Module-2-L2.pdf

Module 2 Lesson 2 The Gendered Self Title: Let’s talk about SEX Learning Outcomes: At the end of this lesson the student should be able to:  Define sexual self;  Trace the human sexual development; ...

Module 2 Lesson 2 The Gendered Self Title: Let’s talk about SEX Learning Outcomes: At the end of this lesson the student should be able to:  Define sexual self;  Trace the human sexual development;  Outline the human sexual response cycle;  Explain the relationship of brain activity to sexual response;  Recognize the diverse sexual behaviours;  Identify sexual orientation and gender identity issues;  Enumerate the various Sexually Transmitted Diseases (STD) and its transmission;  Discuss responsible parenthood and Reproductive Health Act of 2012; and  Differentiate methods of contraception. Time Frame: 6 hours Introduction: This lesson addresses one of human development's most important elements, the sexual self. It highlights environmental and biological factors that influence sexual growth Abstraction: I. Definition of sexual self According to Ariola (2018) sexual self refers to the individual’s feelings, actions, and behaviour concerning various aspects as development of secondary sex characteristics, human reproductive system, the erogenous zones of the body, the biology of sexual behaviour, chemistry of lust, love and attachment, among many others. II. Development of secondary sex characteristics and the human reproductive system Immediately after fertilization of the egg, the development of the reproductive system begins. Rapid reproductive development occurs in the uterus; But when a baby is born before puberty, the reproductive system changes a little. In the absence of a special chemical code, all fertilized eggs occur in women, so the gender of a woman is considered "basic". To become a fertilized egg, a cascade of chemical reactions must be triggered by a single gene on the male Y chromosome known as SRY, the sex-determining region on the Y chromosome. Both male and female embryos have identical cells that grow in the male or female gonads or gonads. III. Further sexual development that occurs at puberty Puberty is the stage of development where individuals become sexually mature. It can be separated into five stages. The characteristics of each stage vary for girls and boys. Table 3 Sexual Development at Puberty STAGES PUBERTY STAGES IN GIRLS PUBERTY STAGES IN BOYS 1 Approx. 8-11 years old: Approx. 9-12 years old: The ovaries enlarge and hormone  No visible signs of production starts, but external development occur, but, development is not yet visible. internally, male hormones become a lot more active.  Sometimes a growth spurt begins at this time. 2 Approx. 8-14 years old: Approx. 9-15 years old:  The first external sign of  Height increases and the puberty is usually breast shape of the body changes. development.  Muscle tissue and fat develop  At first breast buds develop. at this time.  The nipples will be tender  The aureole, the dark skin and elevated. around the nipple, darkens and increases in size.   The area around the nipple  The testicles and scrotum (the aureole) will increase in grow, but the penis probably size. does not.  The first stage of pubic hair  A little bit of pubic hair begins may also be present at this to grow at the base of the time. penis.  It may be coarse and curly or fine and straight.  Height and weight increase at this time. The body gets rounder and curvier. 3 Approx. 9-15 years old: Approx.11-16 years old:  Breast growth continues and  The penis starts to grow during pubic hair gets coarser and this stage. darker.  It tends to grow in length  During this stage, whitish rather than width. discharge from the vagina  Pubic hair is getting darker may be present. and coarser and spreading to  For some girls, this is the where the legs meet the torso. time that the first menstrual  Also, boys continue to grow in period begins. height, and even their faces begin to appear more mature. The shoulders broaden, making the hips look smaller. Muscle tissue increases and the voice starts to change and deepen.  Finally, facial hair begins to develop on the upper lip. 4 Approx. 10-16 years old: Approx. 11-16 years old:  Some girls notice that their  At this time, the penis starts aureoles get even darker and to grow in width, too. separate into a little mound  The testicles and scrotum rising above the rest of the also continue to grow. breast.  Hair may begin to grow on  Pubic hair may begin to have the anus. a more adult triangular  The texture of the penis pattern of growth. becomes more adult-  If it did not happen in Stage looking. Three, menarche (first  Underarm and facial hair menstruation) should start increases as well. Skin gets now. oilier, and the voice  Ovulation may start now, too. continues to deepen. But it will not necessarily occur on a regular basis. (It is possible to have regular periods even if ovulation does not occur every month.)  5 Approx. 12-19 years old: Approx. 14-18 years old:  This is the final stage of  Boys reach their full adult development. height.  Full height is reached, and  Pubic hair and the genitals young women are look like an adult man's do. ovulating regularly.  At this point, too, shaving is  Pubic hair is filled in, and a necessity. Some young the breasts are developed men continue to grow past fully for the body. this point, even into their twenties. IV. Erogenous zones of the body The term erogenous zone is use to describe areas of the body that are highly sensitive to stimuli and are often (but not always) sexually exciting (Otig et al.,2018). Specifically, it refers to parts of the body that are primarily receptive and increase sexual arousal when touched in a sexual manner. Erogenous zones may vary from one person to another. Some people may enjoy being touched in a certain area more than the other areas (Alata, Nicolas, Caslib, Serafica & Pawilen, 2018). a. Non-Specific Skin - It is similar to any other portion of the usual haired skin. Examples: sides and back of the neck, the axilla and side of the thorax b. Specific Skin - It is found the mucocutaneous regions of the body or those regions made both mucous membrane and of cutaneous skin. Examples: prepuce, penis, the female external genitalia, perianal skin, lips, and nipples V. Phases of human sexual response cycle The sexual response cycle refers to the sequence of physical and emotional changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities, including intercourse and masturbation (“Sexual Response”, 2020). In both men and women, these events may be identified as occurring in a sequence of four stages: excitement, plateau, orgasm, and resolution. The basic pattern of these stages is similar in both sexes, regardless of the specific sexual stimulus (Nolen, 2020).  Table 4 Phases of Human Response Cycle PHASES GENERAL CHARACTERISTICS Phase 1: Excitement Muscle tension increases Heart rate quickens & breathing is accelerated Skin may become flushed Nipples become hardened or erect Blood flow to the genitals increases, resulting in swelling of the woman’s clitoris & labia minora, & erection of the man’s penis Vaginal lubrication begins The woman’s breast become fuller and the vaginal walls begin to swell The Man’s testicle swell, his scrotum tightens, and he begins secreting a lubricating liquid Phase 2: Plateau The changes begun in phase 1 are intensified The vagina continues to swell from increased blood flow, and the vaginal walls turn a dark purple The woman’s clitoris becomes highly sensitive & retracts under the clitoral hood to avoid direct stimulation from the penis The man’s testicles are withdrawn up into the scrotum Breathing, heart rate & BP continue to increase Muscle spasm may begin in the feet, face, and hands Tension in the muscles increase Phase 3: Orgasm This phase is the climax of the sexual response cycle. It is the shortest of the phases and generally last only a few seconds. General Characteristics of this phase include the following: Involuntary muscle contractions begin BP, heart rate, & breathing are their highest rates with a rapid intake of oxygen Muscle in the feet spasm There is sudden, forceful release of sexual tension In women, the muscles of the vagina contract. The uterus also undergoes rhythmic contractions In men, the muscles of the vagina contract, the uterus also undergoes rhythmic contractions In men, rhythmic contractions of the muscles at the base of penis result in ejaculation of semen A rash or “sex flush” may appear over the entire body Phase 4: Resolution During this phase the body slowly returns to its normal functioning level. The swelled and erect body parts return to their previous size and color. This phase is marked by a general sense of well-being; intimacy is enhanced; and often fatigue sets in. With further sexual stimulation, some women can return to the orgasm phase. This allows them to experience multiple orgasm. Men, on the other hand, need recovery time after orgasm. This is called refractory period. How long a man needs a refractory period varies among men in his age VI. Roles of the brain in sexual activity   The brain is responsible for translating the nerve impulse sensed by the skin into pleasurable sensations  It controls the nerves & muscles used in sexual activities  Sexual thoughts and fantasies are theorized to lie in the cerebral cortex, the same area used for thinking and reasoning  Emotions and feelings are believed to originate in the limbic system  The brain releases the hormones considered as the physiological origin of sexual desire VII. Roles of hormones in sexual activity  OXYTOCIN – aka. “love hormone” and believed to be involved in our desire to maintain close relationships. It is released during sexual intercourse when orgasm is achieved  FOLLICLE-STIMULATING HORMONE (FSH) – it is responsible for ovulation in females.  LUTENIZING HORMONE (LH) – crucial in regulating the testes in men and ovaries in women. In men, the LH stimulates the testes to produce testosterone. In males, testosterone appears to be a major contributing factor to sexual motivation  VASOPRESSIN – involved in the male arousal phase. The increase of vasopressin during erectile response is believed to be directly associated with increased motivation to engage in sexual behaviour  ESTROGEN & PROGESTERONE – typically regulate motivation to engage in sexual behaviours for females, with estrogen increasing motivation and progesterone decreasing it. VIII. Understanding the chemistry of Lust, Love, and Attachment (Stages of falling in love) a. LUST – marked by physical attraction. It is driven by testosterone in men and estrogen in women. Lust, however, does not guarantee that couples will fall in love forever.  b. ATTRACTION – at this stage, you begin to crave for your partner’s presence. They get excited and energized when they fantasize about things they could do together as a couple. Three chemicals trigger this feeling i. Norepinephrine – responsible for the extra surge of energy and triggers increased heart rate, loss of appetite, as well as the desire to sleep. Your body is in more alert state and is ready for action ii. Dopamine – associated with motivation and goal directed behavior. It makes you pursue your object of affection. It creates a sense of novelty, where the person seems exciting, special, or unique that you want to tell the world about his or her admirable qualities iii. Serotonin – thought to cause thinking. Low levels of serotonin said to be present in people with OCD behaviour c. ATTACHMENT – involves the desire to have lasting commitment with your significant other. At this point, you may want to get married and/ have children IX. Gender differences on sexual desire Factors that contribute to gender differences in sexual desire include culture; The social environment and even political circumstances. Alternatively, some researchers suggest that due to the various evolutionary pressures that men and women face over time, the first human women engaged in selective sex with carefully selected men to maximize productive success, although the men were not under as much pressure. X. Psychological aspect of sexual desire Sexual desire is generally considered a sexual topic or activity of interest. It is sometimes accompanied by genital arousal (penile erection in men and lubrication in women). Sexual desire is triggered by various cues and scenarios, such as personal thoughts, feelings, fantasies, sensual  objects (books, movies, photos), different sensory environments, situations, or social interactions. Sex drive is a basic, biologically mediated stimulus for sexual activity or satisfaction. In contrast, sexual desire is a more complex psychological experience that does not depend on hormonal factors. However, developmental research shows that the ability to experience sexual desire though not hormone-dependent, are probably still facilitated by hormones (Otig et al., 2018). Therefore, physiological arousal is not an essential component of sexual desire and sexual desire should not be considered a more accurate marker than individual self-referring emotions. XI. Physiological mechanism of sexual behavior motivation Animal studies suggest that limbic system structures such as the amygdala and nucleus accubens are particularly important for sexual motivation. a. AMYGDALA – the integrative center for emotions, emotional behavior, and motivation b. NUCLEUS ACCUMBENS – plays a role in motivation and cognitive processing of aversion. It has a Figure 1. The amygdala & nuclesaccumbens significant role in response to reward by Tor Wager (https://bit.ly/2QeJooP) and reinforcing efforts, translating emotional stimulus into behaviors XII. Diversity of sexual behavior Sexual orientation is defined as individual’ s general disposition toward partners of the same sex, the opposite sex, or both sexes. On the other hand, gender identity refers to one’s sense of being male or female. Generally, our gender identities correspond to our chromosal and phenotypic sex, but this is not always the case (Otig et al., 2018).  Table 5 Sexual Orientations L LESBIAN These are females who are exclusively attracted to women. G GAY This can refer to males who are exclusively attracted to any other males. It can also refer to anyone who is attracted to their same gender. B BISEXUAL This can refer to anyone who is sexually/romantically attracted to both men and women T TRANSGENDER/ It is an umbrella term for people who do not identify with TRANSEXUAL the gender assigned to them at birth. Q QUEER It is a useful term for those who are questioning their identities and are unsure about using more specific terms, or those who simply do not wish to label themselves. + PLUS To signify that many identities are not explicitly represented by the letters. This includes (but is not limited to) intersex or people who are born with a mix of male and female bio-traits, and asexuals who are persons who does not desire sexual activities. LGBTQ+ is an umbrella term for a wide spectrum of gender identities, sexual orientations, and romantic orientations. XII. Sexual orientation and gender identity issues a. Sociocultural factors - influence the various issues related to sexual orientation and gender identity i. In the Philippines and most Southeast Asian neighbors view homosexuality as the norm. ii. In New Guinea, young boys are expected to engage in sexual behaviour with any other boys because they believe that it is part of the transformation of boys to men iii. In the Philippines, an individual is classified as either male or female only iv. Thailand recognizes male, female, and “kathoey” (transgender) categories b. Family influences - The children’s interests, preferences, behaviours, and overall self-concept are strongly influenced by parental and authority figure teachings regarding sexual stereotypes. Thus, children whose parents adhere to strict gender-stereotyped roles are, in general, more likely to take on those roles themselves as adults that are peers whose parents provided less stereotyped, more neutral models for behaving. c. Urban setting - Another research discovered that homosexuality positively correlated with urbanization. The study surmised that large cities seem to provide a friendlier environment for same-gender interests than in rural places (Laumann, et al., 1994). d. History of sexual abuse - Previous published studies claimed that abused adolescents, particularly those victimized by males, are more likely to become homosexuals or bisexual in adulthood. These studies were criticized for being non-clinical and un-reliable (Wilson & Wisdom, 2009). XIII. Sexually Transmitted Diseases/ Infections Figure 2. Sexually Transmitted Diseases (https://bit.ly/3lb3Hl9)  Sexually Transmitted Diseases (STDs) are diseases or infections that is transmitted through sexual contact in which the organisms that cause STDs are transmitted from one person to another in blood, sperm and vaginal or body fluids. These infections have a huge impact on all dimensions of a person's life. STDs can negatively impact a person's self-concept and can severely impact a person's entire life and their family. Society, oftentimes associate STDs with promiscuity or socially acceptable behaviors. This makes most persons afflicted with STDs hesitate to seek immediate treatment. Oftentimes, the disease is already in its advance stage when the individual finally decides to consult health professionals (Udan, 2009). It is therefore challenging to reduce social stigma associated with STDs. However, generalizing these infections by talking more openly with friends and family and addressing the importance of testing as part of general health care can help alleviate these barriers and reduce STD rates over time (Denison, Jutel, Bromhead, Dennison & Grainger, 2017). XIV. The Responsible Parenthood and Reproductive Health Act of 2012 An Act providing for a national policy on Responsible Parenthood and Reproductive Health Citation Republic Act. No. 10354 Enacted by House of representatives of the Philippines Date Enacted December 19, 2012 Enacted by Senate of the Philippines Date enacted December 19, 2012 Date signed December 21, 2012  Signed by Miriam Defensor Santiago Date commenced January 17, 2013 *Source: https://bit.ly/2CRRXTn a. Specific objectives:  Reduce by 3 quarters, between 1990 and 2015, the maternal mortality ratio  Reduce by 2/3 between 1990 and 2015, the under-five mortality rate  To have halted by 2015 and begun to reverse, the spread of HIV/AIDS b. Regional objectives:  Improve access to the full range of affordable, equitable, and high- quality family planning and RH services to increase contraceptive use rate & reduce unwanted pregnancies & abortions  Making pregnancy safer  Support countries & areas in developing evidence-based policies & strategies for the reduction of maternal & newborn mortality  Improve access to the full range of affordable, equitable, and high- quality family planning & RH services to increase contraceptive use & reduce unwanted pregnancies  Improve the health & nutrition status of women of all ages, especially pregnant & nursing women  Gender, women & health;  Integrate gender & rights considerations into health policy & programs, especially into RH & maternal health care  Improve the health & Nutrition status of women of all ages XV. Family planning and methods of contraception a. Benefits of family planning/ contraception according to WHO  Prevent pregnancy-related health risk in women  Reduce infant mortality  Help prevent HIV/AIDS  Empower people and enhance education  Reduce adolescent pregnancies  Slow population growth b. Benefits of family Planning according to DOH i. Mother  Enables her to regain her health after delivery  Gives enough time to love & provide attention to her husband & children  Gives more time for her family & own personal advancement  When suffering from illness, gives enough time for treatment and recovery ii. Children  Healthy mothers produce healthy children  Will get all the attention, security, love, and care they deserve iii. Father  Lightens the burden & responsibility in supporting his family  Enables him to give his children their basic needs  Gives him time for his family and own personal advancement  When suffering from illness, gives enough time for treatment and recovery c. Disadvantages i. Birth control health risks  Some allergies to spermicides or latex.  For some women, oral contraceptives can lead to hair loss and weight gain, and the use of diaphragms can lead to UTI ii. Possibility of pregnancy   FP methods are not 100% reliable.  Other than abstinence, there is no birth control method that is completely effective.  Couples who are engaging is sexual activity should always consider the possibility of an unexpected pregnancy iii. Pregnancy after birth control  For some it might take months for ovulation and the menstrual period to return to normal  How long the menstrual period takes to return to its normal cycle is entirely individual, and has nothing to do with how long the woman has been using of birth control or not.  The most important thing to know about stopping your preferred method of birth control.  The most important thing to know about stopping your preferred method of birth control is that ovulation can return immediately. d. Methods of contraception: i. Natural family planning method 1. Periodic abstinence (fertility awareness) method 2. Rhythm (calendar) method – the couple tracks the woman’s menstrual history to predict she will ovulate 3. Cervical mucus (ovulation)/ Billing’s method - examining the color and viscosity of the cervical mucus to discover when ovulation is occurring. 4. Basal Body temperature monitoring - relies on monitoring a woman’s basal body temperature on a daily basis. This indicates fertile and non-fertile stages of the cycle 5. Use of breastfeeding or lactational amenorrhea method (LAM) – Through exclusive breastfeeding, the woman is able to suppress ovulation  6. Coitus interrruptus (withdrawal or pulling method) – this is the oldest method. The couple proceeds with coitus; however, the man must release his sperm outside of the vagina. ii. Hormonal contraception/ Artificial family planning 1. Oral Contraceptives (pill) - contains synthetic estrogen and progesterone 2. Transdermal contraceptive patch – medicated adhesive patch that is placed on the skin to deliver a specific dose of medication through the skin and into bloodstream 3. Vaginal ring – it is a birth control inserted into the vagina & slowly release hormones through vaginal wall into the blood stream to prevent pregnancy 4. Subdermal Implants – involve the delivery of a steroid progestin from the polymer capsules or rods placed under the skin. 5. Hormonal Injections – It is a contraceptive injection given once every three months. It typically suppresses ovulation, keeping the ovaries from releasing an egg. iii. Barrier methods 1. Intrauterine device – small, t-shaped device wrapped in copper or contains hormones. A doctor inserts the IUD into the uterus. IUD prevents fertilization of the egg by damaging or killing the sperm. 2. Chemical barriers – such as spermicides, vaginal gels, creams and glycerin films are used to cause the death of sperm before they can enter the cervix 3. Diaphragm – dome shaped barrier methods of contraception that blocks sperms from entering the uterus 4. Cervical cap – silicone cup inserted in the vagina to cover the cervix and keep sperm out of the uterus 5. Male condom- is a latex or synthetic rubber sheath placed on erect penis before vaginal penetration to trap the sperm during ejaculation 6. Female condoms – thin pouch inserted into the vagina before sex serving as protective barrier to prevent pregnancy and protection from STD 7. Surgical methods/ Permanent contraception 8. Vasectomy – Surgical operation wherein the tube carries the sperm to a man’s penis is cut. It is a permanent male contraception method 9. Tubal Ligation – It is a surgical procedure for female sterilization involving severing and trying the fallopian tube. A tubal ligation disrupts the movement of the egg to the uterus for fertilization and blocks sperm from travelling up to the fallopian tubes to the egg