Sex and disorder

Sexual Disorders
Ronna E. Krozy

SEXUAL DEVELOPMENT Infancy Through Childhood Childhood Through Adolescence Young Adulthood Adulthood Later Adulthood Old Age The Dying Person HUMAN SEXUAL RESPONSE Sexual Desire Sexual Arousal Orgasm Resolution SEXUAL DISORDERS Orgasmic Disorders Female Orgasmic Disorder Nursing Management: Human Response to Disorder Biologic Domain

Psychological DomainSocial Domain Premature Ejaculation Male Orgasmic Disorder Sexual Arousal Disorders Male Erectile Disorder Etiology Nursing Management: Human Response to Disorder Biologic Domain Psychological Domain Social Domain Female Sexual Arousal Disorder OTHER SEXUAL DISORDERS Sexual Desire Disorders Hypoactive Sexual Desire Disorder Sexual Aversion Disorder Sexual Pain Disorders Dyspareunia

VaginismusPriapism Sexual Disorder Caused by General Medical Condition Substance-Induced Sexual Dysfunction Paraphilias Exhibitionism Fetishism Frotteurism Pedophilia Sexual Masochism Sexual Sadism Transvestic Fetishism Voyeurism Paraphilia Not Otherwise Specified Sexual Disorders Not Otherwise Specified GENDER IDENTITY DISORDERS

LEARNING OBJECTIVES

After studying this chapter, you will be able to:
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Describe the psychophysiology of the human sexual response cycle. Distinguish types and etiologies of common sexual dysfunctions and disorders. Analyze biologic, psychological, and social theories that serve as a basis for caring for people with sexual disorders, paraphilias, and gender identity disorders. Identify human responses to sexual dysfunctions. Develop a nursing care planbased on a biopsychosocial assessment of a patient with a sexual disorder. Identify nursing intervention strategies common to treating those with sexual disorders. Identify appropriate resources for referring a patient with a sexual dysfunction.

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CHAPTER H A P T E R

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KEY TERMS

KEY CONCEPTS

advocacy biosexual identity dyspareunia erectile dysfunction excitement exhibitionismfetishism frotteurism gender identity heterosexuality homosexuality human sexual response cycle orgasm orgasmic disorders paraphilias plateau premature ejaculation

primary sexual dysfunction resolution secondary sexual dysfunction sensate focus sex role identity sex therapy sexual addiction sexual aversion disorder sexual desire sexual dysfunction sexual orientation/ preference transvesticfetishism vaginismus voyeurism

human sexual response sexuality

exuality is a life force that encompasses all that is male or female and all that is human. It refers to the combination of biologic, psychological, social, and experiential factors that mold an individual’s sexual development and behavior. Sexuality is also associated with attractiveness, sensuality, pleasure and pleasuring,intimacy, trust, communication, love and affection, affirmation of one’s masculinity and femininity, and reverence for life. Sexuality has a large influence on how we view ourselves and one’s self-concept and consequently on how we relate to others.
KEY CONCEPT Sexuality. Sexuality is a life force that encompasses all that is male or female and all that is human.

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The way we feel about ourselvesand the way society feels about us is intrinsically tied to our sexuality and thus our selfconcept and body image. It is influenced by a person’s emotional and physiologic status, beliefs and values, and morals and laws of society. Robinault (1978), an early researcher into the sexual issues of the disabled, noted that personhood is the threshold of sexuality. Yet, society often views sexual rightsas belonging only to those who are young and attractive or capable of reproducing, while holding negative sexual attitudes about people who may be “different,” such as the physically or mentally challenged, disfigured, obese, aged, institutionalized, or terminally ill. Implicit and explicit messages that a characteristic (such as being aged, mentally ill, or having a disability) has removed all...