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Chapter 13. Sexual Dysfunctions

DOI: 10.1176/appi.books.9781585624836.911950
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Although the criteria for the sexual disorders are relatively straightforward, they hint at the challenge of categorizing sexual problems. For example, a diagnostic system that intends to meaningfully describe sexual dysfunction must take into consideration the broad range of normal sexual response. The system must take into account the fact that dysfunction and distress depend heavily on the individual’s expectations, wishes, and opportunities regarding sexual activity (as well as those of his or her partner). It should consider the effects of aging. It should consider the effects of proscriptive societal and religious norms on sexual behavior as well as take into account what it means to sexually function as a man or woman (or elsewhere on the modern gender continuum). The system should also take into account medications and illnesses that predictably reduce sexual desire and/or function, as well as those that predictably intensify desire and/or function, in addition to the reality that most assessments of sexual function and dysfunction are incomplete without an understanding that although sexual response has a biological underpinning, it is experienced from intrapersonal, interpersonal, and cultural perspectives.

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