Reproductive System: Sex, Gender & Sexuality - PDF

Reproductive System Sex, Gender & Sexuality HCAP 1210   Human reproduction results from the union of a male Reproductive sex cell and a female sex cell. System  The differences in the male and female reproductive systems allow...

Reproductive System Sex, Gender & Sexuality HCAP 1210   Human reproduction results from the union of a male Reproductive sex cell and a female sex cell. System  The differences in the male and female reproductive systems allow for the process of reproduction. Reproductive System Reproductive System Reproductive System  The external female genitalia are called the vulva.  The mons pubis is a rounded, fatty pad over a bone called the symphysis pubis.  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  If pregnancy does not occur, the endometrium (blood-rich lining of the uterus) breaks up and is discharged from the body through the vagina.  The uniting of the sperm and ovum into one cell is called fertilization. Reproductive  During intercourse, millions of sperm System  are deposited into the vagina. If a sperm and an ovum unite in a fallopian tube, fertilization results.  The fertilized cell travels down the fallopian tube to the uterus.  The fertilized cell implants in the thick endometrium and grows during pregnancy.  In men, the hormone testosterone decreases:  Affects strength, sperm production, and reproductive tissues Physical  An erection takes longer Changes to the Reproductive  The phase between erection and orgasm is longer  Orgasm is less forceful than when younger  Erections are lost quickly System  The time between erections is longer  Menopause occurs in women:  Menstruation stops  Woman can no longer have children Physical   Female hormones (estrogen and progesterone) decrease The uterus, vagina, and genitalia atrophy Changes to the  Vaginal walls thin and there is vaginal dryness Reproductive   Arousal takes longer Orgasm is less intense System  The pre-excitement state returns more quickly Sex, Gender, Sexuality  Sex: Refers to physical or physiological differences between males and females, including both primary sex characteristics (the reproductive system) and secondary characteristics such as height and muscularity.  Gender A term that refers to social or cultural distinctions associated with being male or female.  Gender Identity: The extent to which one identifies as being either masculine or feminine  Gender Expression: the way in which a person expresses their gender identity, typically through their appearance, dress, and behavior.  Sexuality: A person's sexual orientation or preference, in relation to the gender to which they are attracted.   Sex is a label — male or female — that you’re assigned by a doctor at birth based on the genitals you’re born with and the chromosomes you have. It goes on your birth certificate.  When someone’s sexual and reproductive anatomy Sex doesn’t seem to fit the typical definitions of female or male, they may be described as intersex.  Intersex people are individuals born with any of several variations in sex characteristics including chromosomes, gonads, sex hormones or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit the typical definitions for male or female bodies"   Gender is much more complex: It’s a social and legal status, and set of expectations from society, about behaviors, characteristics, and thoughts. Each culture has standards about the way that people should behave based on their gender. This is also generally male or female. But instead of being about body parts, it’s more about how you’re expected to act, because of your sex.  The two most common types of gender: Male and Gender Female  The term gender role refers to society’s concept of how men and women are expected to act and how they should behave. These roles are based on norms, or standards, created by society.  Gender is something a person figures out and expresses themselves, not something you can tell by looking at an ultrasound or a baby’s genitals. Gender Identity VS. Gender Expression Gender identity is each person’s Gender expression is how a internal and individual experience person publicly presents their of gender. It is their sense of being gender. This can include behaviour a woman, a man, both, neither, or and outward appearance such as anywhere along the gender dress, hair, make-up, body spectrum. A person’s gender language and voice. A person’s identity may be the same as or chosen name and pronoun are also different from their birth-assigned common ways of expressing sex. gender. Gender Identity Terms to Know! Non-binary: Any gender that Binary: The gender binary is a falls outside of the binary system of male/female or Cisgender: A term used to system of viewing gender as man/woman. describe someone whose consisting solely of two Gender Non Conforming gender identity aligns with the identities and sexes, man and Genderqueer sex assigned to them at birth. woman or male and female. Gender fluid: A person who Bigender: Someone whose Agender: A term for people does not identify with a single gender identity encompasses whose gender identity and fixed gender, and expresses a both man and woman. Some expression does not align with fluid or unfixed gender may feel that one side or the man, woman, or any other identity. One’s expression of other is stronger, but both gender. A similar term used by identity is likely to shift and sides are present. some is gender-neutral. change depending on context.  Transgender: An umbrella term for people whose gender identity and/or expression is different from cultural and social expectations based on the sex they were assigned at birth.  Trans Woman- Someone who is assigned as a male at birth, but identifies as a woman Trans Man- Someone who is assigned as a female at birth, but identifies as a man Gender  Transitioning: The social, legal, and/or medical process a person may go through to live outwardly as the gender with which they identify, rather than the gender they were assigned at birth. Transitioning can include Identity Terms some or all of the following: telling loved ones and co-workers, using a different name and pronouns, dressing differently, changing one’s name and/or sex on legal documents, hormone therapy, and possibly one or more types of surgery.  Transsexual person: A generational term for people whose gender identity is different from their assigned sex at birth, and seek to transition from to Know! male to female or female to male. This term is no longer preferred by many people, as it is often seen as overly clinical, and was associated with psychological disorders in the past.  Dead name: How some transgender people refer to their given name at birth. Gender Identity Terms to Know!  Gender questioning: A person who may be processing, questioning, or exploring how they want to express their gender identity.  Gender dysphoria: Clinically defined as significant and durational distress caused when a person’s assigned birth gender is not the same as the one with which they identify.  Passing: A term used by transgender people which means that they are perceived by others as the gender with which they self-identify.  Two-Spirit (also two spirit or, occasionally, twospirited) is a modern, pan- Indian, umbrella term used by some 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.  A person’s sex, as determined by his or her biology, does not always correspond with his or her gender. Therefore, the terms sex and gender are not interchangeable. A baby boy who is born with male genitalia will be identified as male. As he grows, however, Sex Vs. he may identify with the feminine aspects of his culture. Gender Since the term sex refers to biological or physical distinctions, characteristics of sex will not vary significantly between different human societies. For example, all persons of the female sex, in general, regardless of culture, will eventually menstruate and develop breasts that can lactate. Characteristics of gender, on the other hand, may vary greatly between different societies. For example, in American culture, it is considered feminine (or a trait of the female gender) to wear a dress or skirt. However, in many Middle Eastern, Asian, and African cultures, dresses or skirts (often referred to as sarongs, robes, or gowns) can be considered masculine. The kilt worn by a Scottish male does not make him appear feminine in his culture.   Sexual orientation: Your sexual orientation is 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; Sexuality  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. In other words, demisexual people only experience sexual attraction after an emotional bond has formed  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, It is normal for Promote ways to and intimacy do older adults to be meet the client’s not disappear sexual sexual needs See Respecting See Focus on and Promoting the Long-Term Care: Client’s Sexuality, Residents’ Sexual Box 21-3 (p. 379) Rights (p. 379) Safe Sex  Sex can still be satisfying but will be different from younger years, and might need to be adapted for current age, disability, illness, or surgery- induced body changes. Older adults are more vulnerable to sexually transmitted infections (STIs) than younger adults. Everyone should use safe sex practices.  All types of sex can spread STIs. Talk about your sexual histories, any past STIs, results of STI testing, and whether either of you has ever injected illegal drugs. (Besides sex, HIV/AIDS can also be acquired by sharing syringe needles.) Before having sex, check your partner’s penis or vaginal area for sores, abnormal discharges, or odors  Use one condom and lubricant every time you have vaginal, oral, or anal sex, including during foreplay, until you know your partner’s sexual history!!! Critical Thinking  Libby and Warren have been marrier for 50 years. Throughout their years together their health have respectively deteriorated to the point where they both require home health care. Libby is 64 and has rheumatoid arthritis, Warren is 65 who smoked all his life up until five years ago when he quit after a myocardial infarction. He also has COPD and wear contentious oxygen. He has lost more than 100 pounds in the past several years due to a declining appetite. For several years, he slept in a recliner chair. Libby and Warren each gave up having sexual intercourse with their former spouses many years ago. For Warren, this was due to his breathing difficulties and frequent inability to get an erection; for Libby it is related to her limited hip movement, which causes her pain during sex.  Libby asks the home health HCW “How can I have sex without pain?” What are three recommendations?  What other sexual activities can Libby and Warren try to satisfy themselves that don’t require intercourse?  What are suggestions for ridding the bedroom of irritants that may affect breathing?  What positions for sexual activity may be most tolerated?  What need from Maslow’s theory of hierarchy of needs is being sought?  Describe your level of comfort at this point in your professions insofar as including sexuality as a component of patient care. Critical Thinking!  Jill Talley is a 75-year-old widow living in an extended care facility. She had a stroke 2 years ago and has hemiplegia of her right arm and leg and expressive aphasia. She is clearly able to understand others, and she regularly directs her care. She occasionally needs assistance with hygiene and dressing, although she is independent most of the time. She is able to tolerate a regular diet and eats without assistance; she has no difficulty chewing or swallowing. Jill has a daughter living about an hour away who visits two or three times a month. Ross Walton is a 70-year-old widower living in the same extended care facility. He is completely independent in his ADL and walks without assistance. Ross is moderately impaired due to dementia. He knows where he is and who he is, but he cannot tell what day it is. Staff members need to be sure he has bathed and is wearing clean clothes. Ross likes to walk and sit outside, and he is extremely social. He frequently visits other residents and talks with them about their day. Ross also loves to be an escort for Carrie, a 10-year-old golden retriever owned by one of the staff. Ross takes Carrie from room to room, walks outside, and loves to sit with the dog for hours. Jill also loves Carrie. The nurses at the extended care facility have noticed a recent trend in the “rounds” that Ross makes during his room-to-room stops with Carrie. Jill’s room has become his last stop during the indoor visits with Carrie. Jill then accompanies Ross and Carrie on the short walk to the outside bench, where they have been seen sitting with Carrie and talking while holding hands.  “Sexuality is at the core of who we are and has an impact on our lives in so many ways. It does not stop once we hit the age of 60 or 70 or 90 or even 100 despite the myths and assumptions of society. Sexual desire does not necessarily dissipate with age, but the physical, cognitive, and psychosocial changes that can occur with aging may interfere with sexual outcomes. Issues of sexuality with older adults often become a taboo topic; whether it is the expression of desire or the inappropriate sexual acting out of the individual with disinhibition secondary to dementia”  Sexual expression has major benefits for an older person. What are these?  The statement, “A hundred staff members can have 100 different personal, moral, and religious approaches to sex, but there can only be one institutional approach.” How do you believe this goal can be accomplished?  Why are written policies addressing sexual expression imperative for long-term care facilities?  What are some ways in which the older adult might demonstrate his or her sexuality? Chlamydia  Most people who have chlamydia have no symptoms. If you do have symptoms, they may not appear until several weeks after you have sex with an infected partner. Even when chlamydia causes no symptoms, it can damage your reproductive system.  Women with symptoms may notice  An abnormal vaginal discharge;  A burning sensation when urinating.  Symptoms in men can include  A discharge from their penis;  A burning sensation when urinating;  Pain and swelling in one or both testicles (although this is less common). Gonorrhea  Some men with gonorrhea may have no symptoms at all. However, men who do have symptoms, may have:  A burning sensation when urinating;  A white, yellow, or green discharge from the penis;  Painful or swollen testicles (although this is less common).  Most women with gonorrhea do not have any symptoms. Even when a woman has symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Women with gonorrhea are at risk of developing serious complications from the infection, even if they don’t have any symptoms. Symptoms in women can include:  Painful or burning sensation when urinating;  Increased vaginal discharge;  Vaginal bleeding between periods. Genital Warts  In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus.  The signs and symptoms of genital warts include:  Small, flesh-colored, brown or pink swellings in your genital area  A cauliflower-like shape caused by several warts close together  Itching or discomfort in your genital area Genital Herpes  Most people who have genital herpes have no symptoms, or have very mild symptoms. You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it.  Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands. Pubic Lice  If you have pubic lice (crabs), you may experience intense itching in your genital region. Pubic lice can spread to other areas with coarse body hair, including the:  Legs  Chest  Armpits  Beard or mustache  Eyelashes or eyebrows, HIV Human Immunodeficiency Virus  HIV is a virus that damages the immune system. The immune system helps the body fight off infections. Untreated HIV infects and kills CD4 cells, which are a type of immune cell called T cells. Over time, as HIV kills more CD4 cells, the body is more likely to get various types of infections and cancers.  HIV is transmitted through bodily fluids that include:  blood  semen  vaginal and rectal fluids  breast milk  The virus doesn’t spread in air or water, or through casual contact.  HIV is a lifelong condition and currently there is no cure, although many scientists are working to find one. However, with medical care, including treatment called antiretroviral therapy, it’s possible to manage HIV and live with the virus for many years.  HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. AIDS Acquired Immunodeficiency Syndrome  Without treatment, a person with HIV is likely to develop a serious condition called AIDS. At that point, the immune system is too weak to fight off other diseases and infections. Untreated, life expectancy with AIDS is about three years  AIDS is a disease that can develop in people with HIV. It’s the most advanced stage of HIV. But just because a person has HIV doesn’t mean they’ll develop AIDS. Ensure Safe Sex is Being Practiced!!! “Don’t be silly, wrap your willy” “If you go into heat, package your meat!” “Don’t be a fool, cover your tool!” “No glove, no love!”  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 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. Range of Sexual Abuse Jokes about a senior Not paying attention Treating senior as a Sexual jokes about Minimizing his/her in her or his to his/ her, changing sex object (ogling). seniors. feelings and needs. presence. psychological needs. Sexual labels – such Criticisms about a Uncomfortable or Withholding Seeing need for as “frigid” or “dried senior sexually. unwanted touching. sex/affection. affection as sexual. up”. Senior not able to say “no”, due to Demanding sex with Forcing sex with self Always wanting sex. conditioning, Promiscuity. threats. or others. dementia, other reasons. Sex for purpose of Forcing hurting (use of uncomfortable sex. objects/weapons).  Ethel, a widow of 87 years of age, suffering from dementia is living in a pleasant care facility. One day, when a care aid was preparing her bath, Ethel started to cry and pulled away from her, holding her nightgown as tight as possible. The nurse inspected further and discovered bruise marks over her body.  When the nurses investigated, the lady in the next bed, also in stages of dementia, suddenly said, ” He comes in here late at night and attacks us both!”  What do you do? Case Study Reporting Abuse  Abuse is a crime  Canadian law states that we must report if we suspect that a child, person with mental or physical disability, or older adult is being abused  Listen attentively, reassure the client and provide emotional support  The person reporting  Is protected from any kind of legal action, provided the report is not falsely made and motivated by malice Reporting Abuse Suspected older-adult abuse How to report abuse All provinces and territories have The alleged victim’s name, address, laws that require health care workers phone number, age, and gender to report witnessed or suspected The alleged abuser’s name, address, abuse of older adults phone number, and relationship to Be sure to write down your the victim observations, including as many Description of abuse or neglect, details as possible suspicions, and evidence obtained to Know your employer’s policy and the date; the date, time, and place; only laws the facts that you know or were told by the victim—do not make assumptions Who to Call? SAIL – Seniors Abuse and Information Line Call: 604-437-1940 or Toll Free: 1-866-437-1940 7 days a week (excluding holidays), 8am to 8pm Language interpretation is available Monday through Friday, 9am to 4pm. Our Province wide confidential Seniors Abuse and Information Line (SAIL) is a safe place for older adults, and those who care about them to talk to a trained intake worker about abuse or mistreatment, receive information and support about issues that impact the health and well being of an older adult. Abuse of Health Care Workers  Caregivers are at risk of abuse from:  Family or other member of the team  Clients with mental health disorders, dementia  Employer  Never ignore or accept abuse  If abuse occurs:  Discuss with supervisor—put it in writing; keep records  May need to report it to the police Sexual Harassment Sexual comments, gestures, threats or If behaviour offends you or makes you uncomfortable, it is harassment suggestions Could be from client, family, co-worker Tell person firmly and politely that this is unacceptable and unwelcome Be assertive but not rude Discuss with supervisor; may need to keep private documentation All employers required to prevent sexual harassment and have policies on how to deal with this Sexually Aggressive Clients Behaviour may or may not be Be professional—ask person intentional not to touch you Flirting, exposing themselves, Inform person you will not do what they masturbating, inappropriate touching want Tell them those behaviours are unacceptable and uncomfortable If you feel unsafe, leave the room or house Discuss situation with nurse in charge Sexually Aggressive Client with Dementia Manage inappropriate Explain sexual behavior behavior when it to other people happens Identify triggers and try Make it difficult for to prevent the them to remove inappropriate behavior clothing from starting Talk with a doctor, Lean on trusted family nurse, or other or friends healthcare professional