Human Sexuality

Question 1

Define and differentiate between sex and gender

Answer 1

Sex = biology, chromosomes, external/internal  anatomy 
Gender = social interpretation of sex. How a person identifies, the gender that they feel they are inside

Question 2

What are the main theories of gender development?

1. Biological Theories
2. Sociobiologicl theories
3. Social learning theories
4. Freud’s psychoanalytic theory
5. Cognitive development theory
6. Gender-schematic processing theory
7. Cultural relativisim

Answer 2

1. Biological Theories
   - AGS females, males with testicular feminisation
2. Sociobiological theories
   - gender evolved so that we can adapt to our environment, parental investment theory
3. Social learning theories
   - learn behaviour through being treated differently, observational learning and reinforcement
4. Freud’s psychoanalytic theory
   - rooted in the phallic stage of psychosexual development
5. Cognitive development theory
   - children’s discovery that they are male/female causes them to identify with and imitate same-sex models
6. Gender-schematic processing theory
   - gender identity alone can provide a child with sufficient motivation to assume sex-type behaviour
7. Cultural relativism
   - gender is socially constructed, enormous cultural diversity of male and female roles

Question 3

1. What is the difference between androgen insensitivity syndrome and adrogenital syndrome (congenital adrenal hyperplasia)?
2. What are DHT deficient males?

Answer 3

1. Androgen insenisttivity syndrome = males develop as females
   Congential adrneal hyuperplasia = females develop male external appearance due to XS androgens
2. DHT deficient males = male develops female external apperance due to deficiency of alpha-reductase

Question 4

Give examples of 5 paraphilias

Answer 4

Love of the beyond or irregular 
Sexual urges directed to non-human objects, suffering/humiliaton of oneself or partner, towards other incapable of giving consent
1. fetishism
2. exhibitionism
3. voyeurism
4. sadomasochism
5. paedophilia

Question 5

Why do paraphilias usually begin in adolescence?

Answer 5

Early conditioning
Social learning
Addiction model
Genes?
Structual brain abnomalities?

Question 6

How can paraphilias be managed?

Answer 6

aversive conditioning
recoditioning techniques
cognitive techniques
psychotropic medication
hormonal treatments
efficacy of castration and neurosurgery controversial and considered unethical
Studies looking at efficacy are flawed - further research needed

Question 7

Describe the sexual response cycle

Answer 7

Desire
Arousal
Plateau
Orgasm 
Resolution

Question 8

What three categories can sexual disorders fall under?

Answer 8

Problems of desire
Problems of arousal
Problems of orgasm

Question 9

Describe the 3 problems of desire

Answer 9

1. Lack or loss of desire
   - common
   - due to: age, hormones, medical/psychiatric disorder, medications
2. Sexual aversion
   - rare
   - most have h/o sexual abuse
3. Lack of sexual enjoyment

Question 10

Describe problems arousal in men and women

Answer 10

Women

• lack of subjective excitement as well as lack of adequate physiological response
• may be due to a number of factors e.g. anxiety, infections, post-menopausal oestrogen deficiency

Men

• erectile dysfunction
• lifelong or acquired
• increases with age
• organic and psychological aetiologies
• viagra has changed treatment

Question 11

1. What is non-organic vaginismus?

2. What is non-orgniac dysparenuria?

Answer 11

1. involuntary muscular spasm
   sexual abuse/relationship difficulties
   relaxation techniques, gradual vaginal dilatation procedures
2. pain during sexual activity

Question 12

How to ask about sensitive subjects?

Answer 12

be empathetic and non-judgemental
pre-empt the individuals embarrassment
reassure that sexual dysfunction is common
discuss in plain, clear and specific terms
start with open questions
never assume anything!

Question 13

What are the 3 stages of gender development in children?

Answer 13

gender labelling age 3
gender stability age 4-5
gender constancy age 6-7

Question 14

Are paraphilias mental disorders?

Answer 14

classified as mental disorders according to ICD-10
paraphilias are no longer excluded grin the Mental Health Act 1983
Detention of paedophiles even if they haven’t commited an offence?
Paedophiles who have offended being sent to a hospital rather than prison?

Question 15

What are the general principles of management for sexual dysfunctions?

Answer 15

• history and physical assessment to establish cause
• simple advice, counselling and education
• if secondary to relationship problems, couple therapy
• sex therapy
• physical treatment