Reproductive System / Sex, Gender & Sexuality

• Human reproduction results from the union of a male sex cell and a female sex cell.
• The male and female reproductive systems differ to allow for reproduction.

Reproductive System Anatomy - Male

• The male reproductive system includes the penis, urethra, vas deferens, bladder, prostate, seminal vesicle, testicle, and epididymis.

Reproductive System Anatomy - Female

• The female reproductive system includes the ovaries, fallopian tubes, uterus, cervix, and vagina.

Vulva

• The external female genitalia is called the vulva.
• The mons pubis is a rounded, fatty pad over the symphysis pubis bone.
• The labia majora and labia minora are two folds of tissue on each side of the vaginal opening.
• The clitoris is a small organ composed of erectile tissue.
• It becomes hard when sexually stimulated.

Menstruation & Fertilization

• If pregnancy does not occur, the endometrium (blood-rich lining of the uterus) breaks up and is discharged from the body through the vagina, known as menstruation.
• The union of sperm and ovum into one cell is called fertilization.
• Millions of sperm are deposited into the vagina during intercourse.
• Fertilization results if a sperm and ovum unite in a fallopian tube.
• The fertilized cell travels down the fallopian tube to the uterus.
• The fertilized cell implants in the thick endometrium and grows during pregnancy.

Physical Changes to the Reproductive System in Men, and Testosterone

• In men, the hormone testosterone decreases, which affects strength, sperm production, and reproductive tissues.
• An erection takes longer, as does the phase between erection and orgasm.
• Orgasm is less forceful than when younger.
• Erections are lost quickly, and the time between erections is longer.

Physical Changes to the Reproductive System in Women, and Menopause

• Menopause occurs when menstruation stops, and the woman can no longer have children.
• Female hormones such as estrogen and progesterone decrease.
• The uterus, vagina, and genitalia may atrophy, and the vaginal walls may thin, leading to vaginal dryness.
• Arousal takes longer, and orgasm is less intense.
• The pre-excitement state returns more quickly.

Sex

• Sex refers to physical or physiological differences between males and females, including both primary sex characteristics (reproductive system) and secondary characteristics such as height and muscularity.
• Sex is a label assigned by a doctor at birth based on genitals and chromosomes, appearing on the birth certificate.
• Intersex people are born with variations in sex characteristics that do not fit typical definitions for male or female bodies.
• These variations include chromosomes, gonads, and sex hormones or genitals.

Gender

• Gender is a social and legal status with societal expectations about behaviors, characteristics, and thoughts.
• The most common types of gender are male and female.
• Gender identity: the extent to which one identifies as being either masculine or feminine.
• Gender expression: the way a person expresses their gender identity through appearance, dress, and behavior.
• Gender role refers to society's concept of how men and women are expected to act and behave, based on norms or standards.
• Gender is something a person figures out and expresses themselves.

Gender Identity vs Gender Expression

• Gender Identity: Each person's internal and individual experience of gender, a sense of being a woman, a man, both, neither, or anywhere along the gender spectrum, which may be the same as or different from their birth-assigned sex.
• Gender Expression: How a person publicly presents their gender, including behavior and outward appearance such as dress, hair, make-up, body language, and voice, as well as a chosen name and pronoun.

Terms to know relating to gender identity

• Binary: Gender is viewed as consisting solely of two identities and sexes, man and woman or male and female.
• Non-binary: Any gender that falls outside of the binary system of male/female or man/woman.
• Cisgender: A term used to describe someone whose gender identity aligns with the sex assigned to them at birth.
• Bigender: Someone expressing gender identities encompassing both man and woman.
• Agender: A term for people whose gender identity and expression does not align with man, woman, or any other gender; gender-neutral is a similar term used by some.
• Gender fluid: A person who does not identify with a single fixed gender, and expresses a fluid or unfixed gender identity that shifts and changes depending on context.
• Transgender: An umbrella term for people whose gender identity/expression differs from cultural/social norms.
• Trans Woman: Someone assigned as male at birth but identifies as a woman.
• Trans man: Someone assigned as female at birth but identifies as a man.
• Transitioning: The social, legal, and/or medical process a person may go through to live outwardly as the gender with which they identify. This includes telling loved ones, using a different name/pronouns, hormone therapy, and surgery.
• Transsexual person: A generational term for people whose gender identity is different from their assigned sex at birth and seek to transition. This term is no longer preferred by many people as it is often seen as overly clinical.
• Dead name: How some transgender people refer to their given name at birth.
• Gender questioning: A person questioning or exploring to express their gender identity. Gender dysphoria: Clinically defined as distress when someone's assigned birth gender is not the same as their self-identified gender.
• Passing: A term for transgender people perceived by others as the gender with which they self-identify.
• Two-Spirit: A modern, pan-Indian term used by Indigenous North Americans to describe Native people in their communities who fulfill a traditional third-gender (or other gender-variant) ceremonial role in their cultures.

Sex vs Gender

• A person's sex, as determined by their biology, does not always correspond with their gender. Therefore, the terms sex and gender are not interchangeable.
• Since the term sex refers to biological or physical distinctions, characteristics of sex will not vary significantly between different human societies.
• Characteristics of gender, on the other hand, may vary greatly between different societies.
• For example, in American culture, it is considered feminine to wear a dress or skirt.
• In other cultures, dresses or skirts are considered masculine.

Sexuality

• Sexual orientation: Who you are emotionally, mentally, and physically attracted to based on their sex/gender in relation to your own.
• This may be same-sex orientation, male-female orientation, or a bisexual orientation (all sexes).
• Heterosexuality, the attraction to individuals of the opposite sex.
• Homosexuality (Gay), the attraction to individuals of one's own sex.
• Bisexuality, the attraction to individuals of either sex.
• Asexuality, no attraction to either sex.
• Demisexuality is a sexual orientation where people only experience sexual attraction to folks that they have close emotional connections with.
• Pansexual: A person who experiences sexual, romantic and/or physical attraction to people of all gender/sexual identities or expressions.

The Older Adult and Sexuality

• Love, affection, and intimacy do not disappear with older adults.
• It is normal for older adults to be sexual, and it is important to promote ways to meet clients' sexual needs.

Safe Sex

• Sex is still possible later in life, and is satisfying, but needs to be adapted depending on age, disability, illness, or surgery-induced body changes.
• Older adults are more vulnerable to getting STIs.
• It is important to use safe sex practices.
• All types of sex can spread STIs.
• Discuss sexual histories, any past STIs, STI testing results, and if any illegal intravenous drugs have ever been used.
• HIV/AIDS can also be acquired by sharing intravenous needles as well.
• Check a partners genitals (penis or vaginal area) before having sex looking for sores, abnormal smells or discharges.
• Use condoms and lubricants when having oral, anal, or vaginal sex until you know sexual history.

STI's (Sexually Transmitted Infections)

• Chlamydia is often asymptomatic, but if symptoms develop, women may have a vaginal discharge or burning sensation when urinating, while men may experience discharge from the penis, burning sensation when urinating or, rarely, pain and swelling of the testicles.
• Gonorrhea may be asymptomatic, but men may experience a burning sensation when urinating, with white/yellow/green discharge from penis, and painful/swollen testicles.
• Most women with gonorrhea do not have symptoms, but if they exist can often be mistaken for bladder/vaginal infections which can result in more sever complications for the woman
• Genital warts: can grow on the vulva, vaginal walls, the area between external genitals, and the anus, anal canal, and cervix; in a man, the warts occur on the tip/shaft of penis, the scrotum, or the anus. The symptoms include small brown, pink, or flesh colored swelling, a cauliflower-like appearance, and/or itching in your genitals
• Genital herpes: most often has no symptoms and is often mistaken for another skin condition. When an outbreak occurs, it results in blisters forming around the genitals and rectum which break and leave painful sores. The first time an outbreak can include fever, and body aches
• Pubic lice (crabs): Creates intense itching in genital areas. Can spread throughout other parts of the body with coarse hair
• HIV (human immunodeficiency virus) is a virus that harms the immune system; it is transmitted through body fluids such as blood, semen, breast milk, and affects and kills CD4 cells. There is no cure, but can live a long life by managing with antiretroviral therapy. In addition to sex, can also be spread through infected blood, and from mother to child

AIDS (Acquired Immunodeficiency Syndrome)

• If untreated after having HIV; eventually, AIDS can form which causes the immune system to be extremely weak and unable to ward off infections. Life expectancy then becomes roughly three years

Abuse and Reporting of it

• Contact with an elderly person without their consent.
• Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse
• Sexual abuse can take place with a confused senior, (dementia), or confused residents in care facilities where they may be approached by other vulnerable residents, visiting spouses/partners, or occasionally, by care workers. Sexual abuse can also happen to competent seniors by spouses, partners, family members, or trusted people in their lives.
• Because abuse is a crime, it must be reported if you suspect it of mental/physical disability or with older adults. When reporting, ensure that you listen attentively and provide support to the client. Also, as one reports, they are protected from any kind of legal action.
• All provinces follow labor laws pertaining to protecting workers and the abuser will be investigated accordingly

Sexual Harassment in the workplace

• Sexual comments, gestures, threats or suggestions are harassment; could be from client, family, co-worker
• When encountered; ensure that you firmly and politely state the behavior as unacceptable and unwelcome; if needed, be assertive but don't be rude
• Discuss these private matters with supervisors; may need to keep private documentation
• All employers are required to have polices on how to deal with reports and prevent it