Sexual and Gender Identity DisordersGender Identity DisorderThe
ParaphiliasSexual Dysfunctions
A) A strong and persistent cross-gender identification
manifested in children by four or more of the following: Repeatedly
stated desire to be the other sex Preference for wearing
opposite-sex clothing Strong and persistent preference for
cross-sex roles in make- believe play or fantasies of being
opposite sex Intense desire to participate in games or pastimes of
opposite sex Strong preference for playmates of opposite sex (In
adolescents and adults, desire to live or be treated as opposite
sex, or conviction that he or she has feelings and reactions of
opposite sex)B) Persistent discomfort with his or her sex or sense
of inappropriate- ness in the gender role of that sex (e.g.,
feeling disgusted with ones sexual organs)
The ParaphiliasRecurrent, intense, sexual fantasies, urges, or
behaviors generally involvingNonhuman objectsSuffering or
humiliation of self or partnerChildren or other non-consenting
persons
Condition must be present for at least six months
Condition must cause significant distress or impairment in
social or occupational functioning
The Paraphilias FetishismTransvestic
fetishismPedophiliaExhibitionismVoyeurismFrotteurismSexual
masochismSexual sadismParaphilias NOS
Paraphilias Not Otherwise Specified (NOS)Telephone scatalogia
(obscene phone calls)Necrophilia (sexual urges toward
corpses)Partialism (exclusive focus on a part of the body)Zoophilia
(sexual urges toward animals)Coprophilia (sexual attraction to
feces) Klismaphilia (sexual gratification from enemas)Urophilia
(sexual attraction to urine)Apotemnophilia (sexual interest in
being an amputee)Acrotomophilia (sexual attraction to amputees)
Etiology
Behavioral paraphiliac behavior is modeled and later compensated
operant conditioning
Compensation unable to have normal sexual relations so seek
gratification elsewhere
Physiological Androgen abnormalities during fetal
development
Childhood sexual abuse or distorted parent-child relationship
may result in low level of self-esteem or social skills however
Maletzky (1993): only 1/3 of pedaphiles were CSA
The Paraphilias
The ParaphiliasTreatmentBehavioral orgasmic reorientation
aversion therapysocial skills
trainingBiologicalcastrationmedroxyprogesterone accetate
(Depo-Provera)lowers testosteroneinhibits sexual desire
