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Gender identity disorders (transsexualism, transvestism, transgenderism) and sexual preference disorders (fetishism, pedophilia, exhibitionism, masochism, viewing) - the former consist in the need to live as a person of the opposite sex, and the latter result in sexual satisfaction or arousal they are a reaction to unusual objects or activities, socially unrecognized as sexual stimuli. What are the causes of these disorders? It cannot be said that a particular cause causes a particular disorder. Their causes are not obvious, but it has been found that they are composed of biological, environmental and psychological factors.

Disorders of gender identity and sexual preferences in the ICD-10 classification were included in the group "Disorders of habits and drives". This means that the actions that someone performs under the influence of these disorders do not have a clear and rational justification, it is impossible to control them and they usually harm the person who takes them and their environment.

Gender identity disorders

The origin of gender identity disorders is a combination of many factors. The research results indicate the potential importance of the biological basis: diseases of the central nervous system, genetic conditions and hormonal disorders; and psychogenic background: child's upbringing that does not take into account its biological sex, lack of satisfaction with the child's biological sex, problems with emotional ties (bad relations between father and son, too deep mother-son bond, son identifying with the mother) and complexes resulting from the body structure.

Here are the most common gender identity disorders:

transsexual- the person wants to be accepted as the representative of the opposite sex. Most often, this desire is associated with an aversion to one's own body, and especially to sexual characteristics. A transsexual wants to be treated surgically or hormonally to make the body resemble the body of the sex he prefers as much as possible.

World statistics roughly show that transsexualism occurs in 1 in 30 thousand. men (biologically a person is a man, and mentally a woman) and in 1 in 100 thousand. women (a person is biologically female and mentally a man). The results of Polish research indicate the advantage of women (3.4: 1) inattitude towards men who do not accept their gender (1: 3,4)


In clinical practice, transsexuals are distinguished into: type female / male F / M - transgender man (mentally feeling a man, and physically being a woman) and type male / female M / F - transgender woman (mentally feeling a woman and he is physically a man).

double-role transvestism- a person changes into clothes appropriate for the opposite sex, a short-term sense of belonging to this group is enough. There is no need for a permanent sex change (e.g. operational). Dressing up does not arouse sexual arousal,

gender identity disorders in childhood- occur in childhood (before puberty). A person is dissatisfied with his gender and wants very much to have the characteristics of the opposite sex. He rejects his gender and is interested in the clothes and behavior of the opposite sex. It must not be diagnosed at the beginning and during puberty, and it is not enough for a boy to act like a girl and a girl like a boy.


Transgenderismis an intermediate form between transsexualism and transvestism. A transgenederist does not want to undergo genital change surgery, but uses hormone therapy and decides to have mammoplasty, i.e. breast reduction or implant placement, or mastecotomy, i.e. removal of the breast.

Disorders of sexual preferences

Also, individual disorders of sexual preferences cannot be diagnosed by indicating specific and always the same causes. Paraphilias, as this group of disorders are also referred to, have received several theories trying to explain their etiology. Sexual development disorders are most often considered to be their source. The psychoanalytic theory points to the polymorphic deviant sexuality of a child, i.e. sexuality that can take many forms. These characters are influenced by what happens in childhood, e.g. conflicts in the family and between parents, competition, sexual abuse, lack of acceptance of the child's gender, rigorism.

The Cognitive Behavioral School emphasizes the importance of the learning process. Neutral stimuli in one stage of development in the next, due to positive or negative reinforcements, become sexually significant, and over time they turn into habits; an example may be masturbation, which when we mature, promotes, among others, learning about the pleasure of touching genital areas, later it can replace sexual contact, serve as a way to relieve sexual tension. It is important that self-satisfaction is not becoming more frequenta way to relieve any kind of tension that comes from the stresses of everyday life. And we "reach" for it for a completely different purpose than related to sexual pleasure. How we meet our sexual needs depends on how we learn to meet them.

The source of sexual preference disorders are also, among others: endocrine disorders occurring in the prenatal and postnatal phases, biochemical and brain structure changes, inheritance, older parental age, perverse personality, denial of the existence of love. Paraphilias are more common in men. They can also appear in potentially he althy people, e.g. in conditions of chronic stress, reduced emotional resistance, high fatigue, after psychoactive substances.

fetishism- compulsion to possess certain items. Dependence on them makes a person feel sexually aroused. Certain items are her fetish and she often sees them as extensions of her body, such as shoes or clothes. Sometimes the level of sexual arousal is influenced by the material from which they are made, e.g. rubber, leather, plastic. Items can be the main stimulus for sexual arousal (e.g. asking your partner to wear a specific garment) or a necessary element of achieving sexual satisfaction.

fetish transvestism- to get sexual arousal a person needs to wear clothes of the opposite sex. Apart from just putting on clothes (fetishism), it is important for her to look like the opposite sex. She has a strong need to take off her clothes when she has an orgasm, and then her sexual arousal disappears as well. This disorder can be an early stage of transsexualism.

exhibitionism- periodic or constant tendency to show sexual organs to strangers (usually of the opposite sex) or staying in public places, without the need for close contact with them. Often, during exposure, the exhibitionist becomes sexually aroused and then masturbates. Agitation may increase if the exposure witness reacts with fear or shock.

watching- a person has a constant or recurrent tendency to peek at other people, unaware of it, during their close-ups or intimate activities, e.g. when they undress or have sex. The viewer gets sexually aroused and masturbates.

pedophilia- an adult engages in sexual contact with children who are either before or during puberty. Some people prefer only contacts with boys, and some only with girls, there are also some who dothey are interested in both sexes. The disorder is more common in men.

sadomasochism- the person is in a sexual relationship that allows for enslavement, humiliation and inflicting pain. If her partner chooses to be a victim, then it is masochism, and if he is the doer, sadism. Sadomasochism is diagnosed when such stimulation is necessary to obtain sexual satisfaction.

complex sexual preference disorder- a person has more than one sexual preference disorder, and it is impossible to indicate which one is predominant. Sadomasochism, fetishism and transvestism are the most common.

other sexual preference disorders- in this group there are over 100 diagnosed disorders, including: obscene phone calls, rubbing against other people in crowded public places (choking or terryism); sexual contacts with animals (zoophilia), the use of choking or hypoxia to enhance sexual experiences, necrophilia when the sexual stimulus is a human corpse, or gerontophilia, when a person becomes sexually aroused primarily in intimate contacts with the elderly.

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