Exhibitionism

Exhibitionism refers to exposing bare female breasts and/or buttocks of either a male or female. When genitalia is exposed the behavior is more commonly described as indecent exposure. Exhibitionism is an overall psychosocial concept that, when applied to physical actions, denotes two separate phenomena.

The first, colloquially referred to as flashing, involves the exposure of a person’s “private parts” to another person, in a nonthreatening manner, in a situation where these would not normally be exposed, such as in a social situation (in front of other people) or in a public place. The act of flashing, particularly when done by females involving the breasts but also when involving her vagina and also her buttocks, may be at least partially sexual in intention, i.e. to prompt the sexual arousal of those being flashed (in turn giving the flasher an ego boost). However, flashing may also simply be intended to attract the non-aroused ‘attention’ of another or others, or for shock value.

The second, indecent exposure, involves the same sorts of exposure done in a threatening manner or in a manner perceived by those being exposed-to as threatening. Indecent exposure, when it is assessed to be this, is sometimes prosecuted under laws designed to criminalise it, such as public nuisance laws and indecent-exposure laws. Such laws vary by locality worldwide, including within different parts of the United States.

There is somewhat of a double standard here as concerns the two different types of exhibitionism, since “indecent exposure” has a tendency in the Western world to be equated with a male exposing his genitalia to a female, when such acts are perceived by the female as threatening, while at the same time a female exposing her breasts (“flashing”) to male or female viewers is almost always seen as nonthreatening and in fact is often even requested to occur by those wanting to see bare breasts, such as the non-parade-related celebrations surrounding Mardi Gras and other similar festivals.

Exhibitionism is not automatically a compulsion, but some people do have a distinct psychological tendency to sexually expose themselves, whether it is to “flash” (the nonthreatening form) or to “indecently expose” (the threatening form). When it is a compulsion, it is a condition sometimes called apodysophilia.

Frotteurism

Frotteurism refers to a paraphilic interest in rubbing, usually one’s pelvis or erect penis, against a non-consenting person for sexual gratification. It may involve touching any part of the body including the genital area. A person who practices frotteurism is known as a frotteur. The majority of frotteurs are male and the majority of victims are female, although female on male, female on female, and male on male frotteurs exist. Adult on child frotteurism can be an early stage in child sexual abuse. This activity is often done in circumstances where the victim cannot easily respond, in a public place such as a crowded train or concert.

Usually, such nonconsensual sexual contact is viewed as a criminal offense: a form of sexual assault albeit often classified as a misdemeanor with minor legal penalties. Conviction may result in a sentence or psychiatric treatment.

Pedophilia

As a medical diagnosis, pedophilia (or paedophilia) is defined as a psychiatric disorder in adults or late adolescents (persons age 16 or older) typically characterized by a primary or exclusive sexual interest in prepubescent children (generally age 13 years or younger, though onset of puberty may vary). The child must be at least five years younger in the case of adolescent pedophiles (16 or older) to be termed pedophilia. The term has a range of definitions, as found in psychiatry, psychology, the vernacular, and law enforcement.

The International Classification of Diseases (ICD) defines pedophilia as a “disorder of adult personality and behaviour” in which there is a sexual preference for children of prepubertal or early pubertal age. According to the Diagnostic and Statistical Manual of Mental Disorders(DSM), pedophilia is a paraphilia in which a person has intense and recurrent sexual urges towards and fantasies about prepubescent children and on which feelings they have either acted or which cause distress or interpersonal difficulty. The current DSM-5 draft proposes to add hebephilia to the diagnostic criteria, and consequently to rename it to pedohebephilic disorder.

In popular usage, pedophilia means any sexual interest in children or the act of child sexual abuse, often termed “pedophilic behavior.” For example, The American Heritage Stedman’s Medical Dictionary states, “Pedophilia is the act or fantasy on the part of an adult of engaging in sexual activity with a child or children.” This common use application also extends to the sexual interest in and abuse of pubescent or post-pubescent minors. Researchers recommend that these imprecise uses be avoided; people who commit child sexual abuse commonly exhibit the disorder, but some offenders do not meet the clinical diagnosis standards for pedophilia, which only pertain to prepubescents. Additionally, not all pedophiles actually commit such abuse.

Pedophilia was first formally recognized and named in the late 19th century. A significant amount of research in the area has taken place since the 1980s. Although mostly documented in men, there are also women who exhibit the disorder, and researchers assume available estimates underrepresent the true number of female pedophiles. No cure for pedophilia has been developed, but there are therapies that can reduce the incidence of a person committing child sexual abuse. In the United States, following Kansas v. Hendricks, sex offenders that are diagnosed with certain mental disorders, particularly pedophilia, can be subject to indefinite civil commitment, under various state laws (generically called SVP laws) and the federal Adam Walsh Child Protection and Safety Act of 2006. At present, the exact causes of pedophilia have not been conclusively established. Research suggests that pedophilia may be correlated with several different neurological abnormalities, and often co-exists with other personality disorders and psychological pathologies. In the contexts of forensic psychology and law enforcement, a variety of typologies have been suggested to categorize pedophiles according to behavior and motivations.

Sadomasochism

Sadomasochism broadly refers to the receiving of pleasure—often sexual—from acts involving the infliction or reception of pain or humiliation. The name originates from two authors on the subject, Marquis de Sade and Leopold von Sacher-Masoch. A subset of BDSM, practitioners of sadomasochism usually seek out sexual gratification from these acts, but often seek out other forms of pleasure as well. While the terms sadist and masochist specifically refer to one who either enjoys giving pain (sadist), or one who enjoys receiving pain (masochist), many practitioners of sadomasochism describe themselves as at least somewhat of a switch, or someone who can receive pleasure from either inflicting or receiving pain.

The acronym S&M is often used for sadomasochism, although practitioners themselves normally drop the & and use the acronym SM or S/M. Sadomasochism should be differentiated from the clinical paraphilias which require that such practices lead to clinically significant distress or impairment for a diagnosis. Similarly, sexual sadism within the context of mutual consent should not be mistaken for acts of sexual violence or aggression.

The combination of sadism and masochism, in particular the deriving of pleasure, especially sexual gratification, from inflicting or submitting to physical or emotional abuse. 1. (Psychology) the combination of sadistic and masochistic elements in one person, characterized by both aggressive and submissive periods in relationships with others 2. sexual practice in which one partner adopts a sadistic role and the other a masochistic one Abbreviation SM Compare sadism, masochism

Transvestic Fetishism

Transvestic fetishism is having a sexual or erotic interest in cross-dressing. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association. (Sexual arousal in response to donning sex-typical clothing is homeovestism.)

Transvestic fetishism refers specifically to cross-dressing; sexual arousal in response to individual garments is fetishism. Occurrence of transvestic fetishism is uncorrelated to occurrence of gender identity disorder. Most men who have transvestic fetishism do not have a problem with their assigned sex.

Some male transvestic fetishists collect women’s clothing, e.g. nightgowns, babydolls, slips, brassieres, and other types of nightwear,lingerie, stockings, pantyhose, shoes, and boots, items of a distinct feminine look and feel. They may dress in these feminine garments and take photographs of themselves while living out their secret fantasies. According to the DSM-IV, this fetishism has been described only in men.

There are two key criteria before a psychiatric diagnosis of “transvestic fetishism” is made:

1. Recurrent, intense sexually arousing fantasies, urges, or behaviour, involving cross-dressing.
2. This causes clinically significant distress or impairment, whether socially, at work, or elsewhere.

Thus, transvestic fetishism is not diagnosed unless it causes significant problems for the person concerned.

Anorgasmia

Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm, even with adequate stimulation. In males the condition is often related to delayed ejaculation. Anorgasmia can often cause sexual frustration. Anorgasmia is far more common in females than in males and is especially rare in younger men.

The condition is sometimes classified as a psychiatric disorder. However, it can also be caused by medical problems such as diabetic neuropathy, multiple sclerosis, genital mutilation, complications from genital surgery, pelvic trauma (such as from a straddle injury caused by falling on the bars of a climbing frame, bicycle or gymnastics beam), hormonal imbalances, total hysterectomy, spinal cord injury, cauda equina syndrome, uterine embolisation, childbirth trauma (vaginal tearing through the use of forceps or suction or a large or unclosedepisiotomy), vulvodynia and cardiovascular disease

A common cause of situational anorgasmia, in both men and women, is the use of anti-depressants, particularly selective serotonin reuptake inhibitors (SSRIs). Post-SSRI sexual dysfunction (PSSD) is a name given to a reported iatrogenic sexual dysfunction caused by the previous use of SSRI antidepressants. Though reporting of anorgasmia as a side effect of SSRIs is not precise, it is estimated that 15-50% of users of such medications are affected by this condition. The chemical amantadine has been shown to relieve SSRI-induced anorgasmia in some, but not all, people.

Premature Ejaculation

Premature ejaculation (PE) is a condition in which a man ejaculates earlier than he or his partner would like him to. Premature ejaculation is also known as rapid ejaculation, rapid climax, premature climax, or early ejaculation. Masters and Johnson defines PE as the condition in which a man ejaculates before his sex partner achieves orgasm, in more than fifty percent of their sexual encounters. Other sex researchers have defined premature ejaculation as occurring if the man ejaculates within two minutes of penetration; however, a survey by Alfred Kinsey in the 1950s demonstrated that three quarters of men ejaculate within two minutes of penetration in over half of their sexual encounters.

Most men experience premature ejaculation at least once in their lives. Because there is great variability in both how long it takes men to ejaculate and how long both partners want sex to last, researchers have begun to form a quantitative definition of premature ejaculation. Current evidence supports an average intravaginal ejaculation latency time (IELT) of six and a half minutes in 18-30 year olds. If the disorder is defined as an IELT percentile below 2.5, then premature ejaculation could be suggested by an IELT of less than about 2 minutes. Nevertheless, it is well accepted that men with IELTs below 1.5 minutes could be “happy” with their performance and do not report a lack of control and therefore would not be defined as having PE. On the other hand, a man with 2 minutes IELT may have the perception of poor control over his ejaculation, distressed about his condition, has interpersonal difficulties and therefore be diagnosed with Premature Ejaculation.

Vaginismus

Vaginismus, sometimes anglicized vaginism is the German name for a condition which affects a woman’s ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons, and the penetration involved in gynecological examinations. This is the result of a reflex of the pubococcygeus muscle, which is sometimes referred to as the “PC muscle”. The reflex causes the muscles in the vagina to tense suddenly, which makes any kind of vaginal penetration—including sexual intercourse—painful or impossible.

A woman suffering from vaginismus does not consciously control the spasm. The vaginismic reflex can be compared to the response of the eye shutting when an object comes towards it. The severity of vaginismus and the pain during penetration, including sexual penetration, varies from woman to woman.

Female Sexual Arousal Disorder

Female sexual arousal disorder (FSAD), commonly referred to as frigidity, is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity, or an adequate lubrication-swelling response that otherwise is present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.

Although female sexual dysfunction is currently a contested diagnostic, pharmaceutical companies are beginning to promote products to treat FSD, often involving low doses of testosterone.

Gender Identity Disorder

Gender identity disorder (GID) is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with their biological sex and/or the gender they were assigned at birth). It describes the symptoms related to transsexualism, as well as less severe manifestations of gender dysphoria.

Gender identity disorder in children is usually reported as “having always been there” since childhood, and is considered clinically distinct from GID that appears in adolescence or adulthood, which has been reported by some as intensifying over time. As gender identity develops in children, so do sex-role stereotypes. Sex-role stereotypes are the beliefs, characteristics and behaviors of individual cultures that are deemed normal and appropriate for boys and girls to possess. These “norms” are influenced by family and friends, the mass-media, community and other socializing agents. Since many cultures strongly disapprove of cross-gender behavior, it often results in significant problems for affected persons and those in close relationships with them. In many cases, transgendered individuals report discomfort stemming from the feeling that their bodies are “wrong” or meant to be different.

Many transgendered people and researchers support the declassification of GID as a mental disorder for several reasons. Recent medical research on the brain structures of transgendered individuals have shown that some transgendered individuals have the physical brain structures that resemble their desired sex even before hormone treatment. In addition, recent studies are indicating more possible causes for gender dysphoria, stemming from genetic reasons and prenatal exposure to hormones, as well as other psychological and behavioral reasons.

One contemporary treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one’s perception of mental (psychological, emotional) gender identity, rather than vice versa.

Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD), is considered as a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug (legal or illegal), or some other medical condition.

HSDD is listed under the Sexual and Gender Identity Disorders of the DSM-IV. It was first included in the DSM-III under the name Inhibited Sexual Desire Disorder, but the name was changed in the DSM-III-R.

There are various subtypes. HSDD can be general (general lack of sexual desire) or situational (still has sexual desire, but lacks sexual desire for current partner), and it can be acquired (HSDD started after a period of normal sexual functioning) or life-long (the person has always had no/low sexual desire.)

Erectile Dysfunction

Erectile dysfunction (ED, “male impotence”) is sexual dysfunction characterized by the inability to develop or maintain an erection of thepenis during sexual performance.

A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. Erectile dysfunction is indicated when an erection is difficult to produce. There are various circulatory causes, including alteration of the voltage-gated potassium channel, as in arsenic poisoning from drinking water. The most important organic causes are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects.

Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but often can be helped. Notably in psychological impotence, there is a strong response to placebo treatment. Erectile dysfunction, tied closely as it is about ideas of physical well being, can have severe psychological consequences.

Besides treating the underlying causes such as potassium deficiency or arsenic contamination of drinking water, the first line treatment of erectile dysfunction consists of a trial of PDE5 inhibitor drugs (the first of which was sildenafil or Viagra). In some cases, treatment can involve prostaglandin tablets in the urethra, injections into the penis, a penile prosthesis, a penis pump or vascular reconstructive surgery.

Sexual Disorders and Dysfunction

Sexual dysfunction or sexual malfunction refers to a difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including desire, arousal or orgasm.

To maximize the benefits of medications and behavioural techniques in the management of sexual dysfunction it is important to have a comprehensive approach to the problem, A thorough sexual history and assessment of general health and other sexual problems (if any) are very important. Assessing (performance) anxiety, guilt (associated with masturbation in many Indian men), stress and worry are integral to the optimal management of sexual dysfunction. When a sexual problem is managed inappropriately or sub-optimally, it is very likely that the condition will subside immediately but re-emerge after a while. When this cycle continues, it strongly reinforces failure that eventually make clients not to access any help and suffer it all their life. So, it is important to get a thorough assessment from professionals and therapists who are qualified to manage sexual problems. Internet-based information is good for gaining knowledge about sexual functioning and sexual problem but not for self-diagnosis and/or self-management.

Disorders in this Category

• Exhibitionism
• Fetishism
• Frotteurism
• Pedophilia
• Sadomasochism
• Transvestic Fetishism
• Voyeurism

Dysfunctions in this Category

• Dyspareunia
• Female Orgasmic Disorder
• Female Sexual Arousal Disorder
• Gender Identity Disorder
• Hypoactive Sexual Desire Disorder
• Erectile Dysfunction
• Orgasmic Disorder (Anorgasmia)
• Premature Ejaculation
• Hypoactive Sexual Desire Disorder
• Vaginismus

Voyeurism

In clinical psychology, voyeurism is the sexual interest in or practice of spying on people engaged in intimate behaviors, such as undressing, sexual activity, or other activity usually considered to be of a private nature.

Voyeurism (from the French voyeur, “one who looks”) can take several forms, but its principal characteristic is that the voyeur does not normally relate directly with the subject of their interest, who is often unaware of being observed. The practice of making a permanent image of an intimate activity has been made easier with modern photographic and video technology, and is considered an invasion of privacy. However, in today’s society the concept of voyeurism has evolved, especially in popular culture. Non-pornographic reality television programs such as Survivor and The Real World, are prime examples of voyeurism, where viewers (the voyeur) are granted an intimate interaction with a subject group or individual. Although not necessarily “voyeurism” in its original definition, as individuals in these given situations are aware of their audience, the concept behind “reality TV” is to allow unscripted social interaction with limited outside interference or influence. As such, the term still maintains its sexual connotations.

Sexual Fetishism

Sexual fetishism, or erotic fetishism, is the sexual arousal a person receives from a physical object, or from a specific situation. The object or situation of interest is called the fetish, the person a fetishist who has a fetish for that object/situation. Sexual fetishism may be regarded, e.g. in psychiatric medicine, as a disorder of sexual preference or as an enhancing element to a relationship causing a better sexual bond between the partners. Arousal from a particular body part is classified as partialism.