Sexuality, Sexual Behaviour and Sexual Health Flashcards
Define sexuality
Umbrella term that relates to the private dimension in which people live out their sexual, intimate and/or emotional desires.
Complex and fluid; includes our beliefs, acts, behaviours, desires, relationships and identities.
What is sexuality influenced by?
Historical, social, cultural and political aspects of society and involves relationships with ourselves, those around us, and the society in which we live.
How does the nature vs nurture debate apply to sexuality?
Naturalist approach: sex is biologically determined with minimal influence from societal structures. Traits are fixed and there is no variation.
Nurture approach: sexuality is constructed and influenced by societal structures. Sexuality is seen as giving us potential for choice, change and diversity.
Describe the naturalist (essentialist) perspective of sexuality
Issues relating to sexuality are determined by biology and natural processes, i.e. sexuality is concerned with reproduction.
Uses anatomical differences between males and females to claim there is a biological basis to sexuality.
Heterosexuality = normal expression and identity of sexuality. Assumed to have no cause as it is ‘natural’.
Describe the ‘nurture’ (socially constructed) perspective of sexuality
Sexuality viewed as complex: varied reasons for people engaging in sexual behaviour.
Sexuality is ‘made’: people are experts in their own lives and therefore ‘make’ their identities, including their sexual selves.
Acknowledges biological differences between males and females but recognises that a person’s sexuality is also influenced by societal structures.
Define sexual orientation/identity
What are the most common ‘categories’ and what are these terms used for?
Used to describe the focus of a person’s sexual attractions and desires.
Most common ‘categories’ (used to categorise those into the fixed assumptions about their sexual orientation):
- Heterosexual
- Gay
- Lesbian
- Bisexual
- Transgender
Why is ‘homosexual’ not used often as a term?
Stems from a medical background- implies that same sex attraction is a medical problem and something to be cured.
Has negative connotations.
Define heterosexual
Where people are exclusively, or almost exclusively sexually attracted to people of the opposite sex/gender identity.
Define lesbian
A woman who is primarily sexually attracted to other women
Define Gay
Most often used in relation to men whose primary sexual attraction is to other men
Define bisexual
A person who is sexually and/or emotionally attracted to both the men and women.
Define transgender
Includes those who do not consider themselves to fit into the traditional female/male sex/gender constructs.
Define ‘homophobia’
Why is this now an inappropriate term?
Refers to the intolerance, hatred or fear that people may have of lesbians, gay men and bisexuals.
Outdated term as it assumes that the ‘phobia’ is only part of the individual concerned; ignores the fact that anti-gay prejudice is perpetrated consciously through society’s cultural and structural institutions.
Define ‘internalised homophobia’
The self-loathing that a lesbians, gay men and bisexuals may develop as a response to homophobia.
Define heterosexism/heteronormativity
Refers to a set of assumptions and practices which promote heterosexuality as the norm and only acceptable and viable way to live.
Refers to the fact that heterosexuality is superior and the standard against which other sexual orientations are judged, policed and rendered inferior.
What legislation exists to protect the rights of gay/lesbian/bisexual people?
The 2000 sexual offences ammendment: lowered legal age of consent for gay sex to 16, same as heterosexual sex.
2002 Adoption and Children Act: enabled lesbians and gay men to adopt.
2004 Employment and Equality Act (sexual orientation) Regulations: protects against direct and indirect discrimination, victimisation and harassment in employment.
2004 Civil Partnership Act: enabled lesbians and gay men to have a civil ceremony.
2007 Equality Act (sexual orientation) regulations: prohibits discrimination in providing goods, facilities nd services.
What are the GMC guidelines in terms of personal beliefs regarding sexuality in professional practice?
You must treat patients fairly and with respect whatever their life choices and beliefs.
You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.
The investigations or treatments you provide must be based on the assessment you and the patient make of their needs and priorities, and on your clinical judgement of the effectiveness of the treatment options. You must not refuse or delay treatment because you believe a patient’s actions or lifestyle have contributed to their condition.
You must not unfairly discriminate against patients or colleagues by allowing your personal views to affect your professional relationships or treatment.
What do lesbian, gay and bisexual patients commonly report in terms of medical services?
Low expectations of medical services based on prejudice, stereotyping and invisibility.
What may babies of teenage mothers be more at risk of?
Low birth weight
Premature birth
Death during infancy
What is teenage pregnancy associated with?
Social disadvantage
Poor educational outcome
Lack of aspiration
What are the most common STIs in the UK?
Chlamydia
Gonorrhoea
Hepatitis
Genital warts
Herpes simplex virus
HIV
Non-specific urethritis
Syphilis
Trichomonas vaginalis
What may be responsible for the new decline in HIV diagnoses?
Large increase in HIV testing (including repeat testing of high risk groups)
Improved uptake of anti-retroviral therapy (more undetectable= untransmissable)
Introduction of pre-exposure prophylaxis
Why may STI diagnoses be increasing overall?
Increased sexual activity, particularly amongst younger people.
People are more aware of STIs (less undiagnosed)
Easier access to services (less undiagnosed)
Better diagnostic tests
Artefact (those diagnosed and treated but recurrence)
What do condoms not provide protection for?
Pubic lice
Hepatitis A
What do condoms provide some but not total protection from?
Herpes simplex virus
Human papilloma virus
What do condoms provide high levels of protection against?
Chlamydia
Gonorrhoea
Hepatitis B and C
Syphilis
Trichomonas
For which STIs is there no requirement to inform sexual partners?
Why?
Herpes simples
Genital warts
= no effective treatment or prevention of spread
What are the main reasons for partner notification of an STI?
To offer the partner testing and treatment
To protect the patient from re-infection
To inhibit further spread
What are the main differences between sexual care in primary care units and GUM clinics?
GUM attenders tend to percieve themselves at risk and expect questions about sex, whereas primary care attenders do not.
Testing in GUM clinics can be anonymous, in GP all tests appear in the patient’s notes.
What are the advantages of providing sexual health services in general practice?
People who are asymptomatic may not present to a GUM clinic, GPs offer screening.
The patient may be more likely to discuss their sexual health with someone they know.
GP practices may be more accessible.
STIs can be screened/treated at the same time as providing other care (e.g. cervical smears).
Patients may feel embarassed or uncomfortable about attending a GUM clinic.
How is it recommended that you introduce the subject of sexual health to a patient in general practice?
Ask the patient what they think (particularly with sympatomatic patients)
Make it routine (particularly with the asymptomatic patient)
Introduce the topic of sex by making a statement, e.g ‘given your symptoms we ask all people about their sexual health’
Gain permission to ask about their sex life
Identify 4 circumstances in which a person will have no apparent risk of an STI (therefore doesn’t need testing).
Never had sexual intercourse before.
First sexual relationship for both them and their sexual partner.
Always used a condom, always used it correctly.
No risk (no sex) since last STI screening/treatment.
