Lecture 1: Disorders of Sex & Gender How to differentiate SEX and GENDER? What is (sexual) deviance? What are the “sexual disorders”? What are the paraphilias? – focus on paedophilia Is it possible to talk about (deviant) sexual preferences?

Gender … psychosocial variable, characterised by “one’s personal, social and legal status as male or female, or mixed, on the basis of somatic and behavioural criteria more inclusive than the genital criterion and/or erotic criterion alone” (Money, 1992).

Gender Identity/Role (G-I/R) : “…gender identity is the private experience of gender role, and gender role is the public manifestation of gender identity. Both are like two sides of the same coin, and constitute the unity of G-I/R” (Money, 1992,

John Money on gender identity “…the sameness, unity and persistence of one’s individuality as male, female or androgynous, in greater or lesser degree, especially as it is experienced in self- awareness and behaviour. while sex is dichotomous, gender (in particular, gender identity) is a continuous variable. while sex is dichotomous, gender (in particular, gender identity) is a continuous variable.

SEX (at birth or within 2yrs of birth) GENDER Predominance of female traits Predominance of male traits

So what is “sexual deviance”? Gagnon & Simon (1967): “Normal deviance” vs “Subcultural deviance” vs Individual deviance”

Gagnon & Simon (1967) “Normal Deviance”: Masturbation, premarital intercourse, oral sex: commonly practised, but may be legally proscribed “Subcultural Deviance”: homosexuality, bisexuality, ?paedophilia? “Individual Deviance”: exhibitionism, incest, paraphilias But n.b. social rather than medical criteria determine category membership, and the criteria are constantly changing!

John Curra: The Relativity of Deviance. Sage Pubs., 2000 “We must never forget that any decisions about what is normal sexuality and what is a normal sexual being always reflect historically determined, culture-bound understandings about the proper ends of human social and sexual relationships” (p.44)

Curra on Deviant sexuality… No intrinsic differences need exist between sexual deviance and sexual nondeviance. All that is required is that some group ban certain kinds of sexuality and bedevil those individuals who participate in the forbidden acts

Animal vs. Human Sex: How are they different? Human sexuality is distinctly human…A major reason is that human sexuality is constituted by feelings, thoughts and the exchange of communication in ways that nonhuman sexuality never could be (p.49)

So what are the “sexual disorders”? See Handout from Seligman & Rosenhan text: Both sexual dysfunction and sexual disorders grossly impair affectionate erotic relations between human beings, and as such are abnormal

The paraphilias: Disorder of sexual object choice (see hand-out for list) Sexual object choice is so disordered that it impairs the capacity for affectionate erotic relations between human beings Three types:  sexual arousal & preference for non- human objetcts, e.g. fetishes, transvestism  Ditto for situations involving suffering and humiliation, e.g. S&M  Ditto for non-consenting partners, e.g. exhibitionism, voyeurism and child molesting

Paraphilias: 52 ways to get turned on (see list on hand-out) See case of asphyxophilia: Med. Sci. Law (1983) Vol.23, No.1, pp.54-56): An Unusual Case of Sudden Death Associated with Masturbation.

Fetish: Love token or Erotic Icon Typically acquired during childhood Dysfunctional – interferes with normal sexual relationships, leads to personal distress. May involve conflict with the law Almost exclusively male

Fetishes are to desire as phobias are to fear…….. Selective (limited set of objects)? YesYes Easily acquired? YesYes Robust & resistant to extinction? YesYes Irrational/non- cognitive? YesYes FETISHESPHOBIAS

Transvestism: persistent cross- dressing in order to achieve sexual arousal Predominantly male (ratio 4:1) Typically carried out in secret Typically starts with cross-dressing in childhood Not homosexual (3/4 are married with children), but may feature in transsexual as a feature of preferred gender identity Dysfunctional – may be impotent unless wearing female clothing

S&M: the sexual response to the infliction of pain, psychological humiliation or ritualised dominance or submission Common practices: flagellation (with whip or cane); bondage, together with use of fetish objects (leather clothes and boots) Occurs in women (in milder form) as well as men, but most sadomasochists are men See case of Peter Plumley-Walker

Exhibitionism: repeated exposure of genitals to an unwitting stranger, to produce sexual arousal Very common criminal offence, esp. in immature young men Perpetrator wishes to shock/horrify victims A nuisance (harmless). Exhibitionists need to display masculinity without threat of having to perform in an adequate sex role

Voyeurism (“Peeping Tom”) Voyeurism (“Peeping Tom”) Seeking out of situations in which to espy unsuspecting women who are naked, undressing, or engaged in sexual activity, in order to achieve sexual arousal/orgasm  Predominantly male, but not unknown in females  Voyeurs are shy and sexually immature

Paedophilia (“love of children”) Preference for sexual experience with sexually immature (prepubertal) persons  Predominantly older male, married  May be homo- or heterosexual in orientation  Childhood frequently unhappy, disturbed relationship with parents  Often socially inept and inexperienced  Predominantly non-violent?????

Bancroft (1983) on Paedophilia The majority are non-violent and in many cases the child not only consents but appears to enjoy the experience …in many cases the social reaction against the paedophile and the severity of the sentence imposed…are out of proportion to the gravity of the offence We should be prepared to see the average paedophile as someone more to be pitied…then to be reviled

Remember that… …not all paedophiles are child sex offenders, and not all child sex offenders are paedophiles, but….. Studies show that of incarcerated child molesters:  roughly 50-60% use physical force  42% of victims sustain noticeable injury  young perpetrators more likely to use force than older perpetrators

Transsexualism: a disorder of gender identity Trannies feel they were “born into the wrong body” Cross-dressing is an expression of their preferred gender role Tx is life-long and rare (1 in 100,000) Male-to-female more common than female-to-male Sex-change op. therapy of choice in some cases

Are sexual preferences freely chosen? No! Sexual preference is a moral and political term. Conceptually it implies voluntary choice, that is, that one chooses, or prefers to be homosexual instead of heterosexual or bisexual, and vice versa. Politically, sexual preference is a dangerous term, for it implies that if homosexual choose their preference they can be legally forced, under threat of punishment, to choose to be heterosexual…The concept of voluntary choice is as much in error here as in its application to handedness, or to native language. John Money, Gay, Straight & In-between. 1988