Sexual Variations

1. Sexual Variations Chapter 13

2. Sexual Variations • Deviant Versus Atypical • culturally abnormal • abnormal, deviant, pervert – pejorative • “persistent preference for non-genital sexual outlets” • statistically infrequent • atypical as best descriptor • illness? • bad?

3. Sexual Variations • Paraphilic Disorders DSM-5 “A paraphilia disorder is a paraphilia that is currently causing distress or impairment to the individual or a paraphilia whose satisfaction has entailed personal harm, or risk of harm, to others.”

4. Sexual Variations • Paraphilic Disorders DSM-5 • intense and persistent sexual interest • non-genital or preparatory fondling • paraphilic sexual interest > normophilic sexual interest • erotic activities, or erotic targets

5. DSM-5 Paraphilic Disorders Anomalous Activities Courtship Disorders Voyeuristic Disorder Exhibitionistic Disorder Frotteuristic Disorder Algolagnic Disorders Sexual Mashochism Disorder Sexual Sadism Disorder Anomalous Target Preference Pedophilic Disorder Fetishistic Disorder Transvestic Disorder Sexual Variations

6. Sexual Variations • Exhibitionistic and Voyeuristic Disorders Exhibitionistic Disorder – exposing one’s genitals to an unsuspecting person • power Voyeuristic Disorder – observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity • risk → charge • Frotteuristic Disorder • touching or rubbing against a non-consenting person

7. Sexual Variations • BDSM • bondage and discipline – physical and psychological restraint • dominance and submission • behaviors, customs and rituals relating to the giving and accepting of dominance • sadomasochism • pain, degradation, and humiliation

8. Sexual Variations • BDSM • top and bottom (or master and slave, dominant and submissive) • consensual • Safe, Sane and Consensual • Risk-Aware Consensual • pre-play negotiations • bottom sets limits • safe word(s) • knowledge of physical limits/potential injury • dominatrix and dungeon

9. Sexual Variations • Sexual Sadism and Sexual Masochism Disorders Sexual Sadism Disorderpsychological or physical suffering of the victim is sexually exciting to the person Sexual Masochism Disorderbeing humiliated, beaten, bound or otherwise made to suffer is sexually exciting to the person

10. Sexual Variations • BDSM • arousal transference • endorphins • escape from the self • power release and attainment • giving oneself over for another’s pleasure

11. Sexual Variations • BDSM Myths • submissives want/like to be victims (i.e., abuse) • submissives have no control • respect is expected (dominants) and disrespect is punished • scenarios have to increase in severity • can lead to serious injury and psychological trauma • BDSM always involves sex (or intercourse)

12. Sexual Variations • BDSM Myths participants: • have psychological problems • can’t have normal intimate relationships • like pain in general • are all sex abuse survivors • are all weirdos • are promiscuous

13. Sexual Variations • Pedophilic Disorder • denial/stigmatization • interaction between CJS and mental health • challenge: empathy • conflict between DSM-V diagnosis and cultural beliefs • prevalence • emergence of online support groups • increased attention in popular culture and media

14. Sexual Variations • Pedophilic Disorder DSM-5 • Over a period of 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 or younger). • The individual has acted on these urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty. • The individual is at least age 16 years and at least 5 years older than the child or children in Criterion A.

15. Sexual Variations • Pedophilic Disorder Diagnostic Issues • urges and fantasies versus behaviour • child molesters are not always pedophiles and vice versa • pedophilic sexual interest versus PD • Minor-Attracted Persons (MAPS) • can deny symptoms and still be given diagnosis

16. Sexual Variations • Fetishistic Disorder • stands alone as sexually stimulating • nonliving objects • media fetish • form (object) fetish • body parts

17. Sexual Variations • Transvestic Disorder • intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing • generally, cross-dressing for erotic purposes • different from: transgendered, drag queens/kings, transsexual

18. Sexual Variations • Autogynephilia Blanchard • a male’s paraphilic tendency to be sexually aroused by the thought/image of himself as a female subtypes transvestic – wearing women’s clothing behavioural – typically feminine behaviours physiologic – pregnancy, menstruation, breast feeding anatomic – having a women’s body

19. Sexual Variations • Formicophilia • small creatures • Sthenolagnia • muscles and displays of strength • Autonepiophilia • impersonating or being treated as an infant • infantilism • Macrophilia • giants, primarily domination by giant women or men • Acrotomophilia • amputation in partner • Furries • sexual attraction to anthropomorphic animal characters (i.e., with human characteristics and personalities)

20. Sexual Variations • Paraphilia Erotic Focus • zoophilia animals • klismaphilia enemas • mysophilia filth • urophilia urine • psychrophilia contact with extremely cold objects or watching others freeze • coprophilia feces • agalmatophilia statues, mannequins and immobility • hierophiliareligious or sacred objects (e.g. masturbation with a cross) • vampirism blood • vomerophilia vomit • necrophilia corpses • symphorophilia stage-managed disaster • abasiophilia lamed or crippled partner • apotemnophilia own amputation • vorarephilia eating or being eaten by others; usually swallowed whole

21. Sexual Variations • Theories Courtship Theory – distortions (exaggerations) in courtship behaviour during adolescence become ingrained • location of a potential partner – initial phase of courtship • pretactile interaction – talking or flirting with a potential partner • tactile interaction – usually consists of touching, hugging, hand holding, etc. (this could also be considered foreplay) • effecting genital union – more commonly known as sexual intercourse

22. Sexual Variations • Theories Behavioural Theory – conditioning • pairing of non-sexual stimuli with sexual arousal (positive) • pairing of punishment with sexual arousal, fear (negative) Biological Theory – brain organization Lovemap Theory (Money) • during childhood, develop template for sexual relationships • disruptions → paraphilias

23. Sexual Variations • Treatment • sexual offending ≠ paraphilia • why treat paraphilias? • potentially dangerous paraphilias versus those that are not • motivation?

24. Sexual Variations • Treatment behavioural treatments • systematic desensitization – learn not to respond to problematic stimuli • aversion therapy – pairing of unpleasant stimuli with problematic stimuli • covert sensitization – pairing of imagined aversive stimuli with problematic stimuli • social skills training – learn to better interact with appropriate target • orgasmic reconditioning – pairing of sexual arousal with appropriate target

25. Sexual Variations • Treatment pharmaceuticals • selective serotonin reuptake inhibitors (SSRIs) • reduce anxiety, intrusive thoughts, compulsions, increase positive affect • dampen sex drive • anti-androgens (i.e., chemical castration) • reduces sex drive • Depo-Provera • medroxyprogesterone acetate (MPA)