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![Sexual Health Defined:
“A state of physical, emotional, mental and social well-
being related to sexuality; it is not merely the absence of
disease, dysfunction or infirmity. Sexual health requires a
positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having
pleasurable and safe sexual experiences, free of
coercion, discrimination, and violence. For sexual health
to be attained and maintained, the sexual rights of all
persons must be respected, protected, and fulfilled.”
World Health Organization [WHO]. (2006). Defining Sexual Health. Report of a technical consultation on sexual health 28–31 January
2002, Geneva, Switzerland: WHO. Available at: http://www.who.int/reproductivehealth/publications/en/](https://image.slidesharecdn.com/9781284183573slidch04-230206011315-b7ada7f7/75/Sexual-Health-2-2048.jpg)
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Sexual Health
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- 2. Sexual Health Defined: “Astate of physical, emotional, mental and social well- being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected, and fulfilled.” World Health Organization [WHO]. (2006). Defining Sexual Health. Report of a technical consultation on sexual health 28–31 January 2002, Geneva, Switzerland: WHO. Available at: http://www.who.int/reproductivehealth/publications/en/
- 3. Perspectives on SexualHealth and Sexuality (1 of 4) Cultural and religious dimensions • “Marriage” is universal theme in all cultures sanctioning sexual privileges and obligations. • Sexual behavior is often defined by cultural values. – Normative sex roles – Acceptable types of sexual activity – Sanctions/prohibitions on sexual behavior – Premarital sex – Sexual restraint for females – Same-sex relationships – Contraception decision making
- 4. Perspectives on SexualHealth and Sexuality (2 of 4) Economic dimensions • Daughter in marriage = dowry • Value of bride = virginity • Sexual aggression = power and economic dynamics • Commercial sex industry/prostitution
- 5. Perspectives on SexualHealth and Sexuality (3 of 4) Legal dimensions • Laws prohibiting certain types of sexual behavior/intimacy—cohabitation, fornication, sodomy • Same-sex partners • Marriage, annulment, separation, divorce, child custody, child support
- 6. Perspectives on SexualHealth and Sexuality (4 of 4) Political dimensions • Sex education in schools – Abstinence-only until marriage programs – Comprehensive or abstinence-plus programs
- 7. Class Discussion What aresome current national or international news items related to: • The commercial sex industry or prostitution? • Marriages between same-sex partners? • Sex education curricula in schools?
- 8. Sexual Behavior among Youthin the United States Figure 4-1 Sexual behaviors among U.S. youth, 2017. Data from Centers for Disease Control and Prevention. (2018). Youth risk behavior surveillance—United States 2017. Surveillance Summaries. Morbidity and Mortality Weekly Report 67(SS-8):1–114
- 9. Sex, Gender, andGender Identity Sex: An individual’s biological status (male, female, intersex): anatomy, chromosomes, and biological characteristics Gender: The economic, social, and cultural attributes and opportunities associated with being masculine, feminine, or a combination of both Gender identity: An individual’s personal subjective sense of being male, female, or somewhere in between
- 10. Homologous Sex Structures Figure4-3 External genital differentiation–male and female.
- 11. Definitions (1 of2) Intersex • A person who is born with sex chromosomes, external genitalia, or internal reproductive organs not considered “standard” as male or female Gender expression • The way a person acts to communicate gender within a given culture, such as clothing and interests Androgyny • Having characteristics of both sexes, but appearing gender neutral
- 12. Definitions (2 of2) Transgender • Umbrella term for anyone whose biological sex is not aligned with the person’s sense of self or gender identity Gender dysphoria • Psychological term used to describe a strong and persistent cross-gender identification Transitioning • Process in which transgender people work to change their appearance and societal identity to match their gender identity
- 13. Class Discussion (1) •What are some of the challenges faced by transgender people? As individuals? In school? In social situations? In various public places? • What are some possible solutions to these challenges?
- 14. Sexual Stereotypes: Discussion •Women are undersexed and men are oversexed. • Women are inexperienced and men are experts. • Women are recipients and men are initiators. • Women are controllers and men are movers. • Women are nurturing and supportive, and men are strong and unemotional. • Women are sensitive and men are insensitive. • Women are dependent and men are independent. • Women are passive and men are aggressive.
- 15. Sexual Orientation Sexual orientationrefers to one’s sexual and romantic attraction to other people, whether the attraction is to members of the opposite sex, the same sex, or both sexes. • Opposite sex = heterosexual • Same sex = gay, lesbian, homosexual • Both sexes = bisexual Issues • Homophobia • Profiling • Discrimination in medical care
- 16. External Female SexualAnatomy Figure 4-4 External female sexual anatomy.
- 17. Internal Female SexualAnatomy Figure 4-6 Internal female sexual anatomy.
- 18. Common Problems Relatedwith Menstruation • Dysmenorrhea – Painful menstrual flow • Premenstrual syndrome (PMS) – Group of symptoms linked to menstrual cycle • Premenstrual dysphoric disorder (PMDD) – Severe form of PMS • Amenorrhea – Lack of menstrual flow
- 19. Physical Health andthe Well- Woman Exam Exam steps • Medical history • General physical examination – Breast examination and pelvic examination • Pelvic examination – Phase I = external examination – Phase II = use of speculum; collection of specimens – Phase III = bimanual examination
- 20. Sexual Arousal and SexualResponse Masters and Johnson: Female Sexual Response Cycle Four Phases 1. Excitement 2. Plateau 3. Orgasm 4. Resolution Figure 4-7 Masters and Johnson’s model lists three variations among women in the sexual response cycle.
- 21. Forms of SexualExpression • Traditional heterosexual positions • Masturbation • Petting • Oral-genital stimulation (cunnilingus, fellatio) • Anal intercourse • Use of sex toys and accessories
- 22. Sexuality Through theLife Span (1 of 4) Childhood • Self-genital stimulation • Engage in play that may be viewed as sexual in nature • Curious about secondary sex characteristics Children are innately interested in their bodies. © Asiaselects/Getty Images
- 23. Sexuality Through theLife Span (2 of 4) Adolescence • Puberty – Secondary sex characteristics o Hair growth, breast budding, vaginal walls thicken, uterus enlarges, vaginal pH increases in acidity – Menarche o About 2 years after breasts start to develop and by the age of 15
- 24. Sexuality Through theLife Span (3 of 4) Young to middle adulthood • Increasing number of single, sexually active adults • Marriage at later age • Increase in the number of women who never marry • Placing career goals and advanced education before marriage • Increased divorce rate • Increase in cohabitating adults • Increase in the number of women who no longer depend on marriage to ensure economic stability
- 25. Sexuality Through theLife Span (4 of 4) Older adulthood • Climacteric—physiological changes that occur during period from female fertility to infertility • Menopause—cessation of menstruation – Vaginal dryness and thinning, delayed lubrication, hot flashes • Decline in frequency and intensity of sexual activity • Quality vs. quantity of sexual expression
- 26. Sexual Dysfunction • Prevalence –About 44% of U.S. women report sexual problems, with low desire being the most commons sexual problem (38.7%). • Historically called “frigidity” • Areas of dysfunction – Sexual desire disorders – Sexual arousal disorders – Orgasmic disorders – Sexual pain disorders
- 27. Sex Research Well-known studies •KinseyReport (1948 and 1953) – Factors affecting sexual behavior in males/females •Masters and Johnson (1966) – Sexual response cycle phases •Redbook Survey (1977) – Sexual behavior and attitudes of American women •Hite Report (1976) – Sexual practices of American women •Blumstein and Schwartz (1983) – Sexual and nonsexual components of relationships •ABC Primetime Poll (2004) – Found most Americans were monogamous and happy about it
- 28. Class Discussion (2) Howdo definitions of terms like “virginity” or “premarital” complicate sexual health research? Communication contributes greatly to the satisfaction of an intimate relationship. © Iofoto/Dreamstime.com
- 29. Sexual Violence asa Public Health Problem Types of sexual violence • Sexual assault and rape • Female genital mutilation (FGM) • Forced sterilization
- 30. Informed Decision Making •Gynecological checkup • Understanding personal feelings, thoughts about sexual well-being • Understanding the medical language associated with sexual health • Understanding responsible sexual behavior • Understanding myth vs. fact • Communication between parents and children • Knowledge of healthcare resources