Chapter 4

Sexual health problems

Sexuality is one of the most sensitive areas of our lives. Firstly, because we often have little influence over it. Secondly, it is full of culturally unhealthy beliefs and unnecessary emotions such as fear or shame. About 80% of people consider sex an important part of life.

Therefore, we should report worrying or problematic symptoms to specialists in gynaecology, urology, sexology, venereology or psychotherapy.

Sexual dysfunctions

Sexual dysfunctions are disorders involving abnormal sexual responses. They are usually multidimensional and result from psychological factors (for example, low self-esteem), the relationship and biological factors - including hormonal, circulatory, metabolic and neurological factors. Sexual dysfunctions include disorders of desire, orgasm, lubrication, pain during intercourse, erectile dysfunction.

Paraphilia

Sexual preferences are one of the elements of sexuality. Sometimes they develop in a direction that is not in line with medical norms. It usually happens as a result of biological dependencies or external stimuli such as pornography or sexual experiences. The most destructive paraphilia is paedophilia. This disorder is difficult to treat because it is met with extreme ostracism. Often people with a tendency to have contact with children - before committing the act - are afraid to come forward for help. A paedophilic act is any sexual contact with a child.

Compulsive sexual behaviour

Sexual behaviour can become an unhealthy habit, for example, indulging in practices such as sex or masturbation too frequently and intensely to relieve non-sexual tension caused by boredom, anxiety, helplessness or other emotional states. Hypersexuality or sexual overactivity are the most common terms for this condition.

Although masturbation, casual sex with strangers, seducing, sex with sex workers, phone sex, cybersex or watching pornography are not disorders, they can lead to the development of compulsions.

The presence of the following symptoms helps diagnose compulsive behaviour:

  • emotional - guilt, sadness, anger or self-loathing;
  • relational - becoming less attentive to loved ones - most give up intercourse as it becomes unsatisfying;
  • withdrawal - including irritability, impaired cognitive function, psychosomatic symptoms when unable to complete an activity.

Possible problems related to sexuality in children

Children’s sexuality is different from adolescents’ sexuality. However, they have some features in common. They are both characterised by continuous development and represent a process aimed at forming an individual who is stable and confident in their sexuality. This process must take place in a healthy way. Due to biological, cultural or psychological reasons, however, it is not always possible. Adult intervention and assistance are advisable in such cases.

Characteristics of selected problems related to sexuality in children and adolescents:

  • excessive eroticisation of behaviour - a situation when children engage in overly sexualised behaviour, which is inappropriate for their age (more about this situation in chapter 3. Stages of psychosexual development);
  • experimental and compulsive masturbation - aforementioned autoerotic behaviours that are not developmentally relevant (more about this situation in chapter 3. Stages of psychosexual development);
  • Gender nonconformity in childhood - when a child manifests a gender identity incompatibility with their assigned gender or feels resentment towards their body, especially their sexual characteristics;
  • lack of acceptance of one’s sexual orientation - this most often refers to homosexual orientation. The main cause of this problem is cultural. Heteronormative rules may cause the child to start denying their true orientation. Feelings of guilt, shame, anger and fear of rejection may arise;
  • disturbed body image and reduced self-esteem - the most common disorders among teenagers. They are affected by media messages, pornographic content and lack of healthy communication;

Complexes (often irrational) can lead to risky attempts to change, eating disorders, behavioural disorders or emotional problems, as well as suicide attempts and use of psychoactive substances in the worst cases.

  • disorders resulting from child abuse - sexual abuse is a huge trauma and always leaves negative emotional and cognitive effects. Unattended difficulties can develop into personality disorders. Possible consequences include sexual dysfunctions, paraphilias, problems in building relationships, emotional instability, phobias;
  • other problems related to adolescence and the discovery of one’s sexuality - e.g. suppression of the child’s sexual needs by an overly controlling or religious upbringing, giving false information on masturbation to intimidate children, experiencing first love affairs or being unable to form a romantic relationship.

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