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Human Sexuality in a World of Diversity, 4Ce Sexual Variations Chapter 15 Copyright © 2013 Pearson Canada Inc. 15- 1  Human Sexuality i...

Human Sexuality in a World of Diversity, 4Ce Sexual Variations Chapter 15 Copyright © 2013 Pearson Canada Inc. 15- 1  Human Sexuality in a World of Diversity, 4Ce Normal Versus Deviant Sexual Behaviour What is normal? – Statistical infrequency - how much sexual behaviour deviates from the statistical norm – Social norm – how closely aligned sexual behaviour is with accepted norms in society – Harm – sexual behaviour is abnormal if it causes stress, anxiety, or unhappiness for the individual or harms someone else Copyright © 2013 Pearson Canada Inc. 15- 2  Human Sexuality in a World of Diversity, 4Ce Normal Versus Deviant Sexual Behaviour Atypical variations in sexual behaviour – Atypical behaviours that are considered problematic are labelled paraphilias Copyright © 2013 Pearson Canada Inc. 15- 3  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Paraphilia – A diagnostic category used by the American Psychiatric Association to describe an atypical pattern of sexual arousal or behaviour that becomes problematic in the eyes of the individual or of society – Urges are recurrent and are either acted on or are distressing to the individual who experiences them Copyright © 2013 Pearson Canada Inc. 15- 4  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Paraphilias – Clinicians consider paraphilias to be mental disorders – Milder forms of these behaviours may be practiced by individuals and not considered harmful (continued) Copyright © 2013 Pearson Canada Inc. 15- 5  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Paraphilias (continued) – Involve sexual arousal in response to unusual stimuli such as children or other non-consenting individuals (e.g., watching unsuspecting people), nonhuman objects (e.g., shoes, undergarments), or pain or humiliation – Psychiatric diagnosis requires that the person act on the urges in socially unacceptable or harmful ways or be distinctly distressed by them (continued) Copyright © 2013 Pearson Canada Inc. 15- 6  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Paraphilias (continued) – Perceived as persistent, demanding, compulsive, uncontrollable – Vary in severity – Often replayed in fantasy – Can be harmless and victimless (e.g., tranvestic fetishism) (continued) Copyright © 2013 Pearson Canada Inc. 15- 7  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Paraphilias (continued) – Some believe some paraphilias should not be considered sexual disorders Sexual behaviours and interests are strongly influenced by culture What is considered normal and healthy is influenced by political values New concept proposed: sexual-interest disorder (SID) with key component distress or dysfunction Can learn to express interests in healthier ways Copyright © 2013 Pearson Canada Inc. 15- 8  Human Sexuality in a World of Diversity, 4Ce Innovative Canadian Research Female Paraphiliacs – Little research on female paraphiliacs – One study, by Paul Federoff, based on 14 women highlighted the similarity between women with paraphilias and men E.g., idiosyncratic and obligatory sex “rituals”, high levels of sex guilt Copyright © 2013 Pearson Canada Inc. 15- 9  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Fetishism – A paraphilia in which an inanimate object, such as an article of clothing or items made out of rubber, leather, or silk, elicits sexual arousal – Leather boots and high-heeled shoes are popular – May act on urges while masturbating – Most are harmless and private Copyright © 2013 Pearson Canada Inc. 15- 10  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Partialism – A fetishism-related paraphilia in which sexual arousal is exaggeratedly associated with a particular body part, such as feet, breasts, or buttocks Copyright © 2013 Pearson Canada Inc. 15- 11  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Transvestism – A paraphilia in which a person repeatedly cross- dresses to achieve sexual arousal or gratification or is troubled with persistent, recurrent urges to cross- dress – Clothing or object is only sexually alluring when wearing it – Transvestites are mostly male (gay or heterosexual) (continued) Copyright © 2013 Pearson Canada Inc. 15- 12  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Transvestism (continued) – Different than transsexualism Many transvestites have masculine gender identities and do not seek to change their anatomic sex Transsexuals usually cross-dress because they are uncomfortable with the attire associated with members of their anatomic sex and wish to be members of the other sex (continued) Copyright © 2013 Pearson Canada Inc. 15- 13  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Transvestism (continued) – Origins are largely unknown but has been associated with separation from parents, same- sex sexual experiences, use of pornography, high rates of masturbation, and other paraphilias – Individual may use a single item or a whole outfit Copyright © 2013 Pearson Canada Inc. 15- 14  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Exhibitionism – A paraphilia characterized by persistent, powerful urges and sexual fantasies that involve exposing one’s genitals to unsuspecting strangers – The exhibitionist achieves sexual arousal or gratification from this behaviour (continued) Copyright © 2013 Pearson Canada Inc. 15- 15  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Exhibitionism (continued) – Typical exhibitionist is thought to be male, young, lonely or in an unhappy male-female relationship, and sexually repressed Many are single, find it hard to relate to women May attempt to assert masculinity or express hostility towards women May be shy, passive, lack sexual and social skills – Urge to “flash” usually occurs between the ages of 13 and 16 (continued) Copyright © 2013 Pearson Canada Inc. 15- 16  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Exhibitionism (continued) – Bring in to focus boundaries of normal and abnormal behaviour, i.e., Individuals displaying their body to a relationship partner Exotic dancers exposing themselves to strangers Copyright © 2013 Pearson Canada Inc. 15- 17  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Obscene Telephone Calling (Telephone Scatologia) – A paraphilia characterized by the making of obscene telephone calls – Usually males who become sexually aroused by shocking their victims – Women who do so are usually motivated by rage rather than sexual excitement – Many patterns of obscene phone calling (continued) Copyright © 2013 Pearson Canada Inc. 15- 18  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Obscene Telephone Calling (Telephone Scatologia) (continued) – Typical obscene phone caller is a socially inadequate heterosexual male who has difficulty forming relationships with women Copyright © 2013 Pearson Canada Inc. 15- 19  Human Sexuality in a World of Diversity, 4Ce Applied Knowledge Responding to Exhibitionists and Obscene Phone Callers – How to respond to an exhibitionist Stay calm, do not display shock or fear Could advise individual seek professional help Report incident to the police – How to respond to an obscene phone caller Remain calm, do not reveal shock or fright Hang up, or advise caller to seek professional help Request an unlisted number or call trace Copyright © 2013 Pearson Canada Inc. 15- 20  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Voyeurism – A paraphilia characterized by strong, repetitive urges and sexual fantasies related to observing unsuspecting strangers who are naked, disrobing, or engaged in sexual relations – Voyeur becomes aroused by watching and does not seek to participate – More common among men – Usually begins before age 15 – May include masturbation during or after Copyright © 2013 Pearson Canada Inc. 15- 21  Human Sexuality in a World of Diversity, 4Ce Innovative Canadian Research Normal Voyeurism – Rye and Meaney (2007) conducted a survey to determine if university students would, hypothetically, watch an attractive person undressing or two attractive people having sex – Most said they would watch someone undress if they wouldn’t be caught – Fewer women (40%) than men (70%) said they would watch a couple have sex Copyright © 2013 Pearson Canada Inc. 15- 22  Human Sexuality in a World of Diversity, 4Ce A World of Diversity It Seems Like Voyeurs are Everywhere! – The development of small cameras and lenses has made voyeurism easier, for example, Videotaping or taking pictures of women in the washroom or change room Landlords spying on female tenants Attaching a camera to the shoe to look under women’s skirts Copyright © 2013 Pearson Canada Inc. 15- 23  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Masochism – A paraphilia characterized by the desire or need for pain or humiliation to enhance sexual arousal and attain gratification – Most common paraphilia among women (continued) Copyright © 2013 Pearson Canada Inc. 15- 24  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Masochism (continued) – Sexual masochist A person who becomes sexually aroused by experiencing pain or humiliation experienced by a sexual partner May act on or be distressed by persistent urges and sexual fantasies involving the desire to be restrained. Spanked, whipped, flogged, humiliated, or made to suffer in some way in order to achieve sexual excitement Pain must be a part of an elaborate sexual ritual (continued) Copyright © 2013 Pearson Canada Inc. 15- 25  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Masochism (continued) – Association of sexual arousal with mildly painful stimuli is actually quite common Pain increases overall bodily arousal, which may enhance sexual excitement – When desire for pain for the purposes of sexual arousal overshadows other sources of sexual stimulation, or when masochistic experience causes physical or psychological harm it is considered “abnormal” (continued) Copyright © 2013 Pearson Canada Inc. 15- 26  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Masochism (continued) – Hypoxyphilia A practice in which a person seeks to enhance sexual arousal, usually during masturbation, by depriving themselves of oxygen Also known as auto-erotic asphyxia Miscalculations can result in death by suffocation or strangulation Copyright © 2013 Pearson Canada Inc. 15- 27  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Sadism – A paraphilia characterized by the desire to inflict pain or humiliation on others to enhance sexual arousal and attain gratification – Sexual sadist acts on urges or finds them distressing – Some hurt or humiliate willing partners, a small minority stalk and attach non-consenting victims (continued) Copyright © 2013 Pearson Canada Inc. 15- 28  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Sadism (continued) – Sado-masochism (S&M) A mutually gratifying sexual interaction between consenting partners, in which sexual arousal is associated with inflicting and receiving pain or humiliation Commonly known as S&M Involves power exchange between consenting partners (continued) Copyright © 2013 Pearson Canada Inc. 15- 29  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Sadism (continued) – Sado-masochism (S&M) (continued) Variation is bondage and discipline (B&D) which involves restraining and punishing a submissive partner physically or verbally The term ‘BDSM’ is often used instead of S&M Occasional S&M is quite common in the general population Most experiences are time-limited but some are “24/7” (continued) Copyright © 2013 Pearson Canada Inc. 15- 30  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Sadism (continued) – Sado-masochism (S&M) (continued) Sadomasochism becomes pathological when the fantasies are acted on in ways that become destructive, dangerous, or distressing to either partner Some S&M practices can be dangerous (continued) Copyright © 2013 Pearson Canada Inc. 15- 31  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Sadism (continued) – Sado-masochism (S&M) (continued) Sexual sadists and masochists form a subculture to inflict and receive pain and humiliation during sexual activity Often involves highly elaborate rituals Psychological pain is as common as physical pain Participation varies in terms of gender, gender identity and sexual orientation (continued) Copyright © 2013 Pearson Canada Inc. 15- 32  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Sexual Sadism (continued) – Sado-masochism (S&M) (continued) Negative stereotype that people who engage in S&M behaviours are mentally disturbed Research does not support this view No evidence that people involved in S&M have greater difficulty than others in establishing intimate relationships No evidence that engaging in S&M is distressing or dysfunctional Copyright © 2013 Pearson Canada Inc. 15- 33  Human Sexuality in a World of Diversity, 4Ce Innovative Canadian Research Women’s Submissive Desires – Muise (2008) studied women’s anonymous blogs that focused on sexual desires – Women wrote about their thoughts, feelings, and experiences about submissive sexual desire – Women described the intense physical arousal they felt, especially in their genitals – Some of the women put their experiences into the context of trusting , love relationships Copyright © 2013 Pearson Canada Inc. 15- 34  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Frotteurism – A paraphilia characterized by recurrent, powerful sexual urges and fantasies that involve rubbing against or touching a non-consenting person – Also known as mashing or groping – Has been reported exclusively among males – Mostly takes place in crowded places – Man fantasizes about consenting relationship (continued) Copyright © 2013 Pearson Canada Inc. 15- 35  Human Sexuality in a World of Diversity, 4Ce The Paraphilias Frotteurism (continued) – Often fleeting so goes unnoticed – Many men have difficulty forming relationships with women and are handicapped by fears of rejection – Toucherism A practice related to frotteurism, characterized by the persistent urge to fondle non-consenting strangers Copyright © 2013 Pearson Canada Inc. 15- 36  Human Sexuality in a World of Diversity, 4Ce Other Paraphilias Zoophilia – A paraphilia involving persistent or repeated sexual urges and fantasies that involve sexual contact with animals – Actual contact with an animal is known as bestiality Necrophilia – A paraphilia characterized by a desire for sexual activity with corpses (continued) 15- 37  Human Sexuality in a World of Diversity, 4Ce Other Paraphilias Necrophilia (continued) – Regular necrophilia Individual has sex with deceased person – Necrophilic homicide Individual commits murder to obtain a corpse for sexual purposes – Necrophilic fantasy Individual fantasizes about about sex with a corpse (continued) Copyright © 2013 Pearson Canada Inc. 15- 38  Human Sexuality in a World of Diversity, 4Ce Other Paraphilias Necrophilia (continued) – Some necrophiliacs get jobs where they can access corpses – Primary motivation appears to be desire to completely possess an unresisting and non- rejecting partner Copyright © 2013 Pearson Canada Inc. 15- 39  Human Sexuality in a World of Diversity, 4Ce Other Paraphilias Other Less Common Paraphilias – Klismaphilia A paraphilia in which sexual arousal is derived from the use of enemas – Coprophilia A paraphilia in which sexual arousal is attained in connection with feces – Urophilia A paraphilia in which sexual arousal is associated with urine Copyright © 2013 Pearson Canada Inc. 15- 40  Human Sexuality in a World of Diversity, 4Ce Theoretical Perspectives Biological Perspectives – Influence of endocrine (hormonal) and nervous systems on paraphilic behaviour – Higher-than-normal sex drives – Brain differences Psychoanalytic Perspectives – Psychological defenses, usually against unresolved castration anxiety Copyright © 2013 Pearson Canada Inc. 15- 41  Human Sexuality in a World of Diversity, 4Ce Theoretical Perspectives Cognitive-Behavioural Perspectives – Fetishes and other paraphilias are learned Association Punishment Observational learning Copyright © 2013 Pearson Canada Inc. 15- 42  Human Sexuality in a World of Diversity, 4Ce Theoretical Perspectives Sociological Perspectives – Focuses on the effects of the group and society on individual and group behaviour E.g., S&M provides opportunity to reverse customary power relationships between males and females and social classes Copyright © 2013 Pearson Canada Inc. 15- 43  Human Sexuality in a World of Diversity, 4Ce Theoretical Perspectives An Integrative Perspective – Paraphilias may have complex biopsychosocial origins John Money (2003) traces paraphilias to ‘lovemaps’ which form in childhood Copyright © 2013 Pearson Canada Inc. 15- 44  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Treatment for paraphilias raises a number of issues – Many people don’t want to seek treatment – Health-care providers may encounter ethical problems when asked to persuade sex offenders to change their behaviours – Health-care providers realize they are generally unsuccessful in treating resistant clients – Sex offenders typically claim that they can’t control their impulses (continued) 15- 45  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Psychotherapy – Focuses on resolving unconscious conflicts that are believed to originate in childhood – Has not been subjected to experimental analysis so it is not known how effective this approach is 15- 46  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Cognitive-Behaviour Therapy – Systematic application of the principles of learning in order to modify a problem behaviour – Systematic desensitization A method for terminating the connection between a stimulus and an inappropriate response The individual practices muscle relaxation in the presence of a series of increasingly arousing stimuli, until s/he learns to remain relaxed (and not sexually aroused) in their presence (continued) Copyright © 2013 Pearson Canada Inc. 15- 47  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Cognitive-Behaviour Therapy (continued) – Aversion therapy A method for terminating an undesirable sexual behaviour in which the behaviour is repeatedly paired with an aversive stimulus, such as an electric shock, until the person develops a conditioned aversion to the stimulus (continued) Copyright © 2013 Pearson Canada Inc. 15- 48  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Cognitive-Behaviour Therapy (continued) – Covert sensitization A form of aversion therapy in which thoughts of engaging in an undesirable behaviour are repeatedly paired with imagined aversive stimuli – Pedophiles A person with pedophilia, a paraphilia that involves sexual interest in children (continued) Copyright © 2013 Pearson Canada Inc. 15- 49  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Cognitive-Behaviour Therapy (continued) – Social skills training A method of behaviour therapy that relies upon coaching and practice to build social skills – Orgasmic reconditioning A method for strengthening the connection between sexual arousal and appropriate sexual stimuli Involves repeatedly pairing the desired stimulus with orgasm Copyright © 2013 Pearson Canada Inc. 15- 50  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Medical Approaches – No drug or surgical technique eliminates paraphilic ideas while leaving other cognitive functions intact – Antidepressants – Anti-androgen drugs Substance that reduces sex drive by lowering the level of testosterone Chemical castration (continued) Copyright © 2013 Pearson Canada Inc. 15- 51  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Medical Approaches (continued) – Surgical castration – Evidence suggests that antiandrogens in conjunction with psychological treatment can help some people – Six-level schema for treatment for mild to severe cases: Cognitive-behavioural treatment SSRIs SSRIs and a small dose of antiandrogens Antiandrogens or hormonal treatment Antiandrogens or hormonal treatment by injection High doses of an antiandrogen or LHRH administered by therapist Copyright © 2013 Pearson Canada Inc. 15- 52  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Sexual Addiction, Compulsive Sexual Behaviour, and Hypersexuality – Sex addiction Conceptualized as similar to other addictions A sex addict engages in sexual behaviour to relieve anxiety but doesn’t feel a high level of sexual gratification Addict experiences withdrawal symptoms Treatment similar to other addictions (continued) Copyright © 2013 Pearson Canada Inc. 15- 53  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Sexual Addiction, Compulsive Sexual Behaviour, and Hypersexuality – Compulsive Sexual Behaviour Excessively frequent, out-of-control sexual behaviour is not an indication that an individual is addicted to sex Sees this behaviour as an obsessive-compulsive disorder Treatment is similar to treatment for other obsessive- compulsive disorders, including medications (continued) Copyright © 2013 Pearson Canada Inc. 15- 54  Human Sexuality in a World of Diversity, 4Ce Treatment of Paraphilias Sexual Addiction, Compulsive Sexual Behaviour, and Hypersexuality – Hypersexuality Being considered for inclusion in the DSM-5 Similar to criteria for those commonly described for sex addiction and compulsive sexual behaviour (continued) Copyright © 2013 Pearson Canada Inc. 15- 55  Human Sexuality in a World of Diversity, 4Ce End of Chapter 15 Copyright © 2013 Pearson Canada Inc. 15- 56