Sex and Gender Impact on Health

• Tülay KAVLAK gave this presentation on sex, gender, and impact on health.

Sex

• Sex is the biological characteristics that make a person male or female.
• These characteristics include:
• Genital organs like the penis, testes, vagina, uterus, and breasts
• Predominant hormones such as estrogen and testosterone
• The ability to produce sperm or ovum
• The ability to give birth and breastfeed
• The word "sex" is also used to mean sexual activity that includes intercourse.

Gender

• Gender is not about biological differences; It is about how society sees, perceives, thinks of, and expects people to behave as men and women.
• Gender is how an individual or society defines a man or woman.
• Gender roles involve socially and culturally defined attitudes, behaviors, expectations, and responsibilities for men and women.
• Gender consists of accepted thoughts and expectations (norms) for women and men in society.
• "Typically" feminine and masculine traits and abilities, and expectations shared at large society about how men and women behave are part of gender.
• Thoughts and expectations about gender are learned from family, friends, community leaders, religious and cultural institutions, schools, the workplace, advertising, and other media.
• Gender reflects and influences different roles of women/men in society, their social status, and their economic/political power.
• Girls get taught not to be interested in sexuality more than boys.

Gender and Sexuality

• Women tend to avoid telling men what they find sexually stimulating.
• Women often do not refuse intercourse even if they are not sufficiently stimulated.
• Women tend to avoid taking a more active role in intercourse that would increase their pleasure.
• There is a social expectation that a woman must maintain her virginity until marriage.
• As opposed to women, there can be sexual freedom for men.
• Infidelity is seen differently for men and women.
• Men's infidelities are seen as having an affair
• Women's infidelities are seen as "The Greatest Sin," and can result in "Honor Killing."
• Studies show that there are significant gender differences regarding sexual behavior and attitudes.
• Most boys are not virgins, according to girls.
• The age of first sexual intercourse tends to be earlier in boys than in girls.
• Girls tend to experience more negative emotions, such as guilt, shame, regret, fear, and anxiety, during first sexual intercourse than boys.

Gender Identity

• Gender identity is the perception and acceptance of one's body and self in a certain sexuality, and the showing of appropriate orientations in their feelings and behaviors.
• Gender Identity is about acceptance of the sex to which an individual belongs, and the behavior of their body/self in accordance with their perception, feelings, and behaviors of sexuality.

Gender Identity Development

• A child establishes various identifications during spiritual development.
• Children take adult people as models, and in a narrow sense, their parents; They imitate them, absorb their behaviors, and make them their own characteristics.
• People form identity by integrating the values of friend groups and others in their childhood and adolescence.
• Important components of identity are tied to biological, social, and psychological aspects of gender acceptance and one's identity.
• People without a gender identity problem define themselves as "I am a man" or "I am a woman."
• Gender identity develops based on input from family members, peers, teachers, and other cultural factors.

Sexual Orientation

• Sexual orientation is the gender to which a person's sexual impulse is directed, and their sexual desire is felt.
• Sexual orientation is defined by the gender that a person is sexually and emotionally attracted to.

Types of Sexual Orientation

• Heterosexual: Sexual and emotional attraction to those of the opposite sex.
• Homosexual: Sexual and emotional attraction to those of the same sex.
• Bisexual: Sexual and emotional attraction to people of both sexes.
• Transgender: Those who believe that they should change their gender and that they should have the other gender mentally and physically.
• Heterosexual, homosexual, or bisexual men are all male in their bodily gender and gender identity.
• Heterosexual, homosexual, or bisexual women all have a female bodily gender and gender identity.
• Gay men do not feel like women, or vice versa.

Sexual Orientation Formation

• How sexual orientation forms is not known.
• Why a heterosexual man likes a woman is also generally unknown.
• Common explanations can often be tied to specific environmental factors.
• It is not known whether people are born heterosexual or bisexual/homosexual.
• People cannot make a choice between heterosexuality and other orientations.
• People are not heterosexual because they want to be.
• A person does not decide to be gay or bisexual and become homosexual.
• Sexual experiments shouldn't indicate a person's sexual orientation or gender identity.
• People may have sexual experiences for reasons other than sexual orientation (e.g., survival, money, power), or they may have experiences contrary to their sexual orientation due to social rules.

Sexual Behaviors

• Sexual behaviors are activities related to a person's sexuality, such as touching, kissing, and stimulation of the body by themselves or with other people.
• Activities that are constantly performed as an expression of sexuality are sexual experiences/behaviors.
• The concept of sexuality begins in childhood and takes its final shape with adolescence.
• After puberty, the characteristics of an individual do not change easily.
• Adolescence starts with interest in one's own body, but evolves toward others.
• Curiosity and sexual fantasies become replaced with experimentation and eventually intercourse.

Sexual Intimacy

• Sexual intimacy doesn't just involve "having sex,".
• Kissing, touching, chatting, hugging, caressing, reading love stories, telling jokes, being happy together, fantasizing, and even just staring all count as sexual intimacy or experience.

Sexual Intercourse

• Intercourse involves intimate sexual behaviors.
• This includes oral, anal, and penile-vaginal sex.

Healthy Sexual Intercourse

• A healthy sexual relationship is built on shared values and has five characteristics.
• The five characteristics are:
• Compromise
• Non-exploitation
• Honesty
• Wishing to enjoy each other,
• Protection against unwanted pregnancy
• Protection against sexually transmitted diseases (including AIDS).

Sexually Healthy Adult

• Sexually healthy adults:
• Know the value of their own bodies,
• Take responsibility for their own behavior,
• Communicate with both genders with respect,
• Express love/sincerity consistent with their values.

Psychological, Biological, and Sociocultural Factors

• When an individual experiences a sexual problem or dysfunction, psychological, biological, and sociocultural factors must be accounted for when coming up with a treatment approach.

Perspectives on Sexuality

• People express and experience their sexuality in their own ways.
• Everyone must accept/respect that others have different values/beliefs about sexuality.
• Sexual life must be free from coercion/exploitation.
• Sexual behavior should be sincere and based on mutual trust/respect.
• All children should be loved/protected regardless of gender.
• All sexual decisions have effects/consequences.
• People have the right to make sexual decisions.
• Informing children about sexuality and sharing basic values with them is in the interest of society.

Talking with Adolescents

• Exploring sexuality is natural for young people during sexual maturity.
• Sexual experiences without thinking involve risk.
• Young people having a sexual experience can get information/support from health centers.
• Sexual behavior requires responsibility and self-control.
• Postponing sexual intercourse helps prevent unwanted pregnancies, STIs, and AIDS.
• Young people also develop values about sexuality when becoming adults.
• Learning and adopting protective sexual behavior is an important way to maintain sexual health.

Gender and Health

• Biological and social relationships determine a person's health/disease status.
• Marked differences are seen by sex/gender in health/disease patterns.
• Women have longer life expectancy, but have been reported to have more stress and illness.
• Sexual problems are generally common in countries/cultures.
• Approximately one out of every three people experience at least one sexual dysfunction sometime in their lives.

Sex and Gender in Health

• Women live longer, so their morbidity rates end up being higher.
• Deterioration of health is a part of the aging process for both sexes.
• Elderly woman make up the elderly population in almost all countries.
• Women run at a higher risk of age-related diseases like osteoporosis, diabetes, hypertension, arthritis, and most immune disorders.
• Women are likelier to have problems with their reproductive health.
• Both men and women are at risk for gender-specific diseases throughout life.

Gender in Health Examples

• Cervical and breast cancer affect women.
• Prostate and testicular cancer affect men.
• Women tend to experience reproductive health problems more than men.
• The gender role of women and men affects health.
• The size of negativities affects the "female" much more than the "male", especially in developing countries.

Gender and Problems

• Gender can affect Reproductive Health differently depending upon the age.
• Old Age Problems
• Problems of Infancy and Childhood
• Menopause-related Problems
• Adolescent-related Problems
• Adult-related Problems

Childhood (Negativities due to Health of Girl Child)

• Gender selection
• Unwanted pregnancy
• Voluntary abortion
• Female-Genital Mutilation
• Malnutrition
• Infections
• Negligence, inability to benefit from the service
• Increased morbidity and mortality rates

Adolescence Period (10-19 years)

• Societal pressure
• Sexual harassment and abuse
• Unwanted pregnancies
• Voluntary abortion
• Sexually transmitted infections (STIs)
• Anaemia and malnutrition
• Substance abuse (alcohol, smoking, drugs)
• Sex trafficking
• Violence

Adulthood (15-49 years)

• Pregnancy, childbirth, and postpartum complications
• Unwanted pregnancies/intentional abortions
• STDs
• Anaemia/malnutrition
• Sex trafficing or sexual harassment/abuse/violence
• Maternal mortality

Menopause and Postmenopause Period (50+ years)

• Women's health problems are often neglected.
• Reproductive health problems are often not associated with the patient's gender/reproductive attributes.
• Reproductive Health-related problems experienced by women during this period are:
• Menopausal symptoms
• Malignancies
• Cardio Vascular Diseases (CVD)
• Osteoporosis
• Urogenital prolapse
• Violence

Frequency of Sexual Problems

• Sexuality is prohibited in some societies.
• There can be a lack of sex education.
• Some societies perceive sexuality as a taboo.
• Many care for virginity.
• Premature ejaculation is common in men with insufficient sexual experience.
• Various orgasm difficulties are common in women.
• Kadınlarda vajinismus ve cinsel istek bozuklukları
• Erkeklerde ise cinsel istek ve boşalma bozuklukları

Causes of Sexual Problems

• Lack of sexual education and ignorance
• False beliefs in sexual life
• Diseases
• Drugs

Lack of Sexual Education and Ignorance

• Those lacking widespread, school-age education and insufficient knowledge of sexuality will have issues.
• This lack of knowledge causes many individuals/couples to have problems with their sexual lives, and to deteriorate personal relationships.
• Turkish society shows a lack of education/ignorance, prejudices, and taboos. Psychological causes and stress are common.

False Beliefs in Sexual Life

• Beliefs about sexuality are often exaggerated and wrong.
• These beliefs can come from jokes, anecdotes, daily press sources, and pornographic publications.
• Men often learn such beliefs.
• Media, such publications, and common jokes often promote them.
• Beliefs often have a side that belittles and devalues women.

Problems and Negative Effects

• Beliefs can cause inaccurate value assignments to men and women.
• They can create distance from love, affection, warmth, and closeness.
• Sexuality and sexual pleasure are often perceived as conditions that exist only for men.
• Negative beliefs mostly harm women.
• Common beliefs can mark men as sex machines that shouldn't reveal their emotions.

Diseases that Cause Sexual Problems

• Diseases that cause sexual problems are:
• Cardiovascular and circulatory system diseases
• Renal and urological diseases
• Liver diseases
• Lung diseases
• Genetic diseases
• Nutritional disorders
• Hormone system diseases
• Nervous system diseases
• Poisonings
• Surgeries
• Other radiation treatments and pelvic fractures

Drugs that Cause Sexual Problems

• Diuretics
• Tension medication
• Psychiatric medicine
• Ulcer medicine
• Allergy medicine
• Asthma medicine
• Epilepsy medicine
• Heart medicine
• Cancer treatment
• Other medicine, alcohol and drugs e.g. nicotine, caffeine, marijuana, cocaine, opioids, barbiturates, and amphetamines, etc.