Chapter

7 Sex and Gender Identity Disorders

Clinical Psychology

I. PSYCHOPATHOLOGY

  1. Peggy J. Kleinplatz PhD1,
  2. Charles Moser MD, PhD2,
  3. Arlene Istar Lev LCSW-R, CASAC3

Published Online: 26 SEP 2012

DOI: 10.1002/9781118133880.hop208007

Handbook of Psychology, Second Edition

Handbook of Psychology, Second Edition

How to Cite

Kleinplatz, P. J., Moser, C. and Istar Lev, A. 2012. Sex and Gender Identity Disorders. Handbook of Psychology, Second Edition. 8:I:7.

Author Information

  1. 1

    University of Ottawa, Department of Psychiatry, Ottawa, Ontario, Canada

  2. 2

    Institute for Advanced Study of Human Sexuality, Department of Sexual Medicine, San Francisco, CA, USA

  3. 3

    University at Albany, School of Social Welfare, Albany, NY, USA

Publication History

  1. Published Online: 26 SEP 2012

Abstract

The sex and gender identity disorders of the DSM are reviewed. The major male and female sexual dysfunctions, concerns, and problems are described, including assessment, diagnostic considerations, and causes of these difficulties. Controversies surrounding how to conceptualize sexual problems are discussed, as are theoretical and practical problems of classification in the DSM. Psychogenic, interpersonal, psychosocial, and organic factors in the development of the sexual dysfunctions are reviewed. Such distinctions are more accurate in theory than in practice, where sexual problems are typically multi-determined. Sexual problems tend to be intertwined, as when difficulties with arousal and lubrication lead to pain on intercourse as well as lack of orgasm. The importance of appreciating the context in which clients/patients, their partners, and clinicians come to define sexual and gender difficulties as pathological is underscored for each of the sexual and gender problems. The sex script defining “normal” sexuality and gender provides the social backdrop for viewing and diagnosing other forms of sexual and gender expression as pathological. A variety of other sexual problems, including sexual disappointment, the pain of affairs, infertility, and are not listed in the DSM but may lead to patients presenting in clinicians' offices. Controversies surrounding the paraphilias, the need to distinguish between normophilic and paraphilic interactions, and the implications of such distinctions are discussed. Gender identity disorders are outlined, including the controversies surrounding its inclusion and revision process in the DSM, and the emergence of a transgender community's reaction to diagnostic labeling.

Keywords:

  • sexual dysfunctions;
  • sexual disorders;
  • paraphilias;
  • gender identity disorders;
  • DSM