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Sexual Variants and Dysfunctions 3/29/16 Sociocultural Influences • Sexual “standards” of one’s culture tend to drive what is considered acceptable or not • Examples o Abstinence Theory (1800s) o Ritualized homosexuality in the Sambia Tribe (only between males) • Some sexual standards are culturally consistent o Men: greater emphasis on partner’s attractiveness o Taboos against incest • Kinsey’s research (1950s): developed a scale that looks at people’s sexual orientation o 37% of males reported engaging in some kind of sexual activity at least once o Comparable numbers among women o 7 point scale § 0: entirely heterosexual § 7: entirely homosexual • Sexual Minorities o Kinsey: 10% homosexual, 37% men have at least one experience o Removed from DSM in 1973 o “Homosexuality” is often not a preferred term to refer to people who identify as gay, queer, or lesbian o By 2010, majority of Americans view same-sex relations between adults to be morally acceptable o 2015 Nature twin study revealed 5 DNA markers associated with sexual orientation o Epigenetic markers (chemical changes to DNA that affect how genes are expressed, but not the information they contain) o An algorithm they developed based on the 5 epi-marks could correctly predict the sexual orientation of men in the study 67% of the time • History of sex-related legislation in the U.S. o As late as 1970s, gay men/lesbians not allowed to have a driver’s license in Connecticut o Contraceptives among MARRIED couples were banned until 1965 in some states o As late as 2003, sodomy was illegal between consenting adults in some states (including Alabama) o Alabama sex education: “homosexuality is not a lifestyle acceptable to the general public and homosexual conduct is a criminal offense under the laws of the state” • Sexuality in the U.S.A. o Barriers to conducting sex research (example) § Five-year study of sexual behavior in 20,000 adolescents was funded by National Institutes of Health § Congress found out about the study and pushed legislation through to revoke funding § Result à we don’t have good info on sexual functioning in adolescents o Fantasies, interest and behavior are not synonymous Paraphilia vs. Paraphilic Disorder • Paraphilias (fetishism): unusual sexual interests o Not necessarily a disorder o Prevalence for paraphilias is unknown à people are reluctant to disclose, funding issues • Paraphilic Disorder: unusual sexual interests that cause harm o Can have compulsive quality • RULE: distress or victim Paraphilic disorder • Paraphilic Disorder o 8 disorders characterized by recurrent, intense sexually arousing fantasies, sexual urges, or behaviors that generally involve nonhuman objects, the suffering of humiliation of oneself or partner, or children or other non- consenting persons o Fetishistic Disorder § Fantasies, urges, or behaviors involving inanimate objects or highly specific focus on non-genital body parts to obtain sexual gratification § Must cause significant distress or impairment § Examples: undergarments, shoes, feet o Transvestic Disorder § Heterosexual men- fantasies, urges, or behaviors involving cross- dressing § Must cause significant distress or impairment • Not a drag queen § 3% of men have engaged in some cross-dressing; however, most do not meet a diagnosis • Most (83%) are married • Keep cross-dressing secret, or try to • 87% are heterosexual o Voyeuristic Disorder § Fantasies, urges, or behaviors involving the observation of an unsuspecting person who is undressing or engaging in sexual activity – aka “peeking toms” § Distress/impairment OR acted upon such urges with a non- consenting person § Often no resulting criminal behavior § Why not just use pornography • Most likely lacks the excitement associated with watching someone unsuspecting o Exhibitionistic Disorder § Fantasies, urges, or behaviors involving exposure of one’s genitals to others in inappropriate circumstances and without consent § Distress/impairment OR acted upon such urges § Element of “shock” of the unsuspecting person is arousing to such individuals • Must experience arousal § Commonly co-occurs with voyeurism o Sexual Sadism Disorder § Fantasies, urges, or behaviors involving the infliction of psychological or physical pain on another individual § Themes- dominance, control, humiliation § Distress/impairment OR acted upon such urges with a non- consenting person § Serial killers – are often “extreme” sadists o Sexual Masochism Disorder § Fantasies, urges, or behaviors involving the real act of being humiliated, beaten, bound, or otherwise made to suffer § Causes clinically significant distress/impairment § 5-15% of people enjoy this voluntarily § Autoerotic asphyxia: “self-strangulation” – leads to 500-1,000 accidental deaths/year o Frotteuristic Disorder § Fantasies, urges, or behaviors involving touching or rubbing against a non-consenting person § Distress/impairment OR acted upon such urges § Typically begins age 15-25 § Typically live in big cities where it’s much more crowded and less obvious if you’re rubbing up on someone § Often a gradual decline in frequency of such behaviors or urges o Pedophilic Disorder § Fantasies, urges, or behaviors involving the sexual activity with a pre-pubertal child § Distress/impairment OR acting upon urges § Perpetrator is at least 16 years old and at least 5 years older than the victim § Victims can be male or female § Hebophilia: having fantasies, urges or behaviors involving adolescents o Pedophilic Disorder vs. Child sexual abuse § Pedophilic disorder à sexual interest in children (believed to be inborn, not a choice) § Child sexual abuse à acting on these interests (is a crime)