SEXUAL DISORDER DURING EXCITEMENT STAGE:

FOUR ASPECTS OF SEXUALITY • Males experience stiffening and an

increase in the length and width of the
SEXUAL IDENTITY glans of the penis.
- the pattern of a person’s biologic sexual • Both sexes vital signs increase, fine rah or
characteristics. “sex flush” may appear over the chest and
abdomen.
GENDER IDENTITY
- is a person’s sense of maleness or femaleness.
Stage 3: ORGASM
SEXUAL ORIENTATION
Women experience several strong, rhythmic
- as one’s attractions, desires, and arousals contractions of the vagina, it will then enlarge and the
towards others based on their sex and gender. uterus contracts irregularly.
SEXUAL BEHAVIOR Vital signs and sex flush peak.
- how one responds to sexual impulses and Men experience emission and ejaculation of seminal
desires. fluid.

SEXUALITY ORIENTATIONS Stage 4: RESOLUTION

HETEROSEXUALITY The organs and body systems return to unaroused

state.
- opposite sex
Satisfaction is felt.
HOMOSEXUALITY
- same sex
WHEN IS A SEXUAL BEHAVIOR ABNORMAL?
BISEXUALITY
• Harm to other people,
- both sexes
• Persistent or recurrent distress, or
TRANSVESTISM • Impairment in important areas of functioning.
- “cross-dresser”
TRANSEXUAL/TRANSGENDER SEXUAL DISORDERS
- individuals whose sexual identities are entirely TYPES:
with the opposite sex.
1. Alteration in gender identity
2. Alteration in sexual orientation
3. Alteration in sexual behavior
SEXUAL RESPONSE CYCLE
4. Alteration in sexual functioning
Stage 1: DESIRE 5. Painful sexual disorders

Ability, interest, and willingness to receive sexual

stimulation.
- GENDER IDENTITY DISORDER
This phase involves activation of excitatory and
A condition in which there is a discrepancy
inhibitory functions.
between an individual’s gender identity and
assigned (biological) sex.

Stage 2: EXCITEMENT Refusal to engage in culturally “gender-

appropriate” behaviors.
Occurs as the result of psychological stimulation
(watching sexually explicit movies), foreplay. Recurrent fantasies of being the opposite gender
and cross-dressing.
Females generally experience vaginal lubrication,
clitoral swelling, pelvic congestion, and nipple
erection.
SPECIFIC DIAGNOSTIC CRITERIA ALTERATION IN SEXUAL BEHAVIOR
Child behaviors signifying cross gender identity (at 1. SEXUAL ACTING OUT
least four) • Have extramarital affairs and
1. Stated desire to be other sex. promiscuous individuals.
2. Cross-dressing 2. PARAPHILIA
3. Cross-sex roleplay • Sexual urges or fantasies that are
4. Cross-sex toy activity preference directed toward nonhuman objects,
5. Cross-sex peer affiliation pain to self, partner, or children, or
other non-consenting individuals.
In adults/adolescent, expressed as desires/behaviors
to be the other sex.
CHARACTERISTICS OF PARAPHILIA (DSM-V)
• Inability to experience sexual
THEORIES OF GENDER IDENTITY DISORDER
gratification.
BIOLOGICAL – include pre- and post-natal hormone • Lasting at least 6 months.
levels and genetic makeup. • Emotional immaturity
• Fear of sexual relationship
PSYCHOLOGICAL – it describes how sex-linked
• Shyness
characteristics are maintained and transmitted to
• Need to prove masculinity.
other members of a culture.
• Need to inflict pain.
SOCIAL – include ideas regarding gender roles • Need to endure pain.
conveyed by family, authority figures, mass media, and • Low or poor self-concept
other influential people in a child’s life. • Depression

TREATMENT TYPES OF PARAPHILIAS

PSYCHOTHERAPY 1. FETISHISM
- Very young child-parents should set limits to Substitution of an inanimate object for the genitals.
the child’s cross-gender behaviors.
➢ BODY FETISHISM
- Older Child/Early Adolescent – puberty
- Legs/Feet
blocker, hormones.
- Hair
- Adults – individual and, if appropriate, couples
- Nails
therapy is recommended for adults.
Other Fetishism
➢ Mannequins/Robots
ALTERATION IN GENDER IDENTITY ➢ Underwear
1. TRANSSEXUALISM
- Persistent discomfort about one’s sex
assignment. 2. TRANSVESTISM
- With intense feeling or preoccupation
Wearing clothes of the opposite sex to achieve
about transsexual surgery.
sexual pleasure.
- Feeling of being trapped in the wrong
body.
2. GENDER IDENTITY DISORDER OF CHILHOOD
3. EXHIBITIONISM
• Persistent and intense distress at one’s
sexual identity. Condition characterized by the compulsion to
display one’s genitals in public.

ALTERATION IN SEXUAL ORIENTATION

4. PEDOPHILIA
1. EGO-DYNAMIC HOMOSEXUALITY - Involving sexual activity with children.
• Client experience inappropriate - Can be limited to incest.
homosexual arousal pattern. - Victims are younger than 13 years of age.
- Generally, the individual must be at least 16
years of age and at least 5 years older than
the juvenile of interest to meet criteria for
pedophilias.
 TYPES OF MOLESTERS 5. VOYEURISM

• Situational Molesters Sexual gratification obtained by watching the sexual

• Preference Molesters plays of others.
• Child Rapists

6. SADISM
2/3 of all sexual assault victims are children and
adolescents. Sexual gratification obtained by inflicting pain and
punishment to the partner.

1. SITUATIONAL MOLTERS
- Don’t have a true sexual interest in 7. MASOCHISM
children. Sexual pleasure from enduring physical and
- Has the fewest number of victims. psychological pain.
- Will not limit victims to just children
but will also prey upon the elderly, sick,
or mentally impaired. 8. FROTTEURISM

2. PREFERENCE MOLESTER Sexual pleasure obtained by touching or rubbing

- Prefer children as the providers of against a non-consenting person.
personal and sexual gratification.

3. CHILD RAPIST 9. NECROPHILIA

- A violent child abuser whose behavior Sexual gratification obtained from corpse.
is an expression if hostile sexual
drives.
10. TELEPHONE SCATALOGIA

THEORIES Sexual gratification from or during telephone

conversation.
EARLY LIFE EXPERIENCE
In many cases, child sex abusers suffer from traumatic
11. ZOOPHILIA
experiences during their childhood.
Intense sexual arousal or desire for animals.
PERSONALITY TRAITS
Studies have shown that people with pedophilia
generally experience feelings of inferiority, isolation or 12. SODOMY
loneliness, low self-esteem, internal dysphoria, and
Oral and anal intercourse between males.
emotional immaturity.

TREATMENT ALTERATIONS IN SEXUAL FUNCTIONING

SEXUAL DYSFUNCTION
• BEHAVIORAL TREATMENT
Individual is unsatisfied in his sexual function.
An attempt to remove erotic feelings associated
with children. HYPOACTIVE SEXUAL DEISRE
• COGNITIVE Absence of sexual fantasies and desired.
The use of cognitive therapy has been found SEXUAL AVERSION
effective in changing the maladaptive cognition of
the pedophile. Avoidance of genital sexual contact with a
partner.
• GROUP THERAPY
SEXUAL AROUSAL DISORDER
To confront the denial and rationalization.
Persistent or recurrent lack of subjective sense of
• THERAPEUTIC CONFRONTATION sexual excitement and pleasure.
Set up an environment where people can speak
candidly.
 PAINFUL SEXUAL DISORDERS
VAGINISMUS
- an involuntary vaginal spasm at
penetration
DYSPAREUNIA
- painful sexual intercourse

NURSING DIAGNOSIS
1. Altered sexuality patterns.
2. Ineffective individual coping
3. Altered family process.
4. Anxiety
5. Potential for violence: self-induced

NURSING INTERVENTIONS
1. Sexuality belief and values discussion.
2. Encourage to discuss feelings of guilt,
remorse, anger, and loneliness.
3. Explain to the client the institution of suicidal
precaution.