A summary of paraphilic disorders, gender dysphoria, and clinical assessment and diagnosis and classification for problem 7 of course 1.6. Does not include the article on process-based therapy.
Problem 7: Unusual Preferences?
Paraphilic Disorders → atypical sexual preferences that cause distress, impairment,
or harm to the individual or others. For a diagnosis, the impediment must last for at least 6
months.
Controversiality → there is definitely a challenge behind naming only certain sexual
preferences a disorder. Some say that naming illegal sexual preferences a disorder, such as
pedophilia, could provide an excuse for individuals acting on it. Further issues in naming
paraphilic disorders arise from the limited and inconsistent literature that surrounds them.
CLASSIFICATION
Fetishistic Disorder → sexual arousal depends on objects or non-genital body parts,
such as feet or hands. Soft fetishes revolve around soft, fury, and lacy objects, such as
women’s underwear or fluffy handcuffs. Hard fetishes concern smooth, hard, and black objects,
such as leather or heeled boots. Less than 1% of the population is diagnosed with this disorder,
almost all of whom are males.
Transvestic Disorder → sexual arousal from dressing up in the opposite sexes
clothing. This disorder should not be confused with transvestitism, as those individuals do not
get aroused from dressing up. It usually starts before or during puberty and appears
predominantly in males, specifically, in just under 3% of the male population.
Pedophilic Disorder → sexual fantasies are focused on children, about 2/3 of victims
being between 8-11 years old. Sexual encounters are usually brief and recurrent and may have
a loving or a violent nature. For the disorder to be diagnosed the person must be at least 16
and at least 5 years older than the child. Most with the disorder are heterosexual males,
about 90% know the child from before, and 15% are the child’s relative. Some will even go to
extreme lengths to access a child, such as kidnapping them or marrying the mother.
Sexual Sadism/Masochism Disorder → In sadism, sexual fantasies including the
infliction of pain and/or humiliation of one’s sexual partner. With masochism, the individual
themselves gain gratification from suffering pain or humiliation. Forms of sexual rituals within
these disorders are physical restriction, administration of pain, hypermasculinity practices, and
humiliation. A dangerous form is hypoxyphilia, the extreme deprivation of oxygen.
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