What constitutes a sexual dysfunction? Not being able to get an erection one night? Experiencing difficulties having an orgasm during sexual intercourse? Having no sexual desire for your partner? Do sexual dysfunctions have to happen for extended periods of time, or do they happen only once in a while? There are many types of sexual dysfunctions, and they can happen at any point during sexual activity.
Sexual dysfunctions are classified by the Diagnostic and Statistical Manual (DSM), the major diagnostic system used in U. S. research and therapy. The DSM is occasionally updated, with the last text revision in 2000 (referred to as the DSM IV-TR; American Psychiatric Association, 2000). The DSM provides diagnostic criteria for the most common sexual dysfunctions including description, diagnosis, treatment, and research findings.
Before we discuss the sexual dysfunctions, it’s important to differentiate between common problems with sexual functioning and true sexual dysfunctions. Common sexual problems include things such as insufficient foreplay, lack of enthusiasm for sex, and/or the inability to relax. These problems often occur infrequently and may or may not interfere with overall sexual functioning. Most of us have experienced a problem that has interfered with our sexual functioning at one point or another, but the problem went away without treatment. Even “normal” couples report periodic problems with sexual functioning (E. Frank et al., 1978). A sexual dysfunction is characterized by a disturbance in the sexual response that typically doesn’t go away by itself—in fact, it may get worse over time.
One more point is in need of clarification before moving on—as you will soon realize, the DSM classification system for sexual dysfunctions appears rather heterosexist in that often the criteria for diagnosis revolves around an inability to engage in vaginal in-
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