Sexuality and Human Reproduction PDF

Sexuality and Human Reproduction 1. HUMAN SEXUALITY and its Moral Evaluation OBJECTIVES: 1. Define sexuality in different aspects specifically in: Religious, Biological & Sociological 2. Define marriage and identify the requisites of marriage. 3. Identify the issues on human sexuality and marr...

Sexuality and Human Reproduction 1. HUMAN SEXUALITY and its Moral Evaluation OBJECTIVES: 1. Define sexuality in different aspects specifically in: Religious, Biological & Sociological 2. Define marriage and identify the requisites of marriage. 3. Identify the issues on human sexuality and marriage and distinguish them from one another. 4. Recognize the important laws that governs issues on human sexuality and marriage in the Philippines. SEXUALITY BIOLOGICAL ASPECTS ◦Humans are primarily grouped into male or female sex. The biological aspects of human sexuality deal with the reproductive system, and the factors that affects these aspects. MALE REPRODUCTIVE ORGAN The male gamete, or sperm, and the female gamete, the egg or ovum, meet in the female's reproductive system. When sperm fertilizes (meets) an egg, this fertilized egg is called a zygote. FEMALE REPRODUCTIVE ORGAN It produces the female egg cells necessary for reproduction  I. "MALE AND FEMALE HE CREATED THEM..." 2331 "God is love and in himself he lives a mystery of personal loving communion. Creating the human race in his own image.... God inscribed in the humanity of man and woman the vocation, and thus the capacity and responsibility, of Sexuality love and communion."115 "God created man in his own image... male and female he defined by created them";116 He blessed them and said, "Be fruitful and multiply";117 "When God created man, he made him in the the Catholic likeness of God. Male and female he created them, and he blessed them and named them Man when they were created."118 Church 2332 Sexuality affects all aspects of the human person in the unity of his body and soul. It especially concerns affectivity, the capacity to love and to procreate, and in a more general way the aptitude for forming bonds of communion with others. Pontiff’s remark on homosexuality: In 2013, Pope Francis reaffirmed the Roman Catholic Church's position that homosexual acts were sinful, but homosexual orientation was not. "If a person is gay and seeks God and has good will, who am I to judge?" - Pope Francis Sociological definition of sexuality Sexuality is viewed as a person’s capacity for sexual feelings. Studying sexual attitudes and practices is a particularly interesting field of sociology because sexual behavior is a cultural universal. Throughout time and place, the vast majority of human beings have participated in sexual relationships (Broude 2003). What is considered “normal” in terms of sexual behavior is based on the norms and values of the society. Societies that value monogamy, for example, would likely oppose extramarital sex. Individuals are socialized to sexual attitudes by their family, education system, peers, media, and religion. The Difference between Sex and Gender 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 is a term that refers to social or cultural distinctions associated with being male or female. Gender identity is the extent to which one identifies as being either masculine or feminine. Sexual Orientation Sexual orientation refers to a person’s emotional and sexual attraction to a particular sex (male or female). Sexual orientation is typically divided into four categories: heterosexuality, the attraction to individuals of the opposite sex; homosexuality, the attraction to individuals of one’s own sex; Bisexuality, the attraction to individuals of either sex; And asexuality, no attraction to either sex. Heterosexuals and homosexuals may also be referred to informally as “straight” and “gay,” respectively. Gender Roles 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. In Canadian culture, masculine roles are usually associated with strength, aggression, and dominance, while feminine roles are usually associated with passivity, nurturing, and subordination. Role learning starts with socialization at birth. Gender Identity Gender identity is an individual’s self-conception of being male or female based on his or her association with masculine or feminine gender roles. Individuals who identify with the role that is the opposite of their biological sex are called transgendered. Transgendered individuals who wish to alter their bodies through medical interventions such as surgery and hormonal therapy—so that their physical being is better aligned with gender identity—are called transsexuals. They may also be known as male-to-female (MTF) or female-to-male (FTM) transsexuals. NATURE AND DEFINITION OF MARRIAGE ✓ Humankind’s most basic and oldest social unit is the family. It is a social institution primarily established by society to ensure continuity and to regulate sexual behavior of its members. ✓ The family is the primary group where the child is initially socialized and initiated in the ways of life of his group. ✓ The family provides the child’s social, psychological and emotional needs – warmth, intimacy, affection, love, nurturance, care and security. Aspects of Marriage: Legal point of view (RA 3613 Marriage Law) Posits that marriage is a contract. Religious point of view Posits that marriage is a sacrament “What god has put together let no man put asunder” THE FAMILY CODE OF THE PHILIPPINES EXECUTIVE ORDER NO. 209  Marriage is a special contract of permanent union between a man What is and a woman entered into in accordance with law for the marriage establishment of conjugal and family life. It is the foundation of according to the family and an inviolable social the family institution whose nature, consequences, and incidents are code of the governed by law and not subject to stipulation, except that marriage Philippines? settlements may fix the property relations during the marriage within the limits provided by this Code. Legal capacity of the contracting parties who must be a male and a female.(Article2) A marriage ceremony which takes place with the appearance of the contracting parties before the solemnizing officer and their personal declaration that they take each other as husband and wife in the presence of not less than two witnesses of legal age. Persons Authorized to Solemnize Marriage. — Marriage may be solemnized by — 1.The Chief Justice and Associate Justices of the Supreme Court; 2.The Presiding Judge and Appellate Judges of the Court of Appeals; 3.Judges and Judges-at-large of the Courts of First Instance; 4.The municipal judges and justices of the peace; and 5.Priests or ministers of the gospel of any denomination, church, sect or religion, and chaplains of the Army and Navy of the United States registered in the Philippine National Library as provided in Chapter IV of this Act. (Commonwealth Act 62, Section 1) Who can solemnize marriage? If your marriage is solemnized by an officiant, he/she should sign on the line titled “Signature of Officiating Party” and write his/her title on the line titled “Print Title of Officiating Party."  Issues on Sex Outside Marriage Premarital Sex is defined as sex before cohabitation or formal marriage. (The 2013 Young Adult Fertility and Sexuality Study in the Philippines, 2014; 2013) Adultery refers to an extra marital relationship of a woman to a man other than her husband even if the man is well aware that the she is already married, and concubinage refers to the cohabitation of a married man with a mistress in the same or conjugal dwelling or an involvement of a married man with a woman who is not his wife in any other place. (Gazette, 1930) Both are considered as extramarital sex. Fornication is carnal union between an unmarried man and an unmarried woman. It is gravely contrary to the dignity of persons and of human sexuality which is naturally ordered to the good of spouses and the generation and education of children. Moreover, it is a grave scandal when there is corruption of the young. (Vaticana, 1993) Sexual and Reproductive Health In the Philippines, an increasing proportion of adolescents and young people have early sexual encounters. In 2013, 1 in 3 young people report having premarital sex. The prevalence of early sexual encounters has increased over the last 20 years. Males are more likely to report having premarital sex than females. In 2013, 36% of males reported having early sexual encounters compared to 29% of females. The highest levels of early sexual encounters are reported in NCR (41%) & Central Luzon (31%) regions. Also, many young people marry young, and it is important that they have good information before they are married so that they can make healthy, informed decisions. (The 2013 Young Adult Fertility and Sexuality Study in the Philippines, 2014; 2013) According to the Bible: You shall not commit adultery. Exodus 20:14 New International Version (NIV) 27You have heard that it was said, ‘You shall not commit adultery.’[a]28 But I tell you that anyone who looks at a woman lustfully has already committed adultery with her in his heart. Matthew 5:27-28 New International Version (NIV) According to the Catholic Church Adultery refers to marital infidelity. When two partners, of whom at least one is married to another party, have sexual relations - even transient ones - they commit adultery. Christ condemns even adultery of mere desire. (Vaticana, 1993) The expression covers a number of different situations: concubinage, rejection of marriage as such, or inability to make long-term commitments.182 All these situations offend against the dignity of marriage; they destroy the very idea of the family; they weaken the sense of fidelity. They are contrary to the moral law. The sexual act must take place exclusively within marriage. Outside of marriage it always constitutes a grave sin and excludes one from sacramental communion. (Vaticana, 1993) Continuation: Some today claim a "right to a trial marriage" where there is an intention of getting married later. However, firm the purpose of those who engage in premature sexual relations may be, "the fact is that such liaisons can scarcely ensure mutual sincerity and fidelity in a relationship between a man and a woman, nor, especially, can they protect it from inconstancy of desires or whim. (Vaticana, 1993) According to the 1930 Revised Penal Code of the Philippines: Adultery and Concubinage ARTICLE 333. Who are Guilty of Adultery. — Adultery is committed by any married woman who shall have sexual intercourse with a man not her husband and by the man who has carnal knowledge of her, knowing her to be married, even if the marriage be subsequently declared void. Adultery shall be punished by prisión correccional in its medium and maximum periods. If the person guilty of adultery committed this offense while being abandoned without justification by the offended spouse, the penalty next lower in degree than that provided in the next preceding paragraph shall be imposed. ARTICLE 334. Concubinage. — Any husband who shall keep a mistress in the conjugal dwelling, or, shall have sexual intercourse, under scandalous circumstances, with a woman who is not his wife, or shall cohabit with her in any other place, shall be punished by prisión correccional in its minimum and medium periods. The concubine shall suffer the penalty of destierro. (Gazette, 1930) Issues on Contraception, its Morality, and Ethico- moral Responsibility of Nurses  Contraception and Family Planning LEARNING OBJECTIVES 1 hour 50 mins Explore misbeliefs associated with contraception and the full range of contraceptive methods Identify the main components of family planning and contraceptive services Provide quality counseling on contraception and contraceptive choices to women and gender non-conforming people who use drugs Identify the main barriers to accessing contraception and potential approaches to overcome the barriers  Contraception and family planning GAME: 15 mins Find your correct match! 3 contraceptive methods 3 profiles DISCUSSION: 15 mins  Contraception and family planning BASIC INFORMATION AND CHOICES There are a lot of beliefs and misconceptions associated with contraceptives methods. For example:  Contraceptive methods can cause infertility  Women lose libido with hormonal contraception  Contraceptive methods can cause birth defects Health professional and harm reduction providers may also share these beliefs. The lack of accurate information will impact and limit people’s choices around pregnancy prevention. Every person will have different needs and preferences for contraception. Give them a choice!  Contraception and family planning METHODS OF CONTRACEPTION The main effective methods of contraception are: Hormonal methods: implants, pills (progestogen and combined),IUD, injectables Other methods: copper IUD, vasectomy and female sterilisation Barrier methods: internal (female) and external (male) condoms, diaphragm Other methods exist but are less effective and are not under the control of women (for instance the natural method of withdrawal).  Contraception and family planning HORMONAL METHODS Small, flexible rods or capsules placed under the skin of the upper arm; Implant contains progestogen hormone only. A healthcare provider must insert and remove it. It can be used for 3–5 years, depending on implant. Irregular vaginal bleeding common but not harmful. Efavirenz-based ART may reduce the effectiveness of the implant. Women living with HIV should receive appropriate counselling to choose the contraceptive method most suited to their situation. It thickens cervical mucous to block sperm and egg from meeting and Progestogen-only pills prevents ovulation. It is highly effective when taken correctly and consistently. Can be used while breastfeeding. Must be taken at the same time each day Contains two hormones (estrogen and progestogen). Combined Prevents the release of eggs from the ovaries (ovulation). Reduces risk of endometrial and ovarian cancer but not other cancers. contraceptive pills It is highly effective when taken correctly and consistently. For women who use drugs it may increase the risk of vein problems, such as venous thrombosis or varicose veins. Check with a health professional.  Contraception and family planning OTHER METHODS Small flexible plastic device containing copper sleeves or wire that The copper IUD is inserted into the uterus. Copper component damages sperm and prevents it from meeting (Intrauterine device) the egg. Longer and heavier periods during first months of use are common but not harmful. Permanent contraception to block or cut the vas deferens tubes Vasectomy that carry sperm from the testicles. It keeps sperm out of ejaculated semen. It is highly effective after three months. Does not affect male sexual performance. Voluntary and informed choice is essential. Permanent contraception to block or cut the fallopian tubes. Female Sterilisation Eggs are blocked from meeting sperm. It is highly effective and informed choice is essential.  Contraception and family planning BARRIER METHODS The diaphragm and cervical cap are dome-shaped and made of silicone. The Diaphragm, cervical cap covers only the cervix. The diaphragm is larger. It lodges behind your pubic bone. You need to use cap, sponge spermicide with the diaphragm or cap to help prevent pregnancy. The diaphragm, cervical cap and sponge are among the least effective forms of birth control. Made of very thin latex or polyurethane, it fits over an erect penis. External condom (male Forms a barrier to prevent sperm and egg from meeting. It is effective when used correctly and consistently, with lubricant. condom) Can prevent unintended pregnancy and also protects against sexually transmitted infections, including HIV. Made of very thin, transparent, soft polyurethane – most are latex-free. Internal condom It fits loosely inside the vagina. Unlike external condoms, internal condoms can be used even when the penis isn’t (female condom) erect. Can be used for vaginal and anal sex. It is best to insert the internal condom ahead of time, and always before and until vaginal or anal sex is finished. It is effective when used correctly and consistently (with lubricant). It can prevent unintended pregnancy and HIV, and it offers increased protection against SITs by partially covering external genitalia.  Contraception and family planning EMERGENCY CONTRACEPTIVE PILLS Also called the ‘morning after’ pill. Emergency contraception is not an abortive method as the pill helps avoid conception. Pills are high dose hormonal pills that can be taken up to 72 hours AFTER intercourse but the sooner someone uses emergency contraception the more effective it is. If it contains two pills, take both at the same time. There are no major side effects, but some people may experience vomiting, headache or breast tenderness. If the period does not start in three weeks after taking the pill, check for pregnancy.  Contraception and family planning DUAL PROTECTION People who use drugs and their sexual partners must be counselled on dual protection strategies to prevent the transmission of HIV and STIs, as well as to avoid unintended pregnancy. These include: Condoms, plus another contraceptive method Condoms, plus emergency contraception if condom fails Selectively using condoms and another method (for example, using the pill with the main partner, but the pill plus condoms with others).  Contraception and family planning FERTILITY/INFERTILITY Infertility is a problem for both men and women, but women are often the ones who are blamed. Infections, some reproductive cancers, abnormalities of the reproductive tract (including blocked fallopian tubes), fibroids or long- term hormone use among trans-women can cause infertility. Environmental and lifestyle factors play also a role. Contraceptives do not cause infertility problems.  Contraception and family planning KEY FAMILY PLANNING AND CONTRACEPTIVE SERVICES INCLUDE: Accurate information on a wide range of methods Counselling about the desire to have children Availability of condoms and lubricants and other contraceptives methods Emergency contraception Encouraging shared responsibility between partners Addressing infertility issues and their social consequences  Contraception and family planning ROLE PLAY: 20 mins Based on the stories, provide counselling on contraceptive methods. One person plays the role of a women who uses drugs, the other the health professional/harm reduction provider. DEBRIEFING AND DISCUSSION: 10 mins Do you think the counsellor provided accurate information? As a client, do you feel you were given a choice (informed choice)? Why? As a counsellor, did you feel you could respect the choice of the woman? In your opinion, what are the most important skills needed to provide counselling on contraception?  Contraception and family planning COUNSELLING SKILLS Importance of providing accurate information Non-judgmental attitudes Active listening Clear communication without technical words – use simple language Respect people’s right to confidentiality, privacy and informed choice Non-discrimination (regardless of their age, family or social status, sexual behaviour, kind and frequency of drug use, etc.)  Contraception and family planning BRAINSTORMING 15 mins What are the main barriers to accessing contraception?  Contraception and family planning BARRIERS: APPROACHES TO OVERCOME BARRIERS Lack of access to services and limited choice of methods in Political level the country/area Advocacy to improve political priorities and funding to SRHR and to Legal restriction and lack of access to services for ‘under improve supply chains age’ (under 18 or 16 years old) and unmarried women, etc. Low quality of services (like lack of confidentiality) and Programmatic level negative attitudes of the professionals (judgement), Availability of appropriate services, including stocking a wide range of internalised-stigma contraceptive methods Gender-based violence Emergency pills available with peers on outreach Lack of autonomy in making health decisions Involvement and training of health professionals and harm reduction providers Lack of meaningful involvement of women and gender non- Support the meaningful involvement of women and gender non- conforming people who use drugs in service provision conforming people; support the development of skills and structure in Stigmatisation, and fear of stigma and hostility communities and networks Fear of violence or coercion to adopt long-acting or Creation of new services, such as individual or couple counselling on irreversible methods of contraception contraception Discrepancies between representations of women's Counselling couples on infertility sexuality and contraceptive needs Community level Lack of financial means Empowerment of women and gender non-conforming communities; Lack of knowledge, misbeliefs and fear of side effects, participation of communities perceived health risks Participation and buy-in of men and the wider community Non-recognition of sexuality among certain groups Developing education materials on contraception and the importance (teenagers, people with disabilities) of individual choice selecting contraceptive methods