PS9.1-2 | Psychosexual Health — Glossary

A clinical approach that actively supports and validates a patient's LGBTQA+ identity, uses chosen names and pronouns, addresses minority stress in formulation, and creates a non-discriminatory therapeutic environment.

A person whose gender identity aligns with the sex assigned at birth; used as the contrast term to transgender.

Any practice — psychotherapeutic, pharmacological, or spiritual — that aims to change a person's sexual orientation or gender identity; condemned by WHO, WPA, and NMC as ineffective and harmful.

A short-acting selective serotonin reuptake inhibitor taken on-demand 1–3 hours before intercourse; the only approved pharmacotherapy specifically indicated for premature ejaculation.

Recurrent or persistent genital pain associated with sexual intercourse in males or females, not better explained by a physical condition alone.

Persistent inability to attain or maintain a penile erection sufficient for satisfactory sexual activity, present on most occasions over several months per ICD-11.

A person's deeply held sense of their own gender, which may or may not correspond to the sex assigned at birth; distinct from sexual orientation and biological sex.

An ICD-11 category (HA60–HA61) describing a marked incongruence between a person's experienced/expressed gender and their assigned sex; classified in Chapter 17 (Conditions Related to Sexual Health), NOT in the mental disorders chapter.

A DSM-5 umbrella category that combines vaginismus and dyspareunia; characterised by fear of/during penetration, perineal tension, and marked genito-pelvic pain.

Persistent or recurrent absence of sexual fantasies and desire for sexual activity causing marked personal distress, not explained by a relationship factor or another mental disorder.

International Classification of Diseases, 11th revision (WHO, 2022); classifies sexual dysfunctions in Chapter 17 — Conditions Related to Sexual Health, separate from mental disorders.

International Index of Erectile Function — a validated 15-item self-report questionnaire for assessing erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.

The internalisation of societal stigma against LGBTQA+ identities, leading to self-loathing, shame, or a desire to change one's own orientation or identity; a clinical target for affirmative psychotherapy, not a justification for conversion practices.

Acronym for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Asexual, and other minority sexual orientations and gender identities; the '+' denotes further identities not individually enumerated.

Premature ejaculation that has been present since the first sexual experience (primary); distinguished from acquired PE which develops after a period of normal ejaculatory control.

Indian legislation that replaced the Mental Health Act 1987; prohibits discrimination in mental health care, including on grounds of sexual orientation and gender identity; decriminalises suicide attempt; establishes advance directives and nominated representative rights.

Chronic, identity-specific psychological stress in LGBTQA+ individuals arising from stigma, discrimination, identity concealment, internalised prejudice, and the expectation of rejection; the primary social cause of elevated mental health disparities in this population.

National Legal Services Authority v. Union of India (2014) — Supreme Court of India judgment recognising the right of transgender persons to self-identify their gender and affirming fundamental rights of dignity and autonomy.

Navtej Singh Johar v. Union of India (2018) — Constitutional Bench judgment that read down Section 377 IPC to decriminalise consensual sexual acts between adults, affirming that homosexuality is not a mental disorder.

Physiological erections occurring during REM sleep; preserved NPT in a man with ED suggests psychogenic rather than organic aetiology.

Phosphodiesterase type 5 inhibitor (e.g., sildenafil, tadalafil) that potentiates nitric oxide-mediated smooth muscle relaxation in the corpus cavernosum; first-line pharmacotherapy for erectile dysfunction.

Anticipatory anxiety about sexual performance that triggers sympathetic arousal and physiologically inhibits erection or normal sexual response; the central maintaining mechanism in psychogenic ED.

A graded counselling framework for sexual problems with four levels: Permission, Limited Information, Specific Suggestions, and Intensive Therapy (Annon, 1976).

Ejaculation occurring persistently before or within approximately one minute of vaginal penetration on almost all occasions, causing significant distress.

A provision of the Indian Penal Code (enacted 1861) that criminalised 'carnal intercourse against the order of nature'; after Navtej Johar (2018) it no longer applies to consensual acts between adults; remains in force for non-consensual acts, acts with minors, and bestiality.

A behavioural sex therapy technique (Masters and Johnson) involving graduated non-demand touching exercises to reduce performance anxiety and rebuild sexual intimacy.

A person's enduring pattern of emotional, romantic, or sexual attraction to others; includes heterosexual, homosexual, bisexual, asexual, and others; not a clinical diagnosis.

A cognitive state, first described by Masters and Johnson, in which a person mentally observes their own sexual performance rather than engaging in the experience; the central cognitive mechanism driving performance anxiety.

A behavioural technique for premature ejaculation (Semans) in which sexual stimulation is stopped just before ejaculatory inevitability, then resumed after arousal decreases; repeated to build ejaculatory control.

A legally recognised gender category in India since the NALSA judgment (2014), acknowledging that gender is not binary and affirming the rights of persons who do not identify as either male or female.

An umbrella term for persons whose gender identity differs from the sex they were assigned at birth; being transgender is not classified as a mental disorder in ICD-11.

Indian legislation operationalising NALSA rights, providing for self-declaration of gender identity, anti-discrimination protections in employment, education, and healthcare, and the right to welfare measures.

Involuntary, recurrent contraction of the perivaginal muscles (levator ani) making vaginal penetration difficult, painful, or impossible.