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Sexual Disorders. Rebecca Sposato MS, RN. Normal Sexuality. Necessary for procreation of species, continuation of family heritage Contributes to sense of well-being Desire, arousal/excitement, climax, resolution
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Sexual Disorders Rebecca Sposato MS, RN
Normal Sexuality • Necessary for procreation of species, continuation of family heritage • Contributes to sense of well-being • Desire, arousal/excitement, climax, resolution • An abnormality occurs when one of the steps deviates from natural pattern or is a source of pain or distress for the individual
Abnormalities related to Desire • Hypoactive libido – low motivation to initiate, respond to or maintain sexual activity • Etiology – endocrinal, psychological, relational • Sexual Aversion – revulsion and active avoidance of sexual activity, which lacks pleasure and is marked by anxiety
Abnormalities related to arousal • Arousal/Erectile disorders – delayed, reduced or abnormal physiological response to sexual stimuli, mechanics controlled by the spinal cord • Dyspareunia, vaginismus, • Erectile dysfunction • Hypersexual – increased or inappropriate sexual behavior beyond accepted social norms • Paraphilia – sexual arousal resulting from atypical stimuli • Fetishism – nonliving objects, >6 months • Situations – exhibitionist, voyeurism • BDSM – abnormal if non-simulated • Non-consenting partner– frotteurism, pedophilia
Pedophilia • Persistent or exclusive attraction to prepubescent girls and/or boys • Not all adults who commit an act of sexual abuse on a child are pedophiles • 90% of child victims knew the abuser, over 60% are within the child’s extended family • <5% involve abduction/coercion by a stranger • Only a small minority of pedophiles use force, most groom the child with praise, treats and companionship prior to initiating sexual contact • Most pedophiles seek compliance in the victim • 20% relapse w/i 5 years of completing treatment (www.atsa.com/ppOffenderFacts.html, 2011)
Transsexuals/Gender Dysphoria • The identity of self as opposite gender • Prefers mannerisms of opposite gender • The size of bed nucleus of the stria terminalis (BST) found in the hypothalamus is switched in transsexuals • A) heterosexual male • B) heterosexual female • C) homosexual male • D) MTF transsexual • High rate of depression, anxiety and suicide Kruijever, Zhou, Pool, Hofman, Gooren, & Swaab, 2000
Nursing Interventions • Protect and prevent patient and others from harm and victimization • Maintain matter-of-fact and supportive composure • Nonjudgmental in professional role • Therapy : psychoanalysis, CBT, REBT • Support Groups • Law enforcement if sexual abuse is disclosed
References • Association for the Treatment of Sexual Abusers (2011). Retrieved from http://www.atsa.com/ppOffenderFacts.html • Kruijver, F., Zhou, J., Pool C., Hofman, M. Gooren L., Swaab D. (2000) Male-to-female transsexuals have female neuron numbers in limbic nucleus. Journal of Clinical Endocrinology and Metabolism. 85(5)