Sexuality and Sexual Disorders: Causes, Symptoms, Diagnosis, Treatment

Acceptable norms of sexual behavior and attitudes are significantly different in different cultures. Health care workers should never condemn sexual behavior, even if social pressure requires doing so. In general, questions of the norm and pathology of sexuality can not be solved by a health worker. Treatment is justified in cases where sexual behavior or difficulties disturb the patient or his partner or cause harm.

Masturbation, which was previously considered a perversion and the cause of mental disorders, is now seen as normal sexual activity in the life process; it is pathological only if it suppresses behavior directed towards a partner, is performed in public or is so compulsive that it causes distress. About 97% of men and 80% of women masturbate. Although masturbation itself is harmless, a sense of guilt caused by a disapproving and disapproving attitude on the part of others can lead to marked distress and a violation of sexual function.

Homosexuality is not considered a disorder from the point of view of the American Psychiatric Association for more than 3 decades. About 4-5% of the population define themselves exclusively as homosexuals throughout their life. Like heterosexuality, homosexuality is the result of a complex of biological and external factors leading to the ability to be sexually aroused by people of their gender. Like heterosexuality, homosexuality is not the subject of choice.

Frequent sexual activity with many partners, often with anonymous or occasional single connections, indicates a decrease in the ability to have close relationships. However, promiscuity in itself is not a proof of a psychosexual disorder. Casual sexual relations are quite common, although the fear of HIV infection has led to their decrease. Most cultures do not approve of extramarital sex, but premarital sexual activity is allowed. In the United States, most people start a sexual life before the wedding or without marriage, reflecting the trend towards greater sexual freedom in developed countries. Extramarital sexual relations are often found among married people in spite of social taboos.

Admissible norms of sexual behavior and relationships largely depend on the influence of parents. Repulsive, puritanical rejection of physical sexuality, including touch, parents cause children to blame and shame, suppress their ability to enjoy sex and build healthy intimate relationships in adulthood. Relations with parents can be violated because of excessive emotional detachment, constant punishment or because of open seduction and sexual exploitation. Children who grow up in an atmosphere of verbal or physical hostility, rejection and cruelty often have problems with the formation of sexual and emotional intimacy. For example, love and sexual arousal can dissociate, so emotional connections can be established with people of their social class and intellectual level, and sexual relations can be established only with those who are at a lower level, for example with prostitutes, with whom emotional affinity is not established .

A well-informed physician can provide sensitive, scientifically based advice and should not miss the opportunity for a useful intervention. It is necessary to pay attention to the behavior that puts the patient at risk of infection with sexually transmitted infections. The doctor has the opportunity to recognize and work out psychosexual issues, including sexual dysfunction, sexual identity disorders and paraphilia.

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