The Psychobiology of Sexual and Gender Identity Disorders

Interest in human sexual function has increased in the past decade, in large part as a result of increased recognition of the sexual side effects of various medications, the high incidence of sexual dysfunction among men and women, and the highly publicized success of some treatments for sexual dysfunction (e.g., Viagra for erectile dysfunction). This paper will describe the present knowledge of the endocrine, neurotransmitter, and central and peripheral nervous system mechanisms governing sexual function and dysfunction. The primary focus will be the underlying physiological processes although it should be noted at the outset that it would be misleading to assume that sexual dysfunction is best conceptualized in this manner. Psychological problems, such as depression or anxiety, and relationship issues, such as marital discord or stress, can have a profound effect on sexual functioning. Although such cognitive and emotional factors are often integral to a sexual problem, these aspects will be reviewed only briefly here.