Case Illustration · Applied Exercise
Not Really an Option
His presenting complaint is accurate, and the medication worked. That is what makes this one difficult.
The presentation
A client (AMAB, 31) presents reporting erectile difficulty with partners over several years, and says sex has always felt like something he was supposed to do. He has been prescribed a PDE5 inhibitor by his physician, which he reports works physically and changes nothing about how the encounters feel. He describes himself as having a low sex drive, though he reports reliable spontaneous desire when alone.
Assessment reveals a pattern beginning in his first relationship at 19: a partner who initiated frequently and reacted with hurt or anger when he declined, after which he stopped declining. He does not describe this as coercion.
He says that turning down sex was not really an option, and that he has never thought of it as something a man could do. He describes going somewhere else in his head during sex as normal.
Estimated time to complete this exercise: 15 minutes
Part 1 of 5
Which features bear on distinguishing a primary sexual dysfunction from a compliance-organized pattern?
Select all that do. Four of the seven. You get one submission.
References
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Katz, J., & Tirone, V. (2010). Going along with it: Sexually coercive partner behavior predicts dating women’s compliance with unwanted sex. Violence Against Women, 16(7), 730–742. https://doi.org/10.1177/1077801210374867