Module 2: Biomedical Perspective in Gender and Sexuality PDF

EGE 311 – GENDER AND SOCIETY Module 2 Biomedical Perspective in Gender and Sexuality Essential Topics 1. Anatomy and Physiology of the Reproduction 2. The Process of Reproduction 3. Risky Behaviors and Adolescents 4. Sexual Health and Hygiene...

EGE 311 – GENDER AND SOCIETY Module 2 Biomedical Perspective in Gender and Sexuality Essential Topics 1. Anatomy and Physiology of the Reproduction 2. The Process of Reproduction 3. Risky Behaviors and Adolescents 4. Sexual Health and Hygiene 29 | Page  EGE 311 – GENDER AND SOCIETY Lesson 1 1 Anatomy and Physiology Of Reproduction Learning Outcomes When you finish reading this chapter, you should be able to: 1. Differentiate the female and the male reproductive systems; 2. Analyze the basis for physiological processes in females and males. Time Frame: Week 4 Introduction You must have laughed or have felt uncomfortable when the human reproductive system was taught to you for the first time. The truth is, most of the time, these issues are given sexual associations. This time let’s review the human anatomy and physiology of the human reproductive system openly and slightly desensitized.  Abstraction The reproductive system consists of organs that function in the production of offspring. You need to have a thorough understanding of the anatomy and physiology of the male and female reproductive systems because both types of reproductive organs contribute to the same goal and specialty, that is to produce children and give birth to the new generation. The Biological Female The female reproductive system is a complicated but fascinating subject. It has the capability to function intimately with nearly every other body system for the purpose of reproduction. Puberty signals the final development of primary and accessory organs that support reproduction The female reproductive organs can be subdivided into the internal and external genitalia. 31 | Page  EGE 311 – GENDER AND SOCIETY Fig.1. External Female reproductive system The external structures of the female reproductive system are collectively called as the Vulva. Its function is two-fold: To enable sperm to enter the body and to protect the internal genital organs from infectious organisms. The main external structures of the female reproductive system include:  Mons pubis: a fatty mound which covers the pubic bone.  Labia majora: The labia majora enclose and protect the other external reproductive organs. Literally translated as "large lips," the labia majora are relatively large and fleshy, and are comparable to the scrotum in males. The labia majora contain sweat and oil-secreting glands. After puberty, the labia majora are covered with hair.  Labia minora: Literally translated as "small lips," the labia minora can be very small or up to 2 inches wide. They lie just inside the labia majora, and surround the openings to the vagina and urethra.  Vaginal opening: the canal that joins the lower part of the uterus to the outside of the body.  Urethral opening: opening of the urethra, a tube which carries urine from the bladder outside of the body.  Clitoris: A small structure with sensitive nerve endings located within the labia minora, the sole purpose of which is for sexual arousal and pleasure.  Perineum : The space between the anus and the vaginal opening.  Anus : Rectal opening. 32 | Page  EGE 311 – GENDER AND SOCIETY The internal genitalia are those organs that are within the true pelvis. These include the following as described and shown below: Fig.2. Internal Female reproductive tract  Vagina:The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the body. It also is known as the birth canal.  Uterus (womb): The uterus is a hollow, pear-shaped organ that is the home to a developing fetus. The uterus is divided into two parts: the cervix and the main body of the uterus, called the corpus. The corpus can easily expand to hold a developing baby.  Cervix:The lower portion of the uterus which contains a small opening called the os. Menstrual blood flows through the os into the vagina during menstruation. Semen travels through the os into the uterus and the fallopian tubes following ejaculation during sexual intercourse. The cervical os dilates (opens) during childbirth.  Fallopian tubes: These are narrow tubes that are attached to the upper part of the uterus and serve as tunnels for the ova (egg cells) to travel from the ovaries to the uterus. The fertilization of an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall.  Endometrium: The inner lining contained in the uterus. It builds up and sheds monthly in response to hormonal situation.  Myometrium:is the middle layer of the uterine wall, consisting mainly of uterine smooth muscle cells (also called uterine myocytes) but also of 33 | Page  EGE 311 – GENDER AND SOCIETY supporting stromal and vascular tissue. Its main function is to induce uterine contractions Understanding female reproductive anatomy is not only the study of its external and internal structures; it also includes the hormonal cycle. Keep reading to learn more about hormones and menstrual cycle as it relates to reproduction. Hormones Hormones are natural substances produced in the body. They help to relay messages between cells and organs and affect many bodily functions. Everyone has what are considered “male” and “female” sex hormones. The two main female sex hormones are estrogen and progesterone. Estrogen is the major female hormone. It plays a big role in reproductive and sexual development including: Puberty, Menstruation, Pregnancy and Menopause. Progesterone on the other hand prepares the endometrium for the potential of pregnancy after ovulation. It triggers the lining to thicken to accept a fertilized egg. It also prohibits the muscle contractions in the uterus that would cause the body to reject an egg. The gonadotropins, Follicle-Stimulating Hormone (FSH) is responsible for starting follicle (egg) development and causing the level of estrogen to rise and Luteinizing Hormone (LH) which aids in egg maturation and provides the hormonal trigger to cause ovulation and the release of eggs from the ovary. Did you know that testosterone, even if it is considered a male hormone, females also produce and need a small amount of this, too? It plays a role in several body functions like sexual desire, regulation of the menstrual cycle and bone and muscle strength. 34 | Page  EGE 311 – GENDER AND SOCIETY Menstrual cycle The menstrual cycle is complex and is controlled by many different glands and the hormones that these glands produce. A brain structure called the hypothalamus causes the nearby pituitary gland to produce certain chemicals, which prompt the ovaries to produce the sex hormones estrogen and progesterone. The menstrual cycle is a biofeedback system, which means each structure and gland is affected by the activity of the others. The menstrual cycle can be described by the ovarian or uterine cycle. The ovarian cycle describes changes that occur in the follicles of the ovary whereas the uterine cycle describes changes in the endometrial lining of the uterus. Both cycles can be divided into three phases as described and shown below: Fig.3. Menstrual Cycle Uterine Cycle  Menstrual Phase: Occurs when ovum is not fertilized and does not implant itself into the uterine lining. The continued high levels of estrogen and progesterone causes the pituitary gland to stop releasing FSH and LH. Estrogen and progesterone levels decrease causing the endometrium to be sloughed off and bleeding ensues. It is during this time that ovarian hormones are at their lowest levels. 35 | Page  EGE 311 – GENDER AND SOCIETY  Proliferative phase: FSH is released that stimulates the ovaries to produce estrogen and causes the ova to mature in the ovarian follicles. Endometrium is repaired, thickens and becomes well \vascularized in response to increasing levels of estrogens.  Secretory Phase: LH is released that causes the ovaries to release a mature ovum and causes the remaining portion of the follicle to develop into the corpus luteum which produces the progesterone. Endometrial glands begin to secrete nutrients and lining becomes more vascular. Ovarian Cycle  Follicular phase (day 1-13): It is the first part of the ovarian cycle. During this phase the ovarian follicle mature and get ready to release the egg.  Ovulation phase (day 14): It is the shortest phase in the cycle wherein the mature egg is released from one of the ovarian follicles down the fallopian tube. Mittelschmerz is one-sided, lower abdominal pain associated with ovulation. It's a sign that a female released an egg from one of her ovaries. In most cases, mittelschmerz doesn't require medical attention.  Luteal phase (day 15-28): It is marked after the release of the mature egg. Follicle-stimulating hormone and Luteinizing Hormone cause the remaining parts of the follicle to transform into corpus luteum. It produces progesterone that inhibits the release of FSH and LH by the pituitary. Consequently, the concentration of FSH and LH falls over time and the corpus luteum degenerates. The Biological Male Most of the male reproductive system is located outside of the body. These external structures are the penis, scrotum, epididymis, and testes. The internal organs of the male reproductive system are called accessory organs. They include the vas deferens, seminal vesicles, prostate gland, and bulbourethral glands. 36 | Page  EGE 311 – GENDER AND SOCIETY Fig.3. Male reproductive system  Penis: The male genital organ of higher vertebrates, carrying the duct for the transfer of sperm during copulation. In humans and most other mammals, it consists largely of erectile tissue and serves also for the elimination of urine.  Scrotum: Serves as a cooling unit to maintain the optimal temperature for sperm development. The optimal temperature for sperm development is lower than 37°C.  Epididymis: The narrow, tightly-coiled tube connecting rear of the testicles to the vas deferens). It stores sperm for maturation.  Testes: Are contained in the scrotum, they are the male gonads.  Vas deferens: A long, muscular tube that travels from the epididymis into the pelvic cavity. It transports mature sperm to the urethra in preparation for ejaculation.  Seminal vesicles: Are two small glands that store and produce the majority of the fluid that makes up semen.  Prostate: A walnut-sized gland located between the bladder and the penis. It secretes fluid that nourishes and protects sperm.  Bulbourethral glands (also known as “Cowper's glands”): Are a pair of pea shaped exocrine glands located posterolateral to the membranous 37 | Page  EGE 311 – GENDER AND SOCIETY urethra. They contribute to the final volume of semen by producing a lubricating mucus secretion. Hormones The testosterone is the major male hormone produced mainly by the testes. It is responsible for the growth and development of a boy during adolescence and for the development of sperm and secondary sexual characteristics. Like in females, men has FSH and LH too. LH stimulates testosterone production and FSH helps control the production of sperm  EGE 311 – GENDER AND SOCIETY Lesson 2 2 The Process of Reproduction Learning Outcomes When you finish reading this chapter, you should be able to: 1. Define fertilization, conception and pregnancy; 2. Identify the complications of early pregnancy in the growing adolescent. Time Frame: Week 5 Introduction Reproduction is just one of the physiological processes besides organization, metabolism, responsiveness and movement. In humans there are additional requirements such as growth, differentiation, respiration, digestion and excretion. All these are essential to human and all are interrelated to accomplish the complex goal of sustaining life.  EGE 311 – GENDER AND SOCIETY Abstraction INDEPENDENT READING Powerpoint Presentations: 1. Adolescent Sexuality,Reproductive health and Teen Pregnancy Prevention. RTI.(2017). Peer Education Training Manual on Adolescence Sexuality and Reproductive Health and Teen Pregnancy Prevention 2. Responsible Parenthood and Family Planning. RTI. (2017). Peer Education Training Manual on Adolescence Sexuality and Reproductive Health and Teen Pregnancy Prevention. In a general sense, Reproduction is one of the most important concepts in biology. It means making a copy, a likeness, and thereby providing for the continued existence of species. Definition of terms:  Ovulation is a part of a female’s menstrual cycle when a mature egg is released from the ovary and travels to the fallopian tube for possible fertilization.  Conception is the time when sperm travels up through the vagina, into the uterus, and fertilizes an egg found in the fallopian tube.  Fertilization the time when a sperm cell successfully meets an egg cell in the fallopian tube.  Pregnancy is the period in which a fetus develops inside a woman's womb or uterus. How does Pregnancy occur? Now that you are already familiar with important terminologies, you will know that pregnancy can involve a surprisingly complicated series of steps. Let’s take a closer look at these processes. 41 | Page  EGE 311 – GENDER AND SOCIETY It starts with sperm cells and an egg cell. During Ovulation, a female releases one mature egg and it travels through the fallopian tube towards your uterus. When a male and female have sexual intercourse, the sperm cells get into the vagina through ejaculation. The sperm cells then swim up through the cervix and uterus and into the fallopian tube, looking for an egg. If one sperm does make its way into the fallopian tube and burrows into the egg, it fertilizes the egg and is called a zygote. At the instant of fertilization, the baby’s genes and sex are set. The zygote moves down to the fallopian tube towards the uterus forming a ball of cells called blastocyst. The blastocyst floats in the uterus for 2 to 3 days before it attaches to the lining of the uterus. This is called implantation, when pregnancy officially begins. A pregnancy hormone known as Human chorionic Gonadotropin hormone is in the blood from the time of implantation. The HcG prevents the lining of the uterus from shedding. If the egg does not meet up with the sperm or does not implant tin the uterus, the thick lining of the uterus pass out of the body during menstruation. The occurrence of menstrual period among females occurs at an average age of 12.3 years. It signals maturation of the adolescent female body. It commonly is associated with the ability to ovulate and reproduce. However, the appearance of menarche does not guarantee either ovulation or fertility. Teenage Pregnancy Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female under the age of 20. IT has a tremendous impact on the 42 | Page  EGE 311 – GENDER AND SOCIETY educational, social and economic lives of young people. Early parenting reduces the likelihood that a young woman will complete high school and pursue the necessary post-secondary education needed to compete in today’s economy. Although there is a decline in teenage pregnancy rates it has been steady over the past two decades. Teens are still engaging in sexual activity and teenage girls are still getting pregnant. Equipping the youth with the knowledge, skills and attitudes necessary to protect themselves against unwanted pregnancy and provide them access to reproductive healthcare are needed. Health consequences Early pregnancies among adolescents have major health consequences for adolescent mothers and their babies. For the infant  Low birth weight  Preterm birth  Higher peri- and post-neonatal mortality For the mother  Anemia  Delayed prenatal care  Depression  Inadequate weight gain  Pregnancy induced hypertension  Eclampsia  Second birth as a teen Social consequences of adolescent pregnancy Adolescent pregnancy can also have negative social and economic effects on girls, their families and communities. Unmarried pregnant adolescents may face stigma or rejection by parents and peers and threats of violence. Similarly, girls who become pregnant before age 18 are more likely to experience violence within marriage or a partnership. With regards to education, school-leaving can be a choice when a girl perceives pregnancy to be a better option in her 43 | Page  EGE 311 – GENDER AND SOCIETY circumstances than continuing education, or can be a direct cause of pregnancy or early marriage. Based on their subsequent lower education attainment, may have fewer skills and opportunities for employment, often perpetuating cycles of poverty. Teenage Pregnancy Prevention The surest way to avoid pregnancy is not to have sex. Or if you do have sex, to always use contraception. Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ways: Preventing sperm from getting to the eggs. You have a choice among either to use Artificial and /or Natural methods. Chart for Contraception Type of Benefits other Contraceptive How it Instruction than Method works Effectiveness Benefits for use Contraception Low cost; easily Pill Alters available; (contains natural controlled Taken daily after synthetic ovulation by the menstrual cycle estrogen) cycle. 99-100% woman begins None Injections (given in the 1st days if the menstruation and then every 2-3 months) Not known Given by doctor None Withdrawal No cost (removal of under the the penis Prevents control of from the semen from the man and vagina before going into the woman Dependent on ejaculation) the vagina 70-85% involved the man None Inserted by a doctor in the first few days of Inserted Long-lasting menstruation; 44 | Page  EGE 311 – GENDER AND SOCIETY inside the and should be Intrauterine uterus by a relatively examined every Device (IUD) doctor 95-98% inexpensive few months None Male Condom Low cost; (rubber easily Do not use with Can be sheath that accessible oil-based effective in fits over the Rolled over and reduces lubricants(creams preventing of penis) the penis 80-85% risk of STIs and lotions) STI’s/HIV/AIDS Implant of the Implantable Continuous Continuous capsule in the hormone release of birth control upper arm; done Device hormones Not known for 5 years by the doctor. None Allows the woman to No cost and Woman must Calendar keep track under the keep track with Method of “safe” control of the help of a cycle. days for sex. 60-80% the woman calendar, None Passageway Highly Sterilization for the effective, (Vasectomy sperm or the permanent for males and egg is and one- tubal ligation surgically time Doctor performs for females) tied. 100% expense. the operation. None  EGE 311 – GENDER AND SOCIETY Lesson 3 3 Sexual Health and Hygiene Learning Outcomes When you finish reading this chapter, you should be able to: 1. Identify the important health habits for the developing adolescent. Time Frame: Week 6 Introduction Puberty causes all kinds of changes in the adolescent’s body. These bodily changes are normal part of developing into an adult. There are instances when these changes can be a source of anxiety to the growing teen. Does anyone not worry about smelly breath and underarms? This further puts personal hygiene and health habits being important life skills for the teen.  Abstraction Definition of Terms:  Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.  Hygiene refers to behaviors that can improve cleanliness and lead to good health. 48 | Page  EGE 311 – GENDER AND SOCIETY  Sexual Health refers to a state of physical, emotional, mental and social well-being in relation to sexuality: it is not merely the absence of disease, dysfunction or infirmity. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences. Free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.  Reproductive health refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in all matters relating to the reproductive system and to its functions and processes at all stages of life. It suggests that people with adequate reproductive health have a satisfying and safe sexual life, can have children, and can make a choice as to whether they would like to have children and when and how to prevent them. Let’s talk about teen hygiene Oily Hair Teenagers with greasy hair is a common occurrence. As you’ve probably been told many times, hormones are up and down during this time. The hormones that create acne are the ones responsible for your oily hair too. Each strand of hair has its own sebaceous gland which keeps hair shiny and waterproof. But during puberty when the sebaceous glands produce extra oil, it can make you hair look too shiny, oily and greasy. What to do:  Wash hair regularly.  Do not scrub or rub hair and scalp too hard.  Use conditioner for oily hair.  Pay attention to products you use on your hair. 49 | Page  EGE 311 – GENDER AND SOCIETY Sweat and body odor Perspiration or sweat comes from sweat glands that you have always had in your body. During puberty, these glands become more active and secrete different chemical into the sweat that has a stronger smelling odor. What to do:  Bathe or shower everyday using soap and warm water.  Wear clean clothing everyday (shirts, socks, underwear)  Cotton clothing is recommended as it will help absorb sweat more effectively  To prevent sweaty and underarm odor, use deodorant with antiperspirant. Body Hair Growing body hairs are again due to hormones in action. What to do: (if you decide to shave)  Make sure, blade of your razor is new and sharp to prevent cuts and nicks.  If you razor does not have shaving gel right in the blade area, use shaving cream or gel because they make it easier to pull the razor against your skin.  Do it slowly and carefully to prevent cutting yourself. Dental Hygiene Dental health problems like tooth decay, gum bleeding or swelling, foul breath are indicative of poor health. Dental health problems can cause poor self- esteem and can lower the adolescent’s body image, especially at a time when they are very conscious of their appearance. Explore the issue of body image with the adolescent. 50 | Page  EGE 311 – GENDER AND SOCIETY How does one care for his/her teeth and oral/dental health?  Brush your teeth regularly especially after eating sweet foods;  Make the use of the dental floss a part of your routine after brushing;  Visit the dentist twice a year;  Have a dental prophylaxis of the teeth as advised by the dentist;  Avoid the use of coffee, tea, colas, and certain drugs that discolor the teeth;  Avoid cigarette smoking which discolors the teeth, makes your breath foul, and puts you at risk for many diseases;  Increase your intake of water  Do not share toothbrush with other members of the family. Health care check for the female Breast Self-Exam Breast self-exam, or regularly examining your breasts on your own, can be an important way to find a breast cancer early, when it’s more likely to be treated successfully. While no single test can detect all breast cancers early, performing breast self-exam in combination with other screening methods can increase the odds of early detection. The best time for a self-breast exam is about a week after the last day of your menstrual period, when your breasts are tender and swollen. This should be done at the same time each month. How to do a Breast Self-Exam: The 5 Steps Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here's what you should look for: 51 | Page  EGE 311 – GENDER AND SOCIETY  Breasts that are their usual size, shape, and color  Breasts that are evenly shaped without visible distortion or swelling If you see any of the following changes, bring them to your doctor's attention:  Dimpling, puckering, or bulging of the skin  A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)  Redness, soreness, rash, or swelling Step 2: Now, raise your arms and look for the same changes. Step 3: While you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood). Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger 52 | Page  EGE 311 – GENDER AND SOCIETY and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage. Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4. Keeping the external female genitalia clean  Wash the external genitalia every day especially during menstruation.  According to most skin care specialists, soap is optional for the vulva as they can affect the healthy balance of bacteria and pH levels in the vagina and cause irritation. If you choose to use soap, use plain, unperfumed ones to wash the vulva gently every day.  Wash only the external parts. Do not try to clean the internal genitalia.  The close proximity of the urethra and the rectum makes women susceptible to urinary tract infections (UTIs) because bacteria from the anus can enter the urethra. Avoid contamination of the urethra by “wiping from front to back” following urination or bowel movement. 53 | Page  EGE 311 – GENDER AND SOCIETY  Wear clean, soft and moisture-wicking underwear.  Avoid wearing anything tight against the vulva.  Be aware of any changes in your vaginal fluids – color or odor. If you see and observe any, please visit a health professional immediately. Healthcare Check for the males  Wash the external genitalia using water and unscented, mild soap. Don’t use harsh soaps or scrub the area too hard, as the sensitive skin in the area can be irritated.  Uncircumcised males need to pull back the foreskin and gently wash underneath. Poor hygiene can cause a build-up of smegma, an oily, malodorous, and irritating substance that is known to occur below the foreskin. If smegma builds up, it can cause inflammation to the adjacent skin. This can be uncomfortable and can be a cause balanitis, a condition where the head of the penis becomes red and inflamed.  Use loose-fitting, cotton underwear to prevent irritation.  Seek medical attention immediately if you notice unusual penile discharges, odors, blisters or sores.  EGE 311 – GENDER AND SOCIETY Lesson 4 4 Risky Behaviors and Adolescents Learning Outcomes When you finish reading this chapter, you should be able to: 1. Identify trouble signs that can lead to risky behaviors and its complications; 2. Discuss how to avoid risky behaviors. Time Frame: Week 6 Introduction Adolescence is one of the most important developmental period in which person grows and matures physically, mentally, cognitively, socially and emotionally. It is important to examine the developmental characteristics, risky behaviors and counseling during adolescence period. Risky behaviors restrain adolescents to become responsible adults by threatening their well-being. Preventive interventions should reduce risk factors and enhance protective factors.  Abstraction INDEPENDENT READING Powerpoint Presentations: 1. The Basics of STI and HIV-AIDS RTI.(2017). Peer Education Training Manual on Adolescence Sexuality and Reproductive Health and Teen Pregnancy Prevention 2. STI/HIV-AIDS and the Youth RTI.(2017). Peer Education Training Manual on Adolescence Sexuality and Reproductive Health and Teen Pregnancy Prevention 3. Drug Abuse in the Philippines RTI.(2017). Peer Education Training Manual on Adolescence Sexuality and Reproductive Health and Teen Pregnancy Prevention 58 | Page  EGE 311 – GENDER AND SOCIETY Understanding Developmental Characteristics of Adolescents Physical Development There are three main physical changes that come with adolescence:  The growth spurt (an early sign of maturation);  Primary sex characteristics (changes in the organs directly related to reproduction);  Secondary sex characteristics (bodily signs of sexual maturity that do not directly involve reproductive organs). Cognitive Development Adolescent thinking is on a higher level than that of children. Children are only able to think logically about the concrete, the here and now. Adolescents move beyond these limits and can think in terms of what might be true, rather than just what they see is true. They are able to deal with abstractions, test hypotheses and see infinite possibilities. Yet adolescents still often display egocentric behaviors and attitudes. Emotional Development Adolescents are also developing socially and emotionally during this time. The most important task of adolescence is the search for identity. (This is often a 59 | Page  EGE 311 – GENDER AND SOCIETY lifelong voyage, launched in adolescence.) Along with the search for identity comes the struggle for independence. Risk Behaviors of Adolescents in the Philippines Majority of the youth mature successfully through adolescence without apparent long term problems. All adolescents should be considered at risk due to the prevalence of risk behaviors, the inherent developmental needs of adolescents, and the various risk factors for their initiation and maintenance. Risk taking is a normal part of adolescent development. Risk taking is defined as participation in potentially health compromising activities with little understanding of, or in spite of an understanding of, the possible negative consequences. Adolescents experiment with new behaviors as they explore their emerging identity and independence. The concept of risk has been established as a characteristic that exposes adolescents to threats to their health and well- being. Young people may be exposed to similar risks but respond differently. Some may not sustain any physical or emotional damage while others may be affected for the rest of their lives. Trouble Signs among Teens: Sexual promiscuity Regular use of drugs and alcohol Repeated violation of the law or school regulation Running away more than once in 3 months Skipping school more than once in 3 months Aggressive outbursts/ Impulsiveness Dark drawings or writings Deterioration in hygiene Oppositional behavior Refusal to work/ non-compliance Chronic lateness Falling asleep in class Changes in physical appearance Excessive daydreaming Source: DOH Adolescent Job Aid Manual 2009 60 | Page  EGE 311 – GENDER AND SOCIETY During adolescence, young people begin to explore alternative health behaviors including: Smoking, drinking alcohol, drug use, sexual intimacy, and violence. The Department of Health, in its Adolescent and Youth Health Policy (2000), has identified the following health risks: substance use, premarital sex, early childbearing, abortion, HIV/AIDS, violence, accidents, malnutrition and mental health. Adolescents Health Risks Alcohol use Alcohol is the most frequently used drug by teenagers. Unintentional injuries are the leading cause of death among 15 to 24 years old and many of these injuries are related to alcohol use. Young people who drink are more likely to use tobacco and other drugs and engage in risky sexual behavior than those who do not drink. Drinking alcohol may lead to the following effects:  decreases ability to pay attention  the younger a person is when they begin drinking, the more likely they are to develop a problem with alcohol  deaths due to car crashes in which underage drinking is involved  alcohol is involved in nearly half of all violent deaths involving teens  suicide  likely to engage in sexual activity, unprotected sex, or have sex with a stranger  excess alcohol use can mask other emotional problems, like anxiety or depression  use of other drugs, like marijuana. 61 | Page  EGE 311 – GENDER AND SOCIETY Substance Abuse Substance abuse is the overuse of a drug, with no due regard to accepted medical practices resulting in the individual’s physical, mental, emotional, or behavioral impairment. This results in problems at home (such as more arguments with parents), at school (such as failing grades), or with the law (such as driving under the influence or possessing illegal substances). The effects cause changes in a teen's alertness, perceptions, movement, judgment, and attention. These make the teen more likely to engage in risk-taking behaviors. Cigarette Smoking Adolescents smoke for the following reasons:  social norm (“to be cool”)  curiosity  advertising  social pressure  pleasure  addiction What are the health effects of tobacco?  Cardiovascular: ischemic heart disease, cerebrovascular disease, peripheral vascular disease  Cancer: lung, head and neck, esophageal, gastric, colorectal  Endocrine: menstrual disorders, decreased bone mineral density, erectile dysfunction  Pulmonary: COPD  Gastrointestinal: gastroesophageal reflux, peptic ulcer disease  Dermatologic: premature wrinkling  Pregnancy complications: low birth weight, IUGR, SGA, spontaneous abortion, PROM, SIDS 62 | Page  EGE 311 – GENDER AND SOCIETY Identified Sexual Risks that were found among the growing Filipino adolescents One in three has sexual experience. They also engage in sex at a younger age: first sex for boys: 17.6 years old while first sex for girls: 18.1 years old. One in 50 had sex before age 15 while one in 4 had sex before 18 years old. 7 in 10 of first premarital sex cases a re unprotected against unintended pregnancy and sexually transmitted infections including HIV-AIDS. Sex and Media have been identified as key influencers among adolescents engaging in high risk behaviors, as shown in studies in NCR and CALABARZON. 3 in 5 have watched X-rated movies and videos, the 4th highest in the country. 3 in 10 have sent or received sex videos through cell phones or internet, the 2nd highest in the country. 6 in 100 have engaged in phone sex, higher than the national average. Guidance of family is very important as the adolescent develops into a mature adult. Family arrangement, based on the 2006 McCann Erickson Study, has noted the 53% of adolescents live with both parents. Because of the Overseas Filipino Worker (OFW) phenomenon, 5% live without the mother, 20% live without the father and 23% live without parents. Preventing Multiple Risky Behaviors among Adolescents Strategies to prevent risky behaviors among adolescents include school and extra-curricular activity involvement, safe environments, and positive relationships with caring adults. 1. Support and Strengthen Family Functioning Teaching parents how to cope with stress, communicate clear expectations, eliminate coercive parenting, and reward positive behaviors appears to prevent and deter children and youth from engaging in risky behavior. 2. Increase Connections between Students and Their Schools 63 | Page  EGE 311 – GENDER AND SOCIETY Children and youth who feel connected to their schools are less likely to bully or be bullied, to engage in delinquent behavior, and to use drugs and alcohol. 3. Make Communities Safe and Supportive for Children and Youth Children and youth who live in safe, supportive communities are less likely to use drugs, exhibit aggressive behavior, commit crimes, and drop out of school. 4. Promote Involvement in High Quality Out-of-School-Time Programs Involvement in high quality out-of-school-time programs has been linked with decreased drug abuse, delinquency, and sexual risk-taking behaviors. 5. Promote the Development of Sustained Relationships with Caring Adults Children and youth who report that they have positive relationships with adults and those who receive mentoring in the context of a long-term supportive relationship are more likely to succeed on multiple fronts. 6. Provide Children and Youth Opportunities to Build Social and Emotional Competence Children and youth with strong social and emotional competence are less likely to engage in risky behaviors related to aggression, substance use, and sexual risk taking. 7. Provide Children and Youth with High Quality Education during Early and Middle Childhood Children who receive high-quality early care and/or high-quality education in elementary school are less likely to engage in substance use and risky sexual behavior when they get older