Gender and Sexuality Notes PDF

**GENDER AND SOCIETY** **UNIT 1:GENDER ANDSEXUALITY AS SOCIAL REALITY** **Lesson 1: SEX, GENDER, AND SEXUALITY** *[Definition of Terms: ]* - **Sex** - the biological aspect of sex; maleness or femaleness - **Gender** - the social interpretation of sex; masculinity, femininity, etc. - **Sexuality** - the totality of our own experience of our sex and gender - **Sex chromosomes** - chromosomal markers that distinguish females (XX) from male (XY) species - **Intersex** - individuals with composite genitals (possessing some characteristics of both male and female genitals) **Introduction** What does it mean to be a male or a female, to be feminine or masculine, or to be man or woman? The human mind and body are so complex such that to answer this question, we have to trace our journey from the moment we were born, and go back to the journey we humans have across the life span. First thing you need to understand is the complexities of defining and differentiating sex, gender, and sexuality. Having a clear grasp of these concepts is crucial since we will be using these terms over and over again in succeeding discussions. Likewise, there are nuances in the meanings of these terms, which have an implication on at which context we can appropriately use them. Moreover, as we start our discussion of gender and sexuality as social realities, we also want to understand how a person\'s gender is expressed from birth to adulthood. Our ultimate goal is to foster understanding of the diversity of how humans experience and express their sexuality. **SEX** **Sex** is the biological dimension of your gender and sexuality. Also referred to as **biological sex or physical sex**, the term generally pertains to your identity depending on your sexual anatomy and physiology--*the parts of your body that are relevant to reproduction and the function of these parts*. Sex is typically determined by examining your **genitals**- these are *external organs that are associated with **reproduction*****-***the process or the ability to create offspring.* Among humans, sex is often assigned at birth. If at birth, a child is observed to have a **penis** and **testicles**, then the child is categorized as **male**. If on the other hand, a child is observed to have a **vagina**, then the child is categorized as **female**. However, there are cases when the baby\'s genitals appear to be a conglomerate of male and female organs such that it may be difficult to classify the baby\'s sex without further examination. In the past, this condition is referred to as **hermaphroditism** (from Hermes, a male Greek god, and Aphrodite, a female Greek goddess). In modern times, the term **intersexuality** is used to refer to this phenomenon. Hermaphroditism or intersexuality is a naturally occurring variation in humans and animals (1 in 1,500 births) according to the American Psychological Association (APA) (2006). Since it may be difficult to distinguish biological sex by merely examining the genitals, there are other biological markers used. For instance, your **chromosomes** - *protein structures which contain your genetic materials* are also used to determine sex. There are specific chromosomes referred to as **sex chromosomes**, which *marks a person\'s biological sex*. An individual with a set of XY sex chromosomes is said to be a male, while an individual with a set of XX sex chromosomes is said to be a female. The level of some **hormones**- *chemicals in our body that are responsible for sustaining bodily processes* -- are also used as markers. For example, human males tend to have higher levels of **testosterone**, which is *associated to sex drive and aggressions*. On the other hand, human females tend to have higher levels of **estrogen** and **progesterone**, which are *associated to lactation, menstruation. and other female reproductive functions*. **GENDER** However, humans are meaning-making organisms. Our ability for higher order thinking and our tendency to create social norms, allow us to attach social and cultural meanings to things, including our sex. For example, males are typically expected be **masculine** and females are expected to be **feminine**. Once parents are aware of their child\'s sex (male or female) during birth or through prenatal procedures such as ultrasound, they automatically attach social and cultural meanings to their child\'s sex and in doing so, they already set an expectation in terms of how their child should behave and how they should treat their child. This social dimension of one\'s sexuality is referred to as **gender**. There are many ways through which gender is manifested. As soon as a new baby arrives in the family, adults surrounding the baby manifests their social interpretation of the baby\'s sex by the colors assigned to the baby. For example, it is common for families to buy blue apparels and toys when the baby is a male, as the color blue is associated with boyhood. Conversely, female babies are often assigned the color pink, such that families would buy clothes and toys that are color pink because the color is associated with girlhood. Remarkably, the moment a baby is born, the name, toys, and apparels are picked by parents and relatives based on their interpretation of the baby\'s sex. Throughout childhood and adolescence, this assignment becomes more complex as the expectations go beyond the kind of clothes worn, but also in terms of how the person must or must not behave. There are set of behaviors that all female individuals must follow and so with the male individuals, and all are expected to stick to these behaviors that are aligned with their biological sex. This phenomenon of determining the normality of a behavior based on whether it conforms or not to the expectations relative to one\'s biological sex is referred to as **heteronormativity**. In the Filipino culture, girls are expected to have certain characteristics of being gentle, caring, and loving while boys are encouraged to be strong, rough, and assertive. These expectations also extend to how men and women are expected to behave, the college courses they take, and the jobs they apply to. However, there are people who do not follow culturally-accepted standards of masculinity and femininity like girls not wanting to wear dresses and boys not wanting to play rough sports. This is a natural variation of the human gender expression. Social and cultural practices change through time. Just 60 years ago, women could not wear pants without social disapproval, and now wearing pants is already an accepted fashion trend among people of different genders. How we express our gender is largely based on our social and cultural setting. Most are comfortable with their sex and gender; men who are masculine and women who are feminine. Each culture also has different standards on how to be a man and a woman and how they should present themselves according to their sex and gender. ***Gender Identity*** One important aspect of our gender is our sense of who we are: Do we see and experience ourselves as a man, a woman, or neither. This refers to our **gender identity**. Typically, males are comfortable identifying as a man and females are comfortable identifying as a woman. However, there are cases wherein a person\'s biological sex does not align with one's gender identity. People with this experience are referred to as **transgenders**, such as a male who does not feel comfortable identifying as a man (transgender woman) or a female who is not comfortable identifying as a woman (transgender man). Transgender people may undergo gender reassignment surgery to align their physical characteristics to their gender identity. However, due to many factors such as belief systems, culture, and economics, some do not opt for surgery. **SEXUAL ORIENTATION** Another aspect of our gender pertains to our emotional and sexual attraction to a person. This aspect refers to our **sexual orientation**. According to the Psychological Association of the Philippines, typically at ages 6 or 8, we experience or develop attraction to other people. By adolescence, we already know who we are attracted to and would experiment through dating and relationships. Everyone\'s sexuality is different and deeply personal. Our capacity for emotional and sexual attraction is diverse and complex, but there are a few common terms or labels for us to use. - People who are attracted to the opposite sex are called \'heterosexuals\' or \"straight.\" - People who are attracted to people of the same sex are called \"homosexual,\" \"gay\" or \"lesbian.\" - \"Bisexual\" or \"bi\" people are attracted to both sexes, male or female. - LGBT refers to the lesbian, gay, bisexual, and transgender community **APPRECIATING DIVERSITY** According to the American Psychological Association (APA), nature and nurture play a complex role in shaping our sexual orientation. Homosexuality and heterosexuality are part of the human sexuality and is a large part of the human experience. Identifying as a heterosexual, lesbian, bi, gay, or transgender is a deeply personal process, so it may be more difficult for others to \'come out\' or for them to become comfortable enough with their sexuality that they feel safe to share it with other people. For others, it comes early in adolescence while for some, it may take time to understand and discover themselves. According the Psychological Association of the Philippines, \"we can only truly tell if the person is gay, lesbian, or bisexual if the person shares with us his or her experiences and feelings of attraction towards them.\" That is why it is important for everyone to feel safe as they share their sexuality since it is a personal and sensitive topic. We can do that in an environment wherein we do not feel judged and discriminated upon. People who experience prejudice and discrimination suffer negative psychological effects (APA), so we must work towards an inclusive environment where everyone feels safe. **Summary** The complexities of the human sexuality can be quite overwhelming. We need to look at our own experience on our journey of discovering our sense of being a man and a woman for us to understand others. We also need to engage in conversations with others for us to appreciate the many different faces of human sexuality. A baby is born and is given an assigned sex based on its genitals. In toddler years, they are raised to be a \'man\' or a \'woman\' based on accepted social and cultural standards. We know that these standards change through time, what is not acceptable now may be acceptable in the future. Adolescence is when we discover our emotional and sexual attraction towards other people. For most, it is easy to identify who they are attracted to, but for others, it can be a long and difficult process. Fostering an inclusive environment wherein everyone feels safe is very important at this stage. **Lesson 2: GENDER AND SEXUALITY ACROSS TIME** *[Definition of Terms:]* - **Patriarchy** - social system where men primarily hold power in the political and the private spheres. - **Feminism** - continuing series of social movements that aim to challenge the patriarchal society that creates these oppressive political structures, beliefs, and practices against women. **Introduction** Society has progressed so much in a way that information and knowledge is available to everyone. This gives us an opportunity to examine our social and political conditions in more detail than when information was scarce and limited to only a few individuals. Historical accounts show that across time, humans\' conception of gender and sexuality has also changed. Archeological artifacts reveal that in the distant past, during the dawn of civilizations, human societies have high regard for women. The concept of the **divine feminine** (the sacredness of the woman due to her ability to conceive children) has prevailed, and thus, women are treated equally with men. This make societies **egalitarian** (men and women have equitable power and roles). However, humans\' discovery of **paternity** (fatherhood/ role of the father in conception), presumably during the Agricultural era, when societies began to establish communities and tame rear cattle and stocks, have also changed how societies have viewed women and men therefrom. For the longest time thereafter, societies have privileged men over other genders, mainly because of the preferential given to them in the **productive** sphere (world of public work). Women who have been revered due to their ability to conceive have been viewed as capable only of **reproductive** affairs (world of the home and related tasks such as suckling the young, child rearing, and home management). The gender disparity was intensified by the Industrial era where factors were built and men were preferred because they did not have to bear children for nine months and because of their perceived physical strength. But how did really the conceptualization of gender and sexuality changed? This lesson tackles movements in history which shows how men, women, and people of other genders are viewed in human societies. **PATRIARCHY** A close examination of our society can lead us to see the invisible layers of oppression in our society like patriarchy-a system based on the control and oppression of women wherein they are perceived to be the weaker sex. It is a structure that upholds male supremacy in the law, at home, in the work place, and in society. Patriarchy is from the Greek word Patriarkhes which means \"the rule of the father\". It is a social system where men primarily holds power in the political and the private spheres. This means that in this social system, society is organized and maintained in a way that men rule over women and their children. In the social, legal, political, and economic spheres, men are expected to lead while women are expected to obey and are relegated to house chores, bearing children, and child care. A patrilineal society often follows a patriarchal society, this means only men can inherit property and the family name. Women were left with no inheritance and are expected to marry a man who can support her economically. In fact, women were not allowed to go to schools, or even vote, because they are viewed as a weaker sex and should not concern themselves in learning science or politics. Women had to fight for the right to vote, to go to school, to go to work, and even participate in politics. Patriarchy is viewed by most sociologists as a social construct and not as a biological phenomenon. This is because history proves that in the prehistoric hunter-gatherer tribes and civilization, they prioritized equality of all members, male and female. History suggests an egalitarian system rather than a patriarchal system. Men and women contribute to society, and they enjoy the same social status. Friedrich Engels, a German philosopher and sociologist, argues that patriarchy came about when people started having private property instead of a communal living. The development in agriculture and domestication of animals led to creating product surplus which allows people to have private property. As a way to control the excess wealth generated by these advancements, male dominance was asserted over women so only the male heir can inherit family wealth. **HISTORICAL VIEWS ON GENDER** ***Greek*** Aristotle, Plato, and other Greek philosophers viewed women as the inferior sex and are properties of men whose only job was to obey their husbands, bear children, and take care of the household. They were forbidden to learn philosophy, politics, and science. ***Egypt*** Herodotus, a Greek historian, observed the Egyptian civilization citing that Egyptian women enjoyed higher social status than Greek women because they can inherit property and engage in trade and politics. However, Greek influence quickly spread in Egypt through the conquests of Alexander the Great across Asia and Africa. ***China*** Confucianism has stringent written rules that dictate how women should conduct themselves. The written documents titled \"Three obedience\'s and four virtues\" and \"Precepts of women\" states that women should obey their father, when married she is to obey her husband, and when widowed she is to obey her son. Gendered biases in ancient patriarchal societies were very strict, heavily enforced, and often violent. Imagine not being able to go to school just because you are a woman, not being able to express your opinion on important matters even when it concerns your future, and not being able to say no to any man. Women have come a long way since the ancient times through the feminist movement, however, patriarchy has taken on subtle forms of oppression that often go unnoticed such as: - **sexism** - prejudice, stereotypes, and discrimination based on sex; - **gender pay gap**-men earn more that women; - underrepresentation in politics, military, executive positions, etc; - rape on women and the stigma making women ashamed to report the crime; - very conservative expectations on women on how they behave; - unrealistic depictions of women in fiction, often very sexualized; - women do more housework and childcare; - boys were trained to be leaders while women were trained to do house chores. **WOMEN EMPOWERMENT** Women\'s liberation movement, women\'s movement, or feminism is a continuing series of social movements that aim to challenge the patriarchal society that creates these oppressive political structures, beliefs, and practices against women. It started at different decades in different countries, some are far more advance in their struggle while others are still starting a movement. During the 19th and early 20th century, first-wave feminism spread across the western countries as women demanded for their right to vote or participate in elections and to be able to legally own property. In France, Simone de Beauvoir wrote book titled \"The Second Sex\" in 1949. It outlined how the patriarchal society disadvantaged women by slowly raising her into submission and hindering their productivity and happiness by relegating them to housecleaning. This inspired many women to write and speak their truths, such as Betty Friedan (The Feminine Mystique, 2963), Kate Millet (Sexual Politics, 1969), and Germaine Greer (The Female Eunuch, 1970). Beauvoir\'s book was instrumental in awakening women about their plight as the \"wife-servant\" to their husbands in her famous quote \"one is not born, but rather becomes, a woman\". *Le Mouvement de Liberation des Femmes* or the women\'s liberation movement was formed in Europe and they sought the right to education, right to work, and right to vote in the 1940s. Later, they also won women\'s right to decide on their own bodies and their sexualities. This liberation movement views the intersectionality of economic status or class to patriarchy. Inspired by Beauvoir\'s book, second-wave feminism in 1960\'s through the 80\'s, women drew attention to various social and cultural inequalities such as domestic violence especially marital rape, reproductive rights, wage inequality, and etc. The 90\'s gave birth to the 3rd wave and 2012 started the fourth wave. These movements only show that there is still much to be done for women\'s rights. The United Nations reports that women do more work than men because even when they work at the office, they are still expected to do household tasks. Another report from UN Women states that \"women perform 66 percent of the worlds work, produce 50 percent of the food, but earn 10 of the income and own 1 percent of the property\". This is because in agricultural countries, women participate in making the produce, but only the father or the male head of the family controls the income. To put simply, feminism demands equality. Here are a few salient points that feminism demands. 1. **Women suffrage** - women were not allowed to vote before because they were viewed as irrational and temperamental and therefore, not able to make rational decisions. This changed after World War I (1914 to 1918) wherein women were uprooted from the household. They took on jobs and made significant contributions to their country. Many countries soon started letting women vote since they can no longer argue that women are \"irrational and temperamental\". 2. **Equality in politics and society** - for hundreds of years, women\'s voices were silenced, so society must make an effort to restore their rights. Representation is very important for women, so that their genuine concerns are heard in politics and in society. Feminist have always criticized that old, privileged men always make the decisions for women at home and in politics. 3. **Reproductive rights** means the woman is in control of her body, and she can decide for herself on what she sees is best for her. Contraception, abortion, and other reproductive options should be available to women because it is their body. 4. **Domestic violence** - such as marital rape and physical abuse are often dismissed by society as part of a \"marriage\". Although we have RA 9262 or Anti Violence Against Women and their Children, our culture still dismiss such incidents as \"away mag-asawa\". 5. **Sexual harassment and sexual violence** - The Center for Women\'s Resources in the Philippines estimates that one woman or child is raped every hour mostly by someone they know. 6. Other rights include the right to divorce their husbands, the right to make decisions on her pregnancy, equitable wages, and equal employment opportunity. **Summary** Recognizing patriarchy in the simple things we do is very important for us to identify these instances so we can change it. Even the simplest acts that are seemingly harmless can be analyzed and seen as a way to force women into submission and compliance. That is the power of putting labels on oppressive acts, and you can call it out and stop it. Feminism gained women access to education, right to vote, right to work, take control of their reproduction, and the right to say no instead of just obeying. However, there is still much to be done for gender equality. You can help in making the world a better place for women by learning to respect and recognizing that women deserve the same rights as men-that women are not to be treated as the weaker sex or the submissive sex, but rather as an equal. Also, use gender neutral language that is not sexist: humanity instead of mankind, the unsteady of he, to emphasize inclusion. You can also counter gendered metaphors by vocally criticizing its oppressive nature such as: the aggressive sperm and the passive e.g., *babae kase*, *lalake kase*, etc. You can also advocate for laws and policies that would empower women. You do not have to be a woman to understand that everyone must be treated with the same respect and that everyone is free and equal in dignity and in rights. **Lesson 3: GENDER AND SEXUALITY AS A SUBJECT OF INQUIRY** *[Definition of Terms:]* - **Gender studies** - a field of study concerned about how reproductive roles are interpreted and negotiated in the society through gender. - **Social Research** - the process of investigating social realities. - **Research approach** - the orientation in understanding social realities. This can be qualitative (interpretive), quantitative (deductive), or both. - **Ethics in research** - these are considerations in conducting research to make sure that the well-being of the participants are ensured, and that the outcome of the study is sound without undue harm to people involved. **Introduction** Gender seems so obvious and so simple, many would ask why we have to study it. Well, **gender studies** as an area of knowledge, is about looking into, analyzing, and examining society so that we notice power relations in the seemingly \"simple things\". It helps us see the issues in our everyday lives through a different lens. The goal of this lesson is to define and appreciate gender studies. Gender is a big part of our individuality and society; it is a form of social organization, and it is often unnoticed. In different cultures and different times in our history, gender roles played a big part of social organization. Gender studies emerged from the need to analyze how gender, sex, and sexuality impact our lives, especially how it creates gender inequality. It came about in the mid 1970\'s after the second wave of feminism as a way to challenge the male-defined and male-centered knowledge. **Gender role or sex role** are \"sets of culturally defined behaviors such as masculinity and femininity\" according to the Encyclopedia of Sex and Gender (2019). These roles are not fixed such that the \"culturally defined behaviors\" for men and women may be very different 50 years ago or very different for people from other countries or tribe. In a binary system of viewing gender roles, we only see the male and the female where men are expected to be masculine while women are expected to be feminine. This is the norm or the accepted standards of how to behave like a woman (*mahinhin*) or how to behave like a man (*matipuno/ matapang*). In gender studies, we are asked to disrupt and question these kinds of social expectations, gender roles, and gender norms. **Gender studies is not just for women or all about women, it is about everyone**. It explores how our gender roles have changed throughout our history and how it created inequalities. One hundred years ago, women were not allowed to study at universities since their role was only restricted to domestic or the household. This repressed women\'s potential in shaping the social and political landscape in the past, but it also placed the burden on the men to provide for the whole family. Our society has changed so much since then; the jobs available for everyone is not so much dependent on physical strength, making these jobs accessible to women as well. Most mothers also have a job now, so they also provide for the family. Gender studies would ask us to question, is it still right to say that the men are the providers of the family when both mothers and fathers now work and earn money. **Diversity and Inclusion** Gender roles are socially constructed and are not something that we are \"born with". Society, through a lifelong process of normalization, encourages or reprimands behaviors to make a child adapt to these social expectations. A young boy is always encouraged to be brave, to play rough, to be loud, and to not show signs of weakness such as crying. A young girl is discouraged from playing rough and being loud, instead they are told to be gentle and soft. If a child does not follow these gender roles, they are reprimanded by parents, relatives, friends, or anybody that they interact with. That is how gender norm is forced upon an individual, a lifelong process of normalization. Lesbian, gay, bisexual, and transgender people often do not fit in the traditional binary gender roles so they are often reprimanded, bullied, and discriminated. They are often subjected to violence and hate just because they do not fit in what society calls \"normal\". **Gender studies lets us analyze the creation and maintenance of these gender norms so that it does not create inequalities in our social, political, and economic spheres.** **GENDER STUDIES AND RESEARCH** As a subject of inquiry, Gender Studies utilizes a systematic approach in identifying problems, making hypotheses and assumptions, gathering data, and making conclusions. This systematic process is referred to as the **research process**. **Approaches in Research** Since Gender and Sexuality cuts across a variety of issues that could be biomedical, psychosocial, or political-legal, there is no singular way in conducting the research process There are however a variety of approaches which can be used. **Qualitative** approach focuses more on the meanings created and interpretations made by people about their own personal or vicarious (observed) experiences. For example, if you want to know how women, men, or LGBTQ+ live their lives on a daily basis and how they make sense of their lived experiences, then the qualitative approach is fitting. Some of the methods used in the qualitative approach are as follows: - **phenomenology** - conducting intensive interviews with individuals who have experienced a particular event and understanding their \"lived experience\"; - **hermeneutics** - understanding the meaning of texts (literary works, art works) and what they convey about human realities; and - *ethnography and ethnomethodology* - immersing in a community and taking note of their experiences, beliefs, attitudes, and practices. **Quantitative** approach, on the other hand, focuses more on characterizing a **population** (total number of individuals in a group) or a **sample** (a sub-group within the population), and in some cases, making generalizations about the population based on the behavior of a sample. For instance, if you want to know how many Filipino adolescents are engaged in a romantic relationship or how many of them still believe in marriage, then a quantitative approach is appropriate. Some of the methods used in the quantitative approach are as follows: - **survey**-collecting information from a sample; and - **experiment** - creating actual set-ups to observe behavior of people in an experimental group (a group receiving treatment such as training or a new experience) and comparing it to the behavior of people in a control group (a group without any treatment). In most cases, information from both qualitative and quantitative approaches provide a holistic view about certain social realities, such that there are researchers who prefer to use **mixed methods** (combining qualitative and quantitative methods to derive data from multiple sources). **Ethics in Gender and Sexuality Research** There are some principles to remember in conducting gender and sexuality researches. These principles are referred to as **ethical principles** because they make sure that people involved in the research are protected from harm. Ethics is a prerequisite to a properly conducted study. The following are the principles to remember: - **Informed consent** - Researchers should make sure that the participants in the study are aware of the purpose and processes of the study they are participating in. They should also ensure that only those participants who agree (in writing) will be included, and that they shall not force any participant to join. - **Confidentiality and anonymity** -- Researchers should not reveal any information provided by the participants, much so, their identity to anyone who are not concerned with the study. All data gathered from surveys or interviews should also be placed in a secure location or filing system. - **Non-maleficence and beneficence** - A study should do no harm (non- maleficence) to anyone. Especially in researches involving humans, a study should be beneficial (beneficence) for it to be worth implementing. - **Distributive justice** - Any study should not disadvantage a particular group, especially the marginalized and the oppressed (e.g., poor people, women, LGBTQ+, the elderly). The benefits of a study should be for all. **GENDER, SEXUALITY, AND HUMAN ECOLOGY** Human Ecology, as a field, recognizes the interplay among internal and external environments-physical, socio-economic, cultural (Bronfenbrenner 1994; Bubolz and Sontag 1983). Hence, to look at realities from an ecological perspective is to appreciate that human development across lifespan is influenced by these environments. In the context of gender and sexuality, a human ecological approach looks at human sexual lives and experiences at various levels and spheres of analysis. First, it sees gender and sexuality as an organismic and personal experience. **Summary** Gender, being male or female, has socially constructed meanings, and it is different in every culture and may change with time. It is important to analyze how society enforce gender roles on everyone so we can further understand how power relations in gender roles can limit an individual\'s freedom and promote inequality. To help us have a holistic view, we need to use frameworks and methods from different disciplines-psychology, sociology medicine, and law-among others. This book will provide you with sufficient theoretical and practical perspectives, so you can understand gender and sexuality. **GENDER AND SOCIETY** **UNIT II: BIOMEDICAL PERSPECTIVE IN GENDER AND SEXUALITY** **Lesson 4: ANATOMY AND PHYSIOLOGY OF REPRODUCTION** *[Definition of Terms: ]* - **Reproduction**-process of producing off springs. - **Genitals**-external sex organs. - **Primary sex characteristic** - sex characteristics that are present at birth. - **Secondary sex characteristics**-sex characteristics that emerge during puberty. **Introduction** Humans experience various physical and emotional changes from childhood to adulthood. These changes are gradual and progress at different ages and speed in different people. These stages are based on human growth and development from childhood, adolescence, adulthood, and old age. This chapter focuses on the adolescent stage of human development, which is characterized by dynamic changes in physical and behavioral traits. Despite differences in physical appearance, the sexual organs of men and women arise from the same structures and fulfill similar functions. Each person has a pair of gonads: ovaries are female gonads; testes are the male gonads. The gonads produce germ cells and sex hormones. The female germ cells are ova (egg) and the male germ cells are sperm. Ova and sperm are the basic units of reproduction; their union can lead to the creation of a new life. **THE BIOLOGICAL FEMALE** Anatomy the study of body structure in relation to body parts. The female sexual anatomy is designed for the production and fertilization of ovum, as well as carrying and delivering infant offspring. Puberty signals the final development of primary and accessory organs that support reproduction. A. The ***[female external genitalia]*** consist of the following: - **vulva** - all the external genital structures taken together; - **mons veneris** - pads of fatty tissue between pubic bone and skin; - **labia majora** - outer lips surrounding all the other structures. - **prepuce** - clitoral hood (foreskin above and covering clitoris); - **clitoris** - glans (head), shaft, and crura (root), the clitoris is particularly sensitive to stimulation; - **labia minora** - inner lips surrounding the vestibule where sweat and oil glands, extensive blood vessels, and nerve endings are located; - **vestibule** - area surrounding the urethral opening and vagina, which is highly sensitive with extensive blood vessels and nerve endings, - **urethral opening** - end of tube connecting to bladder and used for urination; - ![](media/image2.png)**vaginal opening** - also called introitus; and - **perineum** - area of skin separating the genitalia from the anus; distance is less in females than males. B. The ***[female internal reproductive]*** structures consist of the following as described and shown below: - **vagina** - collapsible canal extending from vaginal opening back and upward into body to cervix and uterus. During arousal, it is engorged with blood. This aids its expansion and triggers the release of lubricants from vaginal mucosa; - **cervix** - small end of uterus to which vagina leads. It is the opening in cervix leading to interior of uterus; - **uterus** - womb, organ within pelvic zone where fetus is carried; - **fallopian tubes** - carry egg cells from ovaries to uterus, this is where fertilization occurs; and - **ovaries** - produce estrogen and progesterone. Estrogen influences female sex characteristics and initiates menstrual cycle. Progesterone aids in regulation of menstrual cycle and promotes mature development of uterine lining to allow for zygote implantation. Also produce ova, egg cells, and bring them to maturity. As many as 1 million immature ova are present at birth, with about 400,000 surviving to puberty. Of these, only about 400-450 are typically brought to maturity and released into the fallopian tubes. **Puberty** The menstrual cycle marks the beginning of puberty in females. The first episode occurs between 11 to 15 years of age referred to as ***menarche***. Menstruation pertains to the sloughing off of the uterine lining if conception has not occurred. It may last within two to six days which follows a cycle ranging from 24 to 42 days. Regardless of the length of the cycle, menstruation begins about 14 days after ovulation (plus or minus one to two days). The overall cycle is governed by the hypothalamus as it monitors hormone levels in the bloodstream. ![](media/image4.png)It involves changes in the endometrium in response to the fluctuating blood levels of ovarian hormones. There are three phases as described and shown in the figure below. **Menstrual phase**. This occurs if the ovum is not fertilized and does not implant itself into the uterine lining. The continued high levels of estrogen and progesterone causes the pituitary to stop releasing follicle-stimulating hormone (FSH) and luteinizing hormone (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. **Proliferative phase**. It occurs when the hypothalamus stimulates the pituitary gland to release FSH that stimulates the ovaries to produce estrogen and causes ova to mature in the ovarian follicles. Endometrium is repaired, thickens, and becomes well-vascularized in response to increasing levels of estrogens. **Secretory phase**. It occurs when the pituitary gland releases LH that causes the ovary to release a mature ovum and causes the remaining portion of the follicle to develop into the corpus luteum. The corpus luteum then, produces progesterone. Endometrial glands begin to secrete nutrients, and lining becomes more vascular in response to increasing level of progesterone. Problems associated with menstruation include *premenstrual syndrome* (PMS) (80-95% of women experience), *dysmenorrhea* (painful menstruation caused by overproduction of prostaglandins, causing the uterine muscles to contract), and *amenorrhea* (disruption or absence of menstruation). All of these involve the fluctuation of hormone levels associated with menstruation. At *menopause* (usually around age 45-50), a woman stops menstruating as ova are no longer brought to maturity. During the three to four years of this transition women may experience hot flashes, night sweats, sleep disturbances (resulting in fatigue, irritability, short-term memory loss, difficult concentrating), headaches, anxiety, depression, and difficulty of becoming sexually aroused. Female secondary sexual characteristics emerge after puberty: 1. **widening of hips and pelvis** - accommodates giving birth, but also results in downward shift in center of gravity. 2. ![](media/image6.png)**enlargement of breasts** - at puberty, both the glandular and fatty tissues of the breasts develop considerably. Differences in breast size between women are primarily due to differences in the amount of fatty tissue. It is also not uncommon for one of a woman\'s breasts to be slightly larger than the other. The glandular tissue of the breasts responds to sex hormones, and the breasts are involved in a women\'s sexual arousal. The glandular tissue produces milk toward the end of pregnancy and after childbirth in response to hormone levels. **More female characteristics:** - generally shorter than men; - greater proportion of body weight composed of fat than men; - two X chromosomes reduces expression of many sex-linked conditions; and - lower mortality rate at every age and longer projected lifespan than men **THE BIOLOGICAL MALE** The male sexual anatomy is designed for the production and delivery of sperm for fertilization of the female\'s ovum. Puberty signals the final development of primary and accessory organs that support reproduction. A. The ***[male external genitalia]*** consist of the following structures: - **prepuce** - foreskin covering head of penis, removed in male circumcision; - **penis** - glans (head), shaft, and root. The glans is particularly sensitive to stimulation. Running the length of the penis is the urethra surrounded by the spongy body and two cylindrical chambers known as the cavernous bodies. During arousal, these become engorged with blood, resulting in erection; - **corona** - rim of glans where it arises from shaft; - **frenulum** - thin strip of skin connecting glans and shaft on underside of penis; - **scrotum** - sac that encloses the two compartments housing the testes; - **urethral opening**- found on head of penis this is the end of tube connected to bladder and used for urination. It is also tube to which internal structures deliver semen by which male ejaculates; and - **perineum** - area of skin separating the genitalia from the anus, distance is greater in males than females. B. The ***[male internal reproductive organs]***: - **testes** - produce androgen, particularly large quantities of testosterone, which greatly influence male development and drive sexual motivation; also produce sperm cells in virtually unlimited quantity over the entire course of the lifespan: - **vas deferens** - travels from testicle toward urethra carrying sperm; - **seminal vesicles** - two glands that produce alkaline fluid rich in fructose sugar, comprising some 70% of semen volume. Alkaline nature may stimulate sperm to start self-propulsion and sugar may provide sperm nutrients. Ducts carry fluid and connect with vas deferens forming ejaculatory ducts; - **ejaculatory ducts** - connect vas deferens to urethra; - **prostate** - gland producing alkaline secretions that account for about 30% of semen volume. Alkaline nature may help counteract otherwise, acidic environment of urethra and vagina making them more hospitable for sperm. Fluid passes through a series of ducts along wall of urethra; and - **urethra** - tube within penis that carries sperm and semen the rest of the way to the opening of the penis. **More Male Characteristics:** - generally taller and greater proportion of body weight composed of water; - proportionately larger heart and lungs, presumably to handle greater blood fluid volume: - exposure to greater levels of testosterone resulting in heavier body and facial hair, but also increased frequency and degree of baldness; and - single X chromosome resulting in sex-linked conditions such as colorblindness and hemophilia. **Male Hormones** The testosterone is the major male hormone produced mainly by the testes, but there are other glands called the adrenal glands that also produce some testosterone. In case a man has lost his testes, these glands would continue to produce testosterone to support the male physical appearance. Testosterone is responsible for the growth and development of a boy during adolescence and for the development of sperm and secondary sexual characteristics. **Male secondary sexual characteristics that emerge after puberty:** - no monthly cycle; - elongation of vocal cords (lower voice); - broader shoulders; and - deeper chest cavity. **Summary** Humans experience various physical changes from childhood to adulthood. The adolescent state is characterized by dynamic changes in physical and behavioral traits. Despite differences in physical appearance, the sexual organs of men and women arise from the same structures and fulfill similar functions. Each person has a pair of gonads: ovaries are female gonads; testes are the male gonads. The gonads produce germ cells and sex hormones. The female germ cells are ova (egg) and the male germ cells are sperm. Ova and sperm are the basic units of reproduction; their union can lead to the creation of a new life. **Lesson 5: THE PROCESS OF REPRODUCTION** ***[Definition of terms:]*** - **Ovulation** - the process when a mature ovum is released from the ovary and travels to the fallopian tube for possible fertilization. - **Fertilization**-union of the sperm and the ovum. - **Pregnancy**-the process when an offspring develops within the mother\'s womb. **Introduction** Although human beings are fully sexually differentiated at birth, the differences between males and females are accentuated at puberty. This is when the reproductive system matures, secondary sexual characteristics develop, and the bodies of males and females appear more distinctive. Female puberty usually begins at about 8-13 years of age; the reproduction maturation of boys lags about two years behind that of girls. The physical changes of female puberty include breast development, rounding of the hips and buttocks, growth of the hair in the pubic region and the underarm, and the start of menstruation. ***How does one ovulate?*** The major landmark of puberty among females is the onset of the menstrual cycle, the monthly ovulation cycle that leads to menstruation (loss of blood and tissues lining the uterus) in the absence of pregnancy. The menstrual cycle is from the first day of a period until the day before the next period starts. Normally, it lasts around 28 days, on the average, but can be as short as 21 or as long as 40. Whatever the length, ovulation will happen about 10-16 days before the start of the next period. ![](media/image8.png)***How does pregnancy occur?*** For pregnancy to proceed, the sperm needs to meet up with an egg. Pregnancy officially starts when a fertilized egg implants in the lining of the uterus. Pregnancy happens 2-3 weeks after sexual intercourse. This is redundant so it was it redacted. Conception is the process that begins with fertilization of an egg by the sperm and ends with implantation. When a male and female have a sexual intercourse, the penis fits into the woman\'s vagina. Ejaculation or coming releases the sperm via the penis into the vagina. The sperm swims through the female\'s cervix, into the womb, and finally into the fallopian tubes. Once the egg or ovum has been released into the fallopian tube, hundreds of sperm swim up to reach it. Finally, the sperm penetrates the egg in the fallopian tube where fertilization takes place and eventually, becomes an embryo. Once the embryo (fertilized egg) attaches to the inner lining of the uterus (endothelium), a fetus develops within five to seven days from a ball of cells floating in the uterus, which officially begins pregnancy. A normal pregnancy lasts 37-42 weeks (nine months). This is measured from the first day of the last period. Pregnancy is discussed in terms of trimesters (three-month periods). since each trimester is very different from the rest. After eight weeks, the embryo is officially referred to as a fetus. ***What can be done to prevent teenage pregnancy?*** Teen pregnancy has a tremendous impact on the 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 teen 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. **Chart for Contraception:** +-----------+-----------+-----------+-----------+-----------+-----------+ | **Type of | **How It | **Effecti | **Benefit | **Instruc | **Benefit | | Contracep | Works** | veness** | s** | tion | s | | tive | | | | for Use** | Other | | Method** | | | | | than | | | | | | | Contracep | | | | | | | tion** | +===========+===========+===========+===========+===========+===========+ | **Male | Rolled | 80-85 | Low cost, | Do not | Can be | | Condom**: | over the | percent | easily | use with | effective | | rubber | penis | | accessibl | oil-based | in | | sheath | | | e, | lubricant | preventio | | that fits | | | and | s. | n | | over the | | | reduces | such as | of STIs | | penis | | | risk of | creams | and | | | | | STDs/ | and | HIV/AIDS | | | | | STIs | lotions | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Implant | Continuou | Not known | Continuou | Implant | None | | able | s | | s | of the | | | Hormone | release | | birth | capsule | | | Device**: | of | | control | in the | | | continuou | hormones | | for five | upper | | | s | | | years | arm; done | | | release | | | | by the | | | of | | | | doctor | | | hormone | | | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Calenda | Allows | Theoretic | No cost | Woman | None | | r | the woman | ally | and under | must keep | | | method**: | to keep | 85 | the | track | | | woman | track of | percent | control | with the | | | predicts | \"safe\" | but in | of the | help of a | | | the day | days for | reality | woman | calendar | | | of | sex | about 60 | | | | | ovulation | | percent | | | | | by | | | | | | | keeping a | | | | | | | calendar | | | | | | | of the | | | | | | | length or | | | | | | | each | | | | | | | menstrual | | | | | | | cycle | | | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Sterili | Passagewa | Theoretic | Highly | Doctor | None | | zation**: | y | ally | effective | performs | | | vasectomy | for the | 100 | , | an | | | for males | sperm or | percent, | permanent | operation | | | and tubal | the egg | but | , | | | | ligation | is | exception | and one | | | | for | surgicall | s | time | | | | females | y | have been | expense | | | | | tied | known to | | | | | | | take | | | | | | | place | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Birth | Alters | Theoretic | Low cost, | Taken | None | | Control | natural | ally | easily | daily | | | Pill**: | ovulation | 99-100 | available | after | | | contains | cycle | percent, | , | menstrual | | | synthetic | | but women | and | cycle | | | oestrogen | | have | controlle | begins | | | | | conceived | d | | | | | | on the | by the | | | | | | \"pill\" | woman | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Birth | | Not known | | Given by | None | | Control | | | | the | | | Injection | | | | doctor | | | **: | | | | | | | given in | | | | | | | the first | | | | | | | days of | | | | | | | the | | | | | | | menstruat | | | | | | | ion | | | | | | | and then | | | | | | | every 2-3 | | | | | | | months | | | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Withdra | Prevents | Theoretic | No cost | Dependent | None | | wal**: | the semen | ally, | under the | on the | | | removal | from | 85 | control | man | | | of the | going | percent | of the | | | | penis | into the | but in | man and | | | | from the | vagina | reality, | the woman | | | | vagina | | about 70 | involved | | | | before | | percent | | | | | ejaculati | | | | | | | on | | | | | | +-----------+-----------+-----------+-----------+-----------+-----------+ | **Intraut | Inserted | Theoretic | Long- | Inserted | None | | erine | inside | ally | lasting | by the | | | Device | the | 95-98 | and | doctor in | | | (IUD** | uterus by | percent | relativel | the first | | | | a doctor | | y | few days | | | | | | inexpensi | of | | | | | | ve | menstruat | | | | | | | ion; | | | | | | | should be | | | | | | | examined | | | | | | | every few | | | | | | | | | | | | | | months | | +-----------+-----------+-----------+-----------+-----------+-----------+ \*Some of the methods are intrusive in nature and have side effects that maybe harmful. The user must examine its pros and cons before making a choice. ***What are the health effects of early pregnancy in the growing adolescent?*** There are serious health risks associated with early pregnancy because a young woman\'s body is not mature enough to handle bearing a child. When a woman is under zo, the pelvic area (the bone surrounding the birth canal) is still growing and may not be large enough to allow the baby to easily pass through the birth canal. This can result in what is called an \"obstructed labor\". Obstructed labor is dangerous to both mother and child and requires the help of trained medical professionals. Under the best circumstances, the young woman will have an operation called a \"caesarean section\" in which a cut is made in the abdomen and the baby is removed directly from the uterus. A major contributor to high maternal mortality rates is adolescent pregnancy. If a young woman is not physically mature, the uterus may tear during the birth process, and she may die because of blood loss. If she is lucky and survives the delivery, she might face fistula due to prolonged labor. A baby\'s head can also tear the vagina causing a hole between the vagina and bladder or between the vagina and the rectum, resulting in what is known as a fistula. Unless she has an operation to fix her problem, for the rest of her life, she will not be able to hold her urine or feces and this will make her a social outcast. In addition, younger women who become pregnant face a higher risk than older women in developing a number of other complications. These complications can be any or a combination of the following manifestations: - excessive vomiting; - severe anemia; - hypertension; - convulsions; - difficulty in breast feeding (if the girl is too young to produce milk); - premature and low birth weight babies; - infection; - prolonged labor; and - high maternal mortality or death. The risk of having serious complications during pregnancy or childbirth is much higher for girls in their early teens than for older women. Ages of 20-30 years are the safest period of women\'s life for child bearing. The major difference between girls in their early teens and older women is that girls aged 12-16 years are still growing. The pelvis, or the bony birth canal, of a girl can grow wider by as much as 20% between the time she begins menstruating and the time she is 16 years old. This widening of the pelvis can make the crucial difference between a safe delivery and obstructed labor. It is not surprising, therefore, to find that obstructed labor, due to disproportion between the size of the infant\'s head and the mother\'s pelvis, is most common among very young mothers. The consequences of such obstructed labor may be death due to numerous complications or lifetime crippling conditions of vesico-vaginal fistula. **Summary** The developing adolescent is very vulnerable to high risk-taking behaviors that can harm their growth and pose a threat to their future. Warning signs of a troubled teen should be recognized and managed early on to prevent devastating effects on the growing adolescent. **Lesson 6: SEXUAL HEALTH AND HYGIENE** ***[Definition of Terms:]*** - **Health** - 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, such as frequent handwashing, face washing, and bathing with soap and water. Practicing personal hygiene etiquette is difficult, especially in many areas of the world, due to lack of clean water and soap. Inappropriate washing of hands, face, and body can spread many diseases. - **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. Sexual health 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 have them. **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 healthy habits being important life skills for the teen. ***Oily Hair*** The hormones that create acne are the same ones that can make you feel like you\'re suddenly styling your hair with a comb dipped in motor oil. Each strand of hair has its own sebaceous (oil) gland which keeps the hair shiny and waterproof. But during puberty, when the sebaceous glands produce extra oil, it can make your hair look too shiny, oily, and greasy. Washing your hair every day or every other day can help control oily hair. Dozens of shampoos are available in drugstores and supermarkets for you to choose from. Most brands are pretty similar, although, you might want to try one that is specially formulated for oily hair. Use warm water and a small amount of shampoo to work up a lather. Do not scrub or rub too hard-this does not get rid of oil any better and can irritate your scalp or damage your hair. After you have rinsed, you can follow up with a conditioner if you like; again, one for oily hair might work best. When you are styling your hair, pay close attention to the products you use. Some styling gels or lotions can add extra grease to your hair, which defeats the purpose of washing it in the first place! Look for formulas that say \"greaseless\" or \"oil free.\" ***Sweat and Body Odor*** Perspiration, or sweat, comes from sweat glands that you have always had in your body But thanks to puberty, these glands not only become more active than before, they also begin to secrete different chemicals into the sweat that has a stronger smelling odor. You might notice this odor under your arms in your armpits. Your feet and genitals might also have new smells. The best way to keep clean is to bathe or shower every day using a mild soap and warm water. This will help wash away any bacteria that contribute to the smells. Wearing clean clothes, socks, and underwear each day can also help you to feel clean. If you sweat a lot, you might find that shirts, T-shirts, socks, and underwear made from cotton or other natural materials will help absorb sweat more effectively. If you are concerned about the way your underarms smell, you can try using a deodorant or deodorant with antiperspirant. Deodorants get rid of the odor of sweat by covering it up, and antiperspirants actually stop or dry up perspiration. They come in sticks, roll-ons, gels, sprays, and creams and are available at any drugstore or supermarket. All brands are similar (and ones that say they are made for a man or for a woman are similar, too, except for some perfumes that are added). If you choose to use deodorant or antiperspirant, be sure to read the directions. Some work better if you use them at night, whereas others recommend that you put them on in the morning. But keep in mind that some teens do not need deodorants or antiperspirants. So why use them if you do not have to? Deodorant and antiperspirant commercials may try to convince you that you will have no friends nor dates if you do not use their product, but if you do not think you smell and you take daily baths or showers and wear clean clothes, you may be fine without them. ***Body Hair*** Body hair in new places is something you can count on-again, they are hormones in action. You may want to start shaving some places where body hair grows, but whether you do is up to you. Some guys who grow facial hair like to let it develop into a mustache and beard. Some girls may decide to leave the hair on their legs and under their arms as is. It is all up to you and what you feel comfortable with. If you do decide to shave, whether you are a guy or girl, you have a few different choices. You can use a traditional razor with a shaving cream or gel or you can use an electric razor. If you use a regular razor, make sure the blade is new and sharp to prevent cuts and nicks. Shaving cream and gel are often a better bet than soap because they make it easier to pull the razor against your skin. Some of the newer razors contain shaving gel right in the blade area, making even beginners feel comfortable shaving. Whether you\'re shaving your legs, armpits, or face, go slowly. These are tricky areas of your body with lots of curves and angles, and it is easy to cut yourself if you move too fast. An adult or older sibling can be a big help when you are learning to shave. Do not be afraid to ask for tips. You might want to avoid shaving your pubic hair because when it grows back in, the skin may be irritated and itchy. ***Dental Hygiene*** Dentists say that the most important part of tooth care happens at home. Brushing and flossing properly, along with regular dental checkups, can help prevent tooth decay and gum disease. To prevent cavities, you need to remove plaque, the transparent layer of bacteria that coats the teeth. The best way to do this is by brushing your teeth twice a day and flossing at least once a day. Brushing also stimulates the gums, which helps to keep them healthy and prevent gum disease. Brushing and flossing are the most important things that you can do to keep your teeth and gums healthy. Toothpastes contain abrasives, detergents, and foaming agents. Fluoride, the most common active ingredient in toothpaste, is what prevents cavities. So you should always be sure your toothpaste contains fluoride. If you have teeth that are sensitive to heat, cold, and pressure, you may want to try a special toothpaste for sensitive teeth. However, you will still need to talk to your dentist about your sensitivity because it may indicate a more serious problem, such as a cavity or nerve inflammation (irritation). **Tips on Proper Brushing:** Dentists say that the minimum time you should spend brushing your teeth is two minutes twice a day. Here are some tips on how to brush properly: - Hold your brush at a 45-degree angle against your gumline. Gently brush from where the tooth and gum meet to the chewing surface in short (about half-a-tooth-wide) strokes. Brushing too hard can cause receding gums, tooth sensitivity, and, over time, loose teeth. - Use the same method to brush all outside and inside surfaces of your teeth. - To clean the chewing surfaces of your teeth, use short sweeping strokes, tipping the bristles into the pits and crevices. - To clean the inside surfaces of your top and bottom front teeth and gums, hold the brush almost vertical. With back and forth motions, bring the front part of the brush over the teeth and gums. - Using a forward-sweeping motion, gently brush your tongue and the roof of your mouth to remove the decay-causing bacteria that exist in these places. - The main reason for going to the dentist regularly every six months-is prevention. The goal is to prevent tooth decay, gum disease, and other disorders that put the health of your teeth and mouth at risk. **Healthcare Check for the Female:** The best time for a self-breast exam is about a week after the last day of your menstrual period, when your breasts are not tender and swollen. This should be done at the same time each month when you no longer have your menstrual period. **Keeping the external female genitalia clean:** - Use soap and water to wash the external genitalia and your underarms every day, especially during menstruation. - Use either a disposable pad made of cotton, which has a nylon base, or a clean piece of cotton cloth to absorb blood during menstruation. - Properly dispose of the pad after each use, or wash and dry the piece of cloth used as a menstrual pad before reuse. - Wash only the external genitalia. Do not try to clean the inside part of the vagina. - While washing, wash starting from the vagina towards the anus. Do not wash from the anus towards the vagina. This will allow germs to enter the inner genitalia easily and cause infection. - Be aware of abnormal fluids from your vagina. Do not confuse this with normal vaginal fluids. - If you see any changes in the vaginal fluid-a change in color or odor, please visit a health professional. **Healthcare Check for the Male:** **Keeping the external male genitalia clean:** - Wash the external genitalia at least daily with soap and water, as you wash the rest of the body. - Boys who are not circumcised need to pull back the foreskin and gently wash underneath it with clean water. - Be aware of any abnormal fluids coming from your penis. Do not confuse this with the presence of normal fluids. - If you see any abnormal fluid or wound, please visit a health professional. **Summary** In this chapter, we have identified the important health habits for the developing adolescent to address the various changes that take place in the growing adolescent. Practical tips on observing good and healthy hygiene daily have been highlighted as well as indications when to seek help, especially from a healthcare professional. **Lesson 7: RISKY BEHAVIORS OF ADOLESCENTS** ***[Definition of Terms: ]*** - **Risk** - the probability that a hazard in the environment can actually negatively affect the individual. - **Risk-taking** - a behavior of doing something regardless of potential loss. **Introduction** 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. The challenge for health providers is to distinguish between what may be normal exploratory behaviors and those that are health- compromising. Health behaviors in adolescence continue into adult life and will influence health and morbidity throughout life. 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. Guidance of family is also important as the adolescent develops into a mature adult. Family Arrangement, based on the 2006 McCann Erickson Study, has noted that 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 both parents. Data on non-sexual behaviors where adolescents engaging in vices, such as smoking and alcohol drinking, show that the adolescent is the fourth highest in the country who are currently smoking (20.7%). The adolescent is likewise, the fifth highest in the country who are currently drinking alcoholic beverages (38.9%). More than three in 100 of adolescents have used drugs, below the national average, while greater than eight in 100 have ever thought of suicide. This has decreased from 2002 to 2013 compared to the general population. Those who attempted suicide decrease to 2.4%, below the national average. Sex and Media have been identified as key influencers among adolescents engaging in high risk behaviors, as shown in studies in NCR and CALABARZON. Three in five have watched X-rated movies and videos, the fourth highest in the country. Three in ten have sent or received sex videos through cell phones or Internet, the second highest in the country. Six in 100 have engaged in phone sex, higher than the national average. **Identified Sexual Risks that were found among the growing Filipino adolescents are as follows:** **One in three has sexual experience**. They also engage in sex at younger ages: 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 four had sex before age 18. Seven in 10 of 1st premarital sex cases are unprotected against unintended pregnancy and sexually-transmitted infections (STI) including HIV-AIDS. 1.2% have paid for sex and 1.3% have received payment for sex, this is low but above the national average level; 6.7% have engaged in casual sex; 4.1% mostly males have fu\*\* buddy (FUBU) experience; 6.3% have males having sex with males (MSM) experience; 2.9% of married youth (including those in live-in) have engaged in extramarital sex. Giving birth at younger ages has also been evident in the Filipino youth. Such that there is a marked increase in teenage fertility in the past decade, 7.1% aged 15-19 are already mothers. The proportion of women who begun childbearing increases with age: 2.0% aged 16, 31.2% aged 19. Teenage fertility is the lowest among all regions of the country. While prevalence of sexually transmitted infections like HIV and AIDS are increasing in the youth, as of 2013, 86.7% have heard of HIV and AIDS with poor understanding being the highest in the country noting that three in four think that they would not get AIDS. **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 three months; - skipping school more than once in three 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; and - excessive daydreaming. **Harmful practices** Culture and tradition play a significant role in shaping the way young people and adolescents behave and lead their lives. However, young people have become victims of some harmful traditional practices, which affect their human and reproductive rights. These practices differ from place to place but primarily affect women. Common drugs abused by young people and their effects: 1. **Marijuana (also known as Cannabis, Grass, Joint, Splif, Hashish, Pot, Weed).** Marijuana is a plant grown and used worldwide. Usually people smoke the leaves but the leaves and the stem can be made into tea, or even cookies. The effects vary. You can stay under the influence for about two or three hours. Some people become relaxed and happy while others feel panic or fear. Users\' eyes usually become red and their throats and mouths will become dry. Appetite may increase. **Effects**: Marijuana causes increase in heart rate and dilation of certain blood vessels in the eyes, which creates the characteristics of blood-shot eyes. Chronic bronchial irritation is one of the long-term effects of chronic marijuana use. Other potential adverse effects include impairment of long-term memory, gum disease, increased risk of cancers of the mouth, jaw, tongue and lung; and impairment of the immune system. Some studies have suggested that long-term marijuana use may result in decreased testosterone levels, decreased sperm counts, and increased sperm abnormalities in male users. Heavy marijuana use during pregnancy may cause impaired fetal growth and development. 2. **Mairungi (also known as Khat, Qat, and Mirraa).** Mairungi is the common name for a stimulant leaf that is chewed in much of East Africa. Chewing Mairungi can help someone feel more awake, confident, and energetic and can also reduce hunger. In fact, many students use it when \"cramming\" for exams. **Effects**: Negative effects include sleeplessness, anxiety, aggressive behaviour, and hallucinations. Some men are unable to get an erection after they have been chewing. 3. **Alcohol.** Alcohol is the most common drug and is used worldwide. Because it is legal, often kept in the home and comes in extremely cheap local brews, alcohol is extremely easy to find and consume. At first, alcohol causes relaxation and people feel less self-conscious. After more alcohol, and individual gets drunk; reaction time slows down and thinking straight becomes difficult. (This is why people who are drinking are often involved in car accidents). **Effects**: Further drinking can cause slurred speech and aggressive behaviour that can lead to fights, rape, or other kinds of violence. People who consume too much alcohol can end up vomiting, becoming unconscious, or even dying. Because both young men and women often lose their inhibitions when drinking, a girl might have unsafe sex with someone she does not know and a boy might decide to force someone to have sex. Of course, the consequences of these alcohol-based decisions can be very dangerous, even life threatening. Remember: when people drink, their ability to make healthy and safe decisions is impaired. 4. **Cigarettes (tobacco, cigars).** Many young people start smoking tobacco products for different reasons including: influence of friends, seductive advertisements, and older role models like siblings\' or celebrities, to mention a few. Young people find smoking a \'cool\' thing to do, but they become addicted to one of the most addictive and dangerous substances, Nicotine, which is an active ingredient in tobacco. **Effects**: According to WHO (2006), tobacco is the second major cause of death in the world. Nicotine, which is found in tobacco products including cigarettes, is highly addictive. The tar in cigarettes increases a smoker\'s risk of lung cancer, emphysema, and bronchial disorders. The carbon monoxide in smoke increases the chance of cardiovascular diseases. Inhaling smoke passively.causes lung cancer in adults and greatly increases the risk of respiratory illness in children. 5. **Cocaine (also known as Crack, Coke, C, Charlie, Nose candy, Toot, Bazooka, Big C, Cake, Lady, Stardust, Coco, Flake, Mister coffee).** Cocaine is prepared from coca leaves which are greenish-yellow leaves of different size and appearance. Cocaine is often called the \"champagne of drugs\" because of its high cost. It makes one feel like his/ her body is going very fast. His/her heart races and the \"highs\" and \"lows\" are sudden. Crack, which is smoked, is a much stronger form of cocaine. Cocaine usually comes in a white powdered form and crack looks like hard white rocks. It is usually snorted up the nose. It can also be injected or smoked. **Effects:** A small amount of cocaine will raise body temperature, make the heart beat faster, increase the breathing rate, make you feel over confident, and make you more alert with extra energy. When crack is smoked, all of these feelings are intensified. Excessive doses may lead to convulsions, seizures, strokes, cerebral hemorrhage, or heart failure. Long term effects of cocaine/crack use will lead to strong psychological dependence and other health problems like destroying nose tissues, reportorial problems, and weight loss. 6. **Heroine (also known as Hammer, Horse, H, Junk, Nod, Smack, Skag, White, beige, White lady, White stuff, Joy powder boy, Hairy, Harry, Joy powder).** Heroin is a drug obtained from morphine and comes from the opium poppy plant. Heroin is a drug that slows down the user\'s body and mind. It is a very strong painkiller and can be one of the most dangerous things to mix with other drugs. Heroin usually comes in a rock or powdered form, which is generally white or pink/beige in color and could also come in dark grey/medium brown. Heroin can be injected, snorted, smoked, or inhaled. This last method is often called \"chasing the dragon\". **Effects**: When injected, heroin provides an extremely powerful rush and a high that usually last for between four to six hours. The effects of heroin include a feeling of well- being, relief from pain, fast physical and psychological dependence, sometimes nausea and vomiting, sleepiness, loss of balance, loss of concentration, and loss of appetite. An overdose can result in death. One of the most dangerous effects of injecting heroin is the increased possibility of contracting AIDS. A lot of the time, people who inject heroin use each other\'s needles, and this is the main source of infection. Studies have also shown that people who are \"high\" on drugs tend to have unprotected sex. This too, puts the person at risk of getting HIV. 7. **Amphetamines (also known as Speed, Ice, Browns, Footballs, Hearts, Oranges, Wake ups, Black beauties, Crystal meth, Crack meth, Cat, Jeff amp, Dexies, Rippers, Bennies, Browns, Greenies, Pep pills).** Amphetamines are stimulants that affect a person\'s system by speeding up the activity of the brain and giving energy, Ice is a strong type of amphetamine and is very similar to crack. Amphetamines are man-made drugs and relatively easy to make. Usually, they are white or light brown powder and can also come the form of a pill. \"Ice\" usually comes as colourless crystals or as a colourless liquid when used for injecting. It can be swallowed, snorted, injected, or smoked. **Effects**: Amphetamines can cause an increase in heart beat, faster breathing, increase blood pressure and body temperature, sweating, make the person more confident and alert, give him/her extra energy, reduce appetite, make it difficult to sleep, and might make the abuser talk more. The person using amphetamines may also feel anxious, irritable, and suffer from panic attacks. Frequent use can produce strong psychological dependence. Large doses can be lethal. 8. **Ecstasy (also know as Ecstasy, Adam, Essence, MDM, MDMA, XTC, Eve, MDE, MDEA).** Ecstasy belongs to the same group of chemicals as the above category that is stimulants, and is most often used in the form of tablets at rave parties. Ecstasy is a drug that speeds up the users system by increasing his/her physical and emotional energy. Like amphetamines, ecstasy is also a synthetic (or man-made) drug. Ecstasy is usually a small, coloured tablet. These pills can come in many different colours. Some ecstasy tablets have pictures on them, such as doves, rabbits, or champagne bottles. The colour or the \"brand\" of the tablet is usually unrelated to the effects of the drug. Ecstasy tablets are usually swallowed. **Effects:** A person using ecstasy will probably feel happy, warm, loving and more energetic. He/she would feel emotionally close to others, and might say or do things that he/she usually would not. Nausea and vomiting, rise in blood pressure and heart rate, possibly even death due to overheating of the body, and dehydration or loss of water are some effects of ecstasy. Feelings of depression and tiredness are common after stopping the drug. There is mounting evidence that prolonged ecstasy use can lead to brain and liver damage. 9. **Inhalants and solvents.** Inhalants and solvents are chemicals that can be inhaled, such as glue, gasoline, aerosol sprays, lighter fluid, etc. These are not drugs as such and are, in fact, legally available from a large number of shops. However, they are abused widely by the poorer sections of society, particularly street youth. Inhalants can look like almost anything (glue, paint thinner, gasoline, lighter fuel, cleaning fluids, etc). Theyusually come in tubes or bottles. Often, the chemical is placed in the bottom of a cup or container and then, placed over the nose and mouth. Other methods include: soaking a rag in inhalant; placing the rag in bag or sack and then placing the bag over the face, and inhaling the vapors. **Effects**: Inhalants may give the user a "high" for a very brief period of time. They make him/her feel numb for a short period of time, dizzy, confused, and drowsy. They can also cause headaches, nausea, fainting, accelerated heartbeat, disorientation, and hallucinations. They can damage the lungs, kidney, and liver in the long term. They can also cause suffocation, convulsions, and comas. **Tips to Avoid Drugs:** - You do not need to take drugs to be liked by other people. - You do not need to take drugs to feel brave or courageous. - You do not need drugs to cope with sorrow or disappointments. - You have, inside you, the strength and inner resources to deal with any situation and any problem. Whatever problem you are facing, there are people available to help you. You can talk to a friend, a teacher, a parent, or a trusted person at your church or mosque. **Summary** The developing adolescent is very vulnerable to high risk-taking behaviors that can harm their growth and pose a threat to their future. Warning signs of a troubled teen should be recognized and managed early on to prevent devastating effects on the growing adolescent. **GENDER AND SOCIETY UNIT III: PSYCHOSOCIAL PERSPECTIVE IN GENDER AND SEXUALITY** **Lesson 8: GENDER AND SEXUALITY AS A PSYCHOLOGICAL ISSUE** **Definition of Terms:** - **Psychosocial**- a term pertaining to psychological and social factors and the interaction of these factors - **Psychosocial issues**- needs and concerns relating to one or all of the psychosocial dimensions - **Reproductive role**- the social script ascribed to individuals pertaining to their role in child-bearing or child-rearing and related tasks such as maintaining the household. - **Productive role**- the social script ascribed to individuals pertaining to their role in economic production and related tasks such as engaging in public affairs and living in the world of work. **Introduction** In previous sessions, we discussed about the biological dimension of sexuality, We learned that the human person has biological mechanisms for sexual growth and reproduction, and that depending on **sex**, these mechanisms differ. At the beginning of this text book, we also emphasized that these reproductive mechanisms are interpreted by societies, thereby, creating differentiated social standards for behavior and expectations. For instance, since the human female is capable of bearing a child, the society interprets this capacity as associated to womanhood, and thus, sets fulfillment of reproductive role as an expectation among women. On the other hand, since the human male does not have the capability to bear the child but has a relatively larger muscular-skeletal frame, the society expects the human male to perform productive role and associates this role to men. However, while there are distinct physiological differences, much of the capabilities, except those involved in reproduction, can actually be performed by either sexes. Both women and men can perform child-rearing roles. Both can also engage and succeed in the world of work. In many cases, the limits are only set by social expectations. These scenarios only exemplify that much about gender and sexuality is not only biological and physiological but also psychological and social. This perspective of exploring and understanding human sexuality in the lens of psychological social processes is referred to as **psychosocial perspective.** What Does Psychosocial Mean? The term \"psychosocial\" is an encompassing term. It is comprised by two primary aspects: **psychological** and **social**. There are myriad of ways in defining these two terms but in essence, psychological pertains to anything associated with mental process and behavior, while social pertains to anything associated with human relationships, connection, and Interaction. The psychological aspect of gender and sexuality anchors itself on the field of **psychology**. Psychology is a field of science which concerns itself with how people think and feel and how thoughts and feelings interact and lead to behavior. There are three primary psychological domains: affect, behavior, and cognition. **Affect** or the affective domain pertains to people\'s emotions and feelings. **Behavior** or the behavioral domain pertains to people\'s actions-both observable (overt) or not readily observable (covert). **Cognition** or cognitive domain pertains to people\'s thought processes such as memory, perception, and information-processing. Hence, to say that gender and sexuality have a psychological dimension is to note that our sexual behaviors, as well as gender-related behaviors, originate from what sense, think, and feel. On the other hand, the social aspect of gender and sexuality primarily anchors itself on the field of sociology and allied fields such as **social psychology**. In essence, Sociology is a field of science which concerns itself with the human person\'s realities and experiences as part of groups and institutions, including the structures and functions of these institutions, and the dynamics of human relationships within them. **Understanding the Psychosocial Dimension** There are many ways through which the psychosocial dimension of gender and sexuality can be understood and explained. Our experience of gender and sexuality is generally a relational experience. It is ![](media/image10.jpeg)relational because while as individuals, we have our own affect, cognition and behavior to be aware of, we are also viewing ourselves in relation to others who also have their own personal preoccupations. There are some elements of our gendered self which are best viewed in an ecological context-that is, in the circumstances in our physical and social environment. ***Awareness*** At the front of our experience as gendered beings is **awareness**. In simpler terms. awareness is our conscious understanding of something. As individuals, we are in constant process towards **self-awareness**: Who and what am I? What do I like/dislike? What are my strengths and weakness? What motivates me? What are my aspirations? We are in an endless process of asking and trying to understand. In the context of gender and sexuality, we ask What am I physiologically? Am I happy with what I am? How do I genuinely see myself? How do I feel about myself as a sexual being? Is there anything good I should do? But then again, we are not isolated in a vacuum. We social beings. We live our lives in relation to others. Hence, we try to understand ourselves more, we are also in a constant process towards *other awareness*, that is, understanding others: What is the other\'s motivations, preferences, and aspirations? Where am I positioned in her or his life, vis-à-vis where is s/he positioned in my life? How different and or similar am I and other! ***Intimacy and relationship*** In certain situations, when two people recognize and become aware of each other, they decide to keep close distance in each other\'s lives, share their personal bubbles. so to speak, and allow frequency of interaction between them. This forges some form of **human relationship**-a bond formed between two or more people, manifested through communication and interaction. These relationships may be in the form of family, friendships, romantic relationship, or others. While in these relationships, we share resources and emotions, we, as individuals, constantly aim to further understand our own selves as we also try to understand others and be understood by them. This process of knowing others and allowing others to know us is **intimacy**. As social beings, we also learn from our own experiences and from the lessons taught to us by those who have come before us. How we behave in relation to other people, with due consideration to social expectations related to our gender, and how we make choices to balance out personal goals and social goals, might be passed on to us through education and other cultural preoccupations. The process by which we learn cultural norms and traditions is referred to as **socialization**. At the end of it all, as rational beings, also capable of making sense of our experiences vis-à-vis the influences of our environments and integrate these interpretations into our own choice. ***Well-being as a Psychosocial Goal*** The ultimate goal of understanding the psychosocial aspects of our experiences is **well- being**- a state of satisfaction, meaning, and purpose. There are two sides to well-being. One is that kind of well-being which is observed, outward, and can be evaluated through the presence or absence of particular elements in our environment. This is referred to as **objective well-being**. In the aspect of gender and sexuality here are some of the questions to ask: - Does the physical environment allow expression of diversity? Does the physical infrastructure mitigate any possibility of abuse and violence related to gender? - Are material resources (money, properties) equitably available to men, women, and other people with different genders? Are these resources sufficient for them? - Are there health systems which cater to gender-related needs? Are there wellness programs that support women, men and people of different genders? Another side of well-being is our personal experience of satisfaction, meaning, and purpose. This is referred to as subjective well-being. It is subjective because it pertains to our own appreciation of how well we are. Sometimes, even when the environment fully provides for all our needs, we remain unsatisfied, and thus, having low sense of subjective well-being. There are also moments where the environment has shortcomings, but we are at peace and satisfied within. In a common term, the closes word to also mean subjective well- being is happiness. Some of the question to ask are as follows: - How far is your sense of satisfaction about the various areas of your life as a sexual being? - Is your purpose as a person clear to you and if not yet, what are you doing to clarify this purpose? ***Dimensions of Well-being*** Based on what well-being means, we can see that there are various dimensions into it. The following are just the primary dimensions of well-being which we must look into when trying to understand the psychosocial condition of a person: - **physical**- physical/biological health: - **emotional-** positive feelings, mood stability: - **mental-** clarity of mind; healthy thought process; - **material** - available and adequate financial and other resources; and - **social**- healthy and positive interaction and relationship with others. **Summary** One of the essential elements of our gender and sexuality is the psychosocial dimension. Aside from upholding human dignity and human rights, one of the ultimate goals of our discussions of gender and sexuality is to ensure well-being among people of different genders. Understanding our psychosocial needs and concerns, as well as the various elements of our psychosocial conditions as humans, is necessary. **Lesson 9: LOVE, INTIMACY, AND RELATIONSHIP** ***Definition of Terms**:* - **Love**- a complex phenomenon characterized by an affective and cognitive inclination to someone and a set of social behaviors geared towards cohesion. - **Intimacy**- the psychosocial component of love; knowing and being known by someone in a deeply personal level; emotional closeness and connection. - **Passion**-the emotive and physical component of love; drive towards sexual and romantic attraction. - **Commitment**-decision to engage and maintain a loving relationship. - **Relationship** -- social bond between and among individuals manifested through communication and other forms of interaction. This bond may be biological or determined by social contracts such as social consensus or laws. **Introduction** In February 15, 2015, an article featuring a study by McCann World Group, among 30,000 respondents from 29 countries, came out of a national newspaper, bannering the title "Filipinos most expressive about love among Asia Pacific countries-----study"(Hegina 2015).The article presented an interesting result: The Filipinos say "I love you" approximately 17 times in a week, making us sixth among the countries in the survey, which are most articulate and expressive. **Robert Sternberg**, a psychologist renowned for his theory of love asked, in his 1986 paper: "What does it mean "to love" someone? Does it always mean the same thing, and if not, in what ways do loves differ from each other?" In this chapter, we will tackle, perhaps, one of the most complex and celebrated human emotion and experience: love. **LOVE AS A HUMAN EXPERIENCE** Love is a human experience differently defined and conceptualized. ***Love as a culture universal*** Love is construed as a **culture universal**. A culture universal is a phenomenon experienced similarly by people across time and cultures. This means that humans, whether those who lived in the past or who are living now and regardless of their geographic location and socio-cultural identities, have experienced love, in one way or another. Said differently, love is an experience that transcends time and culture. People before us, such as our grandpare

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