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See attached graphic depicting gender findings and biological sex findings in SNOMED. 

Contributors (6)

21 Comments

  1. This is a work-in progress owned by Clair Kronk outlining a structural hierarchy of terms associated with biological sex, gender, and sexual behavior. Please do not use it without Clair's permission first!

  2. Don Juanism - Before I go on I would like to make it clear I am neither making a case for removing or keeping this term, but merely using it as a way to highlight an issue . . . 

    Don Juanism appears in a number of psychiatric papers. Its history can be found here - http://www.psychiatrictimes.com/history-psychiatry/hypersexual-disorder-encounter-don-juan-archives. Reference appears in a number of blogs, the most recent in 2017 http://misspsychobabble.blogspot.com/2017/10/don-juanism-peek-into-world-of.html. Its also interesting that the American Psychological Association (APA) provide a definition in their Dictionary of Psychology - https://dictionary.apa.org/don-juan

    The point being, that what we are looking for is consensus, which from experience is not always as straightforward to find as it should be . . . .

    Ian

    1. Ian,


      Totally understand. If we are keeping the term as a historical reference to literature, it makes sense, but it should be stressed that it is a non-clinical term. Further, Don Juanism and nymphomania were replaced in DSM-III-R in 1987. Historian Carol Groneman noted in her 2000 book Nymphomania: A History that Don Juanism no longer applies with accuracy as a psychological or legal category of psychological disorder.

      PubMed indicates that the most recent use of "Don-Juanism" was in a 2008 article entitled "Post Don-Juanism". In total, only 6 PubMed articles include the term at all, 4 of which are pre-1985 (from 1981, 1977, 1972, and 1952, respectively).

      Generally speaking, of the 719 ontologies available on BioPortal, SNOMED is the only one to list Don Juanism... Simply put, it has been overwhelmingly replaced in modern diagnosis as several variants of hypersexuality and hypersexual behavior.

      I will say, the 2011 copy of Segen's Medical Dictionary includes the term, but in the following context, which is extremely derogatory:

      "A male paraphilia in which insecurity about masculinity and/or latent homosexuality is masked by multiple sexual liaisons with different female partners, without emotional commitment, but not as a paid gigolo, hustler, or call boy"

      So if we keep it, then I'd make an argument for including "paid gigolo" as a term as well.


      See:


      Edit:

      Stopped by the library to see if any books happen to mention Don Juanism in context. To quote Groneman's Nymphomania: A History: "Nymphomania conjures up madness, while Don Juanism hints of nobility and Spanish courts. Liberation notwithstanding, he (anthropologist David Givens) stated, 'Men are (still) less stigmatized by this behavior (sexual addiction/hypersexuality) ... 'for all it's apparent openness, our society doesn't yet loudly applaud a fully sexual woman.'"

      The following titles do not mention Don Juanism in any sense whatsoever:

      • Sexual Desire Disorders, Leiblum and Rosen (1988)
      • Psychological Perspectives on Sexual Problems, Ussher and Baker (1993)
      • Outpatient Treatment of Sex and Love Addicts, Griffin-Shelley (1993)
      • Sex Addiction: Cases Studies and Management, Earle and Earle (1995)
      • Clinical Management of Sex Addiction, Carnes and Adams (2002)
      • Handbook of Clinical Sexuality for Mental Health Professionals, Levine, Risen, and Althof (2003)
      • Standard Practice in Sexual Medicine, Porst, Buvat, and Standards Committee of the International Society for Sexual Medicine (2006)
      • Handbook of Sexual and Gender Identity Disorders, Rowland and Incrocci (2008)
      • Handbook of Clinical Sexuality for Mental Health Professionals, Levine, Risen, and Althof (2010)
      • Sexology: From a Holistic Point of View, Merrick (2011)

      The 2016 Treating Out of Control Sexual Behaviors only notes that "Don Juanism" was used inappropriately in DSM-III. Colman's 2015 A Dictionary of Psychology notes the term as "A non-technical name for satyriasis" (the 2008 version notes this as well).

      It should also be noted that the article you provided ("Hypersexual disorder: an encounter with Don Juan in the archives") notes that the 1968 paper cited explains that the treatment for "Don-Juanism" at the time was "chemical castration" if that helps put it in context time-wise.

  3. Hello all! I've done a basic literature review on the ~80 terms in sex, gender, and sexual orientation that are either derogatory, pejorative, erasive, unscientific, or historical in nature with notes and bibliography. Feel free to comment, raise concerns, or let me know if I miss something!

  4. Ian Green, has there been any progress work? (Sorry, I've just discovered this project).

    We've occasionally got requests to revise some of this content in the AU extension, and either do so piecemeal or advise that it's something that needs to be resolved internationally.

    Having just looked over Clair Kronk's 80 terms above, I'm going to leverage some of these recommendations in our language preferences.

    Most of the people contacting us about the language used, as that's what most users are exposed to. So it's going to be a great improvement for us. Thanks!

    I'll leave any modelling changes for SI to resolve.

    1. Matt Cordell,

      Thanks for posting - glad you discovered the project! 

      We have requested changes to only to a few of these concepts.  We are currently in the process of identifying and prioritizing manageable units of work in the form of narrowly scoped clinical topics. 

      Biological sex, gender, sexual orientation, and sexual behavior are all topics the group has discussed - and for which we've documented proposed changes.  Like you, we've felt these concepts need to be  addressed internationally. The CRG currently has mostly US participation and have tabled these discussions pending more international participation. It would be great to have AU on board for this work, and for us to find ways to engage folks from non-western cultures in this work. 

      Piper

    2. Matt Cordell thanks for commenting! It's been a very long time since things were overhauled and I absolute agree with Piper Allyn Ranallo on the need for international collaboration here. Many terms might be slurs in one context and appropriate in others (for instance, "hijra" is fairly standard in most places in India but is considered a slur in most of Pakistan, with "khwaja sara" the preferred term). 

      I wrote my overhaul before I essentially turned the whole thing into my PhD project, which has spun out into the Gender, Sex, and Sexual Orientation (GSSO) ontology available on BioPortal (https://bioportal.bioontology.org/ontologies/GSSO) and GitHub (https://github.com/Superraptor/GSSO), which is itself much more comprehensive (although not perfect in any respect). 

      I am happy to help with anything or advise in any way I can, but I bring a very Anglo-Europe-centric perspective on this and having participation elsewhere is extremely necessary for more of the international material.

      1. Clair Kronk ,

        Great to see a post from you!  I figured you were buried deep in your dissertation research. (smile) You've done such profound and beautiful work in this area, I'm so glad to see you back on confluence. Can't wait to take a look at your ontology! 

        Piper

        1. Piper Allyn Ranallo thanks so much! Sorry I've been so absent, I've been reviewing so much literature, it's absolutely ridiculous (the ontology has something like 9,000 entries and over 2,000 references and counting... I really could use a couple undergrads helping me on this to be honest!)

          (And thank you so much for introducing me to ontology work! None of this would be possible without you!)

  5. Hi everyone! I know things have been crazy over the last few months, but I was able to publish a newer version of my Gender, Sex, and Sexual Orientation (GSSO) ontology in JAMIA last week (ocaa061.pdf) and the dataset is available on the NCBO BioPortal (https://bioportal.bioontology.org/ontologies/GSSO) and on GitHub (https://github.com/Superraptor/GSSO). I'm curious to know if there's a timeline moving forward with sex/gender-related terms and if there's any way I can help with that! Thank you all!

  6. Hi Claire!

    Congrats on the publication! I can't wait to read it and to check out the ontology on BioPortal. What an exceptional and generous contribution you've made to the literature in a much needed area of work! 

    I'm SUPER glad to hear that things have slowed down a bit for you....mostly b/c I'm selfishly hoping we might get more "Claire time" on our CRG calls (smile) 

    Tagging Paul Amos , Jane Millar , and Ian Greento get their input on the SNOMED work around sex, gender, and sexual orientation. 

    -Piper


  7. Hello everyone! I know it has been a while but the Gender, Sex, and Sexual Orientation (GSSO) ontology is up and running! You can visit the site here: https://gsso.research.cchmc.org/. We’re in the process of assessing site usability and seeking feedback on the vocabulary, and if you have time, could you please fill out the survey here after browsing the site: https://redcap.research.cchmc.org/surveys/?s=EJPEW3C43R. I think we could outline some of the new gender/sex/sexual orientation terminology based on things outlined within the GSSO. Thank you so much! And please let me know if you have any questions!

  8. I have heard that a new sex/gender group at SNOMED-CT is being formed and will begin work in January from the people at HL7 I've been working with? Is it possible to join? I think they mentioned that Jane Millar would be one of the main people to contact? Thanks so much!

  9. Hi Clair,

    Email me if you haven't received an email from Jane inviting you to participate in the Sex and Gender project. 

    Piper

  10. Piper Allyn Ranallo thanks so much! just emailed you!

  11. Piper Allyn Ranallo hi! just wondering, your umn email address is still the correct email right? I just sent another follow-up to that email just in case it got buried! Thanks!

  12. Hi Claire! 

    I responded to both emails. Could my email being going into your spam folder? I also wonder if you may have missed Jane's email as well. I saw a response from her last week. 

    Piper

  13. Piper Allyn Ranallo Jane Millar would be considered in-line to invite other trans and gender-diverse persons to the sex/gender group? do we have demographics on current members of the group and know which regions/identities aren't well represented at this point? thanks so much!

  14. The Sex and Gender Clinical Project Group is meeting in the new year and details will be sent out to the initial membership.

    There is a core membership as we have with all project groups otherwise it is difficult to get the work done,  and it will be adjusted as needed as the work progresses. 

    I will not be communicating further on this topic here but we will be providing a summary of discussions and decisions as we go forward

    Best wishes

    Jane