Human Sexuality Final Flashcards
Types of Contraception for Men and Women
Men: Condom, vesectomy, hormonal gel
Women: IUD, hormonal pills, sterilization, condoms
Why do we need contraception for men
211 million pregnancies globally are unintended
46 million end in abortion
- 60% carried out under safe conditions
- 40% (18 million) not
Methods of contraception
- Fertility awareness
- Hormonal
- Barrier
- Permanent
Stages of the menstrual cycle
- Menstruation
- Follicular phase
- Ovulation
- Luteal phase
Contraceptive methods: fertility awareness methods
Calendar method: tracking period to predict ovulation
Basal body: temperature tracking your body’s lowest temperature at rest to identify when ovulation occurs
Ovulation method: using tests to see when you are ovulating
Contraceptive methods: hormonal methods
Combination pill: Contains synthetic estrogen and progesterone
Minipill: Contains synthetic progesterone, but no estrogen
How does the birth control pill work?
Fools the brain into thinking the woman is already pregnant
Cervical mucus thickens and becomes more acidic, becoming a barrier to sperm
Inhibits the development of the endometrium, making implantation difficult
Barrier methods for Contraception
Male condom:
- Sheaths made of latex, polyurethane, or intestinal membranes of lambs, (which do not provide protection against some STIs)
Female condoms:
- Polyurethane sheath lining entire vagina and external genitals
- Can be inserted up to 8 hours before sex, but should be removed immediately following
Permanent Methods of Contraception
Female sterilization includes tubal ligation which prevents eggs from making their journey out of the ovaries.
- Unfertilized egg is reabsorbed by the body
- Highly effective in preventing pregnancy (.04% failure rate)
- Should be considered irreversible (43% to 88% of reversals are successful)
Male sterilization
Vasectomy = vas deferens cut and tied
Surgically cutting each vas deferens and tying it back or cauterizing it to prevent sperm from reaching the urethra
Carried out in doctor’s office, under local anesthesia, in about 15–20 minutes
Should be considered irreversible (16% to 79% of reversals are successful)
Other forms of contraception
- Abstinence
- Withdrawal
- Breast feeding
- Morning-after pill
Morning after pill vs. Abortion pill
The morning after pill:
Form of emergency contraception
Reduces risk of pregnancy
Delays of inhibits ovulation Will NOT induce an abortion if already pregnant
Steps in male birth control
- Gel
- Pill
- Nonsurgical vasectomy
Childhood sexuality: infancy (birth to 2 years)
Infants engage in a variety of “sexual” behaviours:
* Boys have erections in the first few weeks of life
* Evidence of lubrication and genital swelling has been reported in infant girls
* Stimulation of the genitals can produce pleasure in infants
* These reflexes should not be interpreted according to adult concepts of sexuality
- Explores own body, including genitals
- Displays spontaneous, reflexive sexual response
- Enjoy touch from caregivers
- Enjoys nudity
Learning domains of sexuality during infancy (birth to 2 years)
- Correct names for body parts
- Display spontaneous arousal
- Enjoy touch from caregivers
- Enjoys nudity
Childhood sexuality: early infancy (2 to 5 years)
- Engages in occasional masturbation (soothing, not arousal)
- Still enjoys and is comfortable with nudity
- Consensual exploration of same-aged playmates bodies
Learning domains of sexuality during early infancy (2 to 5 years)
- Basics of reproduction
- Basic rules of privacy and boundaries
- Learns your body belongs to you, autonomy over their own body
- Difference between appropriate and inappropriate touch
Childhood sexuality: middle childhood (5 to 8 years)
- Crushes (our first romantic attachments)
- Curiosity about the genitals increases
- Exploratory same-sex play is more common than play with the other gender
- Same-sex play does not foreshadow adult sexual orientation
Learning domains of sexuality during middle childhood (5 to 8 years)
- Basic understanding of human reproduction- where babies come from
- Acquires preparatory understanding of basic physical changes associated with puberty
- Acquires understanding about basic understanding about all variations of couples
Two ways we can think about human sexuality:
- Sexuality is only for adults- - - therefore we focus on adult sexual behaviours and feel the need to protect children
- Children who do not get answers from parents will look for answers
- When they have sexual feelings they may feel guilty or ashamed
- Children do not learn to say no - Look at sexuality in a broader sense
- Sexuality is something that belongs in all people
- It begins in infancy and increases or changes as we get older
- Sexual feelings are common across all ages
- But the way that people express these feelings differ with age
- Children = curiosity, adults = arousal
When children ask questions what do you do
Short, clear, simple language for explanations
Answer what is asked
Provide the facts
Be honest
Don’t’ include too much information in one sitting
Does providing information related to sexuality increase sexual behaviours?
- Condom accessibility programs in high school:
- Increase in condom acquisition
- Increased use of condoms
- Decreased rates of sexual initiation (or no difference) but NO studies found and increase in sexual activity
Adolescent sexuality (13 to 19 years)
Four main developmental tasks of adolescent sexuality:
1. Adapt to the physical and emotional changes of puberty
2. Accept yourself as a sexual being (likes dislikes and people we are attracted to)
3. Explore romantic and sexual relationships (teaching people how to negotiate in relationships
4. Learn to protect your sexual health
Primary and Secondary Characteristics
Primary sex characteristics: ovaries, sperm
Secondary sex characteristics: puberty changes
Explain the negative feedback loop
A rise in sex hormones turns off the hypothalamus while decrease in sex hormone turns on the hypothalamus
Increased hypothalamus “set point”
In childhood hypothalamus sensitivity is high (very sensitive to change).
Children have a Low set point: only a small amount of hormones are needed to turn off the hyppthalamus
In adolescence hypothalamus sensitivity is low
Adolescences have a High set point: more hormones are needed to turn off the hypothalamus
Trends in Sexuality now
- Approximately 33% of youth experience intercourse by age 17
- By age 20, about 66% of Canadians have had sex
- First sexual experience usually in the context of a romantic relationship
- Far more males report orgasms (76%) compared to females (12%)
- More females (54%) found it emotionally satisfying compared to males (42%)
Sexual Satisfaction Importance
- Sexual satisfaction critical for health, wellbeing, happiness, and relationship satisfaction
- One indicator of sexual satisfaction is reaching orgasm
Trends in who is having an orgasm
- 90% of heterosexual men, 89% of gay men, 88% of bisexual men, 86% of lesbian women orgasm during partnered sex
- 50% of heterosexual women and 66% of bisexual women
- Also 95% of women are physiologically capable of orgasm during masturbation
Reflux /induced ovulators
(female cats) produce a mature egg only when stimulated by intercourse
Spontaneous ovulators:
women produce eggs monthly, independent of sexual intercourse
Byproduct theory
males and females develop similar traits in the first two months of life as our basic body plan and tissue pattern get laid down. Females get orgasms because males get orgasms
Pair-bond theory
adaption based, evolved to strengthen the relationship between male and female, encouraging women to return to man
Why are more women not having orgasms?
Lack of sexual communication
Lack of sexual desire/assertivness
Lack of self esteem
Women orgasm is not seen as important or needed
Role of teen’s perceptions
- Teens overestimate how much sex their peers are having
- About 90% of males and females (avg age 18.5 years) thought that they had fewer sex partners than classmates
- Inaccurate assumptions about the sex lives of others can negatively impact our assessments of our own lives
What did research show as seeing virginity as a gift
- Twice as many university females (40%) as males (21%) viewed their first intercourse experience as giving their partners the gift of their virginity
- Three times as many men (22%) as women (6%) viewed their virginal status as a stigma or embarrassment
What is Early sexual activity related to
o Other high-risk activities, such as drug use, delinquency, and school-related problems
o Forced sex involving drugs/alcohol
o Unprotected sex
o Becoming/causing pregnancy
o Experience of dating violence
o Increased number of sexual partners
Developmental psychopathology approach
Harsh environments undermine healthy development; each girl should start having sex at an early age, have many sexual partners, engage in risky behaviours
Evolutionary approach
In response to difficult early social environments, risky strategies may increase the probability of passing on one’s genes.
Relationship trends in emerging adults
- Dramatic rise in % of single adults
- Serial monogamy – common pattern, long lasting monogamy in normal for most adults over 25%
- Increase in cohabitation
- Decrease in rate of marriage and increase in same sex marriage
- High levels of divorce
Senior sexuality
- Adapting to reduced frequency of sexual desire
- Adapting to reduced intensity of genital sexual response
- Adapting to death of a partner
- Adapting to entry into. Long term facility
- Using protection against STI and HIV
Patterns of sexual activity
- Sexual relations declined with age
- Many reported having sex partners during the previous year
- Average sexual frequency was 2–3 times/month
For many, “great sex” didn’t occur until midlife – why?
- Erotic intimacy, interpersonal exploration, authenticity, freedom to be themselves, and communication were ingredients for great sex
- Couples may respond to physical changes of aging by broadening their sexual repertoires
Protecting sexual health in later life
A number of factors have led to increased risks for STIs among older Canadians:
- It is more socially acceptable for older people to pursue relationships
- Medial advances have made it possible for older people to live longer and healthier
- Increased divorce rates mean older people are back on the signal scene
- Older adults may not be reached by sexual health prevention messages
What is sexual dysfunction?
Persistent or recurring:
- Lack of sexual desire
- Difficulty becoming sexually aroused
- Reaching orgasm
- Pain
Must cause distress
Bio-psycho-social approach Diagnosis
Bio: neurological, vascular, and endocrine systems
Psychological: personal experiences, attitudes and mood
Social: religious beliefs, ethnicity, culture
How might culture impact the interpretation of symptoms and diagnosis of sexual dysfunction?
Related to the belief that semen is a vital component of the human body
Leads to anxiety /undue concern about the debilitating effects of semen loss
Accompanied by symptoms of weakness, fatigue, palpitations, sleeplessness, depression, headaches
Treatment: anti-anxiety and depression medication with cognitive behaviour therapy
Sexual dysfunctions are classified as
Lifelong or acquired
Generalized or situational
Sexual Desire-Related Disorders
Effect both men and women
Male hypoactive desire disorder
Female sexual interest/arousal disorder
Important Note: No clear consensus among clinicians about how to define “low sexual desire”
Male Erectile Disorder
Persistent difficulty in achieving or maintaining an erection sufficient to allow completion of sexual activity
Contributing factor may be societies views or performace anxiety
Incidence increases with age
Performance anxiety
concerning ones ability to perform behaviours especially behaviours that may be evaluated by others
Orgasmic disorders
Female orgasmic disorder- unable to reach orgasm or have difficulty
Delayed ejaculation: Limited to sexual intercourse
Premature ejaculation: Ejaculation occurs with minimal sexual stimulation, and before the man desires it
Sexual pain disorders
Dyspareunia: Painful intercourse or persistent pain associated with any stimulation of the vaginal area
Vaginismus: Involuntary contraction of the pelvic muscles that surround the outer one-third of the vaginal barrel, resulting in pain
Biology Origins of sexual dysfunction
Medical Conditions: heart disease, diabetes
Aging: physical changes (e.g.. Thinning of vaginal walls, associated medical conditions
Drugs: prescription meds
Psychosocial Origins of sexual dysfunction
Predisposing factors:
- Restrictive upbringing
- Disturbed family relationships
- Traumatic early sexual experience
Precipitating factors:
- Random failiure
- Discord in relationship
- infidelity
Maintaining factors:
- Poor emotional intimacy
- Performance anxiety
- Guilt
- Poor communication
- Restricted foreplay
The PLISSIT Model for Treatment for sexual dysfunction
Permission →
Limited Information →
Specific Suggestions→
Intensive Therapy
Treatment for sexual dysfunction: sexual desire
- Self-stimulation exercises combined with erotic fantasies
- Sensate focus exercises
- Enhancing communication
- Expanding couples’ repertoire of sexual skills
- Testosterone
- Treatment for depression
- Counselling or psychotherapy
Treatment for sexual dysfunction: sexual arousal
Relaxation: receive stimulation without anxiety inhibiting natural reflexes (as logn as problem ius psychologically based)
Non-genital sensate-focus exercises: to remove demand (gradually increase in terms sexually explicit touching
Erectile disorder treatments
- Oral medications (e.g., Viagra, Cialis)
- Hormone (testosterone) treatment
- Vascular surgery
- Penile implants
- Vacuum pump
Female sexual interest/arousal disorder treatment
- Sex education
- Searching out and coping with possible cognitive interference
- Working on relationship problems
- Artificial lubricant
- Testosterone skin patches
- Eros clitoral suction device
- Viagra
Treatment for Premature ejaculation
- Sensate-focus exercises
- Biological treatments
- Squeeze technique
- Stop-start method
Treatment for Dyspareunia
- Cognitive-behavioural therapy
- Biofeedback
- Surgery
Puberty
The changes in physiology, anatomy, and physical functioning that develop a person into a mature adult biologically and prepare the body for sexual reproduction
When we think about the elderly and sexuality, what comes to mind?
o Sexual activity is only appropriate for the young
o Older people are sexless
o Older people with sexual urges are abnormal
What might be some changes/factors that will impact our sexuality in later life?
- Adapting to reduced frequency of sexual desire
- Adapting to reduced intensity of genital sexual response
- Adapting to death of a partner
- Adapting to entry into. Long term facility
- Using protection against STI and HIV
A number of factors have led to increased risks for STIs among older Canadians. Why?
- It is more socially acceptable for older people to pursue relationships
- Medical advances have made it possible for older people to live longer and healthier
- Increased divorce rates mean older people are back on the signal scene
- Older adults may not be reached by sexual health prevention messages
Senior sexuality
- Age should not be a barrier to sexual expression
- Social circumstances might be – but can be changed
- Attitudes and expectations may be problematic
Diagnosis of Sexual Dysfunction
For a sexual problem to be diagnosed as a dysfunction:
o Must have occurred for 6 months or more
o Must happen 75–100% of the time
o Must cause the person significant distress
What is bacteria?
Class of single-celled micro-organisms with a simple internal structure; can give rise to many illnesses
Most common bacterial infections
Chlamydia (#1)
Gonorrhea (#2)
Overall increase in in STI rates - Why?
We are seeing a rejection to the antibiotics that help treat chlamydia, the bacteria in our body changes/shifts its layer so it does not react to the antibiotics the same way
Age trends in STI’s
Older people show more of an increase, since they are not the target audience for safe sex
Gender trends in STI’s
Female cases decrease as the women gets older but male cases increase as men get older
From a biological perspective the vaginal surface is larger, so women are more likely to have chlamydia or other STI’s. More of the virus is found in sperm
COVID trends in STI’s
When covid was happening the chlamydia rates seemingly went down, but some research discuss that this might not be reality. Since during covid sex clinics were closed, limited resources for testing, people were more focused on the pandemic instead of getting tested
What are viral infections
Human immunodeficiency virus (HIV): A virus that destroys white blood cells in the immune system, leaving the body vulnerable to life-threatening diseases
Acquired immunodeficiency syndrome (AIDS): A condition caused by HIV and characterized by destruction of the immune system, stripping the body of its ability to fend off life-threatening diseases
CD4 (helper T cells)
quarterback of immune system, recognize invading pathogens and enlist help from other white blood cells
B lymphocytes (B cells)
make antibodies that help your body fight infections
Natural killer cells (NK cells)
contain substances that destroy tumor cells or cells infested with virus
HIV/AIDS Progression
- Shortly after infection, the person may experience mild, flu-like symptoms
- People generally look and act well and may unwittingly pass the virus on to others
- Most people remain symptom-free for years
- Some enter a symptomatic phase that is marked by chronically swollen lymph nodes, intermittent weight loss, fever, fatigue, and diarrhea
- Fall prey to opportunistic infections
Treatment for HIV and AIDS
- A combination of antiviral drugs has become the standard for HIV and AIDS
- Highly Active Antiretroviral Therapy (HAART)
o Combine three or more drug agents in a way that effectively stops HIV from replicating at different points in its life cycle
o If one drug is unable to suppress a certain viral type, one or both of the other agents would be more than likely to do so
Kick and kill method for HIV and AIDS
HIV has long proved very difficult to treat because the disease can hide in dormant cells where the immune system can’t get to it
- Vaccine given to boost immune system’s ability to detect and combat HIV-infected cells
- Second drug reactivates dormant HIV cells –immune system can find and kill them
HIV/AIDS and circumcision
Male circumcision reduced the risk of HIV acquisition for men
- Foreskin particularly susceptible
- Contains specific type of cell that can be easily invaded by HIV virus
- Removing foreskin removes this route of entry
STI epidemiology - Biological factors
- Multiple means of transmission
- Lifelong infections
- Increased vulnerability from some STIs to contracting others
- Gender
- Lack of vaccines and cures
STI epidemiology - Psychological Factors
- Perceived low risk
- Psychological obstacles to condom use
- Alcohol and drug use
- Lack of communication
Obligation to disclose HIV positive status
If you do not diclose you have HIV or AIDS to a intimate partner you mya be charged with:
o Aggravated sexual assault
o Administering a noxious substance
o Common nuisance
o Criminal negligence causing bodily harm
o Attempted murder
What is sexual assault?
*. Any unwanted sexual touching
- Considered to be an act of power and domination
- There is no statute of limitations for persecution of sexual assault
Types of sexual assault
- Stranger sexual assault (18% of reported incidents)
- Acquaintance sexual assault (82%)
- Date sexual assault
Aspects of Sexual Assault (common things and common trends)
- Common form of acquittance sexual assault
- More likely to occur under influence of alcohol
- Perception of willingness if returns home with someone
- Resistance as being coy or game playing
- Can be more challenging for the courts to determine if consent was given in cases of established relationships
Sexual assault case attrition
- Most cases do not make it past the initial interview/meeting with police (e.g., on avg 86% of cases)
Secondary victimization
Refers to behaviours, attitudes of the frontline staff that is experienced as victim blaming or very insensitive.
Impact of Secondary victimization
- victims will feel hopeless and question their stories
- victims may also be forced to go back to a situation where they are unsafe since police will not do anything
- victims go through horrific experiences and now they are being degraded all over again and are being painted as the bad guy
- predators learn that they can get away with it
- builds distrust toward medical staff/police
- massive psychological impact like depression, anxious, blames and overall did not want to seek help again
Brain regions affected by trauma
- HPA Axis: Balances the body following stress by releasing of various hormones, incudes
o Catecholomines: fight or flight response, adrenaline, also impairs rational thought
o Cortisol: helps converse energy, also creates tonic immobility
o Opiods: prevents pain, also leads to a flat effect
o Oxytocin: promotes good feelings
Memory processes impacted by trauma
Hippocampus: processes info into memories
Responsible for:
* Encoding: organizing sensory information
* Consolidation: grouping information into memories and storing them
Amygdala: specializes in the processing emotional memories (works with the hippocampus)
What happens during a sexual assault in the brain?
- Neurobiological changes (e.g., increased stress hormones) result in two important changes:
- Can lead to flat affect/strange emotions/emotional swings
- Can make memory consolidation and recall difficult
Obtaining sexual consent trends
o Most don’t ask explicitly for sex
o Most common non-verbal behaviours: Kissing, moving closer, and touching
o About half consent to sex by not saying no
o A slight majority prefer for consent to be verbalized, but a significant minority would rather assume it until a partner indicates otherwise
Social attitudes and myths of Sexual Assault
- The way a woman is dressed
- If women are physiologically aroused its assumed they wanted it
- If you consent at the one point its okay to proceed no matter id someone says no
- Cant be raped in a relationship
Effects of Sexual Assault Myths
- Victims will feel like it was something they did and question the reality of the event
- Deny abuser responsibility
- Reduce likelihood of seeking help
Prostitution and why people engage in this work
The consensual sale of sexual activity for money or goods of value
- Money- means for survival
- Necessary outlet for men’s sexual desire
- Better to have other experiences so wife’s don’t have to deal with it
Prostitution vs. Sex work as a name
- Many prostitutes have redefined themselves as sex workers, and “prostitution” as “sex work”
- These terms are coined by the sex workers themselves to redefine commercial sex
- Highlights the economic and labour aspects of the work and need for worker protection
- Prostitution had a negative connotation and make people think about this as a valid job
Street-based sex workers
o Often live lives of sex, violence, disease, and substance abuse
o Many feel powerless to control their own fates
o Many die young from drug abuse, disease, suicide, and physical abuse
Brothel/massage parlour workers
o Occupy a middle position in the hierarchy of sex workers
o Work in established places for prostitution, or prostitution as a second service
Escorts
o Post ads in telephone directories and newspaper personals to attract conventioneers and businessmen
o Sex workers who work for escort services usually come from middle-class backgrounds and are well-educated
Call girls
o Sex workers who arrange their sexual contacts by telephone
o “Call” refers to telephone calls and being on call
o Occupy the highest rung on the social ladder of female sex work
o Most attractive, best educated, charge the most money
o Work on their own (without pimps)
o Serve as companions and sex partners
Prostitution laws in Canada in 2007
o The provision against communication for the purpose of prostitution (consent cannot happen)
o The provision against bawdy houses (brothel, massage parlor, anywhere inside, leads to unsafe conditions)
o The provision against living off the avails of prostitution
o All were considered unconstitutional
Prostitution Laws- Bill C-36
- Purchasing offence: obtaining sexual services for consideration, or communicating in any place for that purpose
- Advertising offence: knowingly advertising an offer to provide sexual services for consideration (you can do it yourself, but no one can do it for you)
- Material benefit offence: receiving a financial or other material benefit obtained by or derived from the commission of the purchasing offence (can’t make money off of someone else selling services)
- This bill targets the buyers instead of the sex workers, sex works are not held criminally liable by selling their own sexual services
- Procuring offence: procuring a person to offer or provide sexual services for consideration
- Communicating offence: communicating for the purpose of offering or providing sexual services for consideration in public places that are or are next to school grounds, playgrounds or daycare centres
What are the issues with Bill C-36
- New laws will make it even harder for sex workers to stay safe
- Going to force prostitution underground – where to find clients
- Prosecution as a deterrent - has not worked in the past will it work now
- Did not address root issues as to why people become involved in sex work
- Views all sex workers as victim’s vs making a free valid choice
- Sex work is not just for sex it is for companionship
What is meant by harm when discussing harm reduction ?
- The term harm reduction implies that sex work/prostitution can cause real harms
- Harms are not an inevitable consequence of sex work
- Harms are psychological, physical, social, legal, economic
- Harms are to individual, family, community, society
- They can be prevented or reduced through a range of strategies
Potential Harms of Sex Work
o Increased risk of HIV/STI’s through unsafe sex
o Lack of ability to negotiate safer sex practices, such as condom use
o Increased drug use
o Stigma and social isolation make them vulnerable to harm (e.g., won’t access medical treatment)
o Experience fear, intimidation, violence, harassment, arrest, or humiliation by law enforcement, and other perpetrators (e.g., pimps)
o Sanctions and penalties
o Trafficking, slavery and debt bondage
Benefits of sex work
- Autonomy
- Control of work
- Positive body image
- Status
- Money
Harm reduction programs for Sex Workers
- Provide exit strategies to support sex workers who wish to leave or were coerced into sex work
- Develop and implement programs to address the root causes which result in unwilling entry
- Develop and evaluate population specific programs for those most at-risk
- Strengthen efforts to prevent and end domestic and international human trafficking
Is prostitution the same thing as addiction
- For the sex worker prostitution is not an addiction
- Client as user and sex worker is beings used
- Critics argue that sec work should be compared to domestic violence, slavery, sexual harassment, torture, incest and rape- not addiction
Why harm reduction for sex work
- Sex work is not going to stop so we need to put laws in place to make it safer
- Abstinence will not work, people will not listen when you tell them not to engage
- Enforcement has its limitations and has not really worked to prevent harm
- People will continue to engage in risky sex work practices and suffer consequences
Harm reduction principles
- Pragmatic (practical), not idealistic
- Hierarchy of goals
- Non-judgmental, non-punitive, non-coercive
- Neither condemns not condones
- Humanistic & human rights based
- Reduce stigma
- Autonomy
- Flexibility
