Stephen B. Levine

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Stephen Barrett Levine (born 1942) is an American psychiatrist known for his work in human sexuality, particularly sexual dysfunction and transsexualism.

Contents

Education and career

Levine earned his M.D. from Case Western Reserve University School of Medicine in 1967 and serves as a Clinical Professor of Psychiatry there. His clinical practice began in the mid-1970s as the University Hospitals of Cleveland Sexual Dysfunction Clinic. In 1993 the Clinic separated from University Hospitals, and is presently called The Center for Marital and Sexual Health in Beachwood, Ohio.

His early work focused on premature ejaculation and erectile dysfunction, and he has written on a number of treatment options, including vacuum pumps, [1] injections into the corpus cavernosum of the penis, [2] and Viagra. [3] The most potent aphrodisiacs, according to Levine, are psychological intimacy [4] and voyeurism: "looking at pictures or movies of people engaged in genital or romantic interplay." [5]

Levine has written on sex offenders, including professionals who offend. [6] He cites Kurt Freund as an important influence because Freund wanted to define the subtypes of child molesters to help devise a means of prevention. [7] Levine has written about adultery and infidelity and believes pejorative terms like "cheating" and "infidelity" prevent addressing the issue in realistic terms. [8]

He was section co-editor with R. Taylor Segraves for the section on sexual and gender identity disorders in Treatments of Psychiatric Disorders by Glen Gabbard. Notable contributors included Martin Kafka (paraphilias) and Kenneth Zucker (gender identity disorder in children and adolescents). [9]

Although much of his work is written for other clinicians, Levine has written books for a lay audience, including Solving Common Sexual Problems (1997) and Sexuality in Mid-Life (2004).

He is noted for his work in clinical management of gender identity disorder. Levine was Chair of the fifth edition of the Harry Benjamin International Gender Dysphoria Association Standards of Care in 1998. [10] Levine also served on the American Psychiatric Association DSM-IV Subcommittee on Gender Identity Disorders. [11]

Work on transsexualism

Levine has expressed skepticism towards gender transitioning for children, adolescents, and young adults. [12] Levine also criticized a study by psychiatrist Jack Turban finding that gender dysphoria in children was not caused by social contagion, saying that the study only covers two years and uses survey data instead of clinic referral data. Furthermore, Levine alleged Turban had conflicts of interest and accused him of being "an advocate rather than a scientist." [12]

Levine has testified in many court cases relating to transgender rights, both in the United States and abroad, as an expert witness for states attempting to restrict access to gender-affirming care, like Arkansas. [13] Levine has strongly advocated against allowing social transition for transgender youth, describing it as setting them on a 'conveyor belt' to medical transition. [14] [15] [16] He has also advocated against access to gender-affirming medical care, most notably testifying in the case Bell v Tavistock, [17] [18] and has likened it to the medical experimentation performed by Nazi Germany during the Holocaust. [19] He has additionally testified in favor of overturning Washington state's ban on conversion therapy. [20]

A 2021 article in Wired Magazine described Levine's role in the American prison system, frequently being brought in to testify against allowing trans prisoners access to medical or social transition, and being used by many prisons in a clinical context to deny said measures to individual prisoners. [21]

Selected publications

Related Research Articles

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.

Hypersexuality is a term used for a presumed mental disorder which causes unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the condition in women and men, respectively.

Premature ejaculation (PE) is a male sexual dysfunction that occurs when a male expels semen soon after beginning sexual activity, and with minimal penile stimulation. It has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax and (historically) ejaculatio praecox. There is no uniform cut-off defining "premature", but a consensus of experts at the International Society for Sexual Medicine endorsed a definition of around one minute after penetration. The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse.

Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is sometimes considered a sexual dysfunction, and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug, or some other medical condition. A person with ISD will not start, or respond to their partner's desire for, sexual activity. HSDD affects approximately 10% of all pre-menopausal women in the United States, or about 6 million women.

Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as a "person's inability to participate in a sexual relationship as they would wish". This definition is broad and is subject to many interpretations. A diagnosis of sexual dysfunction under the DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunction can have a profound impact on an individual's perceived quality of sexual life. The term sexual disorder may not only refer to physical sexual dysfunction, but to paraphilias as well; this is sometimes termed disorder of sexual preference.

Sex therapy is a therapeutic strategy for the improvement of sexual function and treatment of sexual dysfunction. This includes dysfunctions such as premature ejaculation and delayed ejaculation, erectile dysfunction, lack of sexual interest or arousal, and painful sex ; as well as problems imposed by atypical sexual interests (paraphilias), gender dysphoria, highly overactive libido or hypersexuality, a lack of sexual confidence, and recovering from sexual abuse ; and also includes sexual issues related to aging, illness, or disability.

Sexual medicine or psychosexual medicine as defined by Masters and Johnsons in their classic Textbook of Sexual Medicine, is "that branch of medicine that focuses on the evaluation and treatment of sexual disorders, which have a high prevalence rate." Examples of disorders treated with sexual medicine are erectile dysfunction, hypogonadism, and prostate cancer. Sexual medicine often uses a multidisciplinary approach involving physicians, mental health professionals, social workers, and sex therapists. Sexual medicine physicians often approach treatment with medicine and surgery, while sex therapists often focus on behavioral treatments.

Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.

<i>Journal of Sex & Marital Therapy</i> Academic journal

The Journal of Sex & Marital Therapy is a peer-reviewed scientific journal published by Routledge and formerly by Brunner/Mazel. Its editor-in-chief is R. Taylor Segraves.

Sensate focus is a sex therapy technique introduced by the Masters and Johnson team. It works by refocusing the participants on their own sensory perceptions and sensuality, instead of goal-oriented behavior focused on the genitals and penetrative sex. Sensate focus has been used to treat problems with body image, erectile dysfunction, orgasm disorders, and lack of sexual arousal.

Kenneth J. Zucker is an American-Canadian psychologist and sexologist. He was named editor-in-chief of Archives of Sexual Behavior in 2001. He was psychologist-in-chief at Toronto's Centre for Addiction and Mental Health (CAMH) and head of its Gender Identity Service until December 2015. Zucker is a professor in the departments of psychiatry and psychology at the University of Toronto.

Heino F. L. Meyer-Bahlburg is a German-born psychologist best known for his work on biology of sexual orientation, gender identity, intersexuality, and HIV.

Robert Taylor Segraves is an American psychiatrist who works on sexual dysfunction and its pharmacologic causes and treatments.

<span class="mw-page-title-main">Lori Brotto</span> Canadian psychologist

Lori Anne Brotto is a Canadian psychologist best known for her work on female sexual arousal disorder (FSAD).

Sexuality can be inscribed in a multidimensional model comprising different aspects of human life: biology, reproduction, culture, entertainment, relationships and love.

Yitzchak M. "Irv" Binik is an American-Canadian psychologist whose main research interest is human sexuality, specifically sexual pain.

Postorgasmic illness syndrome (POIS) is a syndrome in which human males have chronic physical and cognitive symptoms following ejaculation. The symptoms usually onset within seconds, minutes, or hours, and last for up to a week. The cause and prevalence are unknown; it is considered a rare disease.

Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions, as well as sex reassignment therapies, for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world.

<span class="mw-page-title-main">Michael Perelman (psychologist)</span>

Michael A. Perelman is an American psychologist. He is a Clinical Professor Emeritus of Psychology in Psychiatry and former Clinical Professor of Reproductive Medicine, and Urology at Weill Cornell Medicine. Perelman is the co-director of the Human Sexuality Program, Payne Whitney Clinic of the NewYork–Presbyterian Hospital.

References

  1. ↑ Turner LA, Althof SE, Levine SB, et al. (1991). External Vacuum Devices in the Treatment of Erectile Dysfunction: A One-Year Study of Sexual and … Journal of Sex & Marital Therapy
  2. ↑ Althof SE, Turner LA, Levine SB, Risen C, Kursh ED (1987). Intracavernosal injection in the treatment of impotence: A prospective study of sexual... Journal of Sex & Marital Therapy
  3. ↑ Pallas J, Levine SB, Althof SE, Risen CB (2000). A Study Using Viagra in a Mental Health Practice. Journal of Sex & Marital Therapy
  4. ↑ Levine SB (1991). Psychological intimacy. Journal of Sex & Marital Therapy
  5. ↑ Brody JE (August 4, 1993). Personal health. New York Times
  6. ↑ Levine SB, Risen CB, Althof SE (1994). Professionals who sexually offend: Evaluation procedure; and preliminary findings. Journal of Sex & Marital Therapy
  7. ↑ Freeman, Karen (October 27, 1996). Kurt Freund Dies at 82; Studied Deviant Sexual Arousal. New York Times
  8. ↑ Alexander, Brian (April 17, 2007). To stay or stray? Crimes of opportunity. NBC News
  9. ↑ Segraves RT, Levine SB (section editors) Sexual and Gender Identity Disorders. In Gabbard GO, ed. (2001). Treatments of Psychiatric Disorders.
  10. ↑ Levine SB, Brown G, Coleman E, Cohen-Kettenis P Hage JJ, Van Maasdam J, Petersen M, Pfaefflin F, Schaefer LC (1999). The Standards of Care for Gender Identity Disorders. Journal of Psychology & Human Sexuality
  11. ↑ Bradley SJ, Blanchard R, Coates SW, Green R, Levine SB, Meyer-Bahlburg HFL, Pauly IB, Zucker KJ (1991). Interim report of the DSM-IV Subcommittee on Gender Identity Disorders. Archives of Sexual Behavior Volume 20, Number 4 / August, 1991
  12. 1 2 Downey, Caroline (2022-08-16). "'Advocate Rather Than a Scientist': The Compromised Research of Child Gender-Transition Doctor Jack Turban". National Review. Retrieved 2022-08-18.
  13. ↑ "These Paid 'Experts' Are Crisscrossing The Country To Defend Anti-Trans Laws". HuffPost. 2023-09-15. Retrieved 2023-12-17.
  14. ↑ Hecox v Little, 1:20-cv-00184-DCN (United States District Court for the District of IdahoJune 9, 2020).
  15. ↑ John and Jane Doe v Madison Metropolitan School District, 20-CV-454 (State of Wisconsin Circuit Court Dane CountyFebruary 19, 2020).
  16. ↑ BPJ v West Virginia State Board of Education, 2:21-cv-00316 (US District Court for the Southern District of West Virginia Charleston DivisionFebruary 23, 2022).
  17. ↑ Mobley, Andrew; Lepenski, Brenda. "Arkansas trial on transgender treatment for children; new testimony from doctor Monday". ABC.
  18. ↑ Keena, Colm. "Gender distress treatment in young people: a highly charged debate". Irish Times.
  19. ↑ Dylan Brandt et al v Leslie Rutledge et al, 4:21-CV-00450-JM (Eastern District Court of Arkansas Central DivisionJuly 9, 2021).
  20. ↑ Stahl, Aviva (July 8, 2021). "Prisoners, Doctors, and the Battle Over Trans Medical Care". Wired Magazine.
  21. ↑ Stahl, Aviva (July 8, 2021). "Prisoners, Doctors, and the Battle Over Trans Medical Care". Wired Magazine.
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