Human Sexuality 5-7 Flashcards
Define rape under sexual offences law
Rape is committed if:
- A man has unlawful sexual intercourse with a woman who does not give consent during the intercourse
- The man knows she does not give consent but is reckless anyways
- Any penetration of male penis into female vagina * (ejaculation is not required)
Age of consent in HK
Consequence of underage sex
16
Sexual intercourse with a girl under 16 is a criminal offense regardless of her consent
Laws on protection of children against sexual offenses?
1) Any intercourse with a girl under 14 is rape
2) Any exposure of sexually explicit material to a child is a crime
3) Any photo or video of naked children showing private parts or children in sexual act is an international crime
Define indecent assault under HK law
Indecent acts or touching or penetration of bodily orifices by objects other than a male genitalia
e.g. forced oral sex
Highest age group in rape victims
15-19
Offender-victim relationship in rape incidences?
Majority = Friends
2nd and 3rd = Stranger and Intimate Partners
4th and 5th = Work colleagues and Family members
Main places of sexual assault?
Majority = Residential 2nd = Hotel/ Hostel/ Villa 3rd = Outdoor
Main mode of intoxication during sexual assault?
Alcohol
6 main procedures to perform when assessing a rape victim
1) Collect evidence of sexual assault
2) Assist in criminal prosecution
3) Documentation of injury and treatment
4) Screen for STD
5) Prophylaxis for STD
6) Pregnancy test
4 types of control evidence for rape conviction
Hair
Blood
Saliva
Blood or fluids of spouse and sexual partner
How to collect contact evidence from the victim?
Should the victim clean?
Do not change or wash clothes
Do not shower or clean after an attack
Victim stands on clean sheet of paper and undress, clothing collected and packed individually
How to document injuries on rape victim?
Record type, location, size and shape of injury
Interpret age of injury, probable cause of injury
Drawing, photo, video evidence with specific consent
List physical evidences that are collected for rape victims
- Fingernails: for blood, skin or fibers trapped under
- Swabs for dried saliva, semen, blood…
- Genital swabs
- Speculum exam
- Photographic documentation of wounds, hymen
Incidence of physical trauma in rape cases?
Injuries are only found in minority of rape victims
But absence of injuries does not exclude rape
Difference in services provided to rape victims who report vs not report rape
Report:
- Forensic medical exam and evidence collection
- Prophylaxis from A&E doctors
Do not report:
- Prophylaxis from A&E doctors
4 reasons for delayed/ poor reporting of substance-assisted rape
- Retrograde amnesia
- Loss of consciousness
- Disinhibitions
- Relationship between victim and offender
Causes of gender dysphoria (5)
- Severe genital abnormalities
- Androgen exposure
- Specific mutations: RYR3, CYP17 …etc
- Twins (especially male)
- Neuroanatomy changes
Scope of Treatment for gender dysphoria
- Hormone therapy
- Surgery
- Psychotherapy
- Voice and communication therapy
- Social support
Patient management before starting treatment for gender dysphoria
Treat psychiatric comorbidities
Live in identity congruent gender role for 12 months before operative
Physical changes in Transman after hormone therapy
Increase muscle mass and strength Deepen voice Fat redistribution Body and facial hair growth Clitoral enlargement and vaginal atrophy
Physical changes in Transwomen after hormone therapy
Softening skin Decrease muscle mass and strength Breast growth Fat redistribution Decreased hair growth Decrease erection and sperm production
Options for fertility preservation for transgenders
Transwomen: Frozen sperm
Transman: Gamete preservation
Surgery options for transgenders
Male to Female:
- Vaginoplasty
- Breast augmentation
- Vocal cord surgery
- Orchiectomy
- Vaginoplasty
- Facial feminization surgery
Female to Male:
- Phalloplasty
- Subcutaneous Mastectomy
- Vaginoplasty
- Hysterectomy
Paraphilia
- Criteria
- Examples of types
DSM:
- Recurrent intense sexually arousing fantasies/ urges/ behavior involving non-human objects, children, non-consenting person, or humiliation of self or partner
- 6 months +
Fetishism
Pedophilia
Sexual sadism
Voyeurism
Paraphilic disorder
- Criteria
DSM:
- Personal distress about interest
- Sexual behavior that involves another person’s psychological distress, injury, or death
- Desire for sexual behavior involving unwilling persons or persons unable to give consent
4 examples of sex chromosome disorders
Klinefelter syndrome - XXY
Turner syndrome - X only
Triple-X syndrome- XXX
Mixed gonadal dysgenesis - X only or XY
Victim- Offender relationship in rape and indecent assault cases?
Rape: 98% acquaintances
Indecent assault: 38% acquaintances, 62% strangers
Most common type of sexual offense?
Voyeuristic disorder
Paraphilic disorder - derive pleasure from looking at naked bodies ad genital organs, or observing sexual act of others
Voyeuristic disorder
- Criteria
In at least 6 months:
- Recurrent and intense sexual arousal from observing an unsuspecting person who is naked, disrobing or engaged in sexual activity
- Acted on sexual urges with non-consenting person, or urges causing clinically significant distress and daily functional impairment
- Individual with arousal or urges is at least 18
2 types of incest
Incest - sexual activity between family members
Covert/ Emotional incest - Parent or caregiver relies on child for support that a romantic partner would give
Pharmacological treatment for Voyeuristic disorder
Reduce impulse and urges:
Antiandrogens
Antigonadotropics
SSRI
