter Los Angeles. Next, click “view map” to see how many “blue dots” are found in that city alone (each dot represents where one sex offender lives). After you have the map, then click on “view listing” to access the actual offenders. Pick a person from the list and click on their name. Take a look at their profile. If the address is listed, click on the map link. Now, answer the following questions:

  • What are your personal reactions to the site?
  • Do you agree that sex offenders should be mandated to register for life? Why or why not?
  • What surprised you about the person that you viewed?