Skip to main content

Psychosexual Development, Intersex States, and Sexual Dysfunctions

  • Chapter
  • First Online:
Psychopathology in Women

Abstract

Within human sexuality, three basic pillars are entwined, mainly biological factors; individual personality or psychosexuality, which encompasses the sexual identity of the concerned subject, as well as the interaction and conveyance of the different affections to the closest beings (together with the relational aspects derived) and the life circumstances at each particular moment; and the sociocultural environment in which it is lived.

The sexual development of an individual bears a resemblance with a relay race: in a chronological sequence, genetic and chromosomal influences, hormonal, environmental, and psychosocial factors will appear. Each of them, regardless of the opinion of different authors and schools, will play the main role in certain moments, although in the end all will have needed the others to achieve the ultimate goal of a grown and sexually mature and healthy individual (according to an interactionist model), which in his turn will lead to the enhancement of the personal identity (therein included the sexual identity and narcissism itself).

Sexuality is therefore a more general phenomenon than plain physical sex. In that regard, it is worth noting a curious paradox: human sexual behavior is scarcely known, at least from a scientific perspective and through epidemiological and gender-relevant designed and controlled studies.

Finally, intersex states and sexual dysfunctions represent a group of heterogeneous disorders and include an array of processes, which affect the general population, generating a high impact at the life quality and interpersonal relationship levels, and they will be analyzed from a multidimensional and not only DSM-5 perspective.

The night dark before its hour-

heavily, steadily,

the rain lushes and sprinkles

to complete its task-

as if assisting

the encroachments of our bodies

we occupy but cannot cure.

Sufferer, how can you help me,

if I use your sickness

to increase my own?

Will be always be

one up, the other down,

one hitting bottom, the other

flying through the trees-

seesaw inseparables?

Robert Lowell. Seesaw. “Day by day”, Ed. Harper Collins Canada Ltd., 1977.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Damasio A. The strange order of things: life, feeling and the making of cultures. Toronto: Penguin Random House Canada Limited; 2018.

    Google Scholar 

  2. Latif EZ, Diamond MP. Arriving at the diagnosis of female sexual dysfunction. Fertil Steril. 2013;100(4):898–904.

    Article  Google Scholar 

  3. Laumann E, Michael RT, Kolata G. Sex in America. A definitive survey. New York: Warner Books; 1995.

    Google Scholar 

  4. González-Torres MA, Salazar MA, Inchausti L, et al. Lifetime sexual behavior of psychiatric inpatients. J Sex Med. 2010;7(9):3045–56.

    Article  Google Scholar 

  5. Puelles L, Martínez P, Martínez D. Neuroanatomy. Madrid: Panamericana; 2008.

    Google Scholar 

  6. Goldstein JM, Seidman LJ, Horton NJ, Makris N, Kennedy DN, Verne S, Caviness J, Faraone SV, Tsung MT. Normal sexual dimorphism of the adult human brain assessed by in vivo Magnetic Resonance Imaging. Cereb Cortex. 2001;11:490–7.

    Article  CAS  Google Scholar 

  7. Gilmore JH, Lin W, Prastawa MW, Looney CB, Vetsa YSK, Knickmeyer RC, Evans DD, Smith JK, Hamer RM, Lieberman JA, Gerig G. Regional grey matter growth, sexual dimorphism and cerebral asymmetry in the neonatal brain. J Neurosci. 2007;27(6):1255–60.

    Article  CAS  Google Scholar 

  8. Ritchie SJ, Cox SR, Shen X, Lombardo MV, Reus LM, Alloza C, Harris MA, Anderson HL, Hunter S, Neilson E, Liewald DCM, Auyeung B, Whalley HC, Lawrie SM, Gale CR, Bastin ME, McIntosh AM, Deary IJ. Sex differences in the adult human brain: evidence from 5216 UK Biobank participants. Cereb Cortex. 2018;28:2959–75.

    Article  Google Scholar 

  9. Bae BI, Jayaraman D, Walsh CA. Genetic changes shaping the human brain. Dev Cell. 2015;32(4):423–34.

    Article  CAS  Google Scholar 

  10. Lenz KM, Pickett LA, Wright CL, Davis KT, Joshi A, McCarthy MM. Mast cells in the developing brain determine adult sexual behavior. J Neurosci. 2018;38(37):8044–59.

    Article  CAS  Google Scholar 

  11. Rohrback S, April C, Kaper F, Rivera RR, Liu CS, Siddoway B, Chun J. Submegabase copy number variations arise during cerebral cortical neurogenesis as revealed by single-cell whole-genome sequencing. PNAS. 2018;115(42):10804–9.

    Article  CAS  Google Scholar 

  12. Money J. Handbook of sexology. New York: Elsevier/North Holland; 1977.

    Google Scholar 

  13. Rey RA. Fetal sex differentiation: from molecules to anatomy. Rev Chil Anat. 2001;19(1):75–82.

    Article  Google Scholar 

  14. Rey RA, Grinspon RP. Normal male sexual differentiation and aetiology of disorders of sex development. Best Pract Res Clin Endocrinol Metab. 2011;25(2):221–38.

    Article  CAS  Google Scholar 

  15. Kernberg O. Love relations. Normality and pathology. New Haven: Yale University Press; 1998.

    Google Scholar 

  16. Kernberg O. The sexual couple. A psychoanalytic exploration. Psychoanal Rev. 2011;98:217–45.

    Article  Google Scholar 

  17. Fairbairn WRD. Psychoanalytic studies of personality. London: Taylor & Francis Ltd.; 1969.

    Google Scholar 

  18. Stoller RJ. The transsexual experiment. London: Karnac Books; 1975.

    Google Scholar 

  19. Stoller RJ. Sex and gender. London: Karnac Books; 1984.

    Google Scholar 

  20. Stoller RJ. Presentations of gender. New Haven: Yale University Press; 1985.

    Google Scholar 

  21. Stoller RJ. Perversion, the erotic form of hatred. London: Karnac Books; 1986.

    Google Scholar 

  22. Dio Bleichmar E. Female sexuality. Barcelona: Paidós; 1997.

    Google Scholar 

  23. Kernberg O. Limitations to the capacity to love. In: Kernberg O, editor. The inseparable nature of love and aggression. Washington, DC: American Psychiatric Publishing; 2012.

    Google Scholar 

  24. Kernberg O. Sexual pathology in borderline patients. In: Kernberg O, editor. The inseparable nature of love and aggression. Washington, DC: American Psychiatric Publishing; 2012.

    Google Scholar 

  25. Irigaray L. Das Geschlecht das nicht eins ist. Berlin: Merve Verlag; 1979. Spanish translation: Ese sexo que no es uno. Ed. Akal, Madrid, 2009

    Google Scholar 

  26. González-Torres MA, Segarra R. Sexuality. In: Eguíluz I, Segarra R, editors. Introduction to psychopathology. 3rd ed. Madrid: Panamericana; 2013.

    Google Scholar 

  27. www.isna.org [1993–2008].

  28. Blackless M, Charuvastra A, Derryck A, Fausto-Sterling A, Lauzanne K, Lee E. How sexually dimorphic are we? Review and synthesis. Am J Hum Biol. 2000;12:151–66.

    Article  Google Scholar 

  29. Roughgarden J. Evolution’s rainbow. Berkeley: University California Press; 2004.

    Google Scholar 

  30. Sadock BJ, Sadock VA, Ruiz P. Gender identity, gender variance and gender dysphoria. 10th ed. Philadelphia: Wolters Kluwer; 2017.

    Google Scholar 

  31. http://www.isna.org/faq/gender_assignment

  32. http://interalia.org.pl/index_pdf.php?lang=en&klucz=&produkt=1194045247-277

  33. Hughes IA, Houk C, Ahmed SF, Lee PA, LWPES1/ESPE2 Consensus Group. www.archdischild.com. 2006

    Google Scholar 

  34. Griffiths DA. Shifting syndromes: sex chromosome variations and intersex classifications. Soc Stud Sci. 2018;48(1):125–48.

    Article  Google Scholar 

  35. Shoshana Tell AB. Intersex management in the US and non-Western cultures. Einstein J Biol Med. 2015;30:6–15.

    Article  Google Scholar 

  36. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, DSM 5. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

    Book  Google Scholar 

  37. Daley A, Mulé NJ. LGBTQs and the DSM 5: a critical queer response. J Homosex. 2014;61(9):1288–312.

    Article  Google Scholar 

  38. Kingsberg SA, Woodard T. Sexual female dysfunction and diminished desire. Obstet Gynecol. 2015;125:477–86.

    Article  Google Scholar 

  39. Masters WH, Johnson VE. Human sexual response. Boston: Little-Brown; 1966.

    Google Scholar 

  40. Basson R, Brotto LA, Laan E, Redmond G, Utian WH. Assessment and management of women’s sexual dysfunctions: problematic desire and arousal. J Sex Med. 2005;2(3):291–300.

    Article  Google Scholar 

  41. American Psychiatric Association. DSM diagnostic and statistical manual of mental disorders. Massachusetts: American Psychiatric Association Mental Hospital Service; 1785 Massachussets Ave, N. W.; Washington 6, D. C. 1952.

    Google Scholar 

  42. American Psychiatric Association. DSM-III: diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Press; 1980.

    Google Scholar 

  43. American Psychiatric Association. DSM-III-R: diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Press; 1987.

    Google Scholar 

  44. American Psychiatric Association. DSM IV TR: diagnostic and statistical manual of mental disorders. 4th edn, text-revised. Washington, DC: American Psychiatric Press; 2000.

    Google Scholar 

  45. Binik YM, Brotto LA, Graham CA, Segraves RT. Response of the DSM 5 sexual dysfunctions subwork group to commentaries published in JSM. J Sex Med. 2010;7:2382–7.

    Article  Google Scholar 

  46. Ter Kuile NM, Brauer M, Laan E. The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS): psychometric properties within Dutch population. J Sex Marital Ther. 2006;32:289–304.

    Article  Google Scholar 

  47. Basson R, Wierman ME, van Lankveld J, Brotto L. Summary of the recommendations on sexual dysfunctions in women. J Sex Med. 2010;7:314–26.

    Article  Google Scholar 

  48. Shrifen JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112:970–8.

    Article  Google Scholar 

  49. Binik YM. The DSM diagnostic criteria for vaginismus. Arch Sex Behav. 2010;39:278–91.

    Article  Google Scholar 

  50. Brotto LA. The DSM diagnostic criteria for sexual aversion disorder. Arch Sex Behav. 2010;39:271–7.

    Article  Google Scholar 

  51. IsHak WW, Tobia G. DSM-5 changes in diagnostic criteria of sexual dysfunction. Reprod Sys Sex Disord. 2013;2:122.

    Google Scholar 

  52. Shifren JL. Overview of sexual dysfunction in women: epidemiology, risk factors and evaluation. In: UpToDate; 2018. https://www.uptodate.com/contents/overview-of-sexual-dysfunction-in-women-epidemiology-risk-factors-and-evaluation.

  53. McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Segraves RT. Incidence and prevalence of sexual dysfunction in women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. J Sex Med. 2016;13:144–52.

    Article  Google Scholar 

  54. Hayes RD, Bennett CM, Fairley CK, Dennerstein L. What can prevalence studies tell us about female sexual difficulty and dysfunction? J Sex Med. 2006;3:589–95.

    Article  Google Scholar 

  55. Roxo L, Virgolino A, Costa J, Alarcao V. Understanding the relationship between BMI and sexual dysfunction: can DSM-5 shed light into this topic? Rev Int Andrología. 2018;16:3.

    Google Scholar 

  56. Agronin M. Sexual dysfunction in older adults. In: UpToDate; 2018. https://www.uptodate.com/contents/sexual-dysfunction-in-older-adults.

  57. Hayes R, Dennerstein L. The impact of aging on sexual function and sexual dysfunction in women: a review of population-based studies. J Sex Med. 2005;2:317–30.

    Article  Google Scholar 

  58. Potter JE. A 60-year-old woman with sexual difficulties. JAMA. 2007;297:620–33.

    Article  CAS  Google Scholar 

  59. Sarin S, Amsel RM, Binik YM. Disentangling desire and arousal: a classificatory conundrum. Arch Sex Behav. 2013;42(6):1079–100.

    Article  Google Scholar 

  60. Clayton AH, DeRogatis LR, Rosen RC, Pyke R. Intended or unintended consequences? The likely implications of raising the bar for sexual dysfunction diagnosis in the proposed DSM 5 revisions: 1. For women with incomplete loss of desire or sexual receptivity. J Sex Med. 2012;9:2027–39.

    Article  Google Scholar 

  61. Johannes CB, Clayton AH, Odom DM, Rosen RC, Russo PA, Shifren JL, Monz BU. Distressing sexual problems in United States women revisited: prevalence after accounting for depression. J Clin Psychiatry. 2009;70(12):1698–706.

    Article  Google Scholar 

  62. Fenichel O. The psychoanalytic theory of neurosis. New York: Routledge; 1999.

    Google Scholar 

  63. Bourdieu P. Structures, habitus, practices. In: Bourdieu P, editor. The logic of practice. Stanford, CA: Stanford University Press; 1990. p. 52–79.

    Google Scholar 

  64. Bokarius A, Jeffrey JK, Davis MC, Bakhta Y. Disorders of orgasm in women: al literature review of etiology and current treatments. J Sex Med. 2010;7(10):3254–68.

    Article  Google Scholar 

  65. Corrêa LQ, Cozzensa da Silva M, Rombaldi AJ. Sexual dysfunction symptoms in men age 40 or older; prevalence and associated factors. Rev Bras Epidemiol. 2013;16(2):444–53.

    Article  Google Scholar 

  66. Andrology Australia. Australian Centre of Excellence in Male Reproductive Health. 2018. https://consultations.health.gov.au/population-health-and-sport-division-1/online-consultation-for-the-national-mens-health-s/supporting_documents/Evidence%20Review%20%20Current%20state%20of%20male%20health%20in%20Australia.PDF

  67. Cunningham GR, Rosen RC. Overview of male sexual dysfunction. UpToDate. 2018. https://www.uptodate.com/contents/overview-of-male-sexual-dysfunction.

  68. Giuliano F, Droupy S. Erectile dysfunction. Prog Urol. 2013;23(9):629–37.

    Article  CAS  Google Scholar 

  69. Koskimäki J, Shiri R, Tammela T, et al. Regular intercourse protects against erectile dysfunction: Tampere Aging Male Urologic Study. Am J Med. 2008;121:592.

    Article  Google Scholar 

  70. Ludwig W, Phillips M. Organic causes of erectile dysfunction in men under 40. Urol Int. 2014;92(1):1–6. https://doi.org/10.1159/000354931.

    Article  PubMed  Google Scholar 

  71. Castilla del Pino C. Sexual paradigmatic behaviors. In: Castilla del Pino C, editor. An introduction to psychiatry. Vol. I. General issues. Psycho(patho)logy. 4th ed. Madrid: Alianza Editorial, S.A; 1993. p. 215–62.

    Google Scholar 

  72. Althof SE, Schreiner-Engel P. The sexual dysfunctions. In: Gelder MG, López-Ibor JJ, Andreasen N, editors. New Oxford textbook of psychiatry. New York: Oxford University Press. p. 2001.

    Google Scholar 

  73. Santtila P, Jern P, Westberg L, Walum H, Pedersen CT, Eriksson E, et al. The dopamine transporter gene (DAT1) polymorphism is associated with premature ejaculation. J Sex Med. 2010;7:1538–46.

    Article  CAS  Google Scholar 

  74. Janssen PK, Bakker SC, Réthelyi J, Zwinderman AH, Touw DJ, Olivier B, et al. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex Med. 2009;6:276–84.

    Article  CAS  Google Scholar 

  75. McMahon CG, Jannini EA, Serefoglu EC, Hellstrom WJG. The pathophysiology of acquired premature ejaculation. Transl Androl Urol. 2016;5(4):434–49.

    Article  Google Scholar 

  76. McCool ME, Zuelke A, Theurich MA, Knuettel H, Ricci C, Apfelbacher C. Prevalence of female sexual dysfunction among premenopausal women: a systematic review and meta-analysis of observational studies. Sex Med Rev. 2016;4(3):197–212.

    Article  Google Scholar 

  77. Reback CJ, Kaplan RL, Bettcher TM, Larkins S. The role of the illusion in the construction of erotic desire: narratives from heterosexual men who have occasional sex with transgender woman. Cult Health Sex. 2016;18(8):951–63.

    Article  Google Scholar 

  78. Williamslhak W, Bokarious A, Jeffrey JK, Davis MC, Bakhta Y. Disorders of orgasms in women: a literature review of etiology and current treatments. J Sex Med. 2010;7(10):3254–68.

    Article  Google Scholar 

  79. Nguyen HMT, Bala A, Gabrielson AT, Hellstrom WJG. Post-orgasmic illness syndrome. A review. Sex Med Rev. 2018;6:11–5.

    Article  Google Scholar 

  80. Digre K. The American Academy of Neurology Institute. Basic recognizing and evaluating low pressure headache syndromes. 2017. http://www.upandrunningnetworks.com/files/C149_2.pdf

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rafael Segarra-Echebarría .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Segarra-Echebarría, R., Isern-Tena, C., Cañas-Jiménez, S., González-Rodriguez, G. (2019). Psychosexual Development, Intersex States, and Sexual Dysfunctions. In: Sáenz-Herrero, M. (eds) Psychopathology in Women. Springer, Cham. https://doi.org/10.1007/978-3-030-15179-9_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-15179-9_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15178-2

  • Online ISBN: 978-3-030-15179-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics