Understanding Human Sexuality

Understanding Sexuality

• Sexuality includes all life events and aspects, from birth to death
• It includes self-knowledge, gender awareness/roles, sexual feelings, human/sexual relationships, birth, living, and death

Sexuality Definition and Aspects

• Sexuality describes the state of being sexual, very broadly
• Aspects of sexuality include sex, biological/physiological sex, gender, gender identity, gender roles, and sexual orientation

Sexual Orientation

• Sexual orientation is a person's emotional, romantic, sexual, and/or affectionate attraction to others
• It's based on the sex/gender of those they're attracted to, such as attraction to the same sex, opposite sex, or both

Sexual Orientation as a Spectrum

• Sexual orientation exists on a scale that varies from exclusive homosexuality to exclusive heterosexuality
• Bisexuality exists as a form of sexual orientation

Self-Identity

• Sexual orientation is an important part of self-identity and how others perceive a person
• A person's experience and understanding of their sexual orientation can shift over the course of their life

Sexual Orientation v Behaviour

• Sexual orientation reflects feelings and self-identity, not just actions
• People may or may not express their sexual orientation through behavior

Sex vs. Gender

• Sex refers to the biological aspects of being male or female, including physical acts
• Gender includes the psychological and sociocultural meanings added to biological sex

Sex Differences

• Biological sex differences are physical differences that differ between people

Gender Differences

• Gender stems from how people perceive and think about gender

Dimensions of Sex

• Sex dimensions include:
  • Chromosomes: XX
  • Gonads: Ovaries
  • Hormones: Estrogens
  • External genitalia: Labia, clitoris, vaginal opening
  • Internal accessory organs: Vagina, uterus, fallopian tubes, cervix
  • Secondary sex characteristics: Breasts, menstruation
  • Sexual orientation: Heterosexual, lesbian, bisexual
• Sex dimensions include:
  • Chromosomes: XY
  • Gonads: Testes
  • Hormones: Androgens
  • External genitalia: Penis, scrotum
  • Internal accessory organs: Prostate, seminal vesicles, vas deferens
  • Secondary sex characteristics: Beard, low voice, sperm emission
  • Sexual orientation: Heterosexual, gay, bisexual

Gender Dimensions

• Gender identity is related to perceiving oneself as male or female
• Gender role is the degree to which a person is masculine or feminine
• Gender identity is self defined
• Gender roles are socially defined

Gender Identity

• Gender identity is a person's internal sense of being male or female

Environmental Factors

• Environmental and social-cultural factors were initially assumed to be central in determining gender identity
• However, a castrated identical twin reassigned as female later rejected this reassignment, supporting a biological view of gender identity

Gender Roles

• Gender roles are societal expectations for appropriate female and male behavior

Social learning theory

• Social learning theory explains that gender roles develop in children by reward/punishment and imitation

Cognitive-developmental theory

• Cognitive-developmental theory explains that children develop gender schemas

Gender Differences in Cognitive Abilities

• Differences in cognitive abilities exist between genders
• Females score higher on verbal skills
• Males score higher on math and visual-spatial skills

Gender and Aggression

• Males exhibit greater physical aggressiveness
• Females are higher on relational aggression like rumor spreading and exclusion

Scientific Study of Sexuality: Havelock Ellis

• Havelock Ellis was among the first to initiate a scientific study of sexuality
• His researched showed nocturnal emissions and promoted disseminating accurate information on human sexuality

Alfred Kinsey Research

• Alfred Kinsey used surveys and interviews in his research
• He used them to gather data on sexual practices and beliefs

Masters and Johnson Research

• Masters and Johnson brought the study of sexuality into the laboratory
• The primary aim was to study the sexual response cycle in a lab setting

Hypotheses On Men and Women

• Men are thought to have a greater sexual drive, interest, and activity level than women

Explanation: Evolutionary Perspective

• Men seek multiple partners to pass on their genes
• Women seek a good provider

Explanation: Social Role Approach

• Gender differences reflect cultural roles and division of labor
• Women prefer resource-rich men, but only when they live in cultures with little reproductive freedom/educational equality

Homosexuality

• Homosexuality may reflect the impact of biological factors on sexual orientation
• Twin studies are supportive of the genetic influences that may affect sexual orientation

Factors That Do Not Effect Homosexuality

• Does not include:
• Poor parenting
• Arrested development
• Childhood seduction
• Modeling of gay behaviors

Homosexuality Statistics

• 2.8% of men are gay or bisexual
• 1.4% of women are gay or bisexual

Research on Stereotypes

• 44% of gay men fit the feminine stereotype
• 54% of lesbians fit the masculine stereotype

Transsexuals

• Transsexuals identify as a member of the opposite sex
• Transsexuals may undergo "sex reassignment" surgery

Social Influence Hypothesis

• Social influence hypothesis states Homosexuality arises from early sexual experiences
• A study of gay men by Bell found no support for it

Opposing View to this Hypothesis

• Others can influence homosexual behavior
  • Examples include spending more time/being masturbated by other boys

Biological Hypothesis

• 70% of homosexuals remember feeling "different" as early as 4 or 5 years of age
• Gender nonconformity means that Homosexuals show high rates
• They engage in activities preferred by the opposite sex and show an atypical preference for other-sex playmates early in development

Homosexuality and Genetics

• Among siblings of homosexuals, Homosexuality 2-7 times higher than population at-large and rates exist for identical twins vs fraternal twins

The Hamer Research Studies

• Gay men have more gay relatives on mother's side than father's side of family
• 64% of pairs of gay brothers in a study had gay relatives on their mother's side and the brothers shared with the same material at end of the X chromosome
• Other studies have failed to replicate these findings

Hormonal Influences

• Studies of hormone levels of gays and straights show No difference in sex hormone levels
• Attempts to reverse male homosexuality included Administering testosterone to gay men which did not affect sexual preference but increased level of gay sexual activity
• Prenatal differences in hormone levels of animals led to Same-sex preferences for rats, hamsters, ferrets, pigs, zebra finches

Hormonal Influence in Animals

• Critics of hormonal influence findings suggests that Homosexuality only occurs in absence of members of opposite sex
• There is Response to critics:
  • 10% of male sheep prefer other males
  • Some female gulls have formed lesbian pairs

Homosexual Humans

• Little evidence of prenatal hormonal imbalances in Homosexual humans

Brain Structure Differences: INAH3

• The third interstitial nucleus of anterior hypothalamus (INAH3) is involved in sexual activity in animals
• INAH3 is Half the size in gay men and heterosexual women as in heterosexual men

Brain Structure Differences: sSch of Hypothalamus

• The suprachiasmatic nucleus of hypothalamus regulates reproductive cycle of female rats, controls daily cycles in rats and humans, larger in gay men than heterosexual men, contains twice as many cells that secrete vasopressin, excessive vasopressin in male rats associated with increased homosexual behavior

Brain Structure Differences: Anterior Commissure

• Anterior commissure: Connects the left and right hemisphere and is larger in gay men and heterosexual women than heterosexual men
• It can give Partial explanation for higher verbal score of gay men

Brain Structure Differences: BSTC

• Central bed nucleus of stria terminalis (BSTC) is a ½ mm structure in hypothalamus and related to a role in sexual activity of male rats
• Male-to-female transsexuals tend to have a smaller BSTC than other men with similar size as women

Brain Structure Differences: Other BSTC Factors

• Female-to-male transsexuals has male-sized area and hormonal manipulation of fetal rats means affects size of BSTc so brain is feminized during foetal stage?

Female Homosexuality

• Little evidence exists of masculinization of lesbians' brains prenatally and concordance studies are as high for lesbians as for gays

Physical Differences of Lesbians

• Index-to-ring-finger ratios show:
  • Indistinguishable from heterosexual men
  • Ring finger is longer
  • Influenced by testosterone during prenatal period
• Heterosexual women show Index and ring finger the same length

Physical Differences of Lesbians' Ears

• Physical differences of lesbians' ears feature click-evoked otoacoustic emissions
• Click-evoked otoacoustic emissions produce a faint sound given off by inner ear when stimulated but weaker in lesbians and men (both heterosexual and homosexual) and is Influenced by testosterone during prenatal period

Social factors of homosexuality

• If homosexuality is biological, civil rights legislation applies to them
• 75% of homosexuals believe their condition is inborn

The Human Sexual System

• Sexual behavior in males and females involves arousal of the peripheral sex organs, the spinal cord, and the brain
• Factors that modulate activity within any of these regions can impair sexual function
• Sexual arousal involves activity within the parasympathetic nervous system (allows for blood flow to the sex organs)
• Sexual orgasm involves the activation of the sympathetic nervous system

Determinants of Healthy Sexual Function

• Psychological well-being
• Partner relationship
• Developmental experiences
• A history of abuse
• Physical health
• Medication use
• Lifestyle factors includes use of substances

Male Sexual Dysfunction Problems

• Can be described as:
  • Impotence
  • Premature ejaculation

Male and Female Sexual Problems

• Can be described as:
  • Dyspareunia
  • Inhibited desire
  • Sexual aversion

Male Problems

• Can be either:
  • Orgasmic dysfunction
  • Vaginismus

Phases of the Sexual Response Cycle

• Excitement phase:
  • Heightened sexual awareness to thoughts, sights, touches, sounds, and odors
• Plateau phase:
  • HR, BP, respiration, and muscle tension increase
• Orgasmic phase:
  • Ejaculation occurs for men
  • Women experience rhythmic contractions of the pelvic muscles and vaginal walls
• Resolution phase:
  • The body returns to pre-arousal state

Sexual Addiction

• Loss of Control means there's Clear behavior to where you do more than you intend or want
• Compulsive Behaviour is A pattern of out of control
• Efforts to Stop is Repeated specified attempts to stop the behaviour which fail
• There a Loss of Time with Significant amounts of time lost doing or recovering from the behaviour and Preoccupation with Obsessing about or because of the behaviour
• Its an Inability to fulfill Obligations throughThe behavior interfering with work, school, family, and friends
• There's a cycle, such as:Continuation Despite Consequences is Failure to stop the behavior even though you have problems because of it (social, legal, financial, physical) and Escalation is Need to make behavior more intense, more frequent, or more risky.
• Losses can happen when Losing, limiting, or sacrificing valued parts of life such as hobbies, family, relationships, and work.
• Withdrawal is Stopping behavior results in considerable distress, anxiety, restlessness, irritability, or physical discomfort.

Addictive Cycle

• A cycle of despair from:
  • Unmanageability
  • Impaired Thinking
  • Preoccupation
  • Ritualization
  • Compulsive behavior

Sexual Behavior Additives Cycle

• Sexual Behavior creates a cycle that can involve:
  • Chemical Dependency 42%
  • Eating Disorders 38%
  • Compulsive Working 28%
• Compulsive Spending 26%
• Compulsive Gambling 5%

Initial Assement for Sex Addicts

• Sexual Addiction Screening Test – Revised (SAST-R) available can be taken on www.SexHelp.com
• Designed to assist in the assessment of sexually compulsive behavior which may indicate the presence of sex addiction
• Developed in cooperation with hospitals, treatment programs, private therapists, and community groups, the SAST-R provides a profile of responses which help to discriminate between addictive and non-addictive behavior
• Comprised of 45 yes or no questions.

Sobriety Skills: The Process of Quitting

• Breaking through denial
  • List of excuses and consequences
  • Make a secrets lists
• Understanding the Nature of Your Illness
  • List of unmanageable moments that put you back
  • Get self Assessment history
• Limit Behaviour and Take Steps to Fix It
  • Create damage control plan
  • Plan to come clean with people
• Ensure Physical Integrity in Daily Life
  • Maintain daily rituals with people or programs
  • Attend regular meetings and ensure regular contact.

Female Sexual Problems (FSD)

• There are four Primary Categories
  • Sexual Desire Disorders
  • Sexual Arousal Disorders
  • Orgasmic Disorders
  • Sexual Pain Disorders
• These can be Lifelong vs. Acquired or Generalized vs. Situational, and Due to psychological and medical factors

Types of Female Sexual Dysfunction

• Sexual desire disorders become:
  • Hypoactive sexual desire disorder
  • Sexual aversion disorder
• Sexual arousal disorder becomes:
  • Female sexual arousal disorder
• Sexual orgasmic disorder becomes:
  • Female sexual orgasm disorder
• Sexual pain disorders become:
  • Dyspareunia
  • Vaginismus
  • Non-coital sexual pain disorder

Causation of Female Sexual Dysfunction

• Psychological issues
  • Mental health
  • Abuse
  • Stress and Substance misuse Interpersonal issues caused by:
  • lack of partner or privacy
  • Poor performance Sociocultural issues from:
• lack of sex education
  • Societal views or family issues. Physiological issues such as
  • Neurological illness
  • Cancer
  • Hormone issues
  • Medications

Specific Issues of HSDD

• HSDD stands for Hypoactive Sexual Desire Disorder (HSDD)
• Means either you have:
  • Persistently or recurrently low or absent sexual interest in and desire for sexual activity or
  • Little or no sexual fantasy
  • This combination can create or cause distress to the individual or others HSDD should be
  • Not better accounted for by some other Axis I disorder or a medical condition and Distinguished from desire discrepancy
  • its Very common in women at a rate of (NHSLS 22%) and Increases post-menopause so HSDD may require an actual diagnosis

Causation of HSDD

• Hormones, Neurotransmitters, CNS, Illness, Drug use
• Stressed, Intrapsychic or relationship problems

Additional Causes of HSDD

• Intrapsychc:
  • Psychological disorders, Guilt, an abuse history and being Secondary to arousal or orgasmic disorder
• Relationship:
  • Intimacy issues, Power struggles and sexual skill deficit.

Functionality issues specific to Women

• Woman have many reasons for sex and those include
  • Enhancement of wellbeing -Passion and emotional Intimacy

Factors to Consider on How The Woman Relates to Sex

• Psychological and biological factors influence woman's arousability
• Arousal is not primarily about the degree of vulval and vaginal vaso-congestion
• There's sexual desire, an infrequent motive
• Women may sense desire only once the sexual experience is underway
• "Woman's sexuality is highly contextual"

Reasons Why Women Have Sex

• Emotional intimacy
• Enhance one's well-being
• To reassure partner
• To end an argument
• Pleasure and passion

Key Causation of Female Arousal Problems

• Persistent or recurrent inability to attain/maintain adequate lubrication-swelling
• Causes distress to the individual or their relationship
• Often caused by secondary or global factors as well.

Factors That Effect Arousal

• Can be secondary to Orgasmic Dysfunction
• Medical factors and Poor partner technique
• Attitudes, beliefs and expectations impact
• Feelings towards the partner may be involved

Factors that Contribute to Arousal

• There are Biological sexual Factors including
  • DHEA -Testosterone
  • Vasodilation chemicals and Hormonal processes.

Main Issues

• Hormones, Neurotransmitters, Disease, Meds

Hypothalamic axis's relationship to libido

• Deficiency leads to gonadal atrophy, difficulty lubricating
• It's androgens include DHEA and Testosterone
• Estorgens effect sexual libido as well
• Oxytocin promotes muscle contraction

Psychophsiological Studies for Sex Studies

• Psychophysiological Sexual Studies have been done where: they
  • Watch erotic video's to assess arousal
  • Many are highly variable from person to person.

Causation Factors of Problems with Orgasam

• Is commonly 25% of those suffering from problems of adequate stimulation
• Requires both psychological and technique changes for treatment to prevent

Common Issues in this Sphere

• "Women never have learned what works" or Some men are poor sex partners either from bad habits or too little information.

Issues of Pain Due to sex

• Can happen at any moment of interaction with a partner and there has issues with Quality, Location and intensity of pain from this moment

A woman and age related health

• Pain to intercourse due to infections of tissue

Psychological reasons.

• Problems relating to abuse

Male Orgasam Difficulties

• Recurrent involuntary spasms with another that makes pain through intercourse
• High rates are a side effect of Dyspaneunia or related issues.

There are other problems such as

• Sexual Complaints like Lack of Interest, Unable to get off or a feeling of displeasure.
• Vagina Dryness that results in poor sexual intercourse

Creating a Safe Space

• It is important to create clear lines with your partner to help them feel sexually safe
• It builds trust

Women's Sexual Experience

• For questions towards those who do have issues, ask open and trusting questions, give specific questions to menopausal women and ensure they are in a safe and easy place for them.

Evaluation for the Problem

• Need key history data and to look to make sure their functionallity
• Ask a good range of qustions

Main Method to Treat Problems

• Sex Therapy: Masters and Johnson "Focuses on:
• ""The relationship"" -"" Integrates Physiological and psychosocial factors""
• ""Cognitive Factors
• "" Specific behavioral techniques """""

Male Sex Response Cycle

• Cycle through an erection in the order of
  • Arousal
  • Plateau
  • Orgasim
  • Relaxation state
  • Refractory Piod

Male Sexual Dysfuntion (MSD) has four phases

• Stage One

• Stage Two- Plateu with The testes increase in size by 50 ormore. with 100-176 BPM

• Stage Three- Orgasim Muscles rhythmically contract throughout body -The most noticeable change on the penis is a contraction of the ejaculation canal

• Stage Four - Relxatiion. Body return's to regular functioning state, as the penis decreases in size

• Stage Five- Refractory State is a period where the penis cannot get hard due to over stimulation.

  • After the ages of 30 years old, few men can acheive two hard on's back to back.

MSD General Fact's

• 10-52% of people get this problem
• 31% of 18-59 report this.
• Important to learn to identify the problem

Common Problems

• Primary to not beingable to hold a erection do to poor function.

The Most Common 3

Erictile Dysfunction

• Premature Ejaculation
• Retard Ejactulation

There's Phases

Desire Arrousal Orgasm

DIsorder's Hyperactive Sexual Desire

• Hyopoactive Sexual Desire
• Sexual Aversion

Issues related to "desire"

• Hyperactive - Deregulatio in the form and thoughts one percieves as a driving desire..

• Hyopo - A person having issue's or lack of passion Sexual Aversion- A aversion with an avoidance attitude about sex. (common problem's after trama for sex).

Issues

• Treatment must be tailored depending on the case and the person involved.

Common Reason

• Can be due to some physical trauma or from repressive environments.

Some steps against erection

• Have clear boundaries that people can not cross
• Build trust with a partner

Arousing difficulty

• Not being stable enough to remain erect
• Causing distress with the other party or with self
• Being primary or secondary.

The list of Biological

• Vas and Hormones

Hormones

• Lows from glands or issues

• Psychological has to do with a poor "picture" of the problem.

What's important for treatment?

• Being realistic with expectations

Technique/Relationship

• Insuificenct contact
• Not willing to open up with partners, having to look them up.

Problem With Lack of Pain

• Usually starts during sexual intercourse
• With no specific case relating back to trama, is fairly normal.

Reasons for Pain?

• Rarely partner size
• Vaginal infection

Psychological

• Abuse or trama.

Specific to male?