Gender Dysphoria and Identity

• These notes cover different psychological disorders related to gender, sexual interests, and sexual function.

Gender Dysphoria

• Incongruence between experienced and assigned gender causes distress/impairment.
• Example: A child assigned male at birth insists on being female, wears dresses, and is upset when told to act like a boy.

Gender Identity

• Internal experience and understanding of one's gender.
• Encompasses male, female, both, neither, or somewhere along the gender spectrum.
• Example: Someone assigned female at birth identifies and lives as a male.

Transgender Identity

• Psychological identification with a gender different from biological or assigned sex.
• Example: A person assigned female at birth identifies and lives as a man, possibly undergoing hormone therapy.

Gender Dysphoria in Children

• Strong desire to be another gender with related behaviors, lasting ≥6 months.
• Example: A boy wants to be called a girl, wears skirts, and avoids boys' toys/games.

Gender Dysphoria in Adults

• Distress related to gender identity not matching biological sex.
• May involve desire for hormones or surgical treatment.
• Example: An adult assigned male seeks chest surgery to feel aligned with their gender identity.

Paraphilic Disorder

• Intense, persistent sexual interests in non-normative stimuli.
• Involves non-consenting people, suffering, or objects, causing distress or harm.
• Example: A man is sexually aroused only when observing strangers undressing without consent.

Exhibitionistic Disorder

• Recurrent sexual urges to expose genitals to unsuspecting strangers.
• Example: A person flashes people in public, gaining arousal from their shock.

Voyeuristic Disorder

• Sexual arousal from observing others naked or engaged in sexual activity without their knowledge.
• Example: A student installs hidden camera in a shared dorm bathroom.

Fetishistic Disorder

• Sexual arousal from non-living objects or non-genital body parts.
• Example: A man is only sexually aroused when leather boots are present.

Transvestic Disorder

• Sexual arousal from dressing in clothing traditionally associated with the opposite sex.
• Example: A heterosexual man secretly wears women's underwear and feels guilt afterward.

Frotteuristic Disorder

• Recurrent urges to touch or rub against a nonconsenting person.
• Example: A man presses against women in crowded subways.

Pedophilic Disorder

• Recurrent sexual attraction to prepubescent children.
• Example: An adult man seeks child pornography and has urges toward children under 13.

Sexual Masochism Disorder

• Sexual arousal from being humiliated, beaten, or otherwise made to suffer.
• Causes distress or problems in life.
• Example: A woman feels she cannot enjoy sex without being verbally degraded.

Sexual Sadism Disorder

• Sexual arousal from inflicting suffering or humiliation on another person.
• Example: A person becomes sexually excited by causing physical pain to a non-consenting partner.

Male Hypoactive Sexual Desire Disorder

• Little to no interest in sex or sexual fantasies, causing distress.
• Example: A man in a long-term relationship avoids intimacy and feels something is wrong with him.

Female Sexual Interest/Arousal Disorder

• Reduced interest in sexual activity and/or physical arousal.
• Often leads to interpersonal issues.
• Example: A woman avoids intimacy, has few sexual thoughts, and worries about her relationship.

Delayed Ejaculation

• Marked delay or absence of ejaculation during partnered sex despite adequate stimulation.
• Example: A man cannot climax with a partner but has no issue during masturbation.

Premature Ejaculation

• Ejaculation occurs within about one minute of penetration and causes distress.
• Example: A man consistently ejaculates too early and avoids sexual activity.

Female Orgasmic Disorder

• Difficulty or inability to achieve orgasm, even with sufficient stimulation and interest.
• Example: A woman reports enjoying sex but rarely or never orgasms.

Genito-Pelvic Pain/Penetration Disorder

• Difficulty with vaginal penetration due to pain, fear, or involuntary tensing of pelvic muscles.
• Example: A woman involuntarily tightens and avoids sex due to painful past experiences.

Sexual Dysfunction

• Persistent sexual problem that causes distress or difficulty in sexual relationships.
• Example: A person experiences ongoing difficulty maintaining arousal and begins to avoid intimacy.