Definitions Persons sex is defined by their male and female genitals Persons gender is the psychological experience of ones sex Subjective experience of being male or female is referred as gender identity develops in early childhood ID: 745779
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Slide1
Human Sexuality
Dr Aseni GammampilaSlide2
Definitions
Person’s
sex
is defined by their male and female genitals
Person’s
gender
is the psychological experience of one’s sex
Subjective experience of being male or female is referred as gender identity (develops in early childhood)
Greater difference of emotional and social behavior and little difference in cognition among males and femalesSlide3
Definitions of Sexual Orientation
Sexual orientation: to which sex a person is attracted
Homosexual orientation: primary erotic psychological emotional and social orientation is to same sex
Gay males
Lesbian females
Bisexual orientation: attraction to both same & opposite sex partners
More women than men are bisexualSlide4
Definitions of Sexual Orientation
Heterosexual orientation: attraction to opposite sex partner
Asexuality: feeling no sexual attraction to either sex
Asexual people lack sexual attraction to others, but still have desire for friendships, affection, and partnerships
Some asexual people masturbate, but feel no interest in sexual activity with a partner Slide5
Human Sexual ResponsesSlide6
Four Stages of Human Sexual Response Cycle
the excitement phase
the plateau phase
the orgasmic phase
the resolution phaseSlide7
Sexual Response CycleSlide8Slide9Slide10
Sexual Dysfunctions
Abnormality in individual sexual responsiveness
Lifelong or acquired
Generalized or situational
Causes
Physical conditions
Psychological conditions
Substance abuse
Medication
TraumaSlide11Slide12
Types of Sexual Dysfunctions
Hypoactive Sexual Desire
Sexual Aversion Disorder
Female Sexual Arousal Disorder
Male Erectile Disorder
Female Orgasmic Disorder
Male Orgasmic Disorder
Premature Ejaculation
Sexual Pain DisorderSlide13
Hypoactive Sexual Desire Disorder
Individual has an abnormally low level of interest in sexual activity
Causes
Psychological issues
Poor body image
Poor self-esteem
Interpersonal hostility
Relationship issuesSlide14
Sexual Aversion Disorder
Active dislike and avoidance of genital contact with a sexual partner possibly due to disgust, fear, revulsion .
Causes:
Severely negative parental sex attitudes
Pressure by the partner to perform sexual activities
History of sexual trauma
Confusion of gender identitySlide15
Female
Sexual Arousal Disorders
Persistent, recurrent inability to attain or maintain lubricationSlide16
Male Erectile Disorder
Impotence
Recurrent inability to attain or maintain erection till end of activity
May be secondary to alcohol, diabetesSlide17
Orgasmic Disorder
Female
no orgasm despite adequate stimulation
Male
no orgasm with partner, only masturbationSlide18
Premature Ejaculation
Man reaches orgasm long before he wishes to
Sometimes even prior to penetrationSlide19
Sexual Pain Disorders
Dyspareunia
recurrent or persistent genital pain before, during, or after intercourse.
can be from vaginal dryness, antihistamines, injury or irritation
Vaginismus
recurrent or persistent involuntary spasms of the outer third of vaginal muscles
feeling of ripping, burning, or tearingSlide20
Sexually Transmitted DiseasesSlide21Slide22
Chlamydia
Common STD (especially among the young)
Caused by a bacterium -
Chlamydia trachomatis
Infect both men and women
Cause serious, permanent damage to female reproductive organs
Can also spread via the mixing of infected maternal serum with the foetusSlide23
Symptoms of Chlamydia
‘Silent’ infection - most infected people have no symptoms.
Symptoms may occur several weeks after exposure.
Chlamydia can damage a woman’s reproductive organs (asymptomatic)
Infect the cervix and/or the urethra
May have an abnormal vaginal discharge or dysuria. Slide24
Symptoms of Chlamydia
Untreated infections can spread upward to the uterus and fallopian tubes causing pelvic inflammatory disease (PID).
PID can be silent, or cause symptoms (abdominal and pelvic pain)
PID it can lead to infertility and ectopic pregnancySlide25
Symptoms of Chlamydia
Infected men
Have discharge from their penis and
dysuria
Epididymitis
may occur (rare)
Infertility
Chlamydia can also infect the rectum in men and women causing
proctitis
Infected pregnant women
Conjunctivitis or pneumonia in the new bornSlide26
Testing
Annual chlamydia testing
all sexually active women age 25 or younger
older women with risk factors for chlamydial infections (e.g., women who have a new or more than one sex partner)
all pregnant women
men who have sex with men (MSM) who have receptive anal sex should be tested for chlamydia
Sample: cotton swab of the vagina or a urine sampleSlide27
Treatment for Chlamydia
Antibiotics (abstain from sex for seven days after single dose antibiotics, or until completion of a seven-day course of antibiotics, to prevent spreading the infection to partners)
Repeat infection with chlamydia is common
Persons whose sex partners have not been appropriately treated are at high risk for re-infection. Slide28
Prevention
Condom use
Abstinence
MonogamySlide29
Gonorrhea
Caused by a bacterium-
neisseria
gonorrhoeae
or gonococcus
Grow easily in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes and in the urethra.
Bacterium can also grow in the mouth, throat, eyes, and anus.
Can also spread via the mixing of infected maternal serum with the
foetus
Highest rates of infection are among sexually active teenagers and young adultsSlide30
Symptoms of Gonorrhea
Men
may be asymptomatic
common symptoms
dysuria
white, yellow, or green discharge from the penis - usually appears 1 to 14 days after infection
epidydimitisSlide31
Symptoms of Gonorrhea
Women
Most are asymptomatic
If symptomatic
Dysuria
vaginal discharge
vaginal bleeding Slide32
Symptoms of Gonorrhea
Symptoms of rectal infection
discharge
anal itching
soreness
bleeding
painful bowel movements.
Infections in the throat may cause a sore throatSlide33
Symptoms of Gonorrhea
Untreated gonorrhea can cause PID
PID can lead to
internal abscesses
chronic pelvic pain
damage the fallopian tubes causing infertility or ectopic pregnancies
If untreated, gonorrhea infect blood or joints leading to life-threatening conditions Slide34
Diagnosis and Treatment
Testing : a urine test or swab
Treatment
Antibiotics
Drug resistant gonorrhea –if symptoms continue despite treatment
Treat patient and partners
Abstain from sexual activities until treatment in completeSlide35
Genital Herpes
Caused by the herpes simplex viruses type 1 (HSV-1) or type 2 (HSV-2).
Transmission more likely from an infected male to his female partner
Asymptomatic or have very mild symptoms Slide36
Symptoms of Genital Herpes
One or more blisters on or around the genitals, rectum or mouth.
Painful sores that may take two to four weeks to heal
May also experience flu-like symptoms such
Outbreaks are more common in the first year, gradually decreasing over timeSlide37
Maternal Infection
Maternal infection can lead to miscarriage or premature birth.
Neonatal herpes can be fatal - avoid contracting herpes during pregnancy
A woman with genital herpes may be offered antiviral medication from 36 weeks gestation through delivery to reduce the risk of an outbreak.
Cesarean delivery is usually performedSlide38
Diagnosis and Treatment
Testing:
swabs from sores
blood test
Treatment
Antiviral medications
Prevention
latex condom
abstain from sexual contact
monogamySlide39
Human Immunodeficiency Virus- HIV
Presence of other STDs increases the likelihood of both transmitting and acquiring HIV
Increased susceptibility.
Genital ulcers (syphilis,herpes) result in breaks in the genital tract mucosa creating a portal of entry for HIV
STDs increase the concentration of cells in genital secretions that can serve as targets for HIV (e.g., CD4+ cells).Slide40
Human Immunodeficiency Virus- HIV
Increased infectiousness.
HIV and STD infected people are likely to shed more HIV virus in their genital secretions
The median concentration of HIV in semen is as much as 10 times higher in men who are infected with both gonorrhea and HIV than in men infected only with HIV.
STD treatment reduces an individual's susceptibility and ability to transmit HIVSlide41
Symptoms of HIV
First signs of HIV infection appear 1-2months after infection
swollen glands
flu-like symptoms.
Severe symptoms appear months or years later
AIDS is the final stage of HIV infection- body cannot fight life-threatening infections
No cure for HIV
Treatments help people with the virus to live a long and healthy lifeSlide42
Modes of Transmission
Unprotected sex
Sharing infected needles and other injecting equipment to inject drugs
Maternal
foetal
transfer (umbilicus and at birth)
Breast milk
Other body fluids (not saliva)Slide43
Mechanism
Attacks the immune system
Weakens ability to fight infections and diseaseSlide44
Treatment
It takes several weeks after infection for testing to be positive, retest a few weeks later
Post-exposure prophylaxis (PEP)
may stop you becoming infected
treatment must be started within three days of coming into contact with the virus.
Antiretrovirals
slow down the damage the virus does to the immune system
minimise the risk of getting serious illnesses Slide45
Genital Human
Papillomavirus
- HPV
Most common sexually transmitted infection
Infect the genital areas, the mouth and throat
Can cause genital warts and cancers
Nearly all sexually-active men and women get it at some point in their lives (even in monogamy)
A large number of HPV virus strains, but can only be infected with one strain
90% recover without any medication within 2yearsSlide46
Symptoms
Infected person may be asymptomtomatic
Persistent HPV infection cause
Genital warts
Recurrent respiratory papillomatosis (rare) - warts grow in the throat- may cause respiratory distress
Cervical cancer (screening is done)
Other, less common genital cancers (cancer of the vulva, vagina, penis, or anus), and oropharyngeal cancer Slide47
Treatment
HPV vaccines are recommended for 11- or 12-year-old boys and girls Slide48
Syphilis
Caused by a bacterium - treponema pallidum
Cause long-term complications and/or death if not adequately treated
Transmission
direct contact with syphilis sores
transmitted during vaginal, anal, or oral sexual contact
maternal - foetalSlide49
Symptoms
Appearance of the first symptom is 21 days after infection
primary syphilis soreSlide50
Primary Stage
The appearance of a single sore, but there may be multiple sores.
The sore appears at the location where syphilis entered the body
The sore is usually firm, round, and painless
Sore heals within 3 to 6 weeks regardless of treatment
Untreated will progress to secondary stage Slide51
Secondary Stage
Skin rashes and/or sores in the mouth, vagina, or anus (mucous membrane lesions )
starts with a rash on one or more areas of the body .
Rashes appear from the time when the primary sore is healing to several weeks after the sore has healed.
Symptoms
Rash
No itching
rough, red, or reddish brown spots both on the palms of the hands and/or soles
Large, raised, gray or white lesions may develop in warm, moist areas Slide52
Secondary Stage
Other symptoms of secondary syphilis include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue
Symptoms disappear regardless of treatment
Untreated will progress to the latent stage Slide53
Late and Latent Stages
This stage begins when primary and secondary symptoms disappear
Can be asymptomatic
Latent stage can last for years (can appear 10–30 years after infection began)Slide54
Symptoms
Difficulty coordinating muscle movements
Paralysis
Numbness
Gradual blindness
Dementia
Damage brain, nerves, eyes, heart, blood vessels, liver, bones, and joints
DeathSlide55
Maternal Syphilis
Pregnant women should be tested for syphilis and receive immediate treatment, if positive
Foetus with syphilis can have many health problems (low birth weight, premature delivery or stillbirth)
Untreated babies can have many health problems (such as cataracts, deafness, or seizures), and death Slide56
Testing of Syphilis
Pregnant women
Men who have sex with men
Have HIV infection
Have partner(s) who have tested positive for syphilis
Methods of testing
Detected with a blood test (syphilis antibodies)
A person with syphilis sores is 2 to 5 times more likely to contract HIV Slide57
Treatment and Prevention
Antibiotic treatment prevent further damage (penicillin injections)
Treatment will not repair current damage
Abstain from sexual contact until the syphilis sores are completely healed
Can be
re
-infected despite successful treatment
The primary and secondary stages are most infectiousSlide58
Trichomoniasis
Infection with a protozoan parasite -
trichomonas vaginalis
The most common curable STD
Infection is more common in women than in men (older women more likely than younger women) Slide59
Symptoms
women-lower genital tract (vulva, vagina, or urethra)
itching, burning, redness or soreness of the genitals
discomfort with urination
thin discharge with an unusual smell that can be clear, white, yellowish, or greenishSlide60
Symptoms
men- urethra
feel itching or irritation inside the penis
burning after urination or ejaculation
discharge from the penisSlide61
Trichomoniasis
Majority asymptomatic
Maternal infection: Preterm babies and low birth weight babies
Single dose antibiotic (metronidazole or tinidazole)
Can be re-infected in 3 months (all sex partners should be treated)Slide62
Paraphilia
para
= abnormal
philia
= attractionSlide63Slide64
Paraphilias
Recurrent, intense sexually arousing fantasies, urges, or behaviors involving
Nonhuman objects
Nonconsenting
others
Causes suffering
of self or partner, children.
Lasting at least 6 months
For
some these are necessary for erotic arousal & always
include
in sexual
activity, for
other these occur episodically
.
Severity varies
Almost exclusively maleSlide65
Etiology of Paraphilias
Majority committed by males
Classical conditioning – stimulus with sexual arousal
Poor social skills
Gender hostility
Aggressive behavior
Inappropraite sexual practices
Ego issuesSlide66
Types of Paraphilias
Exhibitionism
Voyeurism
Fetishism
Transvestic
Sexual sadism
Sexual masochism
FrotteurismSlide67
Exhibitionism
exposing genitals to strangers (urges, acts or fantasies)
common sex crime
involves shock & risk
often distant from victim
needs to display masculinity without having to perform
the typical exhibitionist is young, unhappily married or single, and relatively sexually repressed.
usually begins before age 18Slide68
Voyeurism
Urges, acts, or fantasies involving observation of an unsuspecting person disrobing or engaging in sexual activity.
The voyeur does not seek contact with the observed person
illegal
, secretive nature is
arousing
most
don’t ever commit more serious sex
crimes
most are nonviolent
they are generally sexually inexperienced men who lack social and sexual skillsSlide69
Fetishism
Strong sexual attraction towards objects (female undergarments)
Depression, anxiety, loneliness
Rarely come to the attention of the criminal justice system
Usually has origins in early to mid-childhoodSlide70
Transvestic F
etishism
Intense sexual arousal obtained through cross-dressing (wearing clothes appropriate to the opposite gender)
Almost always heterosexual males- many married with children - with masculine gender identity.
It usually begins in childhood or early adolescence
most transvestites perform this activity in private and would feel humiliated if “found out”Slide71
Sexual sadism
Sexual arousing urges, fantasies or acts, associated with inflicting psychological or physical suffering on others
Brain pathology and life experiences may underlie sadismSlide72
Sexual Masochism
Sexual urges, fantasies or acts associated with act (real, not simulated) of being humiliated, beaten, bound, otherwise made to suffer
The term sadomasochist refers to someone who derives pleasure from both inflicting and receiving pain
Most sadomasochists engage in both submissive and dominant rolesSlide73
Frotteurism
Urges, acts or fantasies of rubbing against or touching a nonconsenter
most of these acts take place in crowded places
the man usually fantasizes about a relationship with the victimSlide74
Pedophilia
Adult obtains erotic gratification through urges, acts, or fantasies involving sexual contact with a prepubescent child.
Feel
guilty, doomed
Lack confidence, uneasy in social & sexual situations
with adults
Victims are most likely a relative, friend, or casual acquaintance.
Types of molester
Situational molesters
Preference molesters
Child rapistsSlide75Slide76Slide77
Treatment of Paraphilias
Medication
Anti-Androgen
Reduces Testosterone Levels
Psychosocial Treatment
Cognitive
Behavioural
Therapy
Aversion treatment/ suppression
Empathy training (role reversal)
Covert Sensitization
Orgasmic Reconditioning
Family and Marital Therapy
Relapse PreventionSlide78
Gender Identification DisordersSlide79
Gender Identity
The individual's self-perception as a male or femaleSlide80
Gender Identity Disorder
Conflict between a
Person’s anatomical sex
Gender identity
Self identification as male or female
As
child
Cross dressing
Cross sex roles
Played
with
other sex
Insisting is other
sex
Most children with gender identity conflicts do not develop gender identity disorders as adults.
Behaviors persist despite intense ridiculeSlide81Slide82
Gender Identity Disorder
Strong, persistent identification with opposite sex
Sense of being trapped in the body of the wrong sex
Assume the identity of the desired sex
Change is not for sexual desires
Correct identification of gender develops between 18 months and 3 years of ageSlide83
Gender Identity Disorder
Transsexualism
“Specified gender identity disorder”
Strong and persistent cross-gender identification
Persistent discomfort with one’s anatomical sex
Cause significant impairment in social, occupational, or other areas of functioning
Goal is not sexual
No physical abnormalities
Independent of sexual arousal patterns
NOT
TransvestismSlide84
Gender Identity DisordersSlide85
Treatment for Gender
Identity Disorder
Sex-reassignment
75% satisfaction with new identity
Female-to-male conversions adjust better
Psychosocial treatment
Realign psychological gender with biological sex
Modeling and rehearsalSlide86
Other Sexual ConditionsSlide87
Homosexuality
Tendency to direct sexual desire toward another of the same sex
Relating to, or involving sexual intercourse between persons of the same sex
Gay/Lesbian
Homophobia: Irrational fear of homosexuality.Slide88
Rape
Act of intercourse accomplished through force or threat of force
Statutory
R
ape
Act of intercourse with a child younger
Date
R
ape:
Act of sexual activity following substance abuse without the consent. (female college students report having “unwanted sexual intercourse”).Slide89
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