Ch 29 Sexual Disorders

Continuum of Sexual Responses Behaviors occur along continuum –Adaptive- satisfying that respect rights and wishes –Maladaptive-impaired or dysfunctional, harmful to self or others

Adaptive or Helathy Between consenting adults Satisfying to both Not forced or coerced Conducted in privacy

Self Awareness Watch non verbal messages of disaproval or judgment Awareness of your own views about sexuality Value clarification process

Sexuality through life-cycle Childhood –Assigned name – gender indicativve –Unaware gender is a permanent attribute –2 yr old labels self as girl or boy –3 yr accurately label gender of others –7 yr understand gender is permanent –Betw. 7 and 9 learn gender is identified by genitalia –Age 3 identify gender roles –School age – identify with same gender parent –Mid elementary-aware of their gender role

Sexuality in Adolescence 12 yrs. Intensely involved with same gender friends, mixed group activity and dating increase Dating usually begins in 7 th and 8 th grade with social activities dances, picnics etc Group dating, double dating 12 th grade have single pair dates Teens – have difficulty believing that sex can exist without love “true love”

Sexual activity becomes the norm rather than exception with teens Multiple relationships by age 19 STD HIV higher for adolescents than general population

Sexuality in and Adulthood More unmarried, sexually active young adults Ages 18 and 24, multiple partner and serial relationships Women less sexually aggressive than men 25 to 59 – relative monogamy

Sexual behavior changes to situation –New parents- less sex –Fear of unplanned pregnancy

30 and 40 yr olds bearing children and beginning families Single parenthood common Sexual freedom as children leave home and menopause occurs Spontaneous interaction

Older adulthood sexuality Shifts from procreation to companionship, sharing, touching and intimate communication More important than the actual act Established sexual patterns continue

Sexuality and Disability Many are able to enjoy satisfying sex lives with adaptation Cope with negative attitudes and stigmas

Modes of Sexual Expression Express sexuality with members of opposite gender are heterosexual Homosexuality- sexual preference is with members of own gender –Close coupled – akin to married, well adjusted –Open coupled – living together having relations with others, less committed, higher levels of sexual activity than close coupled –Functional – no special partner not interested in finding one –Dysfunctional- regret sexual orientation, more unhappy, depressed or paranoid –Asexual- feel sexually unattractive, lonely, unhappy

Bisexuality Attracted to and engage in sexual activity with members of both genders

Transvestites Cross dressers Excitement from wearing clothing of opposite gender –1 st type- man aroused by certain article of clothing –2 nd type- dresses completely in women’s clothing –Typical- married, with children, secretive, heterosexual, accepted by his wife

Theory Biological-chromosomal, genetic, brain structure, hormones Psychoanalytical – behavior with neurotic or psychopathic motivations –Oedipal/Electra complex sexual feelings to opposite gender parent Behavioral – learned measurable responses Learning- introduced by accidental experience

Sexual disorders- problems that cause distress and impair functioning in individual or others exposed to the behavior Sexual dysfunction – disturbance anywhere during the four stages of sexual response

Paraphilias Group of sexual variations that depart from society’s traditional and acceptable modes of seeking sexual gratification –Pedophilia, voyeurism, exhibitionism

Gender Identity Disorder Unhappy with own gender Want to eliminate own sexual characteristics and trade them for the opposite’s Believe they were born in wrong body Transexualism- persistent desire to become member of opposite sex –Discontented with biological gender

Sexual addiction Progressive and chronic addiction characterized by patterns of compulsive sexual behavior despite negative consequences Obsessive need for self gratification Dysfunctional history with primary caregiver, abuse neglect or abandonment

Therapeutic Interventions Group or individual therapy Hormonal drug therapy Environmental control for undesireable behaviors (jail or prison) Mostly outpatient

Psychosocial Assessment Be aware of client’s level of comfort

Nursing Process Ability to educate Objective Assessment and treatment