Understanding the Self - PDF

# Chapter II: Unpacking the Self ## Lesson 1: The Physical and Sexual Self **Lesson Objectives** At the end of this lesson, you should be able to: 1. discuss the developmental aspect of the reproductive system 2. describe the erogenous zones 3. explain human sexual behavior 4. characterize the div...

# Chapter II: Unpacking the Self ## Lesson 1: The Physical and Sexual Self **Lesson Objectives** At the end of this lesson, you should be able to: 1. discuss the developmental aspect of the reproductive system 2. describe the erogenous zones 3. explain human sexual behavior 4. characterize the diversity of sexual behavior 5. describe sexually transmitted diseases 6. differentiate natural and artificial methods of contraception **Introduction** It has been believed that the sex chromosomes of humans define the sex (female or male) and their secondary sexual characteristics. From childhood, we are controlled by our genetic makeup. It influences the way we treat ourselves and others. However, there are individuals who do not accept their innate sexual characteristics and they tend to change their sexual organs through medications and surgery. Aside from our genes, our society or the external environment helps shape our selves. This lesson helps us better understand ourselves through a discussion on the development of our sexual characteristics and behavior. **Activity** **Defining Beauty** Complete the sentences below. 1. For me, beauty means **Abstraction** Marieb, E.N. (2001) explains that the gonads (reproductive glands that produce the gametes; testis or ovary) begin to form until about the eighth week of embryonic development. During the early stages of human development, the embryonic reproductive structures of males and females are alike and are said to be in the indifferent stage. When the primary reproductive structures are formed, development of the accessory structures and external genitalia begins. The formation of male or female structures depends on the presence of testosterone. Usually, once formed, the embryonic testes release testosterone, and the formation of the duct system and external genitalia follows. In the case of female embryos that form ovaries, it will cause the development of the female ducts and external genitalia since testosterone hormone is not produced. Any intervention with the normal pattern of sex hormone production in the embryo results in strange abnormalities. For instance, a genetic male develops the female accessory structures and external genitalia if the embryonic testes fail to produce testosterone. On the other hand, if a genetic female is exposed to testosterone (as in the case of a mother with androgen-producing tumor of her adrenal gland), the embryo has ovaries but may develop male accessory ducts and glands, as well as a male reproductive organ and an empty scrotum. As a result, pseudohermaphrodites are formed who are individuals having accessory reproductive structures that do not "match" their gonads while true hermaphrodites are individuals who possess both ovarian and testicular tissues but this condition is rare in nature. Nowadays, many pseudohermaphrodites undergo sex change operations to have their outer selves (external genitalia) fit with their inner selves (gonads). A critical event for the development of reproductive organs takes place about one month before birth wherein the male testes formed in the abdominal cavity at approximately the same location as the female ovaries, descend to enter the scrotum. If this normal event fails, it may lead to cryptorchidism. This condition usually occurs in young males and causes sterility (which is also a risk factor for cancer of the testes) that is why surgery is usually performed during childhood to solve this problem. Moreover, abnormal separation of chromosomes during meiosis can lead to congenital defects of the reproductive system. For instance, males who possess extra female sex chromosome have the normal male accessory structures, but atrophy (to shrink) of their testes causes them to be sterile. Other abnormalities result when a child has only one sex chromosome. An XO female appears normal but lacks ovaries. YO males die during development. Other much less serious conditions also affect males primarily such as phimosis, which is due to a narrowing of the foreskin of the male reproductive structure and misplaced urethral openings. Puberty is the period of life, generally between the ages of 10 and 15 years old, when the reproductive organs grow to their adult size and become functional under the influence of rising levels of gonadal hormones (testosterone in males and estrogen in females). After this time, reproductive capability continues until old age in males and menopause in females. The changes that occur during puberty is similar in sequence in all individuals but the age which they occur differs among individuals. In males, as they reach the age of 13, puberty is characterized by the increase in the size of the reproductive organs followed by the appearance of hair in the pubic area, axillary, and face. The reproductive organs continue to grow for two years until sexual maturation marked by the presence of mature semen in the testes. In females, the budding of their breasts usually occurring at the age of 11 signals their puberty stage. Menarche is the first menstrual period of females which happens two years after the start of puberty. Hormones play an important role in the regulation of ovulation and fertility of females. **Diseases Associated with the Reproductive System** Infections are the most common problems associated with the reproductive system in adults. Vaginal infections are more common in young and elderly women and in those whose resistance to diseases is low. The usual infections include those caused by Escherichia coli which spread through the digestive tract; the sexually transmitted microorganisms such as syphilis, gonorrhea, and herpes virus; and yeast (a type of fungus). Vaginal infections that are left untreated may spread throughout the female reproductive tract and may cause pelvic inflammatory disease and sterility. Problems that involve painful or abnormal menses may also be due to infection or hormone imbalance. In males, the most common inflammatory conditions are prostatitis, urethritis, and epididymitis, all of which may follow sexual contacts in which sexually transmitted disease (STD) microorganisms are transmitted. Orchiditis, or inflammation of the testes, is rather uncommon but is serious because it can cause sterility. Orchiditis most commonly follows mumps in an adult male. Neoplasms are a major threat to reproductive organs. Tumors of the breast and cervix are the most common reproductive cancers in adult females, and prostate cancer (a common sequel to prostatic hypertrophy) is a widespread problem in adult males. Most women hit the highest point of their reproductive abilities in their late 20s. A natural decrease in ovarian function usually follows characterized by reduced estrogen production that causes irregular ovulation and shorter menstrual periods. Consequently, ovulation and menses stop entirely, ending childbearing ability. This event is called as menopause, which occurs when females no longer experience menstruation. The production of estrogen may still continue after menopause but the ovaries finally stop functioning as endocrine organs. The reproductive organs and breasts begin to atrophy or shrink if estrogen is no longer released from the body. The vagina becomes dry that causes intercourse to become painful (particularly if frequent), and vaginal infections become increasingly common. Other consequences of estrogen deficiency may also be observed including irritability and other mood changes (depression in some); intense vasodilation of the skin’s blood vessels, which causes uncomfortable sweat-drenching "hot flashes"; gradual thinning of the skin and loss of bone mass; and slowly rising blood cholesterol levels, which place postmenopausal women at risk for cardiovascular disorders. Some physicians prescribe low-dose estrogen-progestin preparations to help women through this usually difficult period and to prevent skeletal and cardiovascular complications. There is no counterpart for menopause in males. Although aging men show a steady decline in testosterone secretion, their reproductive capability seems unending. Healthy men are still able to father offspring well into their 80s and beyond. **Erogenous Zones** Erogenous zones refer to parts of the body that are primarily receptive and increase sexual arousal when touched in a sexual manner. Some of the commonly known erogenous zones are the mouth, breasts, genitals, and anus. Erogenous zones may vary from one person to another. Some people may enjoy being touched in a certain area more than the other areas. Other common areas of the body that can be aroused easily may include the neck, thighs, abdomen, and feet. **Human Sexual Behavior** Human sexual behavior is defined as any activity – solitary, between two persons, or in a group – that induces sexual arousal (Gebhard, P.H. 2017). There are two major factors that determine human sexual behavior: the inherited sexual response patterns that have evolved as a means of ensuring reproduction and that become part of each individual's genetic inheritance, and the degree of restraint or other types of influence exerted on the individual by society in the expression of his sexuality. **Types of Behavior** The various types of human sexual behavior are usually classified according to the gender and number of participants. There is solitary behavior involving only one individual, and there is sociosexual behavior involving more than one person. Sociosexual behavior is generally divided into heterosexual behavior (male with female) and homosexual behavior (male with male or female with female). If three or more individuals are involved, it is, possible to have heterosexual and homosexual activity simultaneously (Gebhard, P.H. 2017). **1. Solitary Behavior** Self-gratification means self-stimulation that leads to sexual arousal and generally, sexual climax. Usually, most self-gratification takes place in private as an end in itself, but can also be done in a sociosexual relationship. Self-gratification, generally beginning at or before puberty, is very common among young males, but becomes less frequent or is abandoned when sociosexual activity is available. Consequently, self-gratification is most frequent among the unmarried. There are more males who perform acts of self-gratification than females. The frequency greatly varies among individuals and it usually decreases as soon as they develop sociosexual relationships. Majority of males and females have fantasies of some sociosexual activity while they gratify themselves. The fantasy frequently involves idealized sexual partners and activities that the individual has not experienced and even might avoid in real life. Nowadays, humans are frequently being exposed to sexual stimuli especially from advertising and social media. Some adolescents become aggressive when they respond to such stimuli. The rate of teenage pregnancy is increasing in our time. The challenge is to develop self-control in order to balance suppression and free expression. Adolescents need to control their sexual response in order to prevent premarital sex and acquire sexually transmitted diseases. **2. Sociosexual Behavior** Heterosexual behavior is the greatest amount of sociosexual behavior that occurs between only one male and one female. It usually begins in childhood and may be motivated by curiosity, such as showing or examining genitalia. There is varying degree of sexual impulse and responsiveness among children. Physical contact involving necking or petting is considered as an ingredient of the learning process and eventually of courtship and the selection of a marriage partner. Petting differs from hugging, kissing, and generalized caresses of the clothed body to practice involving stimulation of the genitals. Petting may be done as an expression of affection and a source of pleasure, preliminary to coitus. Petting has been regarded by others as a near-universal human experience and is important not only in selecting the partner but as a way of learning how to interact with another person sexually. Coitus, the insertion of the male reproductive structure into the female reproductive organ, is viewed by society quite differently depending upon the marital status of the individuals. Majority of human societies allow premarital coitus, at least under certain circumstances. In modern Western society, premarital coitus is more likely to be tolerated but not encouraged if the individuals intend marriage. Moreover, in most societies, marital coitus is considered as an obligation. Extramarital coitus involving wives is generally condemned and, if permitted, is allowed only under exceptional conditions or with specified persons. Societies are becoming more considerate toward males than females who engage in extramarital coitus. This double standard of morality is also evident in premarital life. Postmarital coitus (i.e., coitus by separated, divorced or widowed persons) is almost always ignored. There is a difficulty in enforcing abstinence among sexually experienced and usually older people for societies that try to confine coitus in married couples. A behavior may be interpreted by society or the individual as erotic (i.e., capable of engendering sexual response) depending on the context in which the behavior occurs. For instance, a kiss may be interpreted as a gesture of expression or intimacy between couples while others may interpret is as a form of respect or reverence, like when kissing the hand of an elder or someone in authority. Examination and touching someone’s genitalia is not interpreted as a sexual act especially when done for medical purposes. Consequently, the apparent motivation of the behavior greatly determines its interpretation. **Physiology of Human Sexual Response** Sexual response follows a pattern of sequential stages or phases when sexual activity is continued. 1. **Excitement Phase** - it is caused by increase in pulse and blood pressure; a sudden rise in blood supply to the surface of the body resulting in increased skin temperature, flushing, and swelling of all distensible body parts (particularly noticeable in the male reproductive structure and female breasts), more rapid breathing, the secretion of genital fluids, vaginal expansion, and a general increase in muscle tension. These symptoms of arousal eventually increase to a near maximal physiological level that leads to the next stage. 2. **Plateau Phase** - it is generally of brief duration. If stimulation is continued, orgasm usually occurs. 3. **Sexual Climax** - it is marked by a feeling of abrupt, intense pleasure, a rapid increase in pulse rate and blood pressure, and spasms of the pelvic muscles causing contractions of the female reproductive organ and ejaculation by the male. It is also characterized by involuntary vocalizations. Sexual climax may last for a few seconds (normally not over ten), after which the individual enters the resolution phase. 4. **Resolution Phase** - it is the last stage that refers to the return to a normal or subnormal physiologic state. Males and females are similar in their response sequence. Whereas males return to normal even if stimulation continues, but continued stimulation can produce additional orgasms in females. Females are physically capable of repeated orgasms without the intervening "rest period" required by males. **Nervous System Factors** The entire nervous system plays a significant role during sexual response. The autonomic system is involved in controlling the involuntary responses. In the presence of a stimulus capable enough of initiating a sexual response, the efferent cerebrospinal nerves transmit the sensory messages to the brain. The brain will interpret the sensory message and dictate what will be the immediate and appropriate response of the body. After interpretation and integration of sensory input, the efferent cerebrospinal nerves receive commands from the brain and send them to the muscles; and the spinal cord serves as a great transmission cable. The muscles contract in response to the signal coming from the motor nerve fibers while glands secrete their respective products. Hence, sexual response is dependent on the activity of the nervous system. The hypothalamus and the limbic system are the parts of the brain believed to be responsible for regulating the sexual response, but there is no specialized "sex center" that has been located in the human brain. Animal experiments show that each individual has coded in its brain two sexual response patterns, one for mounting (masculine) behavior and one for mounted (feminine) behavior. Sex hormones can intensify the mounting behavior of individuals. Normally, one response pattern is dominant and the other latent can still be initiated when suitable circumstances occur. The degree to which such innate patterning exists in humans is still unknown. Apart from brain-controlled sexual responses, there is some reflex (i.e., not brain-controlled) sexual response. This reflex is mediated by the lower spinal cord and leads to erection and ejaculation for male, vaginal discharges and lubrication for female when the genital and perineal areas are stimulated. But still, the brain can overrule and suppress such reflex activity-as it does when an individual decides that a sexual response is socially inappropriate. **Sexual Problems** Sexual problems may be classified as physiological, psychological, and social in origin. Any given problem may involve all three categories. Physiological problems are the least among the three categories. Only a small number of people suffer from diseases that are due to abnormal development of the genitalia or that part of the neurophysiology controlling sexual response. Some common physiologic conditions that can disturb sexual response include vaginal infections, retroverted uteri, prostatitis, adrenal tumors, diabetes, senile changes of the vagina, and cardiovascular problems. Fortunately, the majority of physiological sexual problems can be resolved through medication or surgery while problems of the nervous system that can affect sexual response are more difficult to treat. Psychological problems comprise by far the largest category. They are usually caused by socially induced inhibitions, maladaptive attitudes, ignorance, and sexual myths held by society. An example of the latter is the belief that good, mature sex must involve rapid erection, prolonged coitus, and simultaneous orgasm. Magazines, marriage books, and general sexual folklore often strengthen these demanding ideals, which are not always achieved; therefore, can give rise to feelings of inadequacy anxiety and guilt. Such resulting negative emotions can definitely affect the behavior of an individual. Premature emission of semen is a common problem, especially for young males. Sometimes this is not the consequence of any psychological problem but the natural result of excessive tension in a male who has been sexually deprived. Erectile impotence is almost always of psychological origin in males under 40; in older males, physical causes are more often involved. Fear of being impotent frequently causes impotence, and, in many cases, the afflicted male is simply caught up in a self-perpetuating problem that can be solved only by achieving a successful act of coitus. In other cases, the impotence may be the result of disinterest in the sexual partner, fatigue, and distraction because of nonsexual worries, intoxication, or other causes such occasional impotency is common and requires no therapy. Ejaculatory impotence, which results from the inability to ejaculate in coitus, is uncommon and is usually of psychogenic origin. It appears to be associated with ideas of contamination or with memories of traumatic experiences. Occasional ejaculatory inability can be possibly expected in older men or in any male who has exceeded his sexual capacity. Vaginismus is a strong spasm of the pelvic musculature constricting the female reproductive organ so that penetration is painful or impossible. It can be due to anti-sexual conditioning or psychological trauma that serves as an unconscious defense against coitus. It can be treated by psychotherapy and by gradually dilating the female reproductive organ with increasingly large cylinders. **Sexually Transmitted Diseases** Sexually transmitted diseases (STDs) are infections transmitted from an infected person to an uninfected person through sexual contact. STDs can be caused by bacteria, viruses, or parasites. Examples include gonorrhea, genital herpes, human papillomavirus infection, Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), chlamydia, and syphilis (National Institute of Allergy and Infectious Diseases of the National Institute of Health of the United States 2017). STDs are a significant global health priority because of their overwhelming impact on women and infants and their inter-relationships with HIV and AIDS. STDs and HIV are associated with biological interactions because both infections may occur in the same populations. Infection with certain STDs can increase the risk of getting and transmitting HIV as well as modify the way the disease develops. Moreover, STDs can lead to long-term health problems, usually in women and infants. Among the health complications that arise from STDs are pelvic inflammatory disease, infertility, tubal or ectopic pregnancy, cervical cancer, and perinatal or congenital infections in infants born to infected mothers. One of the leading STDs worldwide is AIDS, which is caused by HIV or Human Immunodeficiency Virus. The virus attacks the immune system making the individual more prone to infections and other diseases. The virus usually targets the T-cells (CD4 cells) of the immune system, which serve as the regulators of the immune system. The virus survives throughout the body but may be transmitted via body fluids such as blood, semen, vaginal fluids and breast milk. AIDS occurs in the advanced stage of HIV infection. Aside from HIV and AIDS, there are other sexually transmitted diseases in humans. The following list of diseases is based on Sexually Transmitted Disease Surveillance 2016 of the U.S Department of Health and Human Services Centers for Disease Control and Prevention. **1. Chlamydia** In 2016, a total of 1,598,354 cases of Chlamydia Trachomatis infection were reported to the Centers for Disease Control and Prevention (CDC), making it the most common notifiable condition in the United States. This case count corresponds to a rate of 497.3 cases per 100,000 population, an increase of 4.7% compared with the rate in 2015. During 2015 to 2016, rates of reported chlamydia increased in all regions of the United States. Rates of chlamydia are highest among adolescent and young adult females, the population targeted for routine chlamydia screening. Among young women attending family planning clinics participating in a sentinel surveillance program who were tested for chlamydia, 9.2% of 15 to 19 years old and 8.0% of 20 to 24 years old were positive. Rates of reported cases among men are generally lower than rates among women. **2. Gonorrhea** In 2016, 468,514 gonorrhea cases were reported for a rate of 145.8 cases per 100,000 population, an increase of 18.5% from 2015. During 2015 to 2016, the rate of reported gonorrhea increased 22.2% among men and 13.8% among women. The magnitude of the increase among men suggests either increased transmission or increased case ascertainment (e.g., through increased extra-genital screening) among MSM (men who have sex with men) or both. The concurrent increases among cases reported among women suggest parallel increases in heterosexual transmission, increased screening among women, or both. In 2016, the rate of reported cases of gonorrhea remained highest among African Americans (481.2 cases per 100,000 population) and among American Indians/Alaska Natives (242.9 cases per 100,000 population). During 2012 to 2016, rates increased among all racial and ethnic groups. Antimicrobial resistance remains an important consideration in the treatment of gonorrhea. **3. Syphilis** In 2016, 27,814 Primary and Secondary (P&S) syphilis cases were reported, representing a national rate of 8.7 cases per 100,000 population and a 17.6% increase from 2015. From 2015 to 2016, the P&S syphilis rate increased among both men and women in every region of the country; overall, the rate increased 14.7% among men and 35.7% among women. During 2012 to 2016, P&S syphilis rates were consistently highest among persons aged 20 to 29 years old, but rates increased in every 5-year age group among those aged 15 to 64 years. In 2016, rates were highest among African Americans (23.3 per 100,000 population) and Native Hawaiian/ Other Pacific Islanders (13.9 per 100,000 population); however, rates increased among all racial and ethnic groups in 2012 to 2016. **4. Chancroid** Chancroid is caused by infection with the bacterium Haemophilus ducreyi. Clinical manifestations include genital ulcers and inguinal lymphadenopathy or buboes. Reported cases of chancroid declined steadily between 1987 and 2001. Since then, the number of reported cases has fluctuated somewhat, while still appearing to decline overall. In 2016, a total of 7 cases of chancroid were reported in the United States. **5. Human Papillomavirus** Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Over 40 distinct HPV types can infect the genital tract; although most infections are asymptomatic and appear to resolve spontaneously within a few years, the prevalence of genital infection with any HPV type was 42.5% among United States adults aged 18 to 59 years during 2013 to 2014. Persistent infection with some HPV types can cause cancer and genital warts. HPV types 16 and 18 account for approximately 66% of cervical cancers in the United States, and approximately 25% of low-grade and 50% of high-grade cervical intraepithelial lesions, or dysplasia. HPV types 6 and 11 are responsible for approximately 90% of genital warts. **6. Herpes Simplex Virus** Herpes simplex virus (HSV) is among the most prevalent of sexually transmitted infections. Although most infections are subclinical, clinical manifestations are characterized by recurrent, painful genital and/or anal lesions. Most genital HSV infections in the United States are caused by HSV type 2 (HSV-2), while HSV type 1 (HSV-1) infections are typically orolabial and acquired during childhood. **7. Trichomonas Vaginalis** Trichomonas vaginalis is a common sexually transmitted protozoal infection associated with adverse health outcomes such as preterm birth and symptomatic vaginitis. It is not a nationally reportable condition, and trend data are limited to estimates of initial physician office visits for this condition. Visits appear to be fairly stable since the 1990s; the number of initial visits for Trichomonas vaginalis infection in 2015 was 139,000. **Natural and Artificial Methods of Contraception** **Natural Method** The natural family planning methods do not involve any chemical or foreign body introduction into the human body. People who are very conscious of their religious beliefs are more inclined to use the natural way of birth control and others follow such natural methods because they are more cost-effective (www. nurseslabs.com 2016). **a. Abstinence** This natural method involves refraining from sexual intercourse and is the most effective natural birth control method with ideally 0% fail rate. It is considered to be the most effective way to avoid STIs (Sexually Transmitted Infections). However, most people find it difficult to comply with abstinence, so only a few use this method. **b. Calendar Method** This method is also called as the rhythm method. It entails withholding from coitus during the days that the woman is fertile. According to the menstrual cycle, the woman is likely to conceive three or four days before and three or four days after ovulation. The woman needs to record her menstrual cycle for six months in order to calculate the woman's safe days to prevent conception. **c. Basal Body Temperature** The basal body temperature (BBT) indicates the woman's temperature at rest. Before the day of ovulation and during ovulation, BBT falls at 0.5°F; it increases to a full degree because of progesterone and maintains its level throughout the menstrual cycle. This serves as the basis for the method. The woman must record her temperature every morning before any activity. A slight decrease in the basal body temperature followed by a gradual increase in the basal body temperature can be a sign that a woman has ovulated. **d. Cervical Mucus Method** The change in the cervical mucus during ovulation is the basis for this method. During ovulation, the cervical mucus is copious, thin, and watery. It also exhibits the property of spinnbarkeit, wherein it can be stretched up until at least 1 inch and is slippery. The woman is said to be fertile as long as the cervical mucus is copious and watery. Therefore, she must avoid coitus during those days to prevent conception. **e. Symptothermal Method** The symptothermal method is basically a combination of the BBT method and the cervical mucus method. The woman records her temperature every morning and also takes note of changes in her cervical mucus. She should abstain from coitus three days after a rise in her temperature or on the fourth day after the peak of a mucus change. **f. Ovulation Detection** The ovulation detection method uses an over-the-counter kit that requires the urine sample of the woman. The kit can predict ovulation through the surge of luteinizing hormone (LH) that happens 12 to 24 hours before ovulation. **g. Coitus Interruptus** Coitus Interruptus is one of the oldest methods that prevents conception. A couple still goes on with coitus, but the man withdraws the moment he ejaculates to emit the spermatozoa outside of the female reproductive organ. A disadvantage of this method is the pre-ejaculation fluid that contains a few spermatozoa that may cause fertilization. **Artificial Methods** **a. Oral Contraceptives** Also known as the pill, oral contraceptives contain synthetic estrogen and progesterone. Estrogen suppresses the Follicle Stimulating Hormone (FSH) and LH to prevent ovulation. Moreover, progesterone decreases the permeability of the cervical mucus to limit the sperm's access to the ova. It is suggested that the woman takes the first pill on the first Sunday after the beginning of a menstrual flow, or as soon as it is prescribed by the doctor. **b. Transdermal Patch** The transdermal patch contains both estrogen and progesterone. The woman should apply one patch every week for three weeks on the following areas: upper outer arm, upper torso, abdomen, or buttocks. At the fourth week, no patch is applied because the menstrual flow would then occur. The area where the patch is applied should be clean, dry, and free of irritation. **c. Vaginal Ring** The vaginal ring releases a combination of estrogen and progesterone and it surrounds the cervix. This silicon ring is inserted into the female reproductive organ and remains there for three weeks and then removed on the fourth week, as menstrual flow would occur. The woman becomes fertile as soon as the ring is removed. **d. Subdermal Implants** Subdermal implants are two rod-like implants inserted under the skin of the female during her menses or on the seventh day of her menstruation to make sure that she will not get pregnant. The implants are made with etonogestrel, desogestrel, and progestin and can be helpful for three to five years. **e. Hormonal Injections** A hormonal injection contains medroxyprogesterone, a progesterone, and is usually given once every 12 weeks intramuscularly. The injection causes changes in the endometrium and cervical mucus and can help prevent ovulation. **f. Intrauterine Device** An Intrauterine device (IUD) is a small, T-shaped object containing progesterone that is inserted into the uterus via the female reproductive organ. It prevents fertilization by creating a local sterile inflammatory condition to prevent implantation of the zygote. The IUD is fitted only by the physician and inserted after the woman’s menstrual flow. The device can be effective for five to seven years. **g. Chemical Barriers** Chemical barriers such as spermicides, vaginal gels and creams, and glycerin films are used to cause the death of 'sperms before they can enter the cervix and to lower the pH level of the female reproductive organ so it will not become conducive for the sperm. On the other hand, these chemical barriers cannot prevent sexually transmitted infections. **h. Diaphragm** It is a circular, rubber disk that fits the cervix and should be placed before coitus. Diaphragm works by inhibiting the entrance of the sperm into the female reproductive organ and it works better when used together with a spermicide. The diaphragm should be fitted only by the physician, and should remain in place for six hours after coitus. **i. Cervical Cap** The cervical cap is made of soft rubber and fitted on the rim of the cervix. It is shaped like a thimble with a thin rim, and could stay in place for not more than 48 hours. **j. Male Condoms** The male condom is a latex or synthetic rubber sheath that is placed on the erect male reproductive organ before penetration into the female reproductive organ to trap the sperm during ejaculation. It can prevent STIs (Sexually Transmitted Infections) and can be bought over-the-counter. Male condoms have an ideal fail rate of 2% and a typical fail rate of 15% due to a break in the sheath’s integrity or spilling of semen. **k. Female Condoms** Female condoms are made up of latex rubber sheaths that are pre-lubricated with spermicide. They are usually bound by two rings. The outer ring is first inserted against the opening of the female reproductive organ and the inner ring covers the cervix. It is used to prevent fertilization of the egg by the sperm cells. **l. Surgical Methods** During vasectomy, a small incision is made on each side of the scrotum. The vas deferens is then tied, cauterized, cut, or plugged to block the passage of the sperm. The patient is advised to use a backup contraceptive method until two negative sperm count results are recorded because the sperm could remain viable in the vas deferens for six months. In women, tubal ligation is performed after menstruation and before ovulation. The procedure is done through a small incision under the woman’s umbilicus that targets the fallopian tube for cutting, cauterizing, or blocking to inhibit the passage of both the sperm and the ova. ## Lesson 2: To Buy or Not to Buy? That Is the Question! **Lesson Objectives** At the end of this lesson, you should be able to: 1. explain the association of self and possessions 2. identify the role of consumer culture to self and identity 3. appraise one’s self based on the description of material self **Introduction** We are living in a world of sale and shopping spree. We are given a wide array of products to purchase from a simple set of spoon and fork to owning a restaurant. Almost everywhere, including the digital space, we can find promotions of product purchase. Product advertisements are suggestive of making us feel better or look good. Part of us wants to have that product. What makes us want to have those products are connected with who we are. What we want to have and already possess is related to our self. Belk (1988) stated that "we regard our possessions as parts of our selves. We are what we have and what we possess.” There is a direct link between self-identity with what we have and possess. Our wanting to have and possess has a connection with another aspect of the self, the material self. Let us try to examine ourselves further in the lens of material self. 1. Which among the items in your list you like the most? Why? 2. If ever you were given the chance in real life to have one among the list, which would you choose? Why? 3. Does your choice different from what you answer in question number 2? Why or why not? 4. Let your classmate read your list. Ask her/him to give or write a quick impression of yourself based on the list you showed him/her. 5. Is the quick impression of your classmate has some truth about who you are? **Abstraction** **Material Self** A Harvard psychologist in the late nineteenth century, William James, wrote in his book, The Principles of Psychology in 1890 that understanding the self can be examined through its different components. He described these components as: (1) its constituents; (2) the feelings and emotions they arouse – self-feelings; (3) the actions to which they prompt – self-seeking and self-preservation. The constituents of self are composed of the material self, the social self, the spiritual self and the pure ego. (Trentmann 2016; Green 1997) The material self, according to James primarily is about our bodies, clothes, immediate family, and home. We are deeply affected by these things because we have put much investment of our self to them. The innermost part of our material self is our body. Intentionally, we are investing in our body. We are directly attached to this commodity that we cannot live without. We strive hard to make sure that this body functions well and good. Any ailment or disorder directly affects us. We do have certain preferential attachment or intimate closeness to certain body parts because of its value to us. There were people who get their certain body parts insured. Celebrities, like Mariah Carey who was reported to have placed a huge amount for the insurance of her vocal cords and legs (Sukman 2016). Next to our body are the clothes we use. Influenced by the "Philosophy of Dress" by Herman Lotze, James believed that clothing is an essential part of the material self. Lotze in his book, Microcosmus, stipulates that "any time we bring an object into the surface of our body, we invest that object into the consciousness of our personal existence taking in its contours to be our own and making it part of the self." (Watson 2014) The fabric and style of the clothes we wear bring sensations to the body to which directly affect our attitudes and behavior. Thus, clothes are placed in the second hierarchy of material self. Clothing is a form of self-expression. We choose and wear clothes that reflect our self (Watson 2014). Third in the hierarchy is our immediate family. Our parents and siblings hold another great important part of our self. What they do or become affects us. When an immediate family member dies, part of our self dies, too. When their lives are success, we feel their victories as if we are the one holding the trophy. In their failures, we are put to shame or guilt. When they are in disadvantage situation, there is an urgent urge to help like a voluntary instinct of saving one’s self from danger. We place huge investment in our immediate family when we see them as the nearest replica of our self. The fourth component of material self is our home. Home is where our heart is. It is the earliest nest of our selfhood. Our experiences inside the home were recorded and marked on particular parts and things in our home. There was an old cliché about rooms: "if only walls can speak." The home thus is an extension of self, because in it, we can directly connect our self. Having investment of self to things, made us attached to those things. The more investment of self-given to the particular thing, the more we identify ourselves to it. We also tended to collect and possess properties. The collections in different degree of investment of self, becomes part of the self. As James (1890) described self: "a man’s self is the sum total of all what he CAN call his." Possessions then become a part or an extension of