NURS 2510 Sexuality PDF

Sexuality Concept Introduction NURS 2510 Sufia Turner RN MN Pawandeep Gill RN MN Picture - Stock image Student Learning Objectives Discuss definitions of sexuality and other definitions related to the concept of sexuality. Examine elements of the physiological sexual response. Discuss sexual wellbei...

Sexuality Concept Introduction NURS 2510 Sufia Turner RN MN Pawandeep Gill RN MN Picture - Stock image Student Learning Objectives Discuss definitions of sexuality and other definitions related to the concept of sexuality. Examine elements of the physiological sexual response. Discuss sexual wellbeing. Discuss sexuality as a developmental process. Explore factors potentially affecting the experience of sexuality in individuals. Picture - Stock image Purpose of Concept Introduction Provides foundational understanding of a concept that is related to nursing Previous concept introductions were development and sleep as it relates to individuals Throughout this course and the nursing program, this concept as well as others will be extended or scaffolded within different contexts Will look at: Sexual Response Age Related Differences Sexual Wellbeing/Illbeing Picture - Stock image Sexuality Sexuality is unique to the individual Is the core of who we are, and is dynamic throughout the lifetime Learning and understanding sexuality and sexual wellbeing of patients is an important part of providing holistic care How people experience and express themselves as sexual beings Includes how we express that sense of gender, whom we are attracted to, and who is attracted to us Picture - Stock image “A central aspect of being human throughout life encompasses sex, gender identifies and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. World Health Organization definition (S. Goebel, p 199 in Giddens, 2021) Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, behaviors, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, phycological, social, economic, political, cultural, legal, historical, religious and spiritual factors.” Canadian Institutes of Health Research (CIHR) Definition Sex refers to a set attributes in humans and animals. It is primarily associated with physical and physiological features including chromosomes, gene expression, hormone levels and function, and reproductive/sexual anatomy. Sex is usually categorized as female or male but there is variation, also referred to as intersex. The Sexuality Education Resource Center of Manitoba’s (SERC) definition Sexuality is a word we use to talk about how we understand our bodies and how we understand our relationships. This understanding includes all aspects of who we are – our values and beliefs, bodies, desires, relationships, gender and our thoughts and feelings about all of these. Because our sexuality is made up of so many different components, our understanding of our own sexuality is ever-changing and unique to each person. Gender Gender Definition by Canadian Institute of Health Research (CIHR) Sex is NOT the same as gender (SERC) Gender refers to socially or culturally defined ideas about masculinity and femininity. (SERC) Gender identity is about how someone thinks and feels about the gender they are. (SERC) Gender identity is self-determined, and may change over a person’s lifetime. (SERC) Picture - Stock image Sex, Sexuality and Gender ? Sex Assigned at Birth Sexuality Gender Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). Sex Assigned at Birth ? Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). Sex Assigned at Birth Sex Assigned at Birth - SAAB ? Sex Assigned at medicallyBirth assigned SAAB is a identity often attributed directly to the presence or absence of a penis. Sex encompasses many traits that include genitals, chromosomal make-up, hormones and internal and external reproductive organs. Variation exists! Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). Sex, Sexuality and Gender ? Sex Assigned at Birth Sexuality Gender Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). SEXUALITY ? Sexuality includes multiple components including but not limited to: Sexual Attraction – The gender(s) someone is physically attracted to. Romantic Attraction – The gender(s) someone is emotionally attracted to Sexual Behaviours –Gender The gender(s) someone prefers to engage in sexual activities with. Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). SEXUALITY SPECTRUM Asexual Romantic relationship,, Questioning Aromantic Biromantic Lesbian Bisexual Queer Heterosexual Queer Homosexual Pansexual Questioning Heteroromantic Panromantic Gayromantic/ Homoromantic Gay Gender Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). Sex, Sexuality and Gender Sex Assigned at Birth Sexuality Sexuality Gender Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). GENDER Gender identity and sexual orientation are two different things. '' ? There are many components that need to be considered when discussing gender, such as: Gender Identity – Your internal sense of being a man, woman, both, neither or otherwise. Gender Expression – How one presents their internal gender to the world. Includes, dress, behaviours, mannerisms, hair, etc. Gender Gender Reception – How others view/see your gender Adapted from: Action Canada (n.d).; Canadian Centre for Gender and Sexual Diversity (n.d.).; Egale (2022). GENDER SPECTRUM Gender identity How you receive the word. Agender Man Masculine Androgynous Genderfluid Cisgender Woman Nonbinary Genderfluid Feminine Genderqueer Pangender Gender Asexual people or ACE, are those that (typically) do not experience sexual attraction to others are not sexually dysfunctional Allosexual is the opposite of asexual where one does feel sexual attraction Allosexual is the opposite of asexual, where one does feel sexual attraction Trans people may experience gender dysphoria that may be enhanced daring A Note: intercouse. Gender dysphoria; a disconnect to how you feel about yourself can lead to Trans may experience gender depressionpeople or suicide. dysphoria that may be enhanced during intercourse Goebel, S. K., (2021). Sexuality. In J. F. Giddens, J. F. (Ed.). Concepts for nursing practice, 3rd ed. St. Louis, MO: Elsevier. P. 200 Table 21.1 Continued 2SLGBTQIA+ 2S = Two Spirit – within some Indigenous cultures means a person with both a feminine and masculine spirit living in the same body + (plus) = is inclusive of people who identify as part of sexual and gender diverse communities, who use additional terminologies (Government of Canada, https://women-genderequality.canada.ca/en/free-to-be-me/federal-2slgbtqi-plus-action-plan.html) Terminology Transgender-(adjective) – Describes a person whose gender identity and sex assigned at birth do not correspond based on traditional expectations; for example, a person assigned female sex at birth who identifies as a man; or a person assigned male sex at birth who identifies as a woman. Transgender can also include people with gender identities outside the girl/woman and boy/man gender binary structure; for example, people who are gender fluid or non-binary. Sometimes abbreviated as trans. (https://www.lgbtqiahealtheducation.org/) Non-binary (adjective) – Describes a person whose gender identity falls outside of the traditional gender binary structure of girl/woman and boy/man. Sometimes abbreviated as NB or enby (https://www.lgbtqiahealtheducation.org) https://www.lgbtqiahealtheducation.org/wp-content/uploads/2020/02/Glossary-2022.02.22-1.pdf Terminology cont… Trans man/transgender man (noun) – A transgender person whose gender identity is boy/man/male may use these terms to describe themselves. Some will use the term man (https://www.lgbtqiahealtheducation.org). Trans woman/transgender woman (noun) – A transgender person whose gender identity is girl/woman/female may use these terms to describe themselves. Some will use the term woman (https://www.lgbtqiahealtheducation.org). Two-Spirit (noun): Two-Spirit Peoples are individuals whose spirit embodies masculine and feminine traits. Traditionally, they held special roles and privileges in their communities to maintain peace and balance. Many Indigenous people who use Two-Spirit may also identify within the LGBTTQQIAAP+ spectrum. It is important to distinguish that being Two-Spirit is not an identity by itself since it has different meanings for each nation (other stylizations: two spirit, two spirited, 2Spirit, 2S) (Community-Based Research Centre, Two-Spirit Dry Lab). Mostly among indigenous. Questions?  There are only two genders Myths and False Beliefs  Gender, gender identity and or expression doesn't change  Everyone should be classified as male or female  Transgender individuals are confused or going through a phase You must have hormone treatment or surgery to be transgender All transgender individuals want to be on hormones or have gender affirmation surgery Support & affirm individual identity Gender affirming care According to WHO It encompasses a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with the gender they were assigned at birth. The interventions help transgender people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity. It is an Umbrella term which includes: Using language and pronouns that affirm the clients gender identity Providing a clinical space which is welcoming to transgender/nonbinary individuals Having staff in all areas who are trained in gender affirming care Medical procedures that align with one's gender identity and this can include surgery or hormone treatment Surgical procedures (mastectomy, phalloplasty, orchiectomy, facial feminization, filler injections) ,laser hair removal, hormone therapy, or counseling, social networking and support groups, social transition, legal transition. Gender affirming care is not just a new word for “sex change” or “sexreassignment” but refers to the holistic approach that addresses a person’s mental and physical well-being. Best Practices for Gender-Affirming Care Assume Term Gender Neutral Mom/Dad Parent Girlfriend/Boy friend Partner Wife/Husband Spouse Vagina Internal Genitalia Penis External genitalia Breast Chest Never assume a patient’s gender identity. Ask Ask patients about how they share their gender identity with others in their social circle. Use Language: Use gender neutral language Mirror Mirror the Language they use : If you do not know what a word means ,ask Apologize What if you use wrong pronouns: Apologize, make amends and move on- I am sorry for using wrong pronoun, I will use (He/she/them) from now on Sexual Response In the past sexual response was identified by physiological measures but since then psychological and sociological factors including motivation and desire inform present day models of sexual response Motivation Arousal Genital Congestion Orgasm Resolution Libido Can be impacted by medication Sexual drive Desire "turned on" Release of Neurotransmitters Sexual Excitement Parasympathetic Nervous System Vaso-congestion Genital swelling Pelvic floor contractions Ejaculation Neurotransmitters released Sense of wellbeing Muscle relaxation Age-Related Differences Described as a developmental process beginning at conception and ending at death Sexuality Is influenced by the dynamic combination of biological, societal, cultural and familial factors Early awareness of sexual self as an aspect of selfidentity begins in infancy Development of human sexuality can be observed through the socially defined stages of childhood, preadolescence, adolescence and adulthood Common attributes of sexual development are 1. Gender Identity 2. Sexual Response 3. Capacity for meaningful, intimate relationships Picture - Stock image All pictures from Creative Commons Age-Related Differences Childhood (Birth to 7 yrs) Preadolescence (8-12 yrs) Adolescence (13-19 yrs) Adulthood (20+ yrs) Sexual exploration of genitals, erections and vaginal lubrication Attitudes and behaviours by family Positive physical contact and quality of relationships Social division of boys and girls Sexual curiosity and learning occurs with same sex Many kids engage in masturbation 3840% Puberty Learning to manage physical and emotional aspects Psychosocial factors Gender identity and sexual identity Sexual fluidity Sexual maturation continues Effectively communicate Informed Decisions Family planning Sexual lifestyles Sexual desire ongoing with age Scope of Sexuality Wellbeing (Sexual Function) Ill-Being (Sexual Dysfunction) Practitioners often equate positive sexual functioning with the sexual response (Masters and Johnson) cycle rather than considering the psychological and emotional components of what truly makes up an optimal sexual encounter Sexual Wellbeing (Sexual Function) Being Present Transcendence This picture of “great sex” is not what is painted by the media. These findings illustrate that optimal sexuality is not necessarily about technique or skill but, rather, about attitude, positive behaviours and healthy relationships. Communication Sexual and erotic intimacy Authenticity Intense Emotional connection Sexual Ill-Being (Sexual Dysfunction) Physiological Factors Psychological Factors Sexual Ill-Being Environmental Factors Maturational Factors Risk Factors Populations at Risk Adolescents Persons living with disabilities (cognitive, developmental and physical) Newly unpartnered Individuals at Risk Those to do not practice “safe sex” Use of drugs (prescription or illicit substances), alcohol and marijuana Related to impaired judgement and less thoughtfulness related to sex Underlying medical conditions – chronic health conditions or medication use Vulnerability – social location – risk for exploitation Picture - Stock image ”The 5 P’s” For Sexual Health History CDC in Goebel, 2021, p.203 1. 2. 3. 4. 5. Picture - Stock image Partners Practice Protection (from infection) Past (history of infection) Prevention (of pregnancy) Nurses Role Thinking back to sexual well being and sexual ill-being, what personal values, beliefs, cultural, family expectations, and experiences that might influence how you respond to sexuality Check our biases, assumptions and judgements Nursing Actions Assessment Primary Prevention Secondary Prevention Collaborative Interventions interdisciplinary Picture - Stock image Picture - Stock image  Discuss definitions of sexuality and other definitions related to the concept of sexuality. Summary  Examine elements of the physiological sexual response.  Discuss sexual wellbeing.  Discuss sexuality as a developmental process.  Explore factors potentially affecting the experience of sexuality in individuals. Thank you Questions? [email protected] [email protected]