Many misconceptions exist under the topic of sexual disorders, whether what is known as normal or abnormal, especially in different cultures around the world. There are disorders many suffer with, negatively impacting their life and that with a partner and others around them. Every disorder arises from a cause, from trauma to high stress levels. Also, it is clarified where the limits lie, thus making it easier to distinguish between legally accepted disorders and those that are classified as criminal behaviours. Treatments are difficult to provide, but attempts need to be made in case of a slight possibility of an appropriate achievement.
Different cultures have contrasting beliefs. People choose what to believe when it comes to the idea of sexual terms. This only makes it harder for everyone else to understand what is in fact a medical dysfunction or a criminal behaviour. It needs to be understood that sex in general cannot be feared. It needs to be dealt with and accepted so understanding is possible, especially when assisting people. Religion, culture and other belief systems that are present should not intervene while helping people with dysfunctions. The terms used in society and the actions performed need to be distinguished properly.
Homosexuality, a concept many fear sociably, can cause some fathers to become involved in actions such as father-and-son incest as they are too afraid to express their homosexuality outside the home environment (Bezuidenhout: 2004). Homosexuality was perceived as a terrible sickness. They were seen as having failed to live a ‘normal’ heterosexual life, unable to meet the responsibility of having and keeping a home, were emotionally unstable and neurotic as they lived a lonely life, were immature, and had bad child-bearing incidents (Ratele & Duncan; 2003).
Homosexuality is finally starting to be accepted, but there are still forms of violence that many become victims of. One example is the anti-gay violence where ‘normal’ men go out of their way to ‘rape’ gay men, and vice versa, as an act of violence against homosexuality; most of the victims, according to a study, had some form of physical or cognitive disability (Bezuidenhout: 2004). Now, wouldn’t a man raping another man be seen as having a homosexual behaviour? It is still a same-sex sexual behaviour.
In terms of religion, homosexuality is not normal, but rather an action against all morals and should be punished. Though, this does not mean it is an abnormal disorder. In society, people have started to accept what sexual lives others choose, and live their own without bothering about and condemning others’.
For some cultures, it is not difficult to talk about sex, but it is rather an offence or just wrong to do so. The fact is, sex is part of most of peoples’ lives and its dysfunctions can be caused by various issues or it may also be the cause of issues. In cultures, such as Islamic, they fear that the freedom of homosexuality will in future give freedom for human and animal marriages (Tyndale, Tiemoko & Adebusoye; 2007). They believe that a union is between a man and a woman (or women). Each culture is different, and no other can impose their beliefs on them against their will. Christianity is also against homosexuality as sexual relationships between a man and a woman is for procreation. Many cultures also believe that homosexuality is the cause of the HIV epidemic, thus being evil.
African indigenous cultures have no issues with sexuality as it is seen to be good, blessed and satisfying, as long as it leads to human creation, needing to be between a man and woman, and any action, such as masturbation, homosexuality, incest and rape, that does not fulfil marriage and childbearing, is punished (Tyndale et al;2007).
Just to keep in mind when helping and treating people with sexual disorders and who have a different sexual orientation from the helper; they do have rights. The two most important rights to hold close is the right from discrimination and the right to equality. According to Gutto, unfair discrimination is prohibited (2001). Equality for decisions of how to live life is totally up to the person who owns the life and cannot be degraded and discriminated by any other individual. This creates a foundation of respect for all individuals.
Other rights that they have, and every other individual, is the right to privacy, honour, and reputation where discrimination is wrong; the right to marriage and a family, meaning if two homosexual men want to marry and adopt a child, they should be able to; and freedom of opinion and expression where it includes homosexual couples expressing themselves in their way, and others expressing opinions, as long as there is no degradation (Robertson: 1990).
SEXUAL DYSFUNCTIONS
Sexual dysfunctions are seen to arise from disturbances, distress or interpersonal difficulties in the sexual response cycle (Balon; 2006 – Write a paper; Professional research paper writing service – Best essay writers). Stages in this cycle include arousal, desire, and orgasm. Pain can also be associated with sexual intercourse.
Balon states that there is little known about medicinal treatments for sexual dysfunctions, but management is still possible (2006 – Write a paper; Professional research paper writing service – Best essay writers). Management can be done by understanding psychological causes and creating a healthy lifestyle the individual goes through a weight-loss programme, starts exercising, reduces smoking, improve self-image, sense of well-being, and so on. In general, health improvements are the best, and the patient is supported to learn how to cope with the dysfunction, reduce and prevent any worsening of symptoms.
If accepted by the individual and their cultural background, another helpful method would be to educate them about masturbation (which can also be mutual), vibrators and fantasising.
Dysfunctions are classified into four categories, namely arousal, desire, orgasm and pain. Under arousal, it is found female sexual arousal disorder and male erectile disorder. Desire covers hypoactive sexual desire disorder and sexual aversion disorder. Orgasm disorders are those of inhibited orgasms and premature ejaculation. Finally, sexual pain disorders include dyspareunia and vaginismus.
AROUSAL
This category’s dysfunctions involve an absent or reduction in excitement and pleasure feelings from any type of stimulation, as well as an absent or impaired genital arousal, such as a swelling vulval, little vaginal lubrication, or a reduced sensation of genitalia caressing (Basson; 2005). Also, the individual may become aroused when unwanted, even when desire and interest is non-existent, feeling a throbbing or tingling sensation that can last for hours or days (Basson; 2005).
Female Sexual Arousal Disorder
The issue is not desire as sexual urges and desire to have sex still exist, but they cannot have or maintain adequate vaginal lubrication (Barlow & Durand; 2009). Many women do not see an issue in the absence of lubrication, and they simply choose to use lubricants from stores to compensate. Due to this, little is known about the prevalence as this does not fully interfere with their sexual satisfaction.
Male Erectile Disorder
This disorder relates to the inability to have an erection, keep an erection for long enough to reach satisfaction, or has a decrease in erection rigidity (Balon & Wise; 2011). This impacts the life of the individual, their partner and their family severely.
Some causes come from cardiovascular diseases, lack of exercise and obesity, smoking and possibly metabolic syndrome. Nerve injuries and poor oxygenation are also seen as possible causes for erectile dysfunction (Hatzimouratidis, Amar, Eardley, Giuliano, Hatzichristou, Montorsi, Vardi, and Wespes: 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
Hatzimouratidis et al states that there are only some erectile dysfunctions that can be cured, but for this to happen, the specific causes for the dysfunction need to be identified so any possible treatment is successful (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Some treatments Hatzimouratidis et al mention include the treatment of the specific causes which need to be managed firstly; testosterone replacement for hormonal caused dysfunction (this can only be used as a last resort); therapeutic approaches which could take time to succeed, and combined with other methods; lifestyle changes such as losing weight, exercising and reduce smoking; and provide counselling and education to the individual and partner to learn how to cope and work around the issue.
DESIRE
This relates to disorders where sexual interest, desire, thoughts, fantasies or a responsive desire to any sexual stimulation is absent or reduced, and the disorder is evident when there is little or no motivation to become aroused or sexual stimulation (Basson; 2005).
Hypoactive Sexual Desire Disorder
This disorder happens in both men and women, where there is a consistent or continuous absence of sexual desire or fantasies, and it is also seen as a tricky sexual disorder to define, assess and treat (Meuleman & Lankveld: 2005).
Causes come from the person’s biology or psychology such as age, sex and life context, coronary diseases, antidepressant treatments, as well as emotions such as anger and anxiety which inhibits sexual desire and arousal (Meuleman & Lankveld: 2005). The individuals normally would not reveal their sexual issues easily, like many other sexual disorders.
Meuleman & Lankveld also mention that hypoactive sexual disorders are common among stroke patients, those with damaged amygdale, and often in bodybuilders and individuals with eating and exercise obsession disorders (2005).
In addition, contrary to hypoactive sexual disorder is the hyperactive sexual disorder which was recently proposed. This disorder relates to the excessiveness of sexual behaviour, which is not seen as a paraphilic sexual disorder, but rather a dysregulation of sexual arousal and desire, impulsivity and addiction to sexual actions, as well as sexual compulsivity (Kafka; 2009).
Sexual Aversion Disorder
Barlow and Durand mention that the thought of sex can cause fear or disgust, as sexual acts or fantasies may bring back traumatic images or memories (2009). Little is known about the statistics of sexual aversion disorder, but most of the reported cases seem to be women though it does happen among men also, who experience panic attacks when attempting sexual actions. Barlow and Durand also state that this disorder is treated by solving the panic first, and it is suggested that this disorder should be moved to the anxiety disorder category (2009).
ORGASM
Orgasm disorders involve symptoms where there is no orgasm from any type of stimulation, or it is diminished intensely or significantly delayed, and management of orgasmic disorders include the solving of issues, such as those of trust, safety, attraction to partner, skill and duration of stimulation, through encouragement of self-stimulation as an example (Basson; 2005).
Inhibited Orgasm
Sexual arousal and desire may be present during sexual actions, but one of the partners cannot reach an orgasm, or has a delayed orgasm. Most patients are women as they are more likely to seek professional help, and most commonly among unmarried individuals (Barlow and Durand; 2009).
Premature ejaculation
As the term suggests, this disorder refers to men ejaculating before the desired time, normally about a minute before vaginal penetration. Along with erectile dysfunction, it is a disorder affecting a large number of men and can be primary, meaning lifelong, or secondary, also known as acquired (Hatzimouratidis et al: 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Hatzimouratidis et al explain that lifelong happens quickly and is characterised from experiences from the start of sexual activities, and remains an issue throughout life, and acquired has a slower timeframe than lifelong and is gradual (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
The causes are not clearly known as there is little data, but it is believed that anxiety, penile hypersensitivity and a serotonin receptor dysfunctions are the main causes (Hatzimouratidis et al: 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Premature ejaculation has a terrible psychological effect on the individual as their self-confidence and relationship with their partner is effected, causing distress, anxiety, embarrassment and depression, and still only few men do seek help (Hatzimouratidis et al: 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
Treatment for premature ejaculation, as Hatzimouratidis et al state, should be solved through psychosexual counselling where the individual’s expectations is discussed before starting therapy; behavioural techniques like the ‘squeeze’ technique and masturbation are recommended, but can take time and be hard to do; medications (SSRIs) can also be used, especially for lifelong (2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
PAIN
Barlow and Durand state that dyspareunia and vaginismus are both around women, with dyspareunia having some male sufferers, thus suggesting that these two should be combined into one pain-related disorder, and most individuals with one of these disorders are young and less educated women (2009).
Dyspareunia
Dyspareunia is where there is a consistent pain with complete penile-vaginal intercourse, or attempt. Most women complain with vaginal pain, but it is possible some men to experience pain or pain during ejaculation (Barlow & Durand; 2009).
Many causes have been found for dyspareunia disorder, such as vulvar vestibulitis, vulval atrophy from deficiency in oestrogen levels, hypertonicity of pelvic muscles, interstitial cystitis, and endometriosis, as well as a lack of or a reduced level of arousal (Basson; 2005).
Basson suggests that treatment is only successful if the causes are cured or solved and non-penetrative sex is encouraged while the treatment is being performed (2005).
Vaginismus
Vaginismus is the consistent difficulty to allow vaginal entry, though there is desire. Basson mentions that avoidance, anticipation, fear or pain is experienced, as well as involuntary contractions of pelvic muscles when intercourse is attempted or any other penetration attempt, even a gynaecological exam (2005). Barlow and Durand add on to say that women report to experience feelings of ripping, tearing or burning during penetration (2009).
PARAPHILIAS
Individuals with a specific paraphilia show a unique behaviour (may even be part of their personality) meeting specific psychological, social and physical needs that are typically consistent arousing fantasies, urges or behaviours that involve either non-human objects, the suffering or humiliation of a person, or involves children and others who have not given any sort of consent (Nongard: 2011).
Many paraphilias may be the cause of many arrests, but not all have negative reactions; some may have consent of others, not always will it interfere in the functioning of the other person; it may be simply a strange or obsessive personal characteristic; or be a self-deprivation behaviour (Nongard: 2011).
Treatment for paraphilias can be tricky, but Abouesh & Clayton suggests that serotonergic medications are effective as paraphilias and sexual addictions are a manifestation of serotonergic dysfunction, and SSRIs and testosterone-lowering medication can also be effective (1999). There are studies investigating the relationship between paraphilias and OCD and impulse control disorders
EXHIBITIONISM
Exhibitionists normally engage in public exposure of genitals, or normally wear clothes designed suitably for exposing to strangers (Schneider & Irons: 1998). This does not related to stripe dancers as there is no sexual quality to the actions and the exposure of genitals is simply for cash that they live off as many of them are single mothers with little education. An exhibitionist is only paraphilic when they expose their genitals to gain sexual pleasure from the shocking expressions from the passing strangers. Normally, they go home and masturbate while thinking of the reactions they received throughout the day (Schneider & Irons: 1998).
FETISHISM
This is a disorder where sexual arousing fantasies, urges or behaviour involves the use of non-living objects, which normally result in significant distress or social or occupational impairment, normally males, but is first present during adolescence from causes that are still unclear (Chang & Chow: 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). These behaviours are intended to enhance sexual pleasure, normally with a partner or during masturbation, and focus in generally on the texture, scent, or feel of the objects, without these objects, some men may experience an erectile dysfunction (Nongard: 2011).
Nongard clarifies that specific sexual objects like the vibrator is not considered as a fetish item (2011). Some fetish items include jewellery, scented candles, fabric, images of women in sensual clothing and so on.
Treatment is relied on antidepressants, antiandrogens and anticonvulsants (Chang & Chow: 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer).
FROTTEURISM
This disorder can be seen as an offensive disorder where people rub their genitals against another or touches others’ genitals without consent, usually in public so they can escape easily. Nongard explains that the offender fantasizes of a caring relationship with the person they ‘caressing’, bringing them to a sexual climax, which somehow intensifies if the victim is unaware (2011). Unlike the exhibitionist, they prefer to keep the sexual fantasies to themselves and hidden from the victim
INCEST
Sexual experimentation or exploration between siblings is normal, healthy and necessary for sexual and social development (Katy: 2009). The line is crossed, becoming sexual abuse when the child is in a relationship with a much older person. Most of the times, the victim is intimidated or threatened. Incest in adulthood may be a result from earlier childhood traumas where they have learned to be helpless and become dependent and attached mostly to their abuser (Katy: 2009).
PAEDOPHILIA
This relates to the sexual attraction or action of an adult with a child that has not yet entered puberty. Fantasies, arousal or urges are created with the involvement of children. According to Hall & Hall, paedophiles are either severely distressed by urges, or have interpersonal difficulties, and the attraction to children normally develops around the time when they are in puberty, but can also develop later in adulthood (2007).
In some cultures this is seen as unharmful. Green mentions some examples: the Siwans who lend their sons to other men for anal intercourse or they would be left out; the fully developed, unmarried Aranda Aborigines who would take a boy of about ten or eleven years as a wife until the older man married; in Hawaii and Polynesia, a man takes a young girl into sexual interactions was not seen as wrong, but rather as beneficial to the child (2002). These are a few to mention.
Paedophiles are found to take part in various activities with children such as exhibitionism, voyeurism, masturbating in front of the child, frotteurism, engaging in oral sex or penetration of the mouth, anus or vagina (Hall & Hall: 2007). Hall & Hall also mentions that there is no forcing of the child to do such actions, but manipulation and desensitization is used (2007).
Women can also be sex offenders, and there are classes where they fall under. Hall & Hall mentions some; the experimenter who molests out of curiosity; male coerced who is involved with an abusive male and normally abuses their own children; nurturers or caregivers who molest children with the justification of carrying their duties; psychologically disturbed; teacher or lover who has some authority and sees sex as a consensual relationship and not as abuse; and the traditional offender who molests children to gain satisfaction (2007).
Treatment for paedophilia is not possible unless the individual decides to be treated. Some treatments are castration to stop further offences, or psychotherapy joined with medications (Hall & Hall: 2007).
SEXUAL MASOCHISM
Those with this disorder are seen to seek sexual pleasure from being humiliated, beaten or made to suffer by a more dominant person. Many cases where people are found dead, bound and gagged or beaten or mutilated are often victims of this disorder (Nongard: 2011).
SEXUAL SADISM
Hucker, explains that sexual sadism is the gratification or sexual excitement through causing pain, suffering or humiliation on another person which can be psychological or physical (2011). He also mentions the types of sexual sadism which includes the lust-murder; mutilation of corpses; injury such as stabbing; assaults on women; alone sadistic fantasies without action; sadism with toys or whips; or sadistic acts with animals.
Little is known about the prevalence as very few if any self-report. It does happen among men and women, predominately in men (Hucker: 2011).
Some causes are believed to be related to when the individual was a child and their caretaker brought sexual pleasure and denied the initiation of toilet training or prevented masturbation; endocrine or brain abnormalities (Hucker: 2011).
Treatment is not always possible as some actions do not come to the attention of criminal justice. If it does, then obvious arrest is made.
TRANSVESTIC FETISHISM
This disorder is typically categorised by a male gaining sexual arousal through cross-dressing, though they have a heterosexual orientation (Blanchard: 2009). Many transvestic fetishist may have a history of brief or shallow homosexual encounters. This is different from gender identity disorder. The person does not want to be of the opposite sex, but actually feel aroused by wearing and feeling the texture while dressed in the opposite sex’s clothes.
VOYEURISM
Voyeuristic sex is also known as visual sex where picture, window-peeping and secret observation is performed, and the individual has excessive masturbation, maybe even to the point of injury (Schneider & Irons: 1998).
He voyeur may harm the victim or others so that they will not be discovered and is seen as the most dangerous out of all paraphilias.
OTHERS PATTERNS OF ADDICTIVE SEX
Schneider & Irons adds a few disorders such as fantasy sex where the person is obsessed with the sexual fantasy life; seductive role sex where many relationships or affairs are created through seduction and conquest; anonymous sex which relates to engaging in sex with many strangers or having one-night stands; paying prostitutes for sex or sexual phone calls; and trading sex where one receives money or drugs and sex is the payment (1998).
CONCLUSION
In conclusion, this article distinguished between the different types of sexual dysfunctions that commonly occur due to emotional or medical factors, as well as the paraphilias which are now seen as disorders. Not all paraphilias are criminally offensive, but if used in the incorrect manner or exceeds the limit of tolerance, it can become extremely dangerous.
Religions and cultures always have an impact on the way people think when it comes to sexual issues, and these factors should always be taken into account and respected, but if a disorder is evident, them it needs to be cured or controlled before the worst can happen.
Being open-minded and accepting what society contains is the first step to being willing and being effective in whatever help is intended to be given. More knowledge is gathered, and knowledge is power. And power is in helping those in need. This article was also a major mind-opener to the issues around society such as homosexuality, understanding how men feel when they suffer from erectile dysfunctions, and the severity of incest, as well as a confirmation of how terrible paedophilia can be on children.
