Thursday, July 15, 2010

More on sexual dsyfunctions and DSM-5

As I've reported before, the DSM-5 Sexual Dysfunctions Subworkgroup's literature reviews have been published online. They divided them up into male and female disorders with the ones for females published in Archives of Sexual Behavior and the ones for males published in the Journal of Sexual Medicine. All are available for free here except for the one on HSDD in males.

For the male sexual dysfunctions, commentary was published with the original article, except for the one of HSDD, and for the female ones, a number of commentaries were recently published in the Journal of Sexual medicine: Responses to the Proposed DSM-V Changes. Recently, the DSM-5 Sexual Dysfunctions Subworkgroup has published overall responses to the commentary: Response of the DSM-V Sexual Dysfunctions Subworkgroup to Commentaries Published in JSM.

Of the changes, the ones most relevant to the asexual community are those regarding HSDD. The current proposal is to change this diagnosis to Sexual Interest/Arousal Disorder and make separate diagnoses for men and for women. (No indication is given regarding individuals who do not fit neatly into a gender binary.) As of now, there is no published commentary on the proposed male SIAD, but there is some commentary on the proposal for female SIAD.

Here are a number of points/arguments that were made:
The current proposal is to merge HSDD and Sexual Arousal Disorder (in women) into SIAD. Some authors opposed this. Others supported it. One commentary argued that the proposal be taken even further and that desire, arousal, and orgasmic disorders be lumped into a single diagnosis.

One commentary argued that one of the currently proposed criteria should be made necessary for diagnosis: "(5) Desire is not triggered by any sexual/erotic stimulus (e.g., written, verbal, visual, etc.)" One reason they wanted to add this was because of the possibility that lack of arousal could be because of relationship problems, poor partner technique or the like.

Some commentaries raised the question of whether it makes sense to base a diagnosis on distress, and at least one

In response to these, the Sexual Dysfunction Subworkgroup has argued

-They still think that merging HSDD and Sexual Arousal Disorder is a good idea, but also merging Female Orgasmic Disorder is not such a good idea.

-Whether (5) (quoted above) should be required for a diagnosis will be a matter that will be considered and data from the field trials will be relevant in answering it.

-They are planning on adding the phrase "consideration should be given to context" in the diagnostic criteria for both SIAD and Female Orgasmic Disorder.

For those who are interested, I would definitely recommend reading the full articles, which you may be able to downloaded from the above links, or they can be obtained from the authors.

No mention of asexuality was made in any of the commentaries or the response to them.

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