Human Sexuality Flashcards
Why is Sexual History Important
Part of the overall health of individuals
if ignored, a provider can miss a medical condition or psychological problem that may significantly impact quality of life
The World Health Organization (WHO) defines sexual health as the presence of “a state of ___, ___, ____ and ____ well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.”
Physical
Emotional
Mental
Social well-being
Sexual health requires that a pt have a ___, ___ approach to sexuality and sexual relationships, as well as the possibility of having sexual experiences that are ___, ___, and free of ____, ____ and/or ___.
positive
respectful
pleasurable
safe
coercion
discrimination
violence
Society “normal” is determined by (7) things
Religion Cultural Legacy Social customs Science Medicine Personal experiences Community (socio-economic status, ethnicity, generation)
genetic, anatomical define ______
Biological Sex
____ is the terms for previously “hermaphrodite”; ambiguous genitalia
Intersex
Psychosocial meaning of maleness and femaleness define _____
Examples: ___, ___, ____, ____
Gender
Female, male, third gender, genderqueer
subjective sense of being male or female define _____
Gender Identity
how an individual chooses to present themselves in public (behaviors, clothing, etc.) define ______
___ lies between male and female expression
Gender Expression
Androgynous
Whether an individual is sexually attracted to men or women define _____
Examples: ____, ____, ___,
Sexual Orientation
Bisexual, asexual, pansexual (attracted to the entire spectrum of biological sexes)
The relationship between a person’s gender identity and their biological sex defines ______
(usually don’t match up)
Transgender/Cisgender
___ is a formally derogatory term that is now being embraced by the LGBTQIA community to describe anyone with fluid sexuality or gender identity/expression
Queer:
what does LGBTQIA stand for
Lesbian Gay Bisexual Transgender Queer/Questioning Intersex Asexual
The range of human sexuality is on a scale from ___-___
with 0 being _____
and 6 bring _____
0-6
0= exclusively heterosexual w/ no homosexual 6 = exclusively homosexual w/ no heterosexual
what are the 4 topics of human sexuality that fall on a scale
Gender identity (woman--> man) Gender Expression (feminine--> masculine) Biological Sex (female --> male) Sexual Orientation (heterosexual --> homosexual)
To set the stage for the sex conversation you should Establish \_\_\_\_\_ Appropriate \_\_\_\_\_ Eye \_\_\_\_ & \_\_\_\_ Tone of \_\_\_ Allow time for \_\_\_\_\_\_ Timing is \_\_\_\_\_ Avoid \_\_\_\_
Rapport Timing Level, eye contact Voice Response Everything Assumptions
When are appropriate times to discuss sex with your pt?
Probably anytime it is concerning but….
With a new patient as part of a complete evaluation
With an established patient with whom you previously have never discussed sexual matters
During discussion of presenting medical problem
**Incorporate the topic with ROS routinely
During the physical exam when should you reconsider the sex talk timing
if your patient is undressed
What aspects should you avoid assumptions about a persons sexual hx
Whether they are or are not sexually active
Sex of one’s partner
Number of partners
If married; that they are monogamous
Certain sexual behaviors are associated with specific lifestyles
All sexual activity is consensual
When beginning the sex conversation you should State your ___ and asking ____ to proceed
Intention
Permission
If a person declines talking about their sexual hx what are some tips?
Ask second more specific f/u questions to continue the conversation
Ask questions that are not directly about sex, but assess the person’s safety
Questions to ask about sexual activity
Are they ‘sexually active’?(if no, go to *)
YES:
- Change in your level of sexual activity
- Have you had sex in the past few months?
NO
- Have you ever had sex with another person before?
- If no, do you have concerns with or about your sexual function?
Other sex related questions that are important
of partners
Type of Sexual activity
Pregnancy/Contraception/STI protection or exposure
To be defined as Sexual Dysfunction D/o they duration must be at least _____ (time), cause ___, (for dx of primary sexual dysfxn) not be due to ___ or _____ d/o
6 months
Distress
Medical
Non-sexual mental
Types of male sexual dysfunction d/o
Male Hypoactive Sexual d/o
Male Erectile Disorder: (difficulty getting an erection or keeping one)
Premature Ejaculation: (reach climax or come before you want to)
Delayed ejaculation
Substance/Medication-Induced Sexual Dysfunction
Types of Female sexual dysfunction d/o
Female Hypoactive Sexual d/o
Female Sexual Interest/Arousal D/o: (trouble getting sufficiently lubricated for sexual intercourse)
Female Orgasmic D/o: (Able to reach orgasm)
Genito-Pelvic Pain/Penetration D/o: (pain during intercourse? Do you ever have trouble w/ tightening/tensing of your pelvic floor muscles making sex difficult or not possible? (vaginismus) (vulvar vestibulitis)
Substance/Medication-Induced Sexual Dysfunction
DSM 5 version of Gender Identity disorder
Gender Dysphoria
DSM 5 version of Male orgasmic d/o
Delayed Ejactulation
DSM 5 version of premature ejaculation (trick question )
Premature (early) ejaculation
DSM 5 version of male erectile d/o
Erectile d/o
DSM 5 version of Female sexual arousal d/o
Female Sexual Interest/Arousal d/o
DSM 5 version of Hypoactive sexual desire d/o
Male hypoactive sexual desire d/o
Female sexual interest/arousal d/o
S/S of sexual abuse
depression self-mutilation anxiety PTSD fear of intimacy sexual acting out sexual dysfunction
Types of sexual dysfunction d/o/
Lifelong type
Acquired Type
Generalized Type
Situational Type
Dysfunction is present during all sexual situations describes _____
Generalized Type
Pts who struggle w/ sexual dysfunction their whole lives describes _____
Lifelong type
Pts in which nml sexual functioning preceded the d/o describes ____
Acquired Type
