PSYCH100 Module 6 Sexual-Self PDF

TOPIC 6: THE SEXUAL SELF LEARNING OUTCOMES: At the end of the lesson, you should be able to:  Discuss the sexual concept;  Explain hormones and sexuality;  Discuss gender and sexual diversity (GSD); and  Reflect on the importance of contracepti...

TOPIC 6: THE SEXUAL SELF LEARNING OUTCOMES: At the end of the lesson, you should be able to:  Discuss the sexual concept;  Explain hormones and sexuality;  Discuss gender and sexual diversity (GSD); and  Reflect on the importance of contraception and Reproductive Health TEACHING-LEARNING ACTIVITY (LESSON PROPER): A child asked her mom “What is sex?”. The mother nervously asked, “where did you hear that word?”. Then the child pointed at “sex” on the form that the mother was about to fill out. The mother gave a sigh of relief and explained how one becomes a “male” or a “female”. Talking about sex may be unacceptable among certain cultures and some teens (and even children) may dangerously explore their sexuality. Without proper guidance, adolescents may engage in unsafe practices or become victims of abuse. The following discussions delve into the sexual self-concept, the RH Bill, and guidelines on sexuality. Sexual Self-concept “Sexual self-concept (SSC) – defined as an individual’s evaluation of his or her own sexual feelings and actions” (Winter, 1988, p.123). The cognitive and affective components are believed to be at the core of human sexuality. The following are some of the main factors in forming the SSC (Potki, et al., 2017): a. Biological Factors  Age The SSC becomes more stable with increasing age.  Gender As compared to men, women have been generally shown to experience greater sexual anxiety, depression, and fear. Unfortunately, a number of women reported that their first sexual experience felt forced and it had an abusive feature. Also, women tend to view sexual experiences more romantically while men view it from a more explicit perspective.  Sexually Transmitted Disease (STD) Individuals with STDs such as Human Papillomavirus (HPV), HIV/ AIDS, chlamydia, and gonorrhea experience more feelings of depression and anxiety regarding their sexual relations. Alarmingly, most infected people do not reveal about their diseases to their partners because of fear of rejection. b. Psychological Factors  Body Image Poor body image has been found to be associated with reduced confidence in engaging in intimate relationships.  History of Sexual Abuse Survivors of sexual abuse tend to be less romantic and sensual. They may also often feel guilt, shame, frustration, sorrow, and anger.  Mental Health Sexual incompetence and other negative emotions tend to be higher among those with mental health concerns such as schizophrenia and depression. c. Social Factors  Parents and Peers Parents are generally the first educators on sexual identity and related values like love, humility, and kindness. Also, students report that most of their knowledge on sexuality is gained from peers.  Media The media encompasses a wide array of sexuality-related topics such as reproduction, sexual identity, and romantic relationships. Hormones and Sexuality Hormones are chemical messengers in your body which affect various processes such as metabolism, mood, appetite, and how you experience feelings of intimacy. The following table presents several of such hormones, the glands which produce them, and their influence on sexuality. Hormone Gland Influence Testosterone Testicles, adrenal glands Sexual motivation among (small quantities) males Estrogen Ovaries, placenta Sexual motivation among (during pregnancy) females Progesterone Ovaries, placenta, and Decreases sexual motivation adrenal glands among women; produced during pregnancy Oxytocin Hypothalamus (secreted Released during sexual activity, by pituitary gland) childbirth, and lactation linked with empathy, trust, and attachment Vasopressin Hypothalamus Causes the erectile response (secreted by pituitary among men gland) Gender and Sexual Diversity (GSD) GSD pertains to the varieties of gender identities and sexual orientations. The following are several of the related terms:  Sex: It is the biological difference assigned at birth; it’s being either male or female.  Sexual Orientation: It is about who an individual feels sexually attracted to. For instance, a person may be straight (heterosexual), gay or lesbian (homosexual), or bisexual.   Gender Identity: The internal sense of one’s own gender; it may differ from the assigned sex at birth. Thus, some people may experience their gender differently from what the society expects. Transgender is an umbrella term for people who have gender identities that do not match their sex which was assigned at birth.  Gender Expression: This is how an individual expresses his gender identity. This is shown through body language, way of dressing, manner of talking, etc.  Cisgender: An individual whose sense of gender identity matches their assigned sex at birth.  LGBT, LGBTQ*, LGBTQ +, LGBTTQ, and LGBTQ2: These acronyms allude to the spectrum of gender and sexual identities which include lesbian, gay, bisexual, transgender, two-spirit, queer, questioning, intersex, and asexual. The asterisk (*) or plus (+) means that there are other kinds of identities which are not in the acronym. The RH Law The Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act No. 10354), also known as the RH Bill, RH Law, or Reproductive Health Law, gives a comprehensive framework regarding family planning and reproductive health services. Below is an excerpt regarding the general information of RA 10354 from the Commission on Population (2019). What is responsible parenthood (RP)? Responsible parenthood is the will and ability of parent(s) to respond to the needs and aspirations of the family and children. It is the shared responsibility between parents to determine and achieve the desired number and timing of their children according to their own aspirations. (RA 10354 Section 4v). What is Reproductive Health (RH)? Reproductive health can be defined as a state of complete well-being in matters relating to one’s sexual and reproductive life. It implies that people are able to have a responsible, safe, consensual and satisfying sex life and that they have the capability to reproduce and the freedom to decide of, when, and how often to do so. Further, it implies that men and women attain equal relationships in matters related to sexual relations and reproduction. (RA 10354 Section 4s). What are the guiding principles that govern the RP-RH Law? The RP-RH law is rooted on the human rights of all persons including their right to equality and non-discrimination, the right to sustainable human development, the right to health including RH, the right to education and information, and the right to choose and make decisions for themselves in accordance to their religious convictions, ethics, cultural beliefs and the demand of responsible parenthood. In particular, the law upholds and guarantee the following principles:  The right to make free and informed decisions of every person particularly couples, adult individuals, women and adolescents including preference and choice for FP methods, determination of ideal family size;  The provision of effective and quality RH care services by the state that will lead to universal access to affordable and quality RH care and services;  The provision of truthful information and education on RH; and  The preferential access to the poor and the marginalized. Family Planning As children have the right to be born to parents who are ready to take care of them, using family planning methods is essential. The following are a couple of excerpts and discussions on natural methods and contraceptives.  A. Natural Method: This method does not involve any chemical or barrier. How to Use Natural Family Planning Dr. Willie T. Ong (The Philippine Star)-October 29, 2013 There are four techniques to determine the time of ovulation: 1. Calendar rhythm method. The rhythm method can be used by women with relatively regular menses. For a span of one year, record the woman’s shortest cycle and longest cycle. For example, a woman may have 26 days as the shortest and 34 days as the longest cycle. Next, follow this computation strictly: Subtract 18 days from the shortest cycle, and also subtract 10 days from the longest cycle. In this case, the answers are 8 and 24, respectively. Therefore, the woman is not safe from days 8 to 24 of her cycle. Day 1 counts as the first day of the menstruation period. Other family planning methods can be used for the unsafe 16 days. (The reason for the constants 18 and 10 has to do with the fact that ovulation occurs 14 days before the start of the menstruation. The extra plus four days are for safety purposes because the sperm can live up to three to four days.) 2. Temperature method. For most women, there is a slight rise in temperature just after ovulation. The woman has to take and record her temperature every morning, once she wakes up and before doing anything. For example, from an average of 36.5 degrees Centigrade during non-ovulation period, her temperature can rise 0.3 to 0.5 degrees Centigrade during ovulation. For this method, you need to buy a special thermometer called a basal thermometer, or an electronic thermometer. Remember, the woman is unsafe up to four days after the rise in temperature, and four days before the rise in temperature. Hence, because the temperature will rise only after ovulation, this method is not effective when used alone. 3. Cervical mucus inspection method. Around four days before ovulation (the start of the unsafe period), the woman’s vaginal mucus becomes thin, clear, more profuse, and stretchable. The consistency resembles an egg white, which does not break even if you stretch it between your fingers. When this occurs, this means that the woman is unsafe and may become pregnant. On the other hand, when the mucus returns to become thicker and drier, this means that the woman has finished ovulating. To prevent pregnancy, avoid sexual contact starting from the time the thin, stretchy egg white-like mucus appears until up to four days after the mucus returns to its usual thicker and drier consistency. This technique needs practice, but can be effective. (Important tip: For normal couples who want to become pregnant, having sex during the time that the cervical mucus is thinnest and most stretchable can lead to pregnancy in up to two out of three cases.) 4. Combined mucus and temperature method. The most effective natural family planning method is a combination of all these techniques. The woman checks her early morning (basal) body temperature, then inspects her cervical mucus. In addition, she may also feel other signs of ovulation like breast tenderness, low backache, and pain in the area of the ovaries. Some couples use the withdrawal method or pull-out method. This is taking out the penis before ejaculation. However, this needs a lot of control and 22 % of those who use withdrawal become pregnant (Sutton, 2019). What some people do not know is that the precum (pre-ejaculate fluid released during sexual stimulation) may contain sperm. Hence, you may become pregnant even if the withdrawal happens before ejaculation. B. Contraceptives: These are devices or drugs to prevent pregnancy. Contraceptives in the Philippines: What to Use, Where to Get (Rappler.com, March 21, 2015) Once you start becoming sexually active, responsibility should accompany it. It doesn’t sound too sexy but if having a kid can’t be found anywhere in your 5-year plan, you’ve got to take your bedroom fun a little more seriously.  1. Birth Control Pills How does it work: Prevents ovulation How often do you use it: Take one pill a day. Effectiveness with regular use: >99% Where to get them: Public health centers, drug stores What most of us know and use as birth control pills are more formally known as Combined Oral Contraceptive Pills (COCs). The pill gives you a blend of two hormones: progestin and estrogen. Each kind of birth control pill contains a different proportion of progestin and estrogen, and though it prevents unwanted pregnancies for all women, some pills can cause weight gain, a change in your menstrual cycle, increased or decreased acne, and so on. If you’ll be using birth control pills for an extended period of time, it’s best to seek a prescription. Some up-sides to using COCs are decreased dysmenorrhea, regularizing your menstrual cycle, and a possible lessening of nasty PMS. If you’ve recently given birth and are breastfeeding, don’t use COCs – especially if it’s been less than 6 weeks since the time you’ve given birth. Going on the pill can affect your body’s ability to produce breast milk for your baby. Extended use of the pill is safe but expect that it can delay, or stop your menstruation altogether. Once you stop using the pill, fertility returns almost immediately. If you’re on the pill and you forget to drink one for more than 3 days, you’re liable to get pregnant. 2. Injectables How does it work: Thickens the mucus in the cervix, preventing the sperm from reaching the egg, also prevents ovulation How often do you use it: Get one injection every 3 months Effectiveness with regular use: >99% Where to get them: Public health centers, private clinics, women’s health clinics with trained service providers Injectables available in the Philippines are limited to progestogen only injectables, also known as depot medroxyprogesterone acetate (DMPA). If you’re with a regular partner, it’s a reliable way to prevent unwanted pregnancies that don’t include any daily tasks on your part. Be prepared for possible side effects such as weight gain and changes in your menstrual cycle. For many women, the more regularly they use injectables, the more likely they are to have amenorrhea or an absence of menstruation. Don’t worry, not having your monthly period doesn’t mean you’re unhealthy or infertile. A more serious risk when it comes to DMPAs is the possible loss of bone mineral density, making it more advisable for women who’ve reached or are near to reaching their peak bone mass. It’s been observed that women who use DMPA injectables for up to 5 years experience the kind of bone loss usually associated with breastfeeding. The good news is a 2008 study says that the bone loss is reversible, once you stop using DMPAs. If you have hypertension, or you’ve experienced a cardiovascular disease like a stroke, and if you’re breastfeeding, stay away from DMPAs. Once you stop using the injectables, fertility remains almost immediately but it depends on the length of time you’ve been receiving injectables for birth control. The longer you were on injectables, the more time it will take for your body to be fertile again. If you go without your DMPA for more than 4 weeks, you could get pregnant. Injectables are free in public health centers as long as they have trained service providers who can administer the injection. They’re also available in private clinics and women’s health organizations who have trained health workers. A specific brand of DMPA, Depo Trust, is also available in drug stores. You can buy them by the vial – one vial is good for one dosage. To administer them, you will still have to go to a trained service provider. 3. Implant How does it work: Thickens the mucus in the cervix, preventing the sperm from reaching the egg, also prevents ovulation How often do you use it: Get one implant every 3 years Effectiveness with regular use: >99% Where to get them: Private clinics or women’s health centers Implants are exactly what they sound like. A small rod the size of a matchstick containing progestogen is inserted into your non-dominant arm where it’ll stay for 3 years, after being implanted in just a few minutes. The progestogen, a female hormone, is released into the body little by little throughout the 3 years, stopping eggs from being released into your ovary – the same way it works with DMPAs. Ranging from a time period of either a week or two months from when you’ve been implanted, you’ll have irregular menstruation until it stops completely. Once the implant is removed, most women begin ovulating again within 3 weeks to 3 months. Whatever you choose as the best method for you, remember that contraceptives aren’t replacements for condoms as protection from sexually transmitted diseases. Sex is not just something you do for fun. If you want to stay healthy and accident-free, do away with the carelessness and get to know your contraceptives. C. Barrier Methods Barrier methods require participation from both partners. 1. Condoms This is suggested to protect yourself from sexually transmitted infections. Research has shown that around one out of 50 women get pregnant even if their partners used condoms (Bell, 2018). They should be used with spermicides to be more effective. 2. Spermicides Spermicides come in various forms such as jelly and cream. They are supposed to be inserted into the vagina before sexual activity so they can effectively kill sperm. They are only around 74% effective so they should be partnered with other contraceptives. 3. Diaphragms or Caps Diaphragms or caps are dome-shaped latex barriers fitted over the cervix. They are first filled with spermicides before being used. The cap should be left in place for at least 6 hours after the sexual intercourse. Around 4 to 8 women out of 100 get pregnant even after using diaphragms (National Health Service-UK, 2017). Sterilization Sterilization is a surgical method which often permanently prevents pregnancy. The procedure for women is tubal ligation, the cutting of the fallopian tubes to prevent the egg from meeting the sperm. The procedure for men is vasectomy, the cutting of the vas deferens tubes to prevent the sperm from mixing with the semen which is being ejaculated. In reversible procedures the fallopian and vas deferens tubes are only tied. Psychology Department. (2019). Understanding the self. Unpublished. Taag, G. C., Cuyan, A. S., Awingan, W. A., Balinggan, G. T., Carrera, W. D., & Perez, E. N. Understanding the self. Revised edition. Meycauayan City: IPM Publishing, c2019.