Psych Sexuality Final Exam Flashcards
______ was one of the first companies to get approval for Erectile Dysfunction drug Alista, before Viagra
Vivus
no new sexual problems for women have been discussed in ________.
literature
said they may have drugs for female sexual dysfunction and the market went wild
Vivus
Alista and Viagra were proved to _____ work on women
not
% of women have body issues
80%
skin patch found to boost ______ in women–successful
testosterone
one of the biggest companies in the world; began $100 million marketing before the patch was approved
Proctor and Gamble
Theory: sexual desire is just ______
testosterone
Clinical trials were tested on women who had surgery and had their ____ removed
uterus
patch is estrogen and testosterone patch; not told to public that ____ is included
estrogen
Viagra increases ______, not ______.
blood flow; orgasms
Alista and Viagra
drugs used for erections
occurs in non-human animals, is found in every human society even those with negative feelings about it, and attitudes about same-sex sexuality vary greatly around the world
same-sex sexual behavior
In which era did scientific approaches to understanding sex from a psychological perspective begin
Victorian era
According to Freud, a boy shifts to identifying with his father, taking on the father’s gender role, and acquiring the characteristics expected of men by society, during the ____ stage of psychosexual development?
phallic
A woman with a vaginal infection repeatedly experienced pain during intercourse, leading her to eventually stop having intercourse. This is an example of…
operant conditioning
Critical theories that explain sexual phenomena most likely discuss…
various behaviors and types of people as social constructions.
What is the most common method for measuring sexuality?
Self-reports
Enlargement and concealment are examples of …
purposeful distortion
What is a major advantage of direct observation over self-reports?
it is accurate
It has been used successfully with sexual minorities experiencing work stress from antigay prejudice and microaggressions.
acceptance and commitment therapy (ACT)
Hernando initiates sex with his wife Kiko. Although she is not very interested at first, as they begin kissing and petting each other, she becomes aroused. This pattern of sexual behavior is known as
responsive desire
One of the basic goals of Masters and Johnson’s therapy was to
eliminate goal-oriented sexual behavior.
Some women may only attain an orgasm through masturbation or hand or mouth stimulation by the partner. The notion that this is a disorder can be linked to
sexual scripts/belief there is a right way to have sex
Psychiatrist and sex therapist Helen Singer Kaplan believed that the key to defining the premature ejaculator is the absence of…
voluntary control of orgasm
Distressed married couples and those seeking sex therapy have _________ deficits. Longitudinal study proves that ineffective _________ predicts later relationship problems (likely to break up)
communication
o Criticism: verbally attacking
o Contempt: displays indicating no regard for the person (nonverbal: rolling eyes)
o Defensiveness: “it’s not my fault”
o Withdrawal (stonewalling): refuse to discuss
Poor communication techniques: Gottman’s 4 Horsemen of the Apocalypse
–>relationship satisfaction, sexual satisfaction, high orgasm frequency
positive communication
what you mean
intent
what the other person thinks you mean
impact
impact matches their intent
effective communicator
way of complaining in speaking for yourself, not your partner; focus on own thoughts and feelings; less likely to make your partner defensive; avoids mind reading
“I” language
making certain assumptions about what one is thinking; common among distressed couples
Mind reading
component of giving good messages where you give specific examples of the issue, then can give specific suggestions about what could’ve been done about it
documenting
telling your partner what you are feeling by stating your thoughts clearly, simply, and honestly
leveling
not saying things that would be deliberately hurtful to your partner or would be irrelevant
editing
to make communication clear, clear up expectations, clear up what is pleasant/unpleasant, clear up what is relevant/irrelevant, notice things that draw you closer/push you apart
purposes of leveling
you should ____ mind reading
avoid
Be a _______ listener: focus on what partner is saying/feeling
nondefensive
the goal is to balance ____ and _____
leveling and editing
actively trying to hear and understand what the other is saying
listening
offer a set of acceptable limited choices; make so that “no” is not an acceptable answer (would you want to talk about this today or tomorrow?)
limited choices
“uh huh,” “okay,” nodding head
feedback
repeating in your own words what you think your partner meant, then clear up confusion created with the initial message if it is distorted
paraphrasing
One aspect is self-disclosure: telling personal things about yourself
o Associated with sexual satisfaction
o Stimulates reciprocity
technique of good communication
are better at reading nonverbal cues; more likely to inquire about upsetting situations another is in and use comforting messages; more likely to talk about feelings and relationships; more self-disclosing; use speech to establish relationships; more concerned with the quality of the relationship in which sex occurs
women
more likely to discuss sports, careers, and politics; more likely to interrupt; capable of being self-disclosing when talking to a woman; use speech to exert control, preserve independence and enhance their status
men
Research shows that gender differences are _____, assumes gender differences are the same for all ethnic and social classes
small
the way we say our words; tone of voice, expression on the face, position of the body, whether you touch the other person; emphasis on certain words
nonverbal communication
technique in communication of telling your partner that, given their POV, you can recognize why they think a certain way; try to understand each other’s viewpoint
- Understanding partner’s preferences of sexual tools (foreplay) causes satisfaction
- Causes progress; don’t have to agree with other
Validation
checking out assumption (“am I right about that?”), then following with an open-ended question (“what can we do to make things better?”)
drawing your partner out
communicate positive things about sex; positive reinforcement
- Say when a kiss is good; recognition of strengths can enrich it
- Use frequent verbal and nonverbal feedback
accentuate the positive
In stable marriages, positive: negative ratio for interactions is _:1 or higher
5
Gottman: The Magic Ration
positive communication
- Don’t: have a rigid body saying “let’s get this over with” during sex; do: guide the other’s hand/demonstrate
- Distressed couples differ more from nondistressed in nonverbal communication than verbal
nonverbal communication dos and don’ts
agreed set of rules so the arguments may help and won’t hurt
- Basic rules of ____: don’t be sarcastic/ insulting, don’t bring up names of former lovers, don’t play amateur psychologist (diagnosing partner), don’t threaten to tell your parents/run home, don’t bring children into the argument, don’t dump everything on them at once (stored grievances), don’t hit and run (bring up a serious issue when it’s a bad situation to discuss—having to leave in 5 minutes), and don’t focus on who’s to blame (look for solutions)
fighting fair
We should make sure our message clearly matches our intent and not make assumptions about the meaning of ______ messages
ambiguous
Relationship/marital programs were developed in the
1980s
is not common in society
directness
are effective with all groups: middle-class White, Black, Hispanic, low-income, and LGBTQ couples
Relationship education programs
Problem with verbal/nonverbal sexual communications
often unclear
_____ signals: “I want to have sex now.” ___ signals: dressing nicely
direct; indirect
Better Marriages, Couple Communication, PAIRS (Practical Application of Intimate Relationship Skills), and Prevention and Relationship Education Program (PREP, which is delivered by the U.S. military to military couples)
Relationship/marital programs
_____ relationship education is effective in improving relationship satisfaction and communication skills; found improvements in well-being and reductions in intimate partner violence
couple
Most of these programs are educational (not couple therapy); focus on developing better communication and problem-solving skills with activities for practice; can also focus on info and skills on how to improve a couple’s ability to manage their lives (children/finances)
relationship/marital programs
- Experience of counseling psychologists
- Research comparing distressed and nondistressed couples
What was the finding?
Distressed couples have communication deficits
- Longitudinal research
- Communication of engaged couples measured
o Self-report of negativity in their communication styles
o Videotaped interaction (where they discussed the top problem in their relationship)
o Coded for criticizing, denial, withdrawal
What were the results when following up 5 years later?
Those who divorced had worse communication patterns before marriage (from the self-reports and the videotaped interactions)
o These are rules for good communication in the US and other Western nations
o Different norms in other countries (Japan)
the importance of cultural context
- Women and men are from different linguistic communities
- Implies huge gender differences in communication, great difficulty in cross-gender communication
- The data: gender similarities
- Yes, we can communicate
Tannen, You Just Don’t Understand: Women and Men in Conversation
a dysfunction that develops after a period of normal functioning
aquired sexual disorder
a problem with sexual response that causes a person mental distress (sexual dysfunction)
o Ex: inability to get an erection, inability to orgasm
sexual disorder
one that has been present ever since the person became sexual
lifelong sexual disorder
- desire disorders
- arousal disorders
- orgasmic disorders
- pain disorders
(first 3 correspond to components of the sexual response cycle)
categories of sexual disorders
disorder when individual’s sexual desire is very low and they are not interested in sexual activity
- Characteristics: lack of/sharply reduced interest or a lack of responsive desire
- Common for women: 10-16%, half as many men
- for women over 65, 50%
Hypoactive sexual desire (HSD/Inhibited sexual desire)
one partner wants sex less frequently than the other does, creating conflict
Discrepancy of sexual desire
hypoactive sexual desire (libido) and discrepancy of sexual desire
desire disorders
include female sexual arousal disorder and male erectile disorder (ED)
arousal disorders
DSM’s change of changing hypoactive sexual desire diagnosis into combining female low sexual desire with female arousal disorder
Female sexual interest/arousal disorder
a lack of response to sexual stimulation (lack of lubrication)
o Involves subjective, psychological, and physiological
o 10% of women
o Frequent during and after menopause
Female sexual arousal disorder (FSAD)
inability to have an erection or maintain one
- Man may not engage in sex; can cause depression
- lifelong vs. acquired vs. situational
- Common in 60s
Erectile disorder
frigate, impotence
terms we don’t use anymore
man has never been able to have an erection that is satisfactory for intercourse
Lifelong erectile disorder
man has difficulty getting or maintaining an erection but has erections sufficient for intercourse at other times
Acquired erectile disord
include premature ejaculation, male orgasmic disorder, and female orgasmic disorder
orgasmic disorders
when a man has an orgasm and ejaculates too soon; according to International Society for Sexual Medicine:
o Ejaculation that always occurs before 1 minute of penetration
o Inability to delay ejaculation
o Destress about the problem
o 15% of men
o Many stop having sex and dating
Premature ejaculation (PE)
man is unable to have an orgasm/it is delayed, even though he has a solid erection and stimulation
o Problem can range from occasional problems to never having an orgasm
o Rare—10%
o Intercourse can go on too long—man fakes orgasm
Delayed ejaculation (male orgasmic disorder)
inability to have an orgasm
o Can be lifelong, acquired, or situational
o 20% of women
o Can self-define disorder
Female orgasmic disorder (anorgasmia)
woman has orgasms in some situations but not others (common pattern of female orgasmic disorder)
Situational orgasmic disorder
include painful intercourse and vaginismus
pain disorders
(painful intercourse): genital pain experienced during intercourse; mostly in females
o 8% of women, 2% of men
o About pain, not about sex
dyspareunia
DSM-5-TR merged dyspareunia + vaginismus because they tend to occur together (vaginismus can result in dyspareunia)
Genito-pelvic pain/penetration disorder
spastic contraction of the outer third of the vagina
o Sometimes entrance to vagina is closed and woman can’t have sex
o Not common
Vaginismus
diseases associated with the heart and circulatory system (vascular pathology)
o Diabetes mellitus—circulation problems, peripheral nerve damage, low testosterone levels; ED can be a sign of developing diabetes
o Hypogonadism—under functioning of the testes so testosterone levels are low
o Disease/injury to the spinal cord (location of erection reflex center), severe stress/fatigue, prostate surgery
Erectile disorder causes
physical factors, psychological factors, combined cognitive and physiological factors, and interpersonal factors
causes of sexual disorders
organic factors (diseases/injuries) and drugs
physical causes
mostly psychological
o Local infection like prostatis (physical)
o Genes from monkeys “survival of the fastest”
premature ejaculation causes
erection problems are often caused by
diabetes
mostly psychological, some medical/surgical conditions
o Multiple sclerosis, spinal cord injury, prostate surgery
causes of delayed ejaculation
mostly psychological
o Severe illness, general ill health, extreme fatigue, injury to the spinal cord
causes of female orgasmic disorder
organic factors
o Women: disorders of the vaginal entrance (painful scars), disorders of the vagina (vaginal infections), pelvic disorders (pelvic inflammatory disease)
o Men: poor hygiene (washing foreskin), allergic reaction (creams), prostate problems
o Painful intercourse
causes of painful intercourse and vaginismus
dyspareunia is often caused by
vaginal infection
at low doses increases desire, at high doses decreases erection, arousal, orgasm
Short term pharmacological effects of alcohol
expectation that it will loosen people up, making them more sociable and sexually uninhibited
Expectancy effects of alcohol
have erectile disorder, orgasmic disorder, and loss of desire; negative effects on interpersonal relationships, contributing to sexual disorders
Long-term effects of chronic alcohol abuse
increases sexual desire and makes sexual interactions more pleasurable; smaller amounts enhance sexual desire; larger amounts inhibit sexual functioning; chronic users have decreased sexual desire; concerns that it contributes to risky sexual behavior and may affect testes size and hormones
effects of marijuana
women—increase sexual desire/pleasure; (boosts products of androgens); men—moderate doses increase sexual desire while creating erection problems
Effects of cannabinoids
o Increases sexual desire, sensuality, and delays orgasm
o Chronic use: loss of sexual desire, orgasmic disorders, erectile disorders
o Most negative effects when injected
effects of cocaine
increased sexual desire and arousal
effects of amphetamines
Engage in risky behaviors, lead to paranoia, hallucinations, and violent behavior
effects of crystal methamphetamine
suppress effects on sexual desire and response
o Long-term use of heroine—decreased testosterone levels in males
effects of opiates/narcotics (morphine, heroine)
effect sexual functioning because they alter neurotransmitter levels/ functioning of the central nervous system
o Schizophrenia drugs cause dry orgasm
o Tranquilizers/antidepressants improve sexual responding as they help the person, but SSRIs can cause problems with arousal and delayed orgasm
o Wellbutrin has few sexual side effects
effects of psychiatric drugs
antihistamines reduce vaginal lubrication; antihypertensive drugs can cause erection problems; epilepsy drugs cause erection problems/decreased sexual desire
effects of prescription drugs
immediate causes, prior learning, emotional factors, behavioral or lifestyle factors, and problems with sexual excitation/inhibition
Psychological Causes
various things that happen in the act of lovemaking itself that inhibit the sexual response
Immediate psychological causes
refers to thoughts that distract the person from focusing on the erotic experience
Cognitive interference
anxiety (fear of failure), cognitive interference (problem of attention/spectatoring), failure to communicate (verbally/nonverbally), and ineffective stimulation (simple ignorance cured by education)
Immediate psychological causes
________ experiment: model of sexual dysfunction: how anxiety, positive/negative emotions, and cognitive interference act together to produce sexual disorders—dysfunctionals overthink and take positive stimuli for functionals and make it bad
David Barlow
_____: performance-related distractions; _____: appearance-related distractions
men; women
the things people learned/experienced earlier (childhood, adolescence, adulthood) that now inhibit their sexual response
prior learning
- First sexual act: traumatic (laughed at when no erection, leads to erectile dysfunction)
- Seductive behavior/child abuse by adults can lead to problems with sexual desire, arousal, or aversion
- Growing up in a strict home where sex is bad—want to get sex over with/no enjoyment
- Family punishes child for masturbation—adult can’t orgasm through masturbation
- Teaching double standard—woman’s sexual response in inhibited because she was taught that no nice lady is interested in sex
things people can experience in childhood
child sexual abuse and sex-negative family resulting in a child who grows into an adult with sexual problems is an example of
prior learning
disgust, depression
emoptional factors
Barlow’s model of sexual dysfunction (cognitive-affective model) argues that people with sexual disorders tend to rate ____ on negative affect (anxiety/negative mood) and ____ on positive affect (joy and excitement) in sexual situations
high; low
Smoking, alcohol consumption, and obesity lead to…
higher rates of sexual disorders
By _____ and reducing their body mass index, obese men reduced the incidence of erectile disorder
exercising
the _______________ can be used to maximize effectiveness of therapies for disorders
Sexual excitation-inhibition model
People who are low on sexual excitation, high on sexual inhibition, or both are likely to develop ______
sexual disorders
we function well sexually when we are physiologically aroused and interpret that as sexual arousal (instead of anxiety/nervousness)—people with sexual disorders interpret as anxiety
Cognitive-physiological model of sexual functioning and dysfunction
women who were told they were aroused got more aroused
experiment for Combined Cognitive and Psychological Factors
can lead people away from sex—want surface level relationship like talking about the weather
fear of intimacy
relationship conflict, fear of intimacy
relationship factors
- Progress in a dating relationship to a certain degree of closeness then lose interest
- Can be a result of disappointing intimate relationships with parents in childhood
fear of intimacy
categories of disorders have 3 flaws: treat male sexuality and female sexuality as equivalent, when they differ; ignore the relational context of sexuality and desires for emotional intimacy; ignore differences among women and naturally occurring variations in women’s sexuality.
A New View of Women’s Sexual Problems and Their Causes
- Sexual Problems Due to Sociocultural, Political, or Economic Factors
- Sexual Problems Relating to Partner and Relationship
- Sexual Problems Due to Psychological Factors
- Sexual Problems Due to Medical Factors
A New View new categories of sexual disorders for women
the medicalizing of sex problems (viagra)
Tiefer’s criticism of previous work
Kerrywants to make sure she doesn’t get vaginismus, what should she do to prevent it?
washing and drying her vulva thoroughly when bathing
behavior therapy, cognitive behavior therapy, mindfulness therapy, acceptance and commitment therapy, couple therapy, and biomedical therap
therapies for sexual disorders
developed a behavior therapy model because they saw sexual disorders as learned behaviors rather than symptoms of psychiatric illness: goal was to eliminate a goal-oriented sexual performance (doesn’t lead to failure if don’t achieve)
Masters and Johnson
Drake observes a clear discharge from his urethra and experiences mild discomfort when he urinates. Of the following, Drake is most likely experiencing
Chlamydia
Why should people with herpes be especially careful to use safe sex practices?
Herpes infection increases one’s risk of becoming infected with HIV.
The early stage of human immunodeficiency virus (HIV) infection lasts as long as
the person is feeling well and the T cell count stays around 1,000.
a combination of the behavioral exercises by Masters and Johnson and cognitive therapy; used by many sex therapists
- Use cognitive restructuring (therapist helps client restructure their thought patterns, helping them to become more positive) as a technique
o Therapist challenges client’s negative attitudes (distrusting feelings towards men)
- Address cognitive interference: identify presence of thought, replace with erotic thoughts (out with the bad, in with the good)
- mindfulness therapy
Cognitive Behavior Therapy
system of training people in mindfulness practices; goal is to help people regulate their own negative emotions; effective
Mindfulness Therapy
Increases a women’s focus on their own sensations of arousal, amplifying their subjective sense of arousal and improving their sexual functioning
mindfulness therapy
Online therapy program combining ____ and ______ training was effective (Pursuing Pleasure)
CBT; mindfulness
technique of focusing one’s attention on experiences in the present moment in a calm, nonjudgmental way
Mindfulness
helps clients to learn to stop avoiding and struggling with their challenging emotions and thoughts and instead accept that they are having these feeling; focus on identifying core values
- Uses mindfulness practice
- Used for women wanting a better sexual quality of life, problematic porn use, and sexual minorities experiencing work stress. All were successful.
Acceptancy and Commitment Therapy
assumption that there is a reciprocal relationship between interpersonal conflict and sex problems; relationship is treated with the goal of reducing tensions between the partners; therapists use a combination of cognitive behavior and couple therapy focusing on assessing their sexual scripts
Couple Therapy
- Sexual and performance anxiety reduction (sensate focus exercises); behavior therapy
- Education and cognitive intervention (overcome “all or nothing” thinking); cognitive
- Script assessment and modification (break out of script); cognitive therapy techniques
- Conflict resolution and relationship enhancement; couple therapy
- Relapse prevention training
5-part model in treating men with ED
treatment of premature ejaculation; woman stimulates the man using her hand and stops until the erection goes away, then starts again until erection; man learns that he can an erection and be aroused without having orgasm
Stop-start technique
treatment for women with primary orgasmic disorder; helps orgasms
masturbation
helps women having trouble orgasming; exercise and strengthen the pubococcygeal muscle (entrance of vagina; muscle that stops urine); enhance arousal and facilitate orgasm from awareness of genitals; stimulate partner more by gripping the penis tightly
Kegel exercises
helps women having trouble orgasming; use of a self-help book to treat a disorder; effective for orgasmic disorders in women; effective for couples with a mixture of sexual disorders
Bibliotherapy
widely publicized breakthrough for the treatment of erectile disorder; block an enzyme which relaxes the smooth muscles in the arteries of the corpora cavernosa, allowing blood to flow in and create an erection; produces erection when man is sexually stimulated; lasts a few hours
Viagra
works like Viagra but lasts 24-36 hours
Cialis
work like Viagra; effective in treating ED from removal of prostate
Levitra and Zydena
hypogonadism (testosterone deficiency in men)
testosterone treatment
Pfizer found that ____ does not work for women’s orgasms
Viagra
showed no actual increase in sexual desire in women–unsuccessful; must be taken daily
- FDA rejected in 2010, then approved it in 2015 due to the “pink Viagra campaign”
Flibanserin
Promising approach for women—testosterone(T)+sildenafil(S)=taken for low sexual excitation; testosterone(T)+buspirone(B; anti-anxiety drug)=taken for high sexual inhibition
drug treatments
Helpful for women—_______: treatment of sexual desire problems; changes levels of neurotransmitters in the brain and increases dopamine; inject 45 minutes before sex
- central action
- approved by FDA June 2019
Bremelanotide
treatment for erectile disorders; inject into corpora cavernosa and dilates the blood vessels in the penis; use when Viagra doesn’t work; restores man’s confidence in erection ability and reduces performance anxiety
Intracavernosal Injection
Alprostadil
used instead of needle for intracavernosal injection(cream/place inside urethra)
treatment for erectile disorders; tube with rubber band is placed over the penis, suction is applied to produce erection, which is maintained by the constricting rubber band one the tube is removed.
Suction Devices
- Implanting a penile prothesis; sac of water is implanted in the lower abdomen, connected to 2 inflatable tubes running through the corpora cavernosa with a pump in the scrotum—man can inflate his penis to a full erection
o Damages penis so normal erection is never possible again
The inflatable penis
Semirigid, silicone-like rod is implanted into the penis; less costly than inflatable and lower rate of complications
penile implant
for hypoactive sexual desire (HSDD)
o Testosterone + sildenafil
o Dutch clinical trials in the US published in 2018
o Not yet FDA approved
Lybrido
for HSDD in women taking antidepressants (SSRIs)
o Testosterone + buspirone (short-term serotonin suppression, anti-anxiety
Lybridos
treated with masturbation and sensate focus exercises
Primary orgasmic disorder in women
therapy in sex ed, sexual skills training, communication skills training, body image
Aquired orgasmic dysfunction
treated with progressive vaginal dilators (with Botox injections), relaxation, physical therapy, and Kegel exercises
Viginismus
treated with drugs (antidepressents) combined with CBT
Premature ejaculation
treated with Masters and Johnson therapy and CBT
Hypoactive sexual desire disorder in women
- Some problems can be fixed with psychotherapies instead of drugs
- Szasz says that sex therapy is classifying people who have problems in living and calling them “sick”
o Sex therapists create a lot of illnesses by creating different unnecessary categories
o Thinks these disorders are not scientific
Critiques of theories, causes, effects, and treatment
- Communicate with your partner
- Don’t be a spectator (focus on giving and receiving sexual pleasures)
- Don’t set up goals of sexual performance (you will fail)
- Be choosey about the situations in which you have sex
- “Failures” will occur
good sexual mental health
When choosing a sex therapist, it is important that the person is _____ or ______
licensed; certified
You CANNOT get an STI from oral sex.
False
Birth control protects against pregnancy and STIs
False
Once you’ve had an STI, you CANNOT get it again.
False
Anal sex has a higher risk of spreading STIs than many other types of sexual activity.
True
You CANNOT get an STI if your partner is a virgin.
False
Only promiscuous or “trashy” people get STIs.
False
You CANNOT have two STIs at once.
False
You can get an STI from a toilet seat.
False
Women are more likely to get tested for STIs.
True
Lesbians CANNOT get STIs.
False
If my partner has an STI, I’ll know/see it.
False
How is it spread? Blood, semen, or other body fluids from a person with the virus - even in very small amounts - enters the body of a non-infected person.
How long does it last? Mild illness (a few weeks) but Lifelong or chronic condition.
How serious is it? 15-20% develop chronic liver disease including cirrhosis, liver failure, or liver cancer.
Hepatitis B
_ in _ (__%)sexually active adolescent girls have an STD (affects teens and young adults more)
1;4;20
chlamydia, gonorrhea, syphilis
STIs caused by bacteria
AIDS, HPV, hepatitis B
STIs caused by viruses
STIs caused by bacteria _____ be cured by antibiotics, but STIs caused by viruses _____ be cured but can be treated to reduce symptoms
can; cannot
an infection transmitted through sexual contact with an infected individual
STIs/STDs
Often NO signs or symptomsUNAWARE of infection, and don’t receive treatmentLONG-TERM damagemay have PASSED infection to others
why STIs are a significant health concern
_____% of US adults have an STI at any given time
1/5 (20%)
___ million new infections every year in the US
20
__% of all new STIs occur among young adults between the ages of 15 and 24—commonly HPV, trichomoniasis, and chlamydia for these cases
50
most frequently reported STI in the US with 1.8 million new cases each year
- Spread by vaginal, anal, or oral sex with someone who actively has it
o If partner is male, you can still get if they don’t ejaculate because bacteria may be present in pre-ejaculator fluid
o Infected pregnant women can pass it to their baby during pregnancy/childbirth
Symptoms:
- Female bodied symptoms: 75% asymptomatic, unusual vaginal discharge, burning with urination
- Male-bodied symptoms: 50% asymptomatic, clear discharge from the penis, mild discomfort with urination
Treatment:
- treatable with antibiotics (azithromycin or doxycycline) but does not respond to penicillin
- Without treatment: urethral damage, infection of the epididymis, Reiter’s syndrome, for women: pelvic inflammatory disease that can impact future fertility, baby with eye infection of pneumonia
- Prevention: condoms, regular testing, communication with partners about testing; possible development of a vaccine that prevents infection
Chlamydia
1/8 people 14-49 have–women have higher rates
- Often HSV-1 is lips/mouth, HSV-2 is genitals
- disease of the genital organs caused by the ___ simplex virus (HSV); 2 strains—HSV-1 and HSV-2 (can be caused by either one); transmitted by sexual intercourse and oral-genital sex
- Symptoms: many asymptomatic
- Spread by vaginal, oral, or anal sex or skin-to-skin contact with someone who has it
- Symptoms (“having an outbreak”): one or more blisters on or around the genitals, rectum, or mouth; blisters break and leave painful sores that take 3 weeks to heal but virus lives in the body causing unpredictible periods of sores
- No cure–trying drugs that treat symptoms and vaccinations that prevent; antiviral drugs (acyclovir, valacyclovir) shorten outbreaks and reduce rates of transmission
- For oral: can be treated with medication Valtrex—reduces duration of outbreak
o If taken before the time of infection, can be somewhat preventative and/or reduce possibility of recurrence
- Long-Term Consequences: increased risk of becoming infected with HIV due to open blisters, possible transfer from mother to infant in childbirth
o Some get meningitis, narrowing of the urethra due to scarring
- Psychological Aspects: Coping: there are those who are asymptomatic and unaware living their best lives, and those who experience pain, feel stigmatized, and abstain from sex to avoid affecting others. Makes it worse that outbreaks are unpredictable, and they are always somewhat infectious.
Genital Herpes (HSV-1 and HSV-2)
(“the great imitator”) caused by Treponema pallidum; estimated 35,063 new cases in 2018 in the US
- Less cases but effects are more serious if left untreated—can damage the nervous system or result in death
- Spread by direct contact with a ____ sore (chancre) during vaginal, anal, or oral sex
- More susceptible to HIV
- has 4 stages (chancre in primary)
- Can lead to Congenital ____: fetus is infected when the bacteria crosses the placental barrier; may lead to early death or severe illness; mothers most infectious with primary or secondary-stage but can infect 8 years after initial infection
- Diagnosis: physical exam of genitals and entire body surface; women—pelvic exam, rectal exam if anal intercourse; fluid taken from a chancre and tested for Treponema pallidum; blood tests—VDRL
- Treatment: penicillin not in large doses (unless in later stages) and for those allergic–tetracycline or doxycycline (not for pregnant women)
Syphilis
oldest of sexual diseases; cases raised after penicillin because of the pill (less condom use)
- Spread through vaginal, anal, or oral sex with someone who has the infection.
o Infected pregnant woman can pass it to her baby during childbirth
- Symptoms: men–abnormal penile discharge, burning sensation when urinating, rectal discharge, itching or bleeding, pain/swollen in testicles; women: often asymptomatic, abnormal vaginal discharge, pelvic pain, irregular/painful menstruation, burning while peeing
- nongenital gonorrhea infection: mouth and throat—sore throat; rectal—discharge from the rectum and itching or asymptomatic; eyes—common in infants, swollen and painful with pus, blindness
- Can lead to: sterility/infertility, disseminated infection (rash, fever, arthritis), painful infection tubes attached testicles, pelvic inflammatory disease (PID), long-term abdominal/pelvic pain, ectopic pregnancy scar tissue form in fallopian tubes
- Diagnosis: urine test, throat and rectum swabs; pelvic examination for women may show PID
- Treatment: used to use penicillin but common strains were resistant so started to use antibiotic Cipro, common strains were resistant again so now using an injection of ceftriaxone
Gonorrhea
most common STI in the US with 13 million new cases each year
- Pre-vaccine era: 43% of males 14-59 were infected
- Increases the risk of certain cancers such as cervical cancer and cause genital warts
- More than 40 different types– some low risk (genital warts) and some high (cervical/penil/anal cancer)
- Majority are asymptomatic and go away by themselves withing 2 years
- Diagnosis: DNA test to detect cervical cancers, inspecting the warts (though some are harder to see); no test for high-risk types on the penis/anus yet
- Treatment: chemicals to apply on the warts (podophyllin, bichloroacetic acid), freeze the warts off with cryotherapy, drugs like Podofilox—many cases go away on their own
- Vaccine: 3 shots over a 6 month period and is available to all, protects against 4 types including 16 and 18 (cervical cancer types) and 2 types that cause genital warts. Best to get before sexual activity takes place (approved for women up to 26)–protects against all forms of HPV
HPV (human papillomavirus)
stage with chancre:
men: on penis or scrotum
women: on cervix (unaware she is affected), vaginal walls, or vulva
mouth or rectum: lips, longue, tonsils, around the anus, cuts
Primary stage syphilis
cauliflower-like warts appearing on the genitals, usually around the urethral opening of penis, shaft of penis, scrotum, vulva, walls of vagina, cervix, or anus
Genital warts
3.7 million new cases in 2018 in US
- Spread by parasite passed during vaginal sex but can live on toilet seats
- Symptoms: 70% asymptomatic, abnormal vaginal/penile discharge (white, yellow or green color with foul odor), irritation of urethra, burning urinating and ejaculation, genitals itching, sore, red, burning
- Lower genital tract (vulva, vagina, penis, urethra)
- Long-term consequences: PID, problems with birth, susceptibility/high risk of getting to HIV
- Treatable: metronidazole taken orally
Trichomoniasis
Almost all cases of cervical cancer are linked to
HPV
White American’s common cancer-causing types:
16 and 18
African American’s common cancer-causing types:
33, 35, 45, 58
4-valent vaccine only prevents ___ and ___, but new 9-valent prevents Black’s and Whites
16 and 18
major early symptom of syphilis; a round, ulcerlike lesion with a hard, raised edge resembling a crater; painless; appears at the point where the bacteria entered the body; if untreated, goes away by itself meaning disease has gone underground and will move on to the next stage
- appears usually within 2-6 weeks after exposure but possibly up to 3 months
chancre
stage 4 weeks after chancre heals, body rash that does not itch or hurt forms, hair loss, mucous patches usually in the mouth, vagina, or anus; - Condylomata lata (“fleshy warts”) in anogenital region; disease can still be cured; symptoms disappear, leading to next stage after a few weeks
Secondary-stage syphilis
serious infection of woman’s reproductive organs
- Often from untreated STDs like chlamydia and gonorrhea
- Symptoms: long-term pain in lower abdomen, pain and bleeding during sex, burning while peeing, vaginal discharge with bad odor, bleeding between period, fever, unable to undo damage, fallopian tube scar tissue, ectopic pregnancy infertility
o May have mild or no symptoms
- You are more likely to get PID if you: Have an STD and do not get treated, Have more than one sex partner, Have a sex partner who has sex partners other than you, Have had PID before, Are sexually active and are age 25 or younger, Douche, Use an intrauterine device (IUD) for birth control
Pelvic Inflammatory Disease (PID)
vaginal infection with similar discharge; discharge has a foul odor
Bacterial Vaginosis
½ of people enter stage 10-30 years after infection begins; cardiovascular late ____ (hear and major blood vessels attacked; can lead to death), late benign___, and neuro____ (brain and spinal cord attacked; lead to insanity and paralysis–fatal); gumma: soft gummy tumor
Late syphilis
inflammation of the prostate gland
o Causes: E coli or gonorrhea or chlamydia
o Symptoms: fever, chills, pain around anus and rectum, frequent urination, painful ejaculation
o Can also be chronic and have no symptoms or only lower-back pain
o Treatment: antibiotics
Prostatis
occurs during late stage/at any time
Symptoms: difficulty coordinating muscle movements, paralysis, numbness, blindness, dementia (mental disorder), damage to internal organs, can result in death
Occurs sooner in those who have HIV (can occur in the primary stage)
Neurosyphilis Syphilis
form of vaginitis caused by the yeast fungus _____
o Causes: long-term use of birth control pills, menstruation, diabetes or a prediabetic condition, pregnancy, and long-term use of antibiotics; can be aggravated by intercourse, though not sexually transmitted
o Symptom: thick, white, curd-like vaginal discharge on vaginal lips and walls—causes itching
o Treatment: drugs miconazole or clotrimazole or fluconazole
o If women has while pregnant, can pass it to the child: Thrush (yeast in the baby’s digestive system)
Candida (yeast infection)
stage that may last for years; Treponema pallidum effects the tissues of the body, blood vessels, central nervous system, and bones; no symptoms or infectious in stage; ½ of people stay in stage permanently
Latent syphilis
- Monogamous relationship with an uninfected person, abstain from sex, use condoms
- Washing genitals before intercourse, inspect partner’s genitals, urinating before and after intercourse
- Don’t assume person is uninfected—could be asymptomatic
- It is the person’s ethical responsibility to get diagnosed and treated and tell partners if they have a disease
How to protect yourself
common in women
o Common infections of the sex organs, not sexually transmitted
o Prevent: wash the vulva carefully and dry it, do not use feminine hygiene deodorant sprays, wear cotton underpants, don’t wear pants tight in the crotch, wipe the anus from front to back, do not go from anal to vaginal intercourse
Vaginitis (vaginal inflammation or irritation)
tiny ____ that attach themselves to the base of public hairs and feed on blood from their human host—resemble a crab
- Lay eggs frequently, live for 30 days but die within 24 hours if taken off host
- Transmitted by sexual contact, sheets, towels, sleeping bags, or toilet seats
- Symptoms: fierce itching in the pubic hair
- Diagnosed by finding the ____ or eggs attached to the hairs
- Treatment: drugs Nix and Rid—shampoos and creams (kill the ____)
- Eggs can live up to 6 days
Pubic lice
it is the most common sexual issue reported by women
Lack of interest in sex
40% will be stillborn or die in the hospital
- Transmission can occur during any stage of ______ and during any trimester of pregnancy
- Can cause: prematurity, birth defects, Hutchinson’s teeth, Osteochondritis, developmental delays
Congenital Syphilis
What leads to a decrease in vaginal lubrication?
a decline in estrogen levels
It allows for six gender categories, two of which we would now consider to represent gender fluidity.
Jewish law on gender
allow freedom to individuals, even if society loses some order by their actions.
Pluralists
Why is it important to study the relationship of religion to sexuality?
It helps one to understand the manner in which religion exerts a powerful influence on one’s sexual behavior.
According to the Greek philosophers of the Golden Age, what leads one to achieve wisdom and cultivate virtue?
avoiding all violent passions
In which what way does therapeutic cloning differ from the kind of cloning related to the sheep Dolly?
It has no reproductive component
Women are ____ likely than men to have symptoms of common STDs like chlamydia and gonorrhea
less
Women are ____ likely to confuse symptoms of an STD for something else
more
Women typically see their doctor ____ often than men
more
Women may not see symptoms as easily as men
difference between impacts of STIs on women and men
Pap test screens are for _______; not good for other types of cancers/STDs
cervical cancer
- Lining of vagina is thinner and more delicate that skin on penis so it’s _______ for bacteria and viruses to penetrate
- Vagina is a ___ environment for bacteria to grow
easier; good
STDs can lead to serious health complications and affect a woman’s future ______ plans
reproductive
Untreated STDs can lead to ___, which can result in infertility and ectopic pregnancy
PID
Women who are pregnant can pass ____ to their babies
STDs
Genital herpes, syphilis, and HIV can be passed to
babies
stillbirth, low birth weight (<5 pounds), brain damage, blindness, and deafness
effects of STDs in babies
___ is the most common sexually transmitted infection in women, and is the main cause for cervical cancer
HPV
- place where 1/60 million people infected with HIV: 50% of drug users and 20-45% of prostitutes
- Struck hard because of booming sex tourism and commercial sex industry
- Great demand for prostitutes because it’s good money, cultural beliefs about either being virtuous or a prostitute, all men use them, tourism=more clients
Thailand
the estimated number of new diagnosed or undiagnosed infections
Incidence
Most common STI
HPV
% of Americans are infected with HSV-2 (Herpes)
12%
estimated number of new or existing infections in a given time
Prevalence
- 100 % condom program encouraged everyone to wear condoms and supplied 60 million condoms—only 2% infected by 2000 instead of 10%
- place is having some success with creating a vaccine
Thailand
infections in order from most incidence to least
HPV, Trichomoniasis, Chlamydia, Gonorrhea, HSV-2, Syphilis, HIV, HBV
- Most STIs can’t be passed from a _____ because the bacteria can’t survive for long after leaving the human body (most can’t last more than a few minutes because they dry out and die)
- Trichomoniasis can survive for a long time on ______, but most often transmitted sexually
- Herpes almost always comes from skin-to-skin contact, but if there was fluid from a blister on a cup, toothbrush, or lipstick it can be passed
toilet seat
- Spread by: person ingests infected fecal matter (even small amounts) from contact with contaminated objects, food, drinks
- Lasts: a few weeks to several months
- Seriousness: most recover from mild illness with no lasting liver damage, but death can occur (rare)
Hepatitis A
“inflammation of the liver”
Hepatitis
- Spread: blood from infected person (even small amounts) enters the body of non-infected person
- Lasts: mild illness (few weeks) but lifelong
- Seriousness: 75-85% develop chronic liver disease, 5-20% develop cirrhosis and 1-5% will die
Hepatitis C
- Spread by: blood, semen, or other body fluids from a person with virus (even small amounts) enters the body of a non-infected person
- Lasts: mild illness (few weeks) but lifelong or chronic condition
- Seriousness: 15-20% develop chronic liver disease including cirrhosis, liver failure, or liver cancer
Hepatitis B (HBV)
People believed isolation was the answer at beginningtheory was debunked from boy Ryan White (innocent victim) who got ____ from blood transfusion and was not allowed to stay in school; people told him to die
AIDS
care for people with HIV and AIDS
Ryan White Care Act
Took _ years for president to address the problem of AIDS
5
take a pill once a day, decrease chance of acquiring AIDS
PrEP
found in gay men; ___ causes AIDS; ___ destroys the body’s natural system of immunity to kill diseases so diseases and take over and kill
- Caused 1 million deaths by 2017
HIV
men who have sex with men (66%), heterosexual contact, injection drug use, multiple sources, contaminated blood transfusions. For women, leading cause is heterosexual contact
most to least infected with AIDS
- spread by sexual intercourse, contaminated blood, contaminated hypodermic needles, infected woman to her baby during childbirth
- Likely to get through anal intercourse or great numbers or sexual partners; riskier if partner has HIV, partner is in a high-risk group (gay, drug user), or condoms are not used
- Less likely to get if circumcised
likely:
o By sexual intercourse (penis-in-vagina, anal)
o Through contaminated blood (blood transfusion)
o By contaminated needles in medical or substance use settings
o From an infected pregnant person to their baby during pregnancy/childbirth
HIV/AIDS
- Blood tests to detect: used to screen donated blood, determine if someone is infected
o Most tests detect antibodies but can’t detect until 30 days after infection
o Others detect antigens and antibodies—detect in 18 days because antigens form earlier - Blood tests in the clinic=the most accurate test
Diagnosis of HIV/AIDS
Stage _: initial infection and development of antibodies; need to be tested; stays at stage if the person is feeling well and the T cell count stays around 1,000.
0; HIV/AIDS
Stage _: T cells fall between 200 and 499
2; HIV/AIDS
New cases of HIV/AIDS for women are likely due to
heterosexual contact and injection drug
one of a group of retroviruses: reproduce only in living cells of the host, invade a host cell, cell divides producing copies of the virus with more host cells containing the genetic code
- Goal: find drugs that will prevent the virus from infecting new cells
- invades T-cells (critical to body’s immune response in fighting off infections) so there is little defense against infections
- CCR5 (important coreceptor in early stages of disease) and CCR4 (important in later stages) allow ____ to enter T cells: goal is to block these coreceptors
HIV/AIDS
Stage _: T cell count drops, may have no symptoms or small ones (swollen lymph nodes, fever, diarrhea), immune system slowly declining; T cell count drops but is still over 500
1; HIV/AIDS
_____ women are at risk
trans
Rate of HIV infection in Blacks is _x the rate from White Americans due to poverty and lack of access to medical care; low infection in Asian Americans
9
no cure, but antiviral drugs can control the disease
- AZT
- Protease inhibitors: attack the viral enzyme protease, which HIV needs to make copies of itself
- Darunavir: acts on viruses that are resistant to the protease inhibitors
- ART (drug cocktail of a combination of drugs): make small side effects and can live into 70s, can achieve viral suppression and can’t transmit disease to partner
- Pentamidine: drug that prevents opportunistic infection pneumonia
- Preexposure prophylaxis
Treatment of HIV/AIDS
AIDS is the leading cause of death for _____ women (25-34) and the 5th leading cause for __ women (25-44)
Black; US
AIDs transfer from mother to child has almost been eliminated due to the use of
ART
- _____ do not have programs tailored for them, are not taught to insist condom use, and are not included in clinical trials of drug treatments
- Need education and prevention programs for _____ and _____
Women; Blacks; Latinx
can stop the HIV from multiplying, but can’t repair immune system
AZT
giving an uninfected person antiretrovirals so they don’t become infected; reduces risk
o Good for people in high-risk situations
Preexposure prophylaxis
Stage _: AIDS, T cells fall below 200, vulnerable to opportunistic infections
3; HIV/AIDS
Affects _____ communities more than any other racial or ethnic group
Black
Black male-to-male sexual contact, Latino male-to-male sexual contact, White male-to-male sexual contact, Black women heterosexual contact, Black men heterosexual contact, Latino women heterosexual contact, White women heterosexual contact
Groups commonly affected with HIV/AIDS from greatest to least likely
- 42% of transgender women had ___
o 62% of Black transgender women
o 35% of Latina transgender women
o 17% of White transgender women
HIV stats for trans women
HIV
Human Immune Deficiency Virus
banning partial birth abortion, which is not a recognized medical procedure
strategy used by the pro-life movement
using condoms (80-95% effective against HIV), getting tested (1/5 don’t know they’re infected, knowing can help prevent transmission and development of ___), take PrEP as a preventative measure (new medication that people take to prevent getting infected), and continued treatment of ___ (ART can suppress the amount of virus in the system—non-transmissible)
Prevention and treatment of HIV/AIDS
AIDS
Acquired Immune Deficiency Syndrome
- ___ refers to virus, AIDS refers to most severe stage of HIV infection
- Someone can be HIV positive and not have AIDS; biomedical treatments can cause people to be HIV positive for life but never progress to AIDS
HIV; AIDS; HIV; HIV; AIDS; HIV; AIDS
- Vaccine: many different forms and mutations (hard to direct at all of them)
o Strategies: develop on monkeys, create vaccine to stimulate the body to form resistance to ___, create vaccine to stimulate production of T cells toxic to ___
o Research for ___ vaccine helped develop covid vaccine - Killer T Cells and Chemokines: certain lymphocytes create chemokines (RANTES, MIP-la, MIP-lb) to bind to coreceptor CCR5, blocking ___ from entering cells
- Genetic Resistance: mutation of gene CCR5 creates strong resistance to ___ infection
o Mutation occurred when humans spread out of Africa during bubonic plague or smallpox
o People with 2 copes of the mutation are resistant to infection; people with 1 copy may become infected but show slower disease progression - Microbicides: substances in oil form that kill microbes like ___; put on vagina, anus, penis
o Tenofovir (antiretroviral drug) used vaginally by women reduced infection rates
Progress in research for HIV/AIDS
behaviors (sexual activity, injection drug use) spread HIV; effective interventions: tailor to the group (gay, students), arguments presented to change attitudes, condom use and interpersonal training skills (communication)
Behavioral prevention of HIV/AIDS
Someone is considered to have AIDs 8-10 years after infection; have badly damaged immune systems and may only survive for _ more years
3
- Destroys the body’s natural system of immunity to diseases; once it has damaged the immune system, other diseases can take over and lead to death
- Discovered in 1981, when a physician in LA reported a mysterious and scary new disease in several gay men
- Became a major epidemic in the gay community and some claim it killed off a whole generation of queer people that would be society members today
HIV/AIDS
an outcome of the combined effects of moralism, prudery, and zealousness in American society=the U.S. criminalizes ____ sexual conduct than other developed countries
more
denial of reality, followed by anger, depression
- Social stigma: one with ___ is gay or diseased
- ___ patients need support (support groups)
- Intervention can improve adherence to drug treatment to keep ___ at bay
- Psychotherapy can reduce depression–improved medical outcomes and adhere to ART
- Many have positive psychological growth following diagnosis–higher T cell counts
Psychological effects of HIV/AIDS
Halle and her boyfriend live in Texas. While having sex, they prefer keeping the windows open to reveal the whole act to some of their neighboring apartments. In this scenario, their conduct could be interpreted as
exhibitionism
With respect to legal policies related to commercial sex work, what is an assumption made by Approach 1, the gender inequality approach?
All women who are sex workers are victims of sex trafficking.
An undercover police officer poses as a client and solicits sex from a prostitute. The prostitute is then arrested. This form of discriminatory-arrest practice is called
entrapment
Writings of the _______ recognize 6 genders
Male
Female
Androgynous: someone with both male and female characteristics
Tumtum: someone whose biological gender is unclear
Aylonit: someone who is female at birth but develops male characteristics
Saris: someone who appears male at birth but develops female characteristics
gender categories of Judaism; Talmud
o Insistence on monogamy
o Most other religions permit polygyny (a man having several wives)
o The emphasis on monogamy is a point of frustration for many in today’s culture, but at the time, it could be seen as progressive
o Men were no longer permitted to have wives as possessions
o Jesus opposed divorce, and so men could no longer just divorce their wives when they wanted (women never allowed to initiate divorce)
characteristics of Christianity
someone who appears male at birth but develops female characteristics
Saris; Judaism
- Sex isn’t seen as a biological function but as a deep and intimate part of a relationship between 2 people.
a. Adam and Eve “become one flesh”; “to know” =sexual intercourse; knowledge=the deep intimacy between God and God’s people - In Hebrew scriptures, sexuality could never be separated from its social consequences
a. Sex had to be regulated in Israel tribes to prevent jealousy over sexual partners, which could destroy the group; why Bible includes regulation of sex - Hebrew scriptures see sexual behavior as an aspect of national and religious loyalty
a. Fertility cult
3 themes of Judaism view of sexuality
describe the life and teachings of Jesus—Jesus said nothing about sex
Gospels
o Sex has social consequences for reproduction and populating a community, which matters for maintaining resources
o Rules against adultery (cheating) and incest could be threats to the harmony of the group
o Many such laws across cultures are based in the events of the time that they were created
reasons for hebrew sex laws
someone who is female at birth but develops male characteristics
Aylonit; Judaism
- Was relatively sex-positive within the context of marriage
- Sees sexuality as a gift to be used responsibly and in obedience to God’s will, never as something evil in itself
- Reflected a legalistic approach
Judaism
- Developed from some Judaic practices and belief and frustration with the excesses of Roman life
- Beliefs from the teachings of Jesus, the writings of St. Paul, and the theology of the Fathers of early _____
Christianity
3 themes of Judaism view of sexuality
relationship, social consequences, and national and religious loyalty
- _______ laws: no adultery, no incest, no bestiality, no sex during menstruation,
- _______ scriptures: great regard for married love, affection, and responsible sexuality (doesn’t have to be only for having children)
Hebrew
someone whose biological gender is unclear
Tumtum; Judaism
people who sought to encourage the growth of their crops through their religion
b. Hebrews saw as a threat to their religion and forbid many sexual practices used by Canaanites to be loyal to God: nakedness, cultic prostitution
Fertility cult
ethics based on the assumption that there are no absolute rules, or at least very few and that each situation but be judged individually; based in human experience; focus on relationships rather than rules
Decides matters on a case-by-case basis informed by certain guiding principles (love)
Attractive to people because of the modern scientific worldview
situationism
someone with both male and female characteristics
Androgynous; Judaism
most ___ ____ lie between the 4 extremes of Hedonism, Asceticim, Legalism, and Situationism
ethical systems
_____ scriptures say to marry and procreate, and that sex is good if used responsibly and under God’s will
Hebrew
based in Christianity and has an emphasis on the Bible, but describes itself as a global, inclusive, spiritual community that welcomes all approaches to understanding God
“unity church”
Hebrew scriptures, Old Testament
Traditional Judaism
often provides a set of moral principles that outlines what can be considered right and wrong
religion
comes from Greek word meaning “pleasure” and refers to the belief that the ultimate goal of human life is the pursuit of pleasure, the avoidance of pain, and the fulfillment of physical needs and desires
Hedonism
an approach to life that hold that there is more to life than its material aspects, which must be transcended to achieve true humanity. This approach emphasizes self-discipline and impulse control. It is more likely to see sex as neutral at best and evil at worst.
Asceticism
ethics based on the assumption that there are rules for human conduct (religion) and that morality consists of knowing the rules (right/wrong) and obeying them
Universal laws
Traditional religious ethical systems are usually
Legalism
legalism and situationism
methods of ethical decsion making
- Everyone is influenced by religion, whether you are a believer or not
- In the US, Christianity and Judaism played an important role in shaping our culture
- Most think that sex involves ethical decisions
- It can ask us to examine our own values and what they mean for sexual behavior and choices
why we study ethics and religion in sexuality course
institutions influence sexuality (and religion is one of those institutions)
Sociological approach
a system of moral principles; a way of determining rights and wrong
ethics
Became more dualistic and antisex by the time of the early Christian Church
Judaism
- Sex is understood as a good part of divine creation (in the context of marriage and procreation), but also as a source of temptation that needs to be controlled
- While religion still plays a large role in cultural beliefs about sexuality the cultural shift away from this perspective is due in part to changes in technology and biomedical interventions such as birth control, safe abortion, invitro fertilization where sex for procreation is not essential, etc
- In the past, women had little access to income and resources and were very dependent on men.
o Sex was constrained to marriage in part to ensure that if women became pregnant, there was someone assigned to care for them and the child
Christianity
the notion that body and spirit were opposed to each other, and the goal of life was to become purely spiritual by transcending the physical and material side of life; between 100BCE and 100CE; cults were characterized by
Dualism
positive outlook on sex; has profound interpersonal and spiritual implications (not biological; compared with eating food); advised against marriage and business because he thought the world would end while he was alive; recommended sex for those with strong sexual urges; may have supported same-gender relationships
St. Paul
150CE-600CE: Roman Empire became
Christian
sexuality is for pleasure and secondarily for reproduction, contraception is encouraged, recognize intersex conditions (nonproblematic/discernible and problematic/intractable), recognizes 4 genders
Islam
- Values sexuality very positively, and intercourse in marriage as the highest good of human life
- Polygyny and concubinage allowed, but sex outside of these contexts is seen as a sin
- Striving for worldly pleasures is acceptable
- There is great variety in ways that the law is applied in societies throughout the ____ world
- Contraception is typically encouraged, and even in Iran (which has strict laws around sexuality), has an extensive family planning program—73% of married women use contraceptives
Islam
- 4 possible approaches to life: Kama (pursuit of pleasure), Artha (pursuit of success and material wealth), Dharma (pursuit of the moral life), and Moksha (pursuit of liberation through the denial of the self—nirvana)
- Dharma and Moksha: avoid all passions (sex), seek to pass out of the cycle of continual rebirth, celibacy at the beginning of life and at the end of life; can have family between
Hinduism
teaches that sexual union epitomizes the essential unity of all things by the joining of female energy and male energyleads to spiritual enlightenment
Tantric Buddhism
Traditional teaching by _______: condemned all sexual activity outside of marriage and nonprotective sex (masturbation: moral disorder)
Pope John Paul II
condemned vitro fertilization, surrogate motherhood, artificial insemination, and other reproductive technologies; ethicists criticized the document because they found it too rigid and ill informed
Catholic Church on assisted reproduction
4% of US priests accused of sexually assaulting minors, 81% male victims; hierarchy of the Catholic Church covered up the scandals and continued to assign molesting priests to other churches; views of priests are shifted from holy to being capable of grave sexual sins; people think if priests weren’t required to obey celibacy this wouldn’t happen
Catholic Church sexual abuse by clergy
- Founded by Prophet Muhammad, who lived from 570 to 632 CE in Saudi Arabia. Followers are Muslim, and the sacred scripture is Koran (different interpretations)
- women often have less rights
- Muhammad (founder): sex in marriage is the highest good of human life; introduced the practice of withdrawal
Islam
protestants abandoned celibacy and placed a higher value on marriage and family life, emphasis on the individual conscience in matters like interpretation of the Bible/ethical decision making, gave rise to Puritanism
o Martin Luther (founder of reformation): sex is as necessary as eating/drinking
Protestant Reformation in 16th century
- has typically seen homosexuality as a sin, but there has been a large push to change this perspective in recent times–Catholic thinkers are trying to help the Church rethink its approach to gays
- “The Church and the Homosexual” was published
- December 2023, Pope Francis formally permitted priests to bless same-sex couples. This shifts away from a 2021 ruling by the church that barred these blessings
Catholic Church on LGBTQ
English society held sexual expression in exaggerated disgust, strict standards of decency and purity were enforced; but many ______ had private pornography and prostitution
o ______ repressiveness/hypocrisy caused people of the 20th century to revolt
Puritan/Victorian
- Sex in Western history=good part of divine creation and a temptation that needs to be controlled, marriage/family held in esteem, sex outside of marriage condomed, for procreation, nonprocreative sex=sinful
- Scripture is now seen as meaning different things and technology and behavioral science advances have caused questions about biblical statements (blurry arguments against premarital intercourse); all different religions argue different things
- Roman Catholic Church has experienced the most tension over sexual morality
Current trends in Christianity
insists that values can be found only in human experience in this world, as observed by the philosopher or social scientist; basic goals of human life are self-awareness, avoidance of pain and suffering, the fulfillment of human needs, and individuals must make their own decisions and accept responsibility for them/their consequences
- sexuality view: seeks real intimacy between people and condoms impersonal and exploitative relationships; is tolerant, compassionate, and skeptical of claims of absolute right to wrong
Humanism
prohibits “artificial” contraception because they believe in an inseparable connection between the couple-unification elements and possibility of procreation, but many ignore (only 13% think it is morally wrong)
o Sex is supposed to be a sort if expression of love that comes with the potential of new life
- However, CAN use the rhythm method! Pope Francis (flexible with issue) says that this encourages respect of spouses’ bodies, tenderness between them, and freedom
- Condoms prohibited as birth control, but were allowed to use during AIDS era; now they can be used for disease prevention
Catholic Church on contraception
4 genders: male, female, intersex (khunsa) and effeminate male (mukhannath)
Islam
a highly varied complex of mythology and religious practice founded on the Indian subcontinent; has every approach to sexuality
- Overall positive view of sexuality (especially Kama)
Hinduism
“The Fathers of the Church” (St. Augustine) were celibates and allowed that marriage was good and honorable but thought celibacy (self-denial; abstaining of marriage and sexual relations) to be superior
Christianity
Middle Ages St. _______: sex was intended for procreation so all nonprocreative sex was sinful because it was opposed to human nature and the will of God
o In “Summa”, the sins are: premarital intercourse, nocturnal emissions, seduction, rape, adultery, incest, masturbation, bestiality, homosexuality
St. Thomas Aquinas (1225-1274)
Time when Church forbade intercourse during certain times in a woman’s reproductive cycle, holy days, fast days, Advent, and Lent
o Church regarded sex as evil
Middle Ages
Sharp divisions on the issue of abortion: a large segment is actively/passively against abortion, but a 2019 survey showed that 56% thought abortion should be legal in all or most cases
- Pope Francis reaffirmed opposition to abortion
Catholic Church on Abortion
developed out of Hinduism; little discussion of sex in the teachings
- 2 main traditions: Theravada (strict nonindulgence of the desire that bring joy, morals/discipline) and Mahayana (more active and directed toward love of others)
o Both encourage men to live celibate lives as monks
- The people live ordinary lives and usually marry, the monks cultivate ascetic wisdom
Buddhism
- 85% of Americans believe abortion should be legal
- Roman Catholic Church believes that abortion=contraception
o All life is a gift from God that humans are not permitted to take - Ethical theorists agree with therapeutic abortion (when life/mental health is threatened) over abortion for any reason
Contemporary views on abortion
- Pro-_____: human life begins at conception—supported by Roman Catholics, Orthodox Jews, Eastern Orthodox Christians, and many conservative Protestants
- Pro-______ Catholics: fetus gets human soul at 3 months after conception; if not a person, it can’t be murdered, so first trimester abortion should be allowed
o 48% of US Catholics think abortion should be legal; 47% think should be illegal - are divided on when personhood begins, how various conflicting interests are to be balanced, and how human life is best preserved and enhanced
Pro-life v. pro-choice
- Reduces ethical behavior to follow a series of rules
- Downgrades the goodness of human sexuality and ruins physical pleasure
- Matter of applying universal rules
- Diminishes the full nature of humanity and impoverishes human life
- Pros: always know where they stand, right/wrong and good/bad are clear, show human is more than just the body
Old Morality
Advances in neonatal medicine are pushing back the survival time of premature infants, which may affect acceptability of ____ trimester abortions for some
2nd
regards persons’ sexual orientation as morally neutral but rejects same-gender sexual behaviors
- Gay person can follow God if they remain abstinent; being gay may not be sinful, but homosexual acts are (official position of Roman Catholic)
- Gays were denied use of church facilities; 2020 Pope Francis showed support for civil unions (legal but not religious marriages) of same-sex couples
Position 2—Love the Sinner but Hate the Sin
pregnancy is solely the concern of a woman, and she should have the right to control her own body and determine whether to carry a fetus to term
o Feminism: rules were made by men, who can’t become pregnant
o Individualism: person must be free in all personal decisions
Pro-choice absolute
all children should be wanted, overpopulation, need for more equitable distribution and conservation of natural resources, needs of emerging nations, “responsible use of freedom”
Reasons religious people favor contraception
(most Protestants and Jews): human life is good and should be preserved, but the quality of life is important; there may be situations where it is the least bad choice
o Fetus may have right to life, but might not be wanted/cared for
o In high-risk situations woman’s well-being should take over unborn fetus
Pro-choice modified
- Those who oppose birth control (Roman Catholics, most Jews, and most Protestants) believe it is contrary to the will of God/against natural law.
- Ethicists suggest unmarried people should use birth control
- Pope Paul VI declared birth control as wrong and abstinence in fertile periods (rhythm method) in “Humane Vitae”
o Many Catholics opposed
Contemporary issue of contraception
- Affirms physical and sexual side of humanity
- Broad principles of love, respect, and responsibility
- Doesn’t take human selfishness into account
- Can leave people undisciplined/irresponsible
- Dishonesty about our true motives can blind us to the effects of our actions
- Less certain
New Morality
oppose any sexual acts between people of the same gender and thinks of them as sinner condemned by God; rely on a literal meaning of the Bible
- Same-gender sexuality was common in Christianity in the early Church
- Condemn/reject gays unless they repent and become heterosexual
Position 1—Rejectionism
apparent condemnation in scriptures us not relevant to sexual orientation today; read into what the Bible is saying
- “abomination” does not mean an ethical violation
- Gay groups in medieval Christianity
- Leads Catholics to question if the tradition was understood properly and that sexual relationships with respect, concern, commitment, love are to be valued no matter the genders (revisionist view)
Position 3—Full Acceptance
Rejectionism, love the sinner but hate the sin, full acceptance
Different positions on same-gender sexuality
- Incorporate the need for laws as guidelines for actions, while insisting the guidelines be grounded in the best of current understanding
- Affirm the goodness of human sexuality, while insisting that sexual behavior needs to be responsible
- Differs from Old Morality: stating that ethical principles must be adjusted as technology and society change
- Differs from New Morality: even in human matters, some laws do apply: Life is not a free-for-all, and actions have their consequences
Middle Ground
see the question of public morality as more complex—deny that standards of morality are objective/unchanging and find truth in differing opinions and convictions
o Less likely to appeal to law or religion for the enforcement of their views, more likely to allow freedom to individuals
o New Morality—democratic views
Pluralism
- Episcopal Church, Quakers, Unitarians have shown acceptance for LGBs
- Gays have formed their own churches and organizations: Metropolitan Community Church
- Ordination: some churches allow gays into the ministry, some don’t
- Gay marriage: some churches support, some don’t
o In 2019 same-gender marriage was performed in many churches
Church and same-gender sexuality
sex before marriage
Fornication
Developing medical science of neonatology means that fetuses are viable outside the uterus earlier. Some late-pregnancy abortions produce a fetus that could be kept alive–>hospitals may limit/forbid ____-trimester abortions
2nd
o Approval: allow infertile people to have children with one parent’s genes
o Disapproval: “playing God”, conception may confuse the child, exploiting others in the case of surrogacy, selecting characteristics is unethical
o Can produce many babies by planting many embryos before 9 months; many of these children have disabilities
Views on technologies that enable people to concieve children without sex
Fornication and adultery are held by theological conservatives Jews, Protestants, and Catholics
- Adultery as a sin is not modified, but many ask for a less judgmental, more humane approach: counselor help to find root cause of infidelity
- Pope Francis 2021: declared sex outside marriage is not the most serious sin, causing many ethicists to reopen the question and take less strict positions (contraception, etc)
Sex outside marriage
permits techniques if both egg and sperm come from the couple—otherwise it’s adultery
Orthodox Judaism
all condemned, but they question fertility techniques that remained within the woman’s body using her husband’s sperm (not collected by masturbation)
Roman Catholic
believe that there are defined standards of right and wrong and that a society has the responsibility to insist that all its members conform to them; objective standard of morality as deriving from divine law
o Pro-family position, New Religious Right activists—conservative views
Moralism
technique that substitutes the genetic material from an adult’s cell for the nucleus of the egg
Somatic cell nuclear transfer
Debate of individual sexual freedom is a clash between the ____ Morality and the ___ Morality
New; Old
- Criteria for judging the morality of nonmarital acts: respect, genuine affection and commitment (precautions against unwanted pregnancies/STIs, being sensitive to each other’s needs), and genuine openness and honesty.
- Some think that it’s not about whether unmarried adolescents engage in sex, it’s about sexual violence
Sex outside marriage
child may have a diminished sense of individuality (being identical to mother), might cause eugenics movement where “desirable” individuals are created while others aren’t allowed to reproduce, unknown risksmorally unacceptable to create a human child
reasons why it’s morally unacceptable to clone a child
creating tissues or cells that are genetically identical to those of a patient who needs them to treat diseases; as cloned embryo develops, stem cells can be extracted from it
o Ethicists: may involve the destruction of embryos
Therapeutic cloning
About 10% of men experience sexual disorder which is the opposite of premature ejaculation.
Delayed ejaculation/male orgasmic disorder
The 3 bacterial STIs
Chlamydia, gonorrhea, and syphilis
Rare form of skin cancer is an example of an opportunistic infection that can occur in people with severely compromised immune systems resulting from AIDS.
Kaposi Sarcoma
An approach to ethics, ___ is concerned with following a moral law/set of principles that comes from a source outside the individual (such a religion).
Legalism
An act does not legal harm to anyone or does not provide a demonstratable victim
Victimless Crime
A round, ulcer like lesion with a hard, raised edge, resembling a crater. Although it looks bad, it is painless.
Chancre
An effective form of therapy for many women with primary orgasmic disorder.
Directed masturbation
The word ___ comes from the Greek word meaning “pleasure” and refers to the belief that the ultimate goal of human life is the pursuit of pleasure, the avoidance of pain, and the fulfillment of physical needs and desires.
Hedonism
Term refers to the number of new infections (diagnosed or undiagnosed) of an STI
Incidence
This was made possible by Obergefell v Hodges.
Same-sex marriage
This treatment for erectile disfunction involves an injection of a drug (alprostadil) into the penis.
Intercavernosal injection (ICI)
Tiefer’s New View of women’s sexual problems and their causes proposes 4 new categories of explanations for sexual disorders/problems
Sexual problems due to sociocultural, political, or economic factors; sexual problems relating to partner and relationship; sexual problems due to psychological factors; and sexual problems due to medical factors
Considers sex to be a “sin of the flesh”, believes that true spiritual purity…
Asceticism
4 ways HIV can be transmitted
Sexual intercourse, contaminated blood, contaminated needles, and passing from mother to baby in childbirth/pregnancy
If a pregnancy mother has syphilis, the infection may pass through the placenta to the baby, and the child will get this.
Congenital syphilis
When should Brahmacharya be cultivated by followers of Hinduism?
Both at the beginning and at the end of life
Research has shown that these groups of people are more likely to have laws related to sex work enforced against them.
Women sex workers, people of color, immigrants, and low SES people
These kinds of laws criminalize 2 unmarried people from having sex with one another
Fornication
Term refers to a potential cause of sexual disorders that involves being distracted from the sexual experience and is classified as immediate and psychological.
Cognitive interference
This technique involves substituting the genetic material from an adult’s cell for the nucleus in an egg.
Somatic cell nuclear transfer
The practice of ritual sexual intercourse to encourage the growth of crops.
The Canaanite fertility cult (Baal)
This case said it was unconstitutional to have a law prohibiting being gay, as well as other laws prohibiting consensual sex between adults in the privacy of their own homes
Lawrence v. Texas (2003)
Spectator is a type of____ interference; created by _________
cognitive; Masters and Johnson
This sexual disorder is characterized by genital pain during sex.
Dyspareunia
This approach to reproduction is illegal in some states (IN and MI), legal in some states (CA), while most other states do not have laws on the book for them.
Surrogacy contact
Ch 1-3: this is an issue in sex research and other research where people will play up facts that make themselves look good and downplay facts that make them look bad
Purposeful distortion
Ch 4-6: This hormone is secreted by the hypothalamus and helps to regulate FSH and LH levels in the negative feedback loop
Gonadotropin-Releasing Hormone (GnRH)
Ch 14-16: These are 3 examples of when a victim of rape or sexual assault is incapable of giving consent.
Mentally incapacitated, not sober, or below a certain age
Ch 7-9: this contraceptive is a molded silicone rubber device that…
Diaphragm
Ch 11-13: term refers to one of the 3 primary love styles proposed by Lee, described as a love that develops slowly and remains stable through long separations
Storge
Ch 14-16: this group is most likely to experience rape and other sexual assault.
Bisexual women
Ch 4-6: This is the name of the erectile tissue found in both the penis and the clitoris.
The corpora cavernosa
An example of this would be concealment
Purposeful distortion
Ch 4-6: when an egg implants itself somewhere other than the uterus, it is called this.
Ectopic pregnancy
Ch 7-9: ___ occurs when the muscles contract in the genitals and/or throughout the body.
Myotonia
Ch 11-13: this term refers to variation in one’s sexual identity throughout their lifetime.
Sexual fluidity
Most children who are not educated by their school are taught by _______ and the _____
o The media portrays sexual risk–>little info on contraception
their peers; media
Only 1/3 adolescents report receiving information from their _______ (more condom use)
parents
o Should schools be the place where young people learn about sexuality?
o What should the curriculum look like?
o What are the goals of sex education?
Questions debated about sexual education
High level of public support from ______ for sexuality education in schools (around 90%)
o School education makes it easier to talk to their children about sexual issues
parents
o Teaches students to wait until they are married or adults to have sex
o Learn the basic mechanics of sex, but do not get info on birth control or disease prevention
o Teachers discuss ways for students to say no to sex and avoid temptation
Abstinence-Only Sex Ed
______ is a cornerstone of sexuality education
Morality
comprehensive programs and issues involving school policies/programs as they relate to LGBTQ
current controversial issues about sexuality education
rare, the protestors are usually in a small minority, and the controversy is often not over whether there should be a program but over the use of a particular curriculum, book, or video.
controversy on sexuality education in schools
__________ give parents accurate info and communication techniques to use with their child—effective in sexual communication and condom use, not at delaying sexual activity
o Programs involving parent and adolescent for 10 hours or more
o Adolescent, parent, and health care professional through pediatric offices; parent and adolescent receive 1 training session at clinic and have homework
Reduce condomless sex and UTIs
Interventions
Study: children 5-15 in 4 cultures concluded that American children are _____ ______
o North American children lacked sexual info in comparison to the others
o Swedish children are more knowledgeable that American children because there is sexual education in all their schools starting at 8
sexual illiterates
- Very young: baby always existed; it existed somewhere else before in the mom
- 7 or 8: social relationship between people (love/marriage), sexual intercourse, and the union of sperm and egg
- 12: good explanation of reproduction (embryo, moment of contraception, etc)
Children’s sexual knowledges at different ages
- Child should learn young, starting with simple and progressing to difficult concepts as they get older
- What is taught depends on child’s sexual behavior, sexual knowledge, & sexual interests
What to teach children about sexuality education at different ages
Study: interview of ages 2-6 concluded sexual knowledge evolves during _______ years
preschool
Misconceptions on reproduction result from poor ____ _____ and confusing ____ messages
sex ed; media
Children’s knowledge and interest in sex are reflected in their ______
o _________ reflect an awareness that others are experiencing such growth
- Sexual education curriculum should address the _______ of the age group instead of ______ they haven’t thought of yet
o Should cover reproduction, pregnancy, abortion, birth control options, disease prevention, sexual violence, relationships and gender roles, and values
Questions
abstinence-only programs, HIV/AIDS risk reduction, and comprehensive sexuality education.
Substantial sexual programs
o Teaches students the mechanics of sex and the basics of condoms, birth control, and STIs
o Make sex sound scary
Health and Safety Sex Ed
o Attempts to address health and emotional concerns regarding sex
o Learn about birth control, STI, the basics of sexual negotiation and pleasure, roles of gender, power in sexual relationships, and diverse gender and sexual identities
Comprehensive Sex Ed
States mandate different sex education requirements, so it is essentially up to _____ to determine what they teach (as long as they meet the basic state requirements)
schools
- 1981: Congress passed the Adolescent Family Life Act, which funds ________
o Was an approach for addressing teen pregnancy and negative associated effects
o Had religious undertones and served to fund a variety of religious programs, so the ACLU sued in 1983 to claim this violated separation of church and state (lost)
abstinence-only ed
1996: Welfare reform resulted in $50 million in funding for ______
abstinence-only education
2000: Congress created the Community-based Abstinence Education Program, which granted millions of dollars to groups working towards __________ (many were religious groups)
abstinence-only education
2017: Obama cut ___________ funding from the federal budget and increased funding for comprehensive sex education
abstinence-only education
2018: Trump re-shifted funding back to _______
abstinence-only education
Factual information that affirms young people’s choices are often absent from formal instruction
o __% of young adults say they learned something in sex ed that wasn’t true
20%
o “Men only want to marry virgins.”
o “Oral sex is unhealthy.”
o “IUDs are huge, copper throwing-stars that rip up your uterus.”
- Gender expectations, sexism, and heterosexuality are communicated in these messages
Since increased funding towards _____, fewer teens are learning methods of birth control from formal sex education sources, while more are being taught to say no to sex without any birth control information
abstinence-only sex ed
2007 report from fed gov: researchers evaluated students enrolled in _________ vs. a Control—found that there were no differences in sexual behaviors
Abstinence-Only Programs
Those who only have _______ sex education were just as likely as those who had no sex ed to report a teen pregnancy
Abstinence-Only
Those who had ______ sex education were 2.5x less likely than those who had no sex ed to report a pregnancy
comprehensive
Those who had ______ sex education were 2x less likely than those who had abstinence-only ed to report a teen pregnancy
comprehensive
Those who had _____ and birth control sex education were more likely than those who had abstinence-only or no sex ed to use contraception at first sex
Abstinence-Only
- Young women receive messages that limit their roles as temptress, good girl vs. bad girl, and passive recipients of sex
- ____ promotes lessons on proper clothing and behavior to avoid sexual aggression and victimization by men
- Paints women as in need of protection from men’s persistent and aggressive sexuality
- Portrays men’s sexual desire as constant, difficult to control, and dangerous outside of marriage contexts
- These lessons matter for health outcomes:
o Endorsement of traditional gender norms places adolescents at higher risk of unsafe sex as it affects their ability to negotiate sex
Ex: masculinity norms drive risky sexual behavior in men (avoid condoms)
o Gender inequity places young women at higher risk for gender-based violence, STIs, and unintended pregnancy
Abstinence education
May 2017: only 12 states require that sex education curricula include information about sexual orientation; of those, 3 states (including Texas) require any information about sexual orientations other than heterosexual to be negative
No LGBT Sex Education
programs that promote sexual abstinence as the sole means of preventing pregnancy and exposure to STIS
- 1994 Congress tried to mandate all sexuality education to be ______ but failed
abstinence-only programs
_____ programs that include discussions of gendered sexual dynamics is associated with increased knowledge of sexual and reproductive health, communication
Comprehensive
Sexual minority women do not see themselves as _______ users, feel excluded from conversations about ______ that focuses on heterosexual women, and feel shame/stigma about negotiating and advocating for their sexual health
contraceptive
include content on gender and power in relationships
o Ex: discuss how harmful notions of masculinity/femininity affect behaviors, unequal power, condom use, etc
Comprehensive Sex Ed
- Ineffective: no positive changes in age of first sexual activity, rates of sexual activity, pregnancies, or STIs
- _______ curricula is associated with higher teen pregnancy rates
- American Academy of Pediatrics et al. v. Clovis Unified School District (2015): ruled that use of ________ curriculums violated state laws on medical inaccuracy and bias; showed the power of parental involvement in sex education in the schools
Abstinence-only
_________ educators: more likely to teach more topics, had broader coverage on topics, and more often use of practice-based instruction (involves the student in activities and is more effective)
Professionally prepared (have a major/minor)
programs that provide scientifically accurate, comprehensive information on sexuality, anatomy, contraception, and use of condoms
o Teaches sexuality is a normal/healthy part of life, interpersonal/communication skills, and how to resist social pressures to engage in sex
o Based on social science theories: Health Belief Model, social inoculation theory, and social learning theory (practicing new skillsrehearsal and role-playing)
Comprehensive sexuality education
/ of sexuality education teachers in US received no preservice/in-service training
1/3
Sexual health programs for Latinx adolescents: ____ abstinence, condom use, and sexual knowledge; ______ the number of sex partners
improved; reduced
Many believe that ______ programs do not work, and the millions of dollars being spent on them is a waste of federal, state, and local funds
o Bush continued to request money for them because of “values”
abstinence-only
Abstinence-only programs changed name to ____
sexual risk avoidance programs
- Focused on disease prevention, challenge myths about AIDS/STIs, encourage delay of sex, and support condom use/abstinence from unprotected intercourse; short
- Improve knowledge significantly & cause positive changes in intentions to use condoms
- 98% of US parents believe STDs should be taught about in high school
HIV/AIDS Risk Education
Not ______ programs: positive effects for the prevention of HIV, other STIs, and unintended pregnancies if the program explicitly addressed ‘gender and power’ in relationships
abstinence-only
Sexual minority youth in schools with LGBTQ-inclusive ___ instruction report fewer sexual partners, less frequent recent sex, and less substance use associated with sex than those without ___ instruction
HIV
sexual assault, coercion, children
legitimate sex laws
profession disposition, diversity and equity, content knowledge, legal and professional ethics, planning, implementation, and assessment
o Implementation of these standards as a teacher would result in improvement in the quality of sexuality education in schools and other formal settings
National Teacher Preparation Standards
__% of Americans believe schools should distribute condoms to students
55%
sex by unmarried people or all immoral sexual behavior; results in out-of-wedlock births; prohibited to ensure children have a supportive family
Fornication
Movement for sex-law reform goes hand in hand with the movement for the liberation of
women
______ sex education is rare, and we still have very little research on how it may improve specific health outcomes
LGBTQ-inclusive
_________ opposes condom distribution due to their religion’s ban on contraception, and they believe it will encourage sexual intercourse outside of marriage
o Will promote rampant promiscuity among students
Roman Catholic Church
leading public health and medical professional organizations support a ______ approach to educating young people about sex
comprehensive
US sexual legislation: the American tradition of moralism in politics + the prudery of the Victorian period + the zealousness of “moral entrepreneurs”=opinion that US criminalizes more _____ conduct than other countries with _____ punishments
sexual; harsher
Sex Respect: politically conservative approach, federally funded, targets middle-schoolers, teach that ______ is the only moral and safe approach, condoms fail
o Uses gender-role stereotypes (boys=”sexual aggressors”)
o Teaches skills in resisting peer pressure, but provides false “facts”
abstinence
Education with ______ curricula leads to reduced homophobia, reduced homophobic bullying, and increased allyship across grade levels
LGBT-inclusive
Teachers base sexuality programs on _______ about the prevalence of specific sexual practices and purposes of sexual activity
assumptions
increase condom use and either decrease or have no effect on sexual activity
Condom availability programs
US can’t make sex laws based on _____ (premarital sex, polyamory) because there are so many different views and morals
religion
Bisexual and lesbian women whose sex education involves instruction on how to say no are _____ likely than heterosexual women to report an unwanted pregnancy
more
Sexuality education must reflect/accept the ____ of the participants (ex: recognize own sexual _____, learn about student’s sexual ____, use knowledge to enhance)
cultures
Education that focuses on health matter relevant to _____ youth have lower rates of students with suicide attempts and suicide ideation
LGBTQ
Sexual minority youth in ______ education environments often feel excluded, are told that their behaviors are not normal, and threaten the well-being of the self, family, and community
o Contributes to feelings of social isolation and exclusion that predict worse health outcomes
abstinence-only
___ and ___ education: Let the Circle Be Unbroken: Rites of Passage program: curriculum for blacks that incorporates the family and community context where our sexuality is grounded
Race and Sexuality Education
_____ tailored interventions produce greater effects than interventions that are not ____ tailored (should be a priority)
o Sexual health interventions with Black adolescents: positive effects on abstinence and condom use, no effect on pregnancy or getting an STI
o Sexual health programs for Latinx adolescents: improved abstinence, condom use, and sexual knowledge; reduced the number of sex partners
Culturally
6 characteristics of successful _____ programs: focus on reducing risk-taking behavior, based on theories of social learning, teach through experimental activities that personalize the messages, address media and other social influences that encourage sexual risk-taking behaviors, reinforce clear and appropriate values, and enhance communication skills.
comprehensive
Sexual health interventions with Black adolescents: ____ effects on abstinence and condom use, ___ effects on pregnancy or getting an STI
positive; no
Reasons for _____:
1. legitimacy/safety
2. to preserve the family as the principal unit of the social order (adultery)
3. to ensure children have a supportive family
4. the protection of society’s morals (homosexual acts, bestiality, contraception)
5. religion
6. sexism (regulation of sexual activity=double standard),
Sex laws
Successful: programs that emphasize condom, contraceptives, and abstinence delay sexual initiation, reduce sexual activity, and increase condom/contraceptive use
o Safer Choices: 15% increase in condom use, 11% increase in other contraceptives; prevented 0.12 cases of HIV, 24 cases of chlamydia, 2.8 cases of gonorrhea, 5.9 cases of PID, and 18 pregnancies
o Cost effective: Safer Choices saved $2.65 in medical and social costs for every dollar spent on the program
Comprehensive sexuality programs
must be educated about sexuality and comfortable interacting with learners about sexual topics
- Good listener (understand what a child really wants to know)
Teacher of sexuality education
Rape and sex with childrenseen as crimes of violence and victimization instead of ___ crimes
sex
penetration, no matter how slight, of the vagina or anus with any body part of object, or oral penetration by the sex organ of another person, without the consent of the victim
o Many states have laws criminalizing sexual assault (broader term)
o Rape of a spouse is a crime in all 50 states
rape
harm/threatened harm of physical abuse, neglect, sexual abuse, sexual exploitation, or emotional injury against a child under 18
Child sexual abuse laws
Child sexual abuse laws are covered under ____ laws
state
____ (sexual activity between relatives) laws prohibit sexual relations between children and biological ancestors (some states include step and adoptive parents)
o Most cases involve children and adult relatives
o Seek to prevent genetic problems of inbreeding
Incest
intercourse involving at least one person who is married to someone else
o Is a crime in 21 states
o Is grounds for diverse in almost every state
adultery
Exhibitionism, voyeurism, solicitation, disorderly conduct, being a public nuisance
Crimes against Good Taste
the right to equality and non-discrimination; the right to life, liberty, and security of the person; the right to autonomy and bodily integrity; the right to be free from all forms of violence and coercion; the right to privacy; the right to the highest attainable standard of health, including sexual health with the possibility of pleasurable, satisfying, and safe sexual experiences; the right to enjoy benefits of scientific progress and its application; the right to information; the right to education and to comprehensive sexuality education; the right to enter, form, and dissolve marriage and other similar types of relationships based on equality/full, free consent; the right to decide whether to have children, the number/spacing of children, and the information to do so; the right to the freedom of thought, opinion, and expression; the right to freedom of association/peaceful assembly; the right to participate in public/political life; and the right to access to justice, remedies, and redress.
specific rights for sexuality
(intentional display of sexual body parts) is prohibited in 40 states
o Vague laws, unequal enforcement, punish acts that are offensive to someone—confused with criminal
Some breastfeeding women are arrested
Exhibitionism
Homosexuality, sodomy, and birth control criminalized because considered behavior that interfere with reproduction (Christianity)
o Ban on giving info concerning contraception
o Until 1973: abortion prohibited in all states and contraception prohibited in some
Crimes against Reproduction
some states define as “crimes against nature”/”deviate sexual intercourse”, some states define as “contact between the penis and anus, the mouth and penis, or the mouth and vulva”
o 24 states had laws prohibiting in 1986, but Supreme Court ruled laws are an invasion of privacy in 2003
Sodomy
Illegal to make money from sex in direct form (prostitution) or on paper/electronically (porn); legal to sell products with promises of sexual fulfillment
Criminal Commercial Sex
the exchange of sex for money or other payments (drugs)
o Illegal in all of US, legal in many other countries
o Laws against vagrancy and loitering are also used against prostitutes
o Clients are rarely charged—mostly prostitutes
o Strippers, exotic dancers, camgirls, and sugar daddies/mommies do not count
Prostitution
Texas resident argued that state’s law against abortion denied her a constitutional right; Court agreed and declared that a fetus is not a person; states could not restrict access to 1st trimester abortions
o Invalidated most state laws against abortion
o Limited 2nd and 3rd trimester abortions to reasons of maternal health
Roe v. Wade (1973)
- Porn is not illegal, but ____ is (Roth v. US 1957: ____ is not protected by 1st amendment)
o Roth case reactions: some thought Court had opened the gates to porn, civil libertarians found definition too restrictive
obscenity
arrest of 2 men engaging in sex in their own home; Court invalidated Texas law due to violation of privacy
Lawrence v. Texas (2003)
Current definition of _____ is from Miller v. California (1973): “hard-core porn”—give governments more power to regulate it
o Problem for civil libertarians: hard to predict what a jury may think is _____
o Owners of adult businesses (ACE strip clubs) are fighting back by encouraging people to vote, etc
obscenity
- Bostock v. Clayton (2020): employees of several organizations were fired for being ___/___
o Court ruled that an employer who fires an employee simply for being ___/___ violates the Title VII to mean discrimination on the basis of sexual orientation of gender, including ____ status - ____ could be refused/dismissed from service in the army until “Don’t Ask, Don’t Tell Repeal Act of 2010” which allowed ____ to serve openly in the military
gay/trans
hard to determine without violating 1st Amendment
o In most it is a crime to sell material or present a play/film/performance that is obscene
o Laws have 2 goals: attempt to prevent the corruption of morals by materials that incite sexual thoughts/desires and attempt to ensure that no one will profit by the production/distribution of such materials
Obscenity
Supreme Court Case resulted in gay marriage becoming legal 2015: bundled 4 cases from states that banned same-sex marriage and ruled that the fundamental right to marry was guaranteed to same-sex couples and all 50 states must license gay marriages
o The Equal Protection Clause in the 14th Amendment of the US Constitution
o Issues: no insurance benefits from employers for employee and spouse, in heritance rights (one dies), and children faced discrimination for lack of legal recognition of parents’ marriage
Obergefell et al. v. Hodges
Legalization of prostitution effects in Rhode Island: increased size of prostitution market, decreased prices, decreased gonorrhea by 40% –>legalization results in decreasing spread of ___
STIs
State is more likely to reform its sex laws than repeal them because if practices are “____”, people can get upset and accuse the state of condoning them
legalized
physician was prosecuted for giving married couple information on contraceptives; Court decided that right to privacy was cut when couple was denied access to information
o The right of privacy is not stated in the Bill of Rights, but it is implied
Eisenstadt v. Baird (1972)
o Issues: no insurance benefits from employers for employee and spouse, in heritance rights (one dies), and children faced discrimination for lack of legal recognition of parents’ marriage
Issues of laws against gay marriage
Supreme Court avoided making definitive ruling for accepting gay marriage by ruling on a technicality
Hollingsworth v. Perry (2013)
- Laws are enforced very inconsistently, leading to serious abuses and demands for radical reform of _____ laws and a bad effect on law enforcement
o Offender can lose job, reputation, friends, family, blackmail
o Arrest practices are discriminatory: more likely if sex worker is a woman, POC, immigrant, or poor
o Some police use entrapment to pose as a client to make arrests (no respect for law)
o Knowledge that ____ laws are violated with impunity created disrespect for the law - Enforcement of ____ laws outlaws activities that many people approve of
sex
law to regulate only rape, deviate sexual intercourse by force, corruption/seduction of minors, sexual assault, and indecent exposure
o Idea that private sexual behavior between consenting adults is not the law’s business
o Followed by half the states
Model Penal Code
- The gender inequality approach: assumption that prostitution legitimizes the sexual exploitation of women by men—all women sex workers are victims of sex trafficking, and their work is involuntary (punish the men)
- The social inequality approach: assumption that prostitution is a problem of social inequality among the lines of gender, race, and social class; treat prostitution as a legitimate occupation
a. Sex workers have the same rights as workers—workplace safety
b. Should reduce stigma for sex workers
2 different approaches to legal policy for everyone/sex workers
child porn is not protected by the constitution
o Majority of cases are about possession or distribution of child porn
New York v. Ferber (1982)
the right to privacy, equal protection, victimless crimes, and freedom of speech
Legal principles used to change sex laws
ceasing to define certain acts as criminal or removing penalties attached to them; recommended by Model Penal Code for many kinds of sexual behavior
o Neutral—neither approves nor disapproves
Decriminalization
Another approach to ____: attempt to regulate/eliminate its sale through zoning (Renton, Washington: forbid adult film theaters within 1,000 feet of residential zone, family dwelling, church, park, or school)
o Push stores into lower-income neighborhoods
child porn
bills forbidding the expenditure of any federal money for abortions—expanded to Medicaid and other government insurance programs
o Poor women have been denied means of paying for abortions
o House tried to make permanent legislation of amendment when it passed the No Taxpayer Funding for Abortion Act, but did not go to the Senate
Hyde Amendment (1976)
polygynous family said laws in Utah prohibiting polygamy are unconstitutional; judge declared cohabitation and multiple marriage licenses to the same person constitutional
Brown et al. v. Buhman (2013)
Strategies of ______ movement to eliminate abortions: funding restriction, procedural requirements (parental consent, 3rd-party notification, education, clinical restrictions), the Human Life Amendment, ban on partial birth abortions, disruptive action against abortion providers, and crisis pregnancy centers
o Also made effort to pack Supreme Court with conservative justices who would overturn Roe
pro-life
Alabama law prohibiting distribution of masturbation devices unconstitutional
o Reliable Consultants, Inc v. Ronnie Earl: Texas law prohibiting sale of sexual devices violated 14th amendment
Williams v. Pryor
_____ is controversial because businesses could require proof of age for access to material
o Congress passed Communications Decency Act (illegal to distribute indecent material accessible to children)–>declared unconstitutional because violated 1st amendment
o Congress passed Child Online Protection Act–>ruled unconstitutional in Ashcroft v. American Civil Liberties Union in 2004
Internet
Right to __________ of the law: supported by 14th and 5th amendments
o Supports challenges to laws that discriminate against gays, sex workers, etc
o __________ clause was the main support for the legalization of gay marriage
equal protection
argument that when an act does no legal harm to anyone or doesn’t provide a demonstratable victim, it can’t be defined as a crime
- Most crimes there is no victim
- Less expensive
Victimless Crimes
1985-2005: countries repealed laws regulating adultery and sodomy but expanded rape, sexual assault, and child abuse laws
o Nations are moving away from ____ view of law should protect to _____ view that encourages consensual sexual activity but prohibits harm
institutional; individualistic
clear discrimination against woman because she is usually prosecuted
Prostitution
- _____ is used to prohibit sex offenders from living near main areas—debate on effectiveness (no evidence of success), cause some offenders to be homeless, make police jobs harder
- _____ used for massage parlors—caused the spread of parlors all over the city, many in residential neighborhoods
Zoning
rules crisis pregnancy centers are free to say whatever they want, including false info, and states may not require them to provide accurate info
National Institute of Family and Life Advocates v. Becerra (2018)
not a recognized medical procedure; vague
o Federal ban on ___________ in 2003
o Gonzales v. Carhard et al. (2007): uphold federal banning ___________
partial birth abortions
_____ against abortion providers in the US increased during COVID-19
violence
- Picketing and engaging in acts of civil disobedience outside abortion clinics, Planned Parenthood facilities, and physician’s homes
o Defensive Action and the Army of God: arson and bombing of abortion clinics
o Army of God: published handbook on how to conduct violent protests - Freedom of Access to Clinic Entrances Act (1994)
Disruptive actions in response to abortion
Run by ______ ______ nonprofits; goal is to draw in pregnant women and counsel them against having an abortion using persuasive techniques
o Often give false info: abortion is dangerous to physical/mental health, condoms are ineffective
o Don’t give women information on all their options
conservative Christian
California required any licensed health care facility that provided pregnancy services to post a notice to help women know all about their options
Reproductive FACT Act in 2015
federal crime to use violence/ threat of violence to interfere with access to a reproductive services provider; act declared unconstitutional in 1995
Freedom of Access to Clinic Entrances Act (1994)
Regulations in Title X of the Public Health Act denying funds to organizations (family planning agencies) that make referrals for _____ and granting funds to organizations that oppose _____
abortions
*Mississippi passed that that prohibits abortion after 15 weeks with only exceptions for medical emergency or fetal abnormality (not rape or incest); Court upheld Mississippi law and overturned Roe v. Wadestates can outlaw/pass laws on abortion
- Argument if right to abortion is stated in the constitution (some argue that 13th and 14th amendment guarantee reproductive rights)
- Dissenting judges said women do not have liberty is they don’t have reproductive rights and that other freedoms could be under attack next (contraception, same-sex marriage)
Dobbs v. Jackson Women’s Health Organization
The only _____ stats are for White, Black, and Hispanic women (American Indian and Asian American women= “other”)
abortion
Efforts to require parental consent for a minor and notification of husband for
abortions
between an individual who provides her uterus and the parents raising the child; specify costs of pregnancy
o Regulated by state laws—some criminalize surrogacy, some recognize and enforce contacts, and some have no laws
Surrogacy contracts
Absence of responsible regulation in many states—possible solution: pass the ABA’s ____ ____
Model Act
states could require parental consent for under 18, but don’t have to notify husbands
o 38 states required parental consent
o Caused no impact on pregnancy rates and minors to leave the state for an abortion, but decline in abortion rates of minors
o Upheld Pennsylvania’s Requirement women getting abortions during 3rd trimester to be informed about fetal development (often wrong/biased information)
Planned Parenthood v. Casey (2004)
potentially 5 people who count be parents—egg donor, sperm donor, donor of uterus, and couple intended to raise the child.
o UPA states that a donor is not the parent of a child resulting from ART, person who consents to assisted reproduction with a woman with the intent of being the child’s parent is the parent
o Crucial in determining inheritance rights or costs if child has birth defects
Determination of parentage
Problem: Concerns that _____ may lead to exploitation of low-income women (they need money)
surrogacy
- Require women seeking an abortion be given certain information (consequences)
o Wrong info—abortion is linked to breast cancer - Require a woman to have an ultrasound and view the resulting images
- Require mandatory counseling and waiting period laws
o Impact: increase in out of state abortions and 2nd trimester abortions - Requirement of physicians performing abortions to admit privileges in a nearby hospital
o Claim disputed by many because 1st trimester abortions=safest surgical procedure in US
Procedural requirements for abortions
To avoid future conflict between partners on who gets to make choices about the embryos, couples should use a _____ _____ before creation of the embryos (what will happen to them in the event of divorce, death, unexpected circumstances)
binding agreement
ruled that abortion providers must have admitting privileges at a hospital within 30 miles and clinic had to meet the standards of ambulatory surgical centers including irrelevant equipment (2nd restriction was dismissed because too expensive—Texas abortion clinics declined from 42 to 19)
Whole Woman’s Health v. Hellerstedt (2016)
Debate on if there is a right to _____: if there is, one can’t argue against collaborative conception; if there isn’t, it is reasonable to limit/prohibit the tech
o Ruling: there is no right to procreate, but there is a right to not procreate
reproduce
embryo is a person and shall not intentionally be destroyed, an embryo is a tissue, and (moderate) an embryo is less than a person but more than a tissue and should be treated with the respect due to potential human life
Views on assisted reproductive technologies
- American Indian women living on reservations are denied federal funding and no Indian clinic performs abortions
- Access to abortion commonly requires travel because of the decline in providers
- _____-class _____ _____ have more access
Middle; White women
2 Decisions that chipped away at Roe v. Wade:
1. Webster v. Reproductive Health Services (1989): states could restrict abortion in some ways (forbidding it in state-owned hospitals and banning abortion of viable fetuses)
2. Planned Parenthood v. Casey (1992): restrictions on abortion (parental consent, info, and a waiting period)
- Restrictions have not had a major impact besides on poor women who can’t afford to travel long distances
Roe v. Wade
American Bar association created a ____ ____ (not yet adopted by states)
Embryo transfer, assisted reproduction, payment to donors, etc
Model Act
Only law that regulates industry of assisted reproductive technologies; requires clinics to report their success rates to CDC
Fertility Clinic Success Rate and Certification Act (1992)
would prohibit all abortions; introduced repeatedly in Congress since 1983 but not been brought to a vote
Human life amendment (“Personhood” Amendment)
- ____ __ ____ need more access to information and education sensitive to their cultural heritage
- ____ __ ____ are more likely to have abortions than White women and more likely to have abortions after the 1st trimester
- ____ __ ____ must often spend a while raising funds for an abortion because Medicaid denied them, meaning abortion can be delayed to 2nd trimester
Women of color
Artificial insemination, IVF, surrogate motherhood, and embryo fertilization/transfer are raising ____ questions for infertile people being able to have children
legal
