Human Sexuality Final

Gender

State of being male/female/other

Gener Identity

Internal sense of being male/female/other

Gender role

Traits/behaviours expected based on gender

Sexual Orientation

Emotional and erotic attraction to others (gynophliic vs androphilic)

Sterotype

Generalization, assumption, fixed narrow view based on gender roles

Gender schema

Idea of how things should be, general framework about gender

Intersectionality

Considers meaning and consequences of multiple categories

Acculturation

Ethnic minority groups are influenced by larger cultures

South Asian Communities

\-Indian and Pakistanis

\-Religion major focus of life

\-Arranged marriages common

\-Boys freedom > girls

\-Female virginity prized but not male

\-Men may visit sex workers before/during marriage, women are not to complain

Chinese Communities

\-Family and community > individual

\-Males as head of home

\-Couples w marital problems reluctant to divorce

\-Premarital and extramarital sex not acceptable for females

English-Speaking Caribbean communities

\-Strong sense of family and community

\-Many single parent families headed by women

\-Restrictions on female teens to prevent pregnancy

\-Serial monogamy common for women

\-Men often non-monogamous

\-Important for women to have partner and children

Fa’afatama

\-Trans men (“The Rogers”)

\-Not as accepted or revered as Fa’afafine (trans women)

\-Samoa support trans women > trans men

Indigenous Communities

\-↑male dominance w European contact in North America

\-2/3 of 200 Aboriginal language, concept of “two-spirited” → refers to third gender

\-Not strictly binary

Nonsexual stereotypes

\-Women are more emotional

\-Wome are more nurturing, natural caregivers

\-Men are the providers

Sexual Stereotypes

\-Men are oversexed; women are undersexed

\-Men are initiators; women are recipients

\-Men are pursuers; women are gatekeepers

\-Men are “experts”; women are naive

\-Sexual experience good for men, bad for women

\-Components of traditional sexual script

Aggression (Non-sexual behaviour)

\-Men are more verbal/physical

\-Women are more relationaly manipulative

\-Average men>women

\-Boys are aggressive in earlier years

Communication styles (Nonsexual behaviour)

\-Women are better communicators, more likely to self-disclose

\-related to socialization (men dissuaded from personal conversation)

\-Men becoming better at sexual communication (especially younger generations)

Decoding nonverbal behaviour (Nonsexual behaviour)

\-Women>men

\-Mixed signals

Impulsivity (Nonsexual behaviour)

\-Men>women display impulsive behaviour

\-Evolutionary→ hunters had to take risks

Use of Pornography (Sexual behaviour)

\-Men>women

\-Women: arousal vs disgust (male domination)

Masturbation (sexual behaviour)

\-Men>women

\-Becoming more equal in younger generations

Attitudes towards casual sex (sexual behaviour)

\-Double standard

\-More acceptable for men

Erotica (Sexual behaviour)

\-Egalitarian, sensual

\-Romantic stimulation (nonsexual) → same for men and women (compared to neutral stim physiologically)

\-Suschinsky (2009) → Subj. and obj. measures (neutral vs erotic stim) → both genders low arousal w neutral and higher arousal w erotic stim

\-Hetero and lesbian women more aroused to lesbian erotica

\-Men: self-report w obj arousal in highly correlated (less correlated for women)

\-Correlation is higher if women focus on physical arousal (connect thought to physical)

Person-centered vs body-centred sexuality (Sexual behaviour)

Adolescent women: person (body w age)

Adolescent men: body (person w age)

Person = focus on other person, body = focus on body response

Orgasm consistency (Sexual behaviour)

\-Men>women

\-Lesbian>hetero women

Sex drive (Sexual behaviour)

\-Generally men>women

\-Men think about sex (and food and sleep) > women

Bogus Pipeline Study

\-3 conditions: ensured anonymity, hooked up to “lie detector” (bogus pipeline), had to give answers publicly (expose threat)

\-asked # of sexual partners

\-Conditions did not change mens answers

\-Women ↓ # of partners w each condition (bogus pipeline > anonymous > exposure threat)

Hormonal differences in gender

\-↑Tes in males = ↑ sexual desire

\-Women may be more sensitive to Tes

\-Problems w generalizing humans to animals (studies)

Anatomy differences in gender

\-Boys → penis is visible

\-Female anatomy is hidden

Cognitive and culture factors (gender differences)

\-Identification, modelling, media

\-Reinforcement and punishment

\-Double standard

\-Traditional sexual script

Transgender or Trans

\-People whose gender identity does not match assigned birth gender or appearance of genitals (natal gender)

\-Transsexual, transgender, cross-dressing, gender nonconforming, gender fluid, genderqueer, transgender and gender nonconforming (TGNC)

Gender Dysphoria

Psychological distress about a mismatch between a person’s gender identity and natal gender

Transgender Diagnosis Issues

\-Gender dysphoria (can appear in childhood)

\-Controversial → may stigmatize trans people

\-20% of gender dysphoria persists into adulthood

Experiences of Trans Individuals

\-Transphobia

\-Anti-trans prejudice (microaggressions, discrimination in workplace, housing, and healthcare)

Sexual Orientation and Transgender Identity

\-Trans identity does not refer to sexual attraction

\-FtM who are gynephilic more interested in penis construction

\-Some trans folks are bisexual:

MtF attraction: 23% to men, 29% to women, 31% both

FtM attraction: 25% women, 13% men, 13% both

Gynephilic

Attraction to female

Androphilic

Attraction to male

Sexual Disorders Definition

\-DSM: must cause major distress and last 6 months

\-Unclear how many people have a disorder (due to ignorance or embarrassment)

\-Most people experience a sexual problem in their lifetime

Primary sexual disorder

\-Person has always had the disorder

Secondary sexual disorder

\-Disorder develops during a person’s lifetime

Generalized sexual disorder

\-Disorder occurs regardless of situation

Situational sexual disorder

\-Disorder only happens in particular situations

Sources of sexual disorders

\-Drugs, alcohol, organic factors (injury/disease), anatomy

Alcohol (Physical cause of sexual disorders)

\-Short term low does: perception of ↑ desire, + effect on satisfaction

\-Short term high dose: Impair sexual function (vaginal dryness, erectile dysfunction)

\-Chronic use: Physical issues, liver issues, ↓ desire

Recreational drugs (Physical cause of sexual disorders)

\-Cannabis (mixed research): women = ↑desire/arousal in low doses, - effect at high dose, men = pos effect at moderate dose, can cause issues

\-Cocaine: + perceived arousal, - with chronic use

\-Meth: ↑ risk of risky sexual behaviour

Prescription Drugs (Physical causes of sexual disorders)

\-Dr should explain sexual side effects (important to ask questions)

\-Antihistamines: ↓ desire and cause vaginal dryness in women

\-BP medication: Can cause erection problems in men

Organic factors (Physical causes of sexual disorders)

\-Injury or disease

\-Regular blood flow needed

\-Difficulty with erections with diabetes

Anatomy (Physical causes of sexual disorders)

\-Men born with bent penis (rare)

\-Δ hymen in women

\-Both can be corrected through surgery

Misinformation (Psychological causes of sexual disorders)

\-Lack of education, poor understanding

Negative attitudes (Psychological causes of sexual disorders)

\-Body shame, - attitude toward self, internalized homonegativity

General anxiety (Psychological causes of sexual disorders)

\-Worries about pregnancy, sexual trauma, difficulty conceiving

Cognitive interference (Psychological causes of sexual disorder)

\-Evaluating yourself in the moment

\-Spectatoring

Predisposing causes of sexual disorders

Happens in childhood, static, - sexual experience

Maintaining causes of sexual disorders

\-What happens in present that keeps the sexual problem happening (ex. anxiety, relationship issues)

Techniques (Psychological causes of sexual disorders)

\-Poor communication

\-Not understanding what partner likes/dislikes

Relationship distress (Psychological causes of sexual disorders)

\-Emotional issues must be addressed before sexual issues

Lifestyle (Psychological causes of sexual disorders)

\-Work, kids, long distance, substances, sedentary lifestyleP

Psychological distress (Psychological causes of sexual disorders)

\-Mental health → depression, anxiety, psychosis

Barlow’s studies

\-Functional vs dysfunctional men

\-Induced anxiety and threatened to shock

\-Function group :could be aroused, could put aside cognitive issues and be in the moment

\-Dysfunctional group: could not be aroused, had anxiety and cognitive interference, were threatened with shock if they did not perform

Changes in Sexual Disorder Dx in DSM5

\-No longer classified by phase of sexual response cycle

\-Problem must persist at least 6 months

Male hypoactive sexual desire

\-Low sexual desire

\-

Erectile disorder

\-Inability to have or maintain erection

\-Can be primary/secondary/generalized/situation (can help to determine cause)

\-

Premature Ejaculation

\-Ejaculation sooner than desired

\-Lack of control and distress

\-Rates vary depending on definition

\-24% of men saw it as a problem vs 10% of women (women concerned about partners feelings)

\-Use thoughts to postpone ejaculation (sad events or grandmother) → sex neutral thoughts vs + or -

\-Mostly caused by psychological factors, but can be physical (infection, MS nervous system damage)

Delayed ejaculation

\-Cannot orgasm or orgasm is greatly delayed despite adequate stimulation

\-Most often situational

\-

Female sexual interest/arousal disorder

\-# of criteria (lack of physiological response and desire)

\-39% report Sx but 8% meet criteria

\-More frequent during and after menopause

\-Many have ↓arousal and ↓desire but do not meet Dx criteria

Female orgasmic disorder

\-21% of women don’t usually orgasm during intercourse (not necessarily a disorder)

\-Most commonly situational (and heterosexual)

\-Most often caused by psychological factors (misinformation, technique), but can be physical (illness, spine injury)

Genito-Pelvic Pain/Penetration Disorder

\-15% of women persistent pain during intercourse

\-Pain can differ in intensity (constant, intermittent) and location (vulva, vagina)

\-Most often caused by physical factors (scars, infection, thinning of vaginal walls with age and ↓est, tumours, etc)

\-Can lead to vaginismus (involuntary vagina spasms)

\-Can occur in men, often caused by prostate problems

Critique of the DSM5

\-Sexual disorders do not account for sociocultural, relationship, psychological and medical factors

Self vs professional (Being a sex therapist)

\-Self help books vs seeing a sex therapist

\-Anyone can be a sex therapist (not regulated)

\-Partner with regulated body for billing

\-Standard of care

\-Mental health professionals → courses and workshops to specialize

\-Undergrad → sex therapist (US, none in Canada)

Procedure (Assessment of Sexual Difficulties

\-Rule out medial factors

\-Couple comes together, start with Hx

\-Therapist sees each partner separately and confidentially, then return together to asses issuesT

Types of Information (Assessment of Sexual Difficulties)

\-Presenting problems

\-Family and childhood background

\-Dating and relationship Hx

\-Psychological functioning

\-Sexual hx

\-Current sexual functioning

Behavioural therapy

\-Goal is to facilitate partner communication about likes/dislikes

\-Associates touch, sex, and pleasure

\-5 steps: ground rules, self-exploration, self-pleasuring, mutual pleasuring (sensate focus), intercourse (if that is a goal)

Cognitive Behavioural Therapy

\-Cognitive restructuring → redshift values about sex, enjoyment > goal

\-Cognitive interference → Thoughts that distract and impact sexual function

Mindfulness Therapy

\-”Being in the moment”

\-Associated with cognitive interference

Couple Therapy

\-Script assessment and modification

\-Conflict resolution

\-Heterosexual sexual scripts

\-Women more assertive, takes pressure of men

\-Communication (withdraw)

Specific Interventions for Sexual Disorders

\-Stop-start or squeeze → premature ejaculation

\-Masturbation → primary orgasm disorder

\-Kegel exercises → enhance arousal, treat dyspareunia (through relaxation, differentiate relaxation and tension of pelvic floor muscles)

\-Bibliotherapy → Becoming Orgasmic, The New Male Sexuality

\-Biomedical therapies → Drug treatment (Viagra), surgery (prostate, hymen, bent penis), vacuum devices

Sexual Identity

\-Whom we are emotionally, romantically, and sexually attracted to

\-Homosexual, heterosexual, bisexual, asexual, demi-sexuel (bond not gender), pansexual (regardless of gender), lesbian, gay, LGB, Queer (proud term→ gay men, transgenders, lesbians)

Kinsey’s continuum

\-Defined sexual identity by sexual behaviour (problematic)

\-Spectrum with varying amounts of sexual behaviour from exclusive homosexual → exclusive heterosexual

\-NSFG and CCHS studies: sexual identity and behaviour do not always align

Sexual Fluidity

\-Changes in a person’s sexual attraction, identity, or behaviour over time

\-More common for women>men

Asexuality

\-Someone who does not experience sexual attraction to any gender

\-1-1.5% of population

\-May be married and/or have engaged in sex

\-Physiological arousal > self-report attraction

\-Sexual stim still causes body arousal, but individuals self-report no attraction

Bisexuality

\-Difficult to define parameters

\-Discrimination within sexual minority groups (ex. female bi who only dates women is “too scared to be fully lesbian”

\-Same sex experiences in last decade (cultural shift): tripled for women (4%→11%), small ↑ for men (5%→6%)

Sex drive and sexual attraction

\-Heterosexual women: high sex drive = higher attraction to men and women

\-Heterosexual and gay men and lesbians: high sex drive = only increased attraction to one sex or the other

LGBs and the Law

\-Canada decriminalized homosexuality in 1969

\-LGB were not protected under Charter until 1992

\-Right to marry was ratified in 2005

\-Discrimination against public displays of sexual identity (could be fired from jobs or discharged from military)

Lesbian and Gay Families

\-No difference between children raised by LGB vs straight families

\-No difference in children’s psychosocial development, gender identity, sexual orientation (well adjusted overall)

\-37% of youth verbally harassed about sexual orientation of their LGBTQ+ parents

Genetic Factors (Biological Theories of Sexual Orientation)

\-20-50% concordance rate between identical twins (lower for non-identical twins)

\-Much lower % for adopted siblings

\-Genotyping shows multiple genes responsible in part for sexual orientation

Prenatal factors (Biological Theories of Sexual Orientation)

\-Sexual differentiation of brain and prenatal hormones (androgen)

\-Δ androgen conc. in animals showed ↑ sexual behaviour with same sex (for both sexes)

\-Sexual preference can be manipulated by Δandrogen levels during critical periods (animal studies)

\-Blanchard and Boegart studies

Blanchard and Boegart studies

\-Found high rate of gay men were men born as youngest brother in large family of boys

\-Theorized mother forms antibodies to antigen on the Y chromosome

\-Antibodies develop with each successive pregnancy

Brain factors (Biological Theories of Sexual Orientation)

\-LeVay: differences in hypothalamus of gay and straight men (problematic study: autopsies done on gay men who died of AIDs)

\-Hypothalamus function differences of gay and straight individuals linked to olfactory system (response to pheromones)

Hormonal Factors (Biological Theories of Sexual Orientation)

\-Hx: believed gay men had ↑tes

\-Studies showed ↑ test did not change sexual orientation, just ↑ sexual desire for preferred sex

Learning Theories for Sexual Orientation

\-People are born sexual and their orientation is dependent on rewards and punishment (behaviour shaped by learning)

\-Includes modelling

\-No support for this theory among humans

\-Humans are BORN with sexual orientation, how you BEHAVE depends on rewards/punishments

Can sexual orientation be changed by Psychotherapy?

\-Conversion/reparative therapy (LGBs → heterosexuals), been around for 100+ years, banned in USA and Canada, APA opposes these therapies

\-Does not change sexual orientation but makes people feel guilty, usually pressured by family

Data Sources for Child/Adolescent Sexuality

\-Surveys in which people recall childhood sexual behaviour (problematic → retrospective)

\-Interviews of children (ethical concerns)

\-Talking computer interviews

\-Ex. Canadian Youth, Sexual Health, HIV/AIDS study

Sexuality during infancy (Child/Adolescent Sexuality)

\-Children as sexual beings (0-2 yrs)

\-Sexual response

\-genital fondling/masturbation

\-infant-parent bonding and attachment

Sexual Response (Child/Adolescent Sexuality during Infancy)

\-Erections in prenatal boys

\-Sexual lubrication in girls

\-Response to feelings of pleasure

\-Evidence of orgasm

Genital fondling/masturbation (Child/Adolescent Sexuality during Infancy)

\-Boys learn to use hands for pleasure

\-Can lead to erection and orgasm (not capable of ejaculation at this age)

Infant-parent bonding (Child/Adolescent Sexuality during Infancy)

\-Attachment: predictor of empathy, physical and mental health in adolescence (developmentally)

Children understanding Gender Identity

\-Know their gender by 2½-3 years

\-Gender ideas are rigid by 4-6 years (what gender looks like → slowly changing over time)

\-1 in 2000 do not identify with assigned birth gender (may exhibit cross-gender behaviour → not necessarily transgender)

Masturbation (Child/Adolescent Sexuality during Early Childhood)

\-44% girls and 60-71% boys touched genitals

\-16-18% girls and 17-28% boys masturbated

\-Increased interest in sexual feeling and sensation of masturbating

\-Understand PRIVACY at this age

Mixed-sex behaviour (Child/Adolescent Sexuality during Early Childhood)

\-Larsson and Svedin: 64-65% of boys and girls viewed others’ genitals

\-34% boys and 20% grill showed own genitals

\-Interest in marriage

Same-sex behaviour (Child/Adolescent Sexuality during Early Childhood)

\-Engaging in sex play out of curiosity