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Sexual Dysfunctions

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Sexual Dysfunctions
315
Sexual Behavior
these topics, researchers will want to learn more about the genetic makeup, mental style,
and behavioral characteristics of people with different sexual orientations. Are there personality characteristics associated with particular sexual orientations? If so, do those characteristics have a strong genetic component? To what extent are heterosexuals, gays, lesbians, and bisexuals similar—and different—in terms of biases, coping skills,
developmental histories, and the like (Bailey, Dunne, & Martin, 2000)? The more we learn
about sexual orientation in general, the easier it will be to interpret data relating to its
origins.
Yet even classifying sexual orientation is not simple, because people do not always
fall into sharply defined categories (American Psychological Association, 2002a; SavinWilliams, 2006). Should a man who identifies himself as gay be considered bisexual
because he occasionally has heterosexual daydreams? What sexual orientation label
would be appropriate for a forty-year-old woman who experienced a few lesbian
encounters in her teens but has engaged in exclusively heterosexual sex since then?
Progress in understanding the origins of sexual orientation would be enhanced by a
generally accepted system for describing and defining exactly what is meant by the term
sexual orientation (Stein, 1999).
■ What conclusions are most reasonable?
The evidence available so far suggests that genetic factors, probably operating via prenatal hormones, create differences in the brains of people with different sexual orientations. However, the manner in which a person expresses a genetically influenced sexual orientation will be profoundly shaped by what that person learns through social
and cultural experiences (Bancroft, 1994). In short, as is true of other psychological
phenomena, sexual orientation reflects the complex interplay of both genetic and nongenetic mechanisms—of both nature and nurture.
Sexual Dysfunctions
sexual dysfunctions Problems with
sexual motivation, arousal, or orgasmic
response.
The biological, social, and psychological factors that shape human sexual behavior can
also contribute to sexual dysfunctions, which are problems in a person’s desire for,
or ability to have, satisfying sexual activity (Goldstein & Rosen, 2002). For men, a common problem is erectile disorder, a persistent inability to have or maintain an erection
adequate for sex. Physical causes—such as fatigue, diabetes, high blood pressure, the use
of alcohol or other drugs, and perhaps even genetics—account for some cases (Fischer
et al., 2004; Heiman, 2002). Psychological causes such as anxiety are also common
(Everaerd & Laan, 1994). As its name implies, premature ejaculation is a recurring tendency to ejaculate during sex sooner than the man or his partner desires.
For women, the most common sexual dysfunction is sexual arousal disorder (once
called frigidity), which involves a recurring inability to become aroused during sexual
activity (Phillips, 2000; Wilson et al., 1996). Sexual arousal disorder can stem from inadequate genital stimulation, hormonal imbalances, insufficient vaginal lubrication, or
inadequate blood flow to the clitoris (Anastasiadis et al., 2002; Mansfield, Voda, & Koch,
1995; Wilson et al., 1996). However, it is also often tied to psychological factors such
as guilt or self-consciousness, which can affect men as well as women (Davidson &
Moore, 1994; Laan et al., 1993).
Many people experience episodes of at least one of these problems at some point in
their lives (Heiman, 2002; Laumann, Paik, & Rosen, 1999; Mercer et al., 2003), but these
episodes are considered dysfunctions only if they become a persistent and distressing
obstacle to sexual functioning (American Psychiatric Association, 1994; Mercer et al.,
2003). Fortunately, most sexual dysfunctions can be overcome through psychotherapy,
medication, or both (Braunstein et al., 2005; de Silva, 1994). For example, Viagra and
other drugs that affect blood flow in the penis are effective in treating many cases of
erectile disorder.
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