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Chapter 17Sexual Disorders Sexuality Defined An innate part of human dynamics Blend of physical, chemical, psychologic functioning characterized by gender and sexual behavior Sexual Orientation Individual preference or sexual attraction Heterosexualitypreference for members of the opposite sex Homosexualitypreference for members of the same sex Bisexualityattraction to members of both sexes Sexual Disorders All mental alterations that prevent a person from functioning in a normal healthy relationship within societal norms Categories ◦ Sexual dysfunctions ◦ Paraphilias ◦ Gender identity disorders Sexual Desire Disorders Hypoactive sexual desire disorder Sexual aversion disorders Sexual arousal disorder Orgasmic disorders Sexual pain disorders (dyspareunia) Sexual dysfunction due to general medical condition/medication Paraphilias Intense, sexually arousing fantasies, urges, or behavior with nonhuman objects ◦ Involve suffering or degradation to self or partner that is sexually exciting ◦ Required for sexual arousal on each encounter ◦ Values are self-centered and powerseeking ◦ Secrecy ◦ In conflict with society and law Paraphilias (cont.) Incidence and etiology ◦ Not often seen in clinical setting ◦ Treatment commonly connected to entanglements with law ◦ Most prevalent among men ◦ Behaviors tend to be chronic Gender Identity Disorder Strong and persistent cross-gender identification Insist that he or she is, or has desire to be, of the other sex Continual discomfort with his or her sexual role Different than nonconformity to stereotype Gender Identity Disorder (cont.) May adopt dress, habits, and appearance of the opposite sex Social isolation May express wish to be the opposite sex Adults may use hormonal or surgical means to adopt appearance and social role of the opposite sex Onset around age 2-4 Treatment of Sexual Disorders Sexual dysfunction disorders ◦ Hormonal therapy ◦ Medication change ◦ Psychotherapy Paraphilias ◦ Long-term cognitive-behavioral therapy ◦ Social skills training/support groups ◦ Antidepressants/other drugs that alter sex drive Treatment of Sexual Disorders (cont.) Gender identity disorder ◦ Therapy with family or partner of an adult ◦ Hormonal therapy ◦ Sex-change surgery Nursing Process Applied Assessment ◦ Multidisciplinary ◦ Social and sexual history ◦ Psychosexual and psychologic testing ◦ Physiologic studies of sexual arousal patterns ◦ Possible psychiatric evaluation Nursing Process Applied (cont.) Selected nursing diagnoses Expected outcomes may include ◦ Develops an awareness of the feelings and rights of others ◦ Confronts and resolves traumatic developmental issues Nursing Process Applied (cont.) Interventions ◦ Discomfort can be perceived by the client as disapproval ◦ Nurturing and caring milieu ◦ Relapse is common during treatment for paraphilia disorders ◦ The client must take daily inventory of thought processes ◦ Participates in treatment plan to change behavior Nursing Process Applied (cont.) Evaluation ◦ Satisfying, acceptable sexual practices with alternative ways of dealing with sexual feelings ◦ Willingness to change patterns of thinking ◦ Realistic problem solving ◦ Improvement in self-worth Question Intense, sexually arousing fantasies, urges, or behavior with nonhuman objects are associated with the sexual disorder category called A. Paraphilias B. Sexual aversion disorders C. Sexual dysfunctions D. Gender identity disorders Answer • • A. Paraphilias Rationale: Sexual disorders are classified under the categories of sexual dysfunctions, gender identity disorders, and paraphilias. The paraphilia disorders encompass all altered mental processes related to sexual expression that prevent functioning within the laws and morals of society. Question Tell whether the following statement is true or false. A multidisciplinary approach is most effective in helping a person with a sexual disorder. Answer True Rationale: A multidisciplinary approach covers the full range of sexually deviant behaviors. The assessment aspect of the nursing process uses the multidisciplinary approach to gather information so that the client can receive appropriate treatment. Question Blend of physical, chemical, psychologic functioning characterized by gender and sexual behavior is called A. Sexual orientation B. Sexuality C.Voyeurism D. Dyspareunia Answer B. Sexuality Rationale: Sexuality is an innate part of human dynamics and is integral in human development throughout the life cycle.
