Module 4 (b) Sexuality And Sexual Health

Question 1

5 P’s of Sexual Health

Answer 1

1. Partners
2. Practices
3. Protection from STDs
4. Past STD Hx
5. Pregnancy plans or prevention

Question 2

Sexuality Definition

Answer 2

1. Wide range of practices, and behaviors, including fantasy, self-stimulation, noncapital pleasuring, erotic stimuli other than touch, ability to identify what is wanted and pleasurable, enthusiastic consent and communication about needs and desires

Question 3

Sexual Health Definition

Answer 3

1. Appreciation that satisfying sexual activity stemming from sexual agency is healthy and contributes to overall well-being

Question 4

Sexual Response in Women

Answer 4

1. Sexual response involves capacity (capable of experiencing) and activity (Actual experience)
2. Physiologic response to sexual stimulation — Vasocongestion and muscle tension
3. Basson’s model is based on theory that women are not motivated toward sexual activity by predominantly physical urges
   —Less linear than traditional sexual response cycle

Question 5

Sexual Health Assessment

Answer 5

1. History is the first step in excellent sexual health care
   - Provide privacy
   - Start w/ easiest material
   - Avoid medical terminology and euphemisms
   - Focus on behaviors, practices, and woman’s perception of her sexual experiences rather than labels about sexual orientation
2. Physical exam is indicated by the history
3. Screen based on practices not based on assumptions (gender/sexual orientation)

Question 6

General Principles LGBTQ

Answer 6

1. Create welcoming, non-threatening environments
   - Physical environment
   - Inclusive intake forms/EMR
   - Confirm name/pronouns each visit
   - Awareness of community resources and referral sources

Question 7

LGBTQ Definitions

Answer 7

1. Anatomic Sex — designation based on chromosomes, hormones, and genitalia
2. Gender identity — person’s understanding of their gender; psychological sense of self
3. Gender expression — Outward gender presentation
4. Attraction — Not attached to gender

Question 8

LGBTQ Health Disparities

Answer 8

1. Mental health — Depression, anxiety, suicide and self-harm — Higher rates in transgender vs lesbian and bisexual/Queer
2. Substance Use — Tobacco use, binge drinking more common in LBQ vs heterosexual
3. Violence & Trauma
4. Vaginal infections/STI — Low screening/knowledge, Low barrier method use
5. Cervical Cancer — Screen based on organs that are presentTEST — Lack of access = Lack of screening
6. Unintended Pregnancy

Question 9

Gender Affirming Care

Answer 9

1. Medically necessary, life-saving care that allows for congruence between gender presentation and gender identity
   - Non-Medical — Social interventions (Drivers license change), Gender presentation
   - Hormones Therapy — Masculinizing or feminizing
   - Procedures — chest/breast, genitals, body