Indirect means of expressing hostility toward women, but they aren’t in touch with this
About 50% report erections during, usually masturbate later
Few are women—women who do this are typically motivated by rage/revenge
Few are women—women who do this are typically motivated by rage/revenge
Males—motivated by desire for sexual excitement
Most aren’t dangerous, don’t make repeated calls to the same person
Many patterns—obscenities, breathe heavily, sexual overtures, sex surveys, etc.
Life exhibitionist-socially inadequate heterosexual male who can’t form intimate rel.
Sexual sadism—sexual arousal from inflicting pain on another person
Sexual sadism—sexual arousal from inflicting pain on another person
Sexual masochism—experiencing pain
Masochism is the only paraphilia found with any frequency in women—about 5% of masochists are women
Sadomasochism is highly ritualized—not all pain is gratifying
In a mild form—not uncommon
Pain may be symbolic—like rubber paddle
Serious injury is usually avoided
Survey from S&M magazine—3/4 male, most married, men interested since childhood, women introduced to it
Causes
May have bio links to pleasure—pain causes release of endorphins, but this doesn’t explain symbolic pain or sadism
Learning theorists—being spanked for masturbation
Sociologists—losing control, letting go
Problems—
Problems—
1) Don’t want/seek tx
2) No motivation to change even if in tx (thus cog tx doesn’t work)
3) Should therapist impose own goals?
4) Perceived responsibility—client must know he can change
Behavior tx
Systematic desensitization—pair relaxation with arousing images
Aversion tx—shock, nausea inducing drugs
Social skills training
Orgasmic reconditioning—begin with old images, then switch to appropriate ones
Drugs
Prozac—some effectiveness for exhibitionism, voyeurism, fetishism (OCD-type beh)
Anti-androgen drugs—depo provera—decreases sexual desire in those at risk for sexual offenses. Decreases desire—not urges or behavior in a particular direction. High refusal and drop out rates for this treatment.
Money (1978)—8 variables of gender
Money (1978)—8 variables of gender
Chromosomal (xx vs. xy)
Gonadal (testes vs. ovaries)
Prenatal hormonal gender
Prenatal and neonatal brain hormonalization
Internal accessory organs
External genital appearance
Pubertal hormonal gender
Assigned gender identity
1) Persistent cross-gender identification
1) Persistent cross-gender identification
2) Profound discomfort or disgust with biological sex
In kids
Girls—tomboys
Boys—less interest in rough and tumble play, lower activity levels, more creative, theatrical. More often described as beautiful or feminine babies. Typically show cross-gender preferences as early as 2 or 3—around that age—boys will seek dolls, may tuck away penis when playing.
Typically ostracized in school.
Transsexualism, also known as transgender—people with GID who do something about it
Male to female 3x as common ; 1/30000 males, 1/100,000 females seek surgery.
Also more effective
Don’t consider selves to be homosexual
Found throughout history
Typically show cross gender preferences in play and dress early in childhood. Many say they have felt this way forever.
There is no clear cause or understanding of this disorder.
There is no clear cause or understanding of this disorder.
Psychotherapy typically fails.
May be influenced by prenatal hormonal imbalances
Also possibility that they are treated inappropriately or ambiguously by parents
Sexual reassignment surgery—long process
Counseling to assure adjustment (ie not someone who is lonely or schizophrenia)
Hormone tx
Real life test—live 1-2 yrs as new gender
Surgery—male—remove genitalia without severing nerves. Then artificial vagina is created with skin of penis. Use device to dilate it for next 6 mos so it doesn’t close. Female—penis and scrotum are created from tissues in genital area. Need implants to stiffen penis.
Largely cosmetic.
Hormones for life.
Outcome—Lundstrom et al (1984)—international literature—90% happy with surgery, positive results.
Less unhappy with life. Those with better looking results have more positive outcome.
Links between childhood sexual abuse and many negative outcomes
Links between childhood sexual abuse and many negative outcomes
PTSD, low self-esteem, depression, anxiety, sexual precocity, sexual withdrawal
About 1/3 show no signs
Prevalence—depends on definition, but about 10-12% men and 15-20% of women
