Human sexuality

Human sexuality
role in society and individual

1. HUMAN SEXUALITY

2. What is Normal Sexuality? … perception of being male or female and all those thoughts, feelings, behaviours, connected with sexual gratification and reproduction, including the attraction of one person to another involves feelings of desire, behavior that brings pleasure to oneself and one’s partner…. Devoid of guilt or anxiety… and not compulsive

3. Human Sexuality Expression of sexual sensation and intimacy between persons Expression of identity through sex Comprises a broad range of behavior and processes

4. Human Sexuality Determined by anatomy, physiology, psychology, culture, relationship with others, and developmental experiences SEXUALITY PERSONALITY PSYCHOSEXUAL

5. Physiological Aspects of Human Sexuality Influenced by hormonal changes during pregnancy/ genetic predisposition Sexual Dysfunction: libido diminution erectile dysfunction

6. Social Aspects of Human Sexuality Governed by rules of behavior and status quo Influenced by social norms and vice versa Example: gender identity

7. Psychological Aspects of Human Sexuality Sexual Identity Gender Identity Orientation Intention Sexual Function Sexual Desire Sexual Arousal Orgasm Sexual Satisfaction

8. Gender Identity Sense of self as masculine or feminine Gender in which a person identifies Gender that other people attribute to the individual on the basis of gender role Is affected by a variety of social structures

9. Gender Identity and Sexual Identity Majority it is congruent Human beings are cisgendered based on their biological sex Gender is social and sex is biological

10. Gender Role Usually related to and derived from gender identity Includes all disclosures of a person as having the status of a man or a woman

11. Sexual Orientation Describes the direction of an individual’s sexuality AKA: sexual preference Markers: Self-labelling Actual sexual behavior Sexual fantasy Erotic arousal pattern

12. Sexual Orientation “dynamic and multi-variable process” Klein, 1985 “The Bisexual Option”

13. Sexual Orientation and Mental Illness Psychiatric disorders were more prevalent among homosexually active people Depression/ anxiety Suicide Substance abuse (alcohol/ smoking) Sense of alienation predisposes them to mental illness

14. Sexual Intention What a person wants to do to his/ her partner during the sexual behavior and what is done to him or her Sexual Desire Interest that a person experiences Drive – biological aspects Motive – psychological aspects Wish – social aspects

15. Sexual Arousal The emotion of sexual excitement based on pelvic vasocongestion and autonomic arousal Orgasm Stimulated by high levels of arousal that results to brief, intense pleasure and release of pelvic congestion

16. Sexual Satisfaction Private judgment that sexual behavior is pleasurable

17. Factors Affecting Sexuality A. Developmental Considerations - sexuality is the only distinguishing trait present at conception - gender, or sex, influences behavior throughout life

18. Stages: Birth – 12 yrs = gender related By 3 yrs . = gender identity - obtain pleasure from touching/fondling genitals - toys are gender related - able to identify own gender

19. Preschooler = increased awareness of body parts - sexuality has been internalized and preference for sexual partners determined - enjoys exploring body parts of self and playmates - engages in masturbation School Aged = gender role behaviors - tendency toward having same-sex friends - increasing self-awareness

20. Adolescence = need information regarding changes; information obtained based on myths - develop opposite-sex relationships - masturbation is common - girls concerned w/reputations and self-image - become “hippy” and w/small waist - boys preoccupied w/competitiveness of sexual activity - increase in testes size and they drop further into place - increased perspirations and vaginal secretions

21. Young / Middle Adulthood = premarital sex is common - may experiment w/various sexual expressions - develop own value system and respects values of others - women are in “childbearing” mode and searching for a mate; become menopausal w/an increased sex drive - men begin graying, having decreased ejaculations and sex drive

22. Older Adulthood = orgasms may become shorter and less intense in both sexes - vaginal secretions decrease and period of resolution in men lengthens - fear loss of sexual abilities

23. B. Culture - every culture has its own norms dictating duration of sexual intercourse, methods of sexual stimulation and sexual positions - some cultures promote childhood sexual play, polygamy/monogamy, and puberty rites including male circumcision - religious beliefs promote beliefs on premarital / extramarital coitus, homosexuality, and decisions on circumcision (male and female)

24. C. Religion - some view organized religion as having a generally negative effect on expression of sexuality - sexual expression other than male-female coitus are considered unnatural by some - concept of virginity came to be synonymous with purity, and sex became synonymous with sin - double standards and rigid regulations exists in many religions - sexual dysfunctions can be related to anguish over negative connotation of sex dictated by religion - many have recognized the importance of sold sex education w/in the realm of church - new interest in spirituality of marriage, supporting the intimate/sexual relationship of married couples - provides guidelines

25. D. Ethics - healthy sexuality depends on freedom from guilt and anxiety - what one views bizarre, perverted or wrong may be natural and right to another - if sexual expression is performed by consenting adults, is not harmful to them and is practiced in privacy, it is not considered a deviant behavior - many accept sexual expression of various forms

26. E. Lifestyle - both men and women are exposed to stress, and many are under considerable strain to perform and function in workplace as well as at home - stressors may be external (job, financial demands) or internal (competitive) - although some couples view sexual activity as a release from stressors of everyday life, most place sex far from the top of the list of things to do - crucial for relationships to set aside priority time - - if not for lovemaking, then for intimate,quiet contact - sexual expressions from heterosexual, homosexual, bisexual, and transsexual

27. F. Health State 1. Chronic Pain 2. diabetes 3. cardiovascular diseases 4. Diseases of Joints and Mobility 5. Surgery and Body Image 6. Spinal Cord Injuries

28. 7. Mental Illness 8. Sexually Transmitted Disease G. Medications - some meds have side effects that affect sexual functioning - some people use illegal drugs because of their reputed ability to heighten sexual experience, but can have serious and even deadly side effects

29. Sexual Dysfunction Men – erectile failure (impotence) = history of diabetes, spinal cord trauma, cardiovascular disease, surgical procedure, alcoholism - use of antihypertensions, antidepressants, or illicit drugs - mental depression that may be present premature ejaculation = pt defines dysfunction and ability to control - causative relationship factors like anxiety, guilt, lack of time, new partner retarded ejaculation = history of neurologic disorders, Parkinson’s disease, certain meds

30. Women – inhibited sexual desire = use of oral contraceptives or hormonal therapy, alcohol or certain meds - history of sexual abuse, rape or incest, depression, or other sexual dysfunctions orgasmic dysfunction = communication pattern between pt and partner - usual sexual pattern and behavior

31. dyspareunia = history of diabetes, hormonal imbalance, vaginal infection, endometriosis, urethritis, cervisitis or rectal lesions - use of antihistamines, alcohol, tranquilizers, or illicit drugs - ability for vaginal lubrication during sex - use of coital positions - use of cosmetic or chemical irritants to genitals

32. vaginismus = pattern of sexual activity (how often, level of arousal, orgasm) - presence of other sexual dysfunctions - history of sexual abuse, trauma or rape - feelings regarding partner - causative factors (fear of pregnancy, anxiety, guilt)

33. The Sexual Response Cycle

34. The sexual response cycle refers to the sequence of physical and emotional changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities, including intercourse and masturbation. Knowing how your body responds during each phase of the cycle can enhance your relationship and help you pinpoint the cause of sexual dysfunction.

35. The Phases of the Sexual Response Cycle

36. Phase 1: Excitement Phase 2: Plateau Phase 3: Orgasmic Phase 4: Resolution

37. Human sexual response cycle

38. Normal Sexual Behavior Sexual response is a true psychophysiological experience There is…. Arousal Experience of tension Orgasm Four phase response cycle in relation to stimulation Phase 1: Desire Phase 2: Excitement Phase 3: Orgasm Phase 4: Resolution

39. Physiologic Changes Associated with the Sexual Response Cycle

40. Phase 1: Excitement The excitement phase (also known as the arousal phase or initial excitement phase ) is the first stage of the human sexual response cycle. It occurs as the result of any erotic physical or mental stimulation , such as kissing , petting , or viewing erotic images , that lead to sexual arousal . During the excitement stage, the body prepares for coitus , or sexual intercourse .

41. Four Phase Response Cycle Phase 1: Desire Motivation, drives, and personality towards the love object Sexual fantasies and desire to have sexual activity

42. Phase 1: Excitement Signs Present in Both Sexes Signs Present In Males Only Signs Present In Females Only Increased muscle tension Moderate increase in heart rate, respiration, and blood pressure Sex flush (less prevalent in men than in women; present in 75% of women) Nipple erection ( 60% of men and most of women) Penile erection Tensing, thickening, and elevation of the scrotum Partial elevation and increase in size of testicles Enlargement of the clitoral glands Vaginal lubrication Widening and lengthening of the vaginal barrel Separation and flattening of the labia majora Reddening of the labia minora and vaginal wall Breast enlargement and enlarge areolae

43. Phase 2: Plateau The period during which sexual tension increases to levels nearing orgasm, may last from 30 seconds to 3 minutes

44. Four Phase Response Cycle Phase 2: Excitement Subjective sense of pleasure from Psychological stimulation (fantasy, presence of the love object) Physiological stimulation (Stroking or kissing) Combination of both Male Female Lasts several minutes to several hours Penile tumescence (increase in diameter/ length) Tightening & lifting of the scrotal sac and elevation of the testes; 50% increase in the size of the testes 2-3 drops of mucoid fluid that contain viable sperm are secreted at the height of excitement Increase in heartbeat and respiration rates Heightened excitement lasts 30 secs to several minutes Lasts several minutes to several hours Vaginal lubrication, nipple erection Clitoral enlargement, thickening of the labia minora Increase in breast size (25%) Vaginal color change to dark purple; vaginal transudate appears 10-30 secs after arousal Labia minora changes color to bright and deep red Increase in the heartbeat and respiration rates Heightened excitement lasts 30 secs to several hours

45. Phase 2: Plateau Signs Present in Both Sexes Signs Present In Males Only Signs Present In Females Only Increased voluntary and involuntary myotonia Abdominal, intercostal , anal, and facial muscle contraction Accelerated heart rate and respiratory rate and blood pressure Sex flush ( appearance in some men late in the phase; spread over the entire body in women) Increased in penile circumference, at the coronal ridge, and deepening in color 50% increase in testicular size, and elevation close to the perineum Appearance of a few drops of mucoid secretions from the bulbourethral glands at tip of penis; may contain sperm Retraction of the clitoris under the hood Appearance of the orgasmic platform, increased in the size of the outer one-third of the vagina and the labia minora Slight increase in width and depth of the inner two-thirds of the vagina Farther reddening of the labia minora Appearance of few drops of mucoid secretion from the Bartholin’s glands to lubricate the inner labia Farther increase in breast size and areolar enlargement

46. Phase 3: Orgasmic This phase is the climax of the sexual response cycle. It is the shortest of the phases and generally lasts only a few seconds.

47. Four Phase Response Cycle Phase 3: Orgasm Peaking of sexual pleasure with subsequent release of sexual tension and rhythmic contraction of the perineal muscles and the pelvic organs Male Female 3-15 seconds Forceful emission of semen (ejaculation) (12-20 inches at age 18, decreasing with age to seepage at 70) 4-5 rhythmic spasms of the prostrate, seminal vesicles, vas, and urethra Loss of voluntary muscle control (facial grimacing; carpopedal spasm) BP up to 40-100 mm systolic, 20-50 mm diastolic HR up to 180 beats per minute Respiration up to 40 respirations a minute 3-15 seconds Breasts may become tremulous Uterine contractions throughout orgasm Contractions of the lower third of the vagina Loss of voluntary muscle control ( carpopedal spasm; facial grimacing) Hyperventilation and tachycardia

48. Phase 3: Orgasmic Signs Present in Both Sexes Signs Present In Males Only Signs Present In Females Only Involuntary spasms of muscle groups throughout the body Diminished sensory awareness Involuntary contraction of the anal sphincter Peak heart rate (110-180bpm), respiratory rate (40/min or greater) Rhythmic, expulsive contractions of the penis at 0.8 seconds interval Emision of seminal fluid into the prostatic urethra Closing of the internal bladder sphincter Orgasm may occur without ejaculation Ejaculation of semen through the penile urethra and expulsion from the urethral meatus . Approximately 5-12 contractions in the orgasmic platform at 0.8 seconds interval Contractions of the muscles of the pelvic floor and uterine muscles Varies pattern of orgasm including minor surges and contractions, multiple orgasms, or a simple intense orgasms similar to that of the male

49. Phase 4: Resolution Occurs after orgasm and allows the muscles to relax, blood pressure to drop and the body to slow down from its excited state.

50. Four Phase Response Cycle Phase 4: Resolution Disgorgement of blood from the genitalia (detumescence) With subjective feelings of well-being, general relaxation and muscle relaxation If it does not occur, may take 2-6 hours associated with irritability and discomfort Women do not have a refractory period

51. Phase 4: Resolution Signs Present in Both Sexes Signs Present In Males Only Signs Present In Females Only Reversal of vasocongestion in 10-30 minutes; disappearance of all signs of myotonia within 5 minutes Genital and breast return to their preexcitement states Sex flush disappears in reverse order of appearance Heart rate, respiratory rate, blood pressure returns to normal Other reactions include sleepiness, relaxation, and emotional outbursts such as crying or laughing A refractory period during which the body will not respond to sexual stimulation; varies, depending on age and other factors, from a few moments to hours or days

52. Masturbation

53. Masturbation Nearly all men and three fourths of all women masturbate sometime during their lives Moral taboos have generated myths that masturbation causes mental illness or a decrease in sexual potency

54. Masturbation Form of release from excessive sexual tension is probably a universal and inevitable aspect of psychosexual development, and in most cases…….. ADAPTIVE Becomes pathologic if it becomes a compulsion

55. Homosexuality What would your reaction be if you found out that your best friend is homosexual? Homosexuality is a disorder…..?

56. Homosexuality Homosexuality is a disorder…..? Not a disorder In 1973, was eliminated as a diagnostic category by the APA In 1980, was removed from the DSM If not a disorder, what?

57. Homosexuality An alternative lifestyle A variant of human sexuality Definition: A person’s overt behavior, sexual orientation, and a sense of personal or social identity. Lesbian or gay men Same sex or male female

58. Homosexuality Prevalence 1948 : 10% of men 5% of women 37% had a homosexual experience 1988 : 2-3% of men 1989 : < 1% of either sex 1993 : 1% exclusively homosexual

59. Expression of Human Sexuality Adolescent age group

60. REVIEW: ERIK ERIKSON’S STAGES OF THE LIFE CYCLE STAGE 5: Identity vs. Role Diffusion 11 years through end of adolescence Struggle to develop ego identity Danger of role confusion, doubts about sexual and vocational identity

61. Some of the expressions of human sexuality in adolescents are the following: Dating Behavior Pre-marital Sex

62. Definition: Dating Behavior DATE- is defined as any activity that involved going out with someone of the opposite sex whether in a group or as a couple Group date Single date

63. Proportions ever Dated Most Filipino youth aged 15-24 years have dated 60% or 3 out of 5 have experienced going out on a date 49% of the teenagers claimed to have gone out on a date

64. Proportions ever Dated Dating either in groups or alone with someone of the opposite sex occurs quite early 10-13 years for only a few youth By the age 15 the propensity to date picks up At 16, more than a third of boys and 2 out of 5 girls date

65. GROUP DATES OR SINGLE DATES 3 out of five-group date Girls more likely to start with group date Boys immediately launched into a single date

66. TIMING OF THE FIRST DATE First date can trigger a series of events that might change the subsequent life of a person During teens, boys date twice as much as girls Age 15, 1/5 of the girls have dated while only 1/10 in boys have dated

67. FIRST SINGLE DATE PARTNER Irrespective of gender, the partner was a classmate or officemate introduced by a friend or a neighbor At the time of the first date: 46% already a boyfriend/girlfriend 28% friend 16% admirer or crush 10% acquaintance

68. DATING WITH A STEADY PARTNER Boys revealed that their partners became their girlfriends after only 3 months Girls report the same after 6 months Favorite dating places: movie houses, restaurants, parks and shopping malls

69. CHAPERONES Traditional role: ensure that no untoward incident happens during a date Nowadays: chosen to assuage and persuade the parents or partner to agree to the date and leaves the couple during the actual date

70. BEHAVIOR DURING first DATES 36% Kissed 3% sexual intercourse *17 % of the girls confided intercourse happened without their consent

71. IN THE SUBSEQUENT DATES the number of those engaging in very intimate behaviors (petting and intercourse) increased dramatically from 15-28%

72. Dating and related events The urban youth have their first crushes at 14 Admiring the opposite sex at 15 Group date at 16 Single dates with BF and GF at 17-18

73. Differentials in dating behavior Those who have had exposure to urban life were prone to date about a quarter more than those who have always remained in the rural setting. Having lived in a dorm, studied in a private school and living away from parents increase tendency to date

74. Determinants of dating behavior Live away from parents Older age Lived in the city Attends private school Fathers are college graduates Less strict parents Unstable marriage of parents

75. Premarital Sex Committed Casual Commercial

76. COMMERCIAL PREMARITAL EXPERIENCE one pays for sexual favors usually with a prostitute Prevalence: 1 in 14 single men 1 in 8 married men

77. CASUAL PREMARITAL SEX Sexual intercourse with acquaintance or friend Most common first sexual experience of boys

78. COMMITTED PREMARITAL SEX Sexual experience before a union is formed Experienced more equally between males and females

79. INITIAL EXPERIENCE WITH PREMARITAL SEX Occurs at 18 years old 18% of today’s youth engage in premarital sex Most popular venue for sexual encounters is the HOME Majority of the youth did not use contraception because they did not expect to have sex at that time In those who practiced contraception, withdrawal and condom were them most commonly used

80. DESPITE THE ACCEPTANCE OF PREMARITAL SEX, VIRGINITY IS STILL GENERALLY VALUED . ZABLAN, 1995: 91.5% CONSIDER VIRGINITY AS AN IMPORTANT VIRTUE

81. Conclusion 49% HAVE GONE OUT ON A DATE DATING OCCURS AS EARLY AS 10 YRS OLD GIRLS MORE LIKELY TO GROUP DATE FIRST FIRST DATE CAN TRIGGER EVENTS THAT MAY CHANGE THE PERSON’S LIFE INITIAL EXPERIENCE WITH PREMARITAL SEX OCCURS AT AGE 18 MOST COMMON FIRST SEXUAL EXPERIENCE WITH BOYS IS CASUAL SEX

82. Conclusion MAJORITY OF THE YOUTH DID NOT USE CONTRACEPTION BECAUSE THEY DID NOT EXPECT TO HAVE SEX AND DESPITE ACCEPTANCE OF SUCH PRACTICES, VIRGINITY IS STILL A HIGHLY REGARDED VIRTUE SEXUALITY is at it’s peak in adolescence as expressed in dating behavior and premarital sex

83. Types of Sexual orientation 1. Heterosexuality -one who finds sexual fulfillment w/a member of opposite gender 2. Homosexuality -a person who finds sexual fulfillment w/ a member of his or her own sex. 3. Bisexuality -people who achieve sexual satisfaction from both heterosexual & homosexual 4. Transexuality -example is sex change operation .

84. Types of sexual expression 1.Celibacy -abstinence from sexual activity 2.Masturbation -self stimulation for erotic pleasure 3.Erotic stimulation -use of visual materials such as magazine or photographs for sexual arousal 4.Fetishism -sexual arousal by use of certain objects or stimulations. 5.Transvestism -individual who dresses to take on the role of opposite sex. 6.Voyeurism -Sexual arousal by looking at others body

85. 7.Sadomasochism -involves inflicting pain(sadism)or receiving pain(masochism)to achieve sexual satisfaction. 8.Exhibitionism -reavealing one’s genitals in public. 9.Phidophiles -interested in sexual encounters with children

86. Disorder of sexual functioning Primary sex dysfunction(life long condition) 1.Erectile Dysfunction -inability to produce an erection enough for vaginal penetration formerly called as impotence.drug of choice is Sildenafil (Viagra) 2.Premature Ejaculation -ejaculation before penile contact. 3.Failure to achieve orgasm -can be due to poor sexual technique or concentration. 4.Vaginismus -involuntary contraction of the muscles at the outlet of vagina when coitus is attempted,prohibits penile penetration usually occurs w/ raped trauma victims 5.Dyspareunia -pain during coitus 6.Inhibiting Sexual Desire -lack of desire for sexual relations.

87. Secondary sexual dysfunction Chronic disease,such as peptic ulcer,or chronic pulmonary disease that cause frequent pain or discomfort may interfere with a man or woman’s overall well being. Obese men and women may have difficulty achieving deep penetration because of bulk in their abdomen

88. Another classification of sexual disorders

89. SEXUAL DISORDER   » These are disorders that are related to human sexuality due to psychological causes

90. » Types: 1. Alteration in gender identity 2. Alteration in sexual orientation 3. Alteration in sexual behavior 4. Alteration in sexual functioning 5. Painful sexual disorders

91.   ALTERATION IN GENDER IDENTITY 1. Transexualism • Persistent discomfort about one’s sex assignment • Caused by confused learning about gender roles • Feeling of being trapped in the wrong body

92. 2. Gender Identity Disorder of Childhood • Persistent and intense distress at one’s sexual identity • Client insist that he/she is an opposite sex • Assertion that he/she will grow up to have transsexual surgery

93. 3. Nontranssexual Cross Gender Disorder • Persistent discomfort about one’s sex but with no preoccupation with getting rid of the genitalia

94. ALTERATION IN SEXUAL ORIENTATION 1. Ego-Dystonic Homosexuality • Weak heterosexual arousal with desire to have heterosexual relationship • Client experience inappropriate homosexual arousal pattern

95.   ALTERATION IN SEXUAL BEHAVIOR 1. Sexual Acting Out - Disturbed conduct or poor impulse control - May create a sexually provocative remarks - Have extramarital affairs and promiscuous - Have high sexual drive - Presence of inadequate coping and interpersonal skills

96. 2. Paraphilias - Sexual urges or fantasies that are directed toward nonhuman objects pain to self, partner, or children, or other non-consenting individuals - This may be asymptomatic - Behavior often followed by guilt, shame. low-esteem, or anxiety - Not due to other mental disorder

97.   Types of Paraphilias: 1. Fetishism - substitution of an inanimate object for the genitals 2. Transvestism - wearing clothes of the opposite sex to achieve sexual pleasure 3. Exhibitionism - sexual pleasure obtained by exposing the genitals 4. Pedophilia - attraction to children as sex objects

98. 5. Voyeurism - sexual gratification obtained by watching the sexual plays of others 6. Frotteurism - sexual obtained by touching or rubbing against a non-consenting person 7. Telephone Scatologia - sexual gratification form during telephone conversation 8. Dendrophilia – sexual gratification in woods

99. ALTERATION IN SEXUAL FUNCTIONING 1. Sexual Dysfunction - individuals is unsatisfied in his sexual function 2. Hypoactive sexual desire- absence of sexual fantasies and desires 3. Sexual aversion - avoidance of genital sexual contact with partner

100. 4. Sexual arousal disorder - failure to attain and maintain erection in males • Lack of lubrication • Persistent or recurrent lack of subjective sense of sexual excitement and pleasure