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Unit 2: Unpacking The Self

TOPIC 2: THE SEXUAL SELF


Gladys Lavarias, MA

“Sex is something you do. Sexuality is something you are.” – Anna Freud

Sexual self-concept refers to the totality of yourself as a sexual being, including positive
and negative concepts and feelings. Sexual self-concept in this unit will be described along three
dimensions according to theorists (1) sexual self-esteem, (2) sexual depression, and (3) sexual
preoccupation. Because attachment style moderates sense-of-self in general, and your
expectations about and strategies for approaching relationships, sexual self-concept may be a
good indicator of what kinds of relationships we tend to get into, and how we tend to behave
within relationships, with an emphasis on sexual satisfaction. Interestingly, all of these will be
unpacked for 6 hours.

LEARNING OBJECTIVES

At the end of this lesson, you will be able to:

1. evaluate your sexual self in terms of:


a. differences in your primary and secondary sexual characteristics from those of the
opposite sex;
b. naming the different parts/organs of the male and female reproductive systems;
c. identifying your erogenous zones in the body;
d. how the brain controls sexual arousal;
e. establishing ways on how you can deal with – in appropriate ways, your sexual energies;
f. identifying yourself among the different types of sexual behaviors;
2. characterize the four phases of the sexual response cycle;
3. enumerate the pros and cons of premarital sex;
4. illustrate ways on how the three levels of romantic love – lust, attraction, and attachment, differ
from each other by citing examples; and
5. produce a brochure for information dissemination on sexually transmitted diseases and methods
of contraception and family planning.

DEVELOPMENT OF PRIMARY AND SECONDARY SEXUAL CHARACTERISTICS

During sexual maturation (puberty growth spurt), there are two important physical
changes that occur in your body as you transition from being a child to that of being an adult:
development of the primary sexual characteristics and development of the secondary sexual
characteristics.

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Primary Sexual Characteristics

Primary sexual characteristics are the physical characteristics directly involved in reproduction,
such as the sex organs. Sex organs are a broad category that includes any gland, organ, or part that is
necessary for reproduction. (Study.com) The sex organs show a major physical change during puberty –
its growth and development make up the primary sexual characteristics. Primary sexual characteristics
are there from birth (for example, penises vs. vaginas). In mammals, sex is determined through hormonal
events in utero that under normal circumstances are controlled by the combination of X and Y
chromosomes. If an egg is fertilized with a sperm carrying the X chromosome, the gonads should develop
into ovaries and the offspring will be female; if the egg is fertilized with a sperm carrying the Y
chromosome, the gonads should develop into testes and the offspring will be male. (Reid, 2018).

For the male: scrotum, testes(or testicles or male gonads), epididymis, vas deferens,
prostate, seminal vesicles, urethra, and penis all qualify as being part of the sex organs.
(Study.com) The male gonads (testes), which are located in the scrotum (sac), outside the body,
are only approximately 10% of their mature size at the age of fourteen years. Rapid growth occurs
for a year or two, after which growth slows down; the testes are fully developed by the age of
twenty or twenty-one. The penis accelerates in growth shortly after the rapid growth of the testes
begins. At first, the growth is seen in length, followed by a gradual increase in circumference.
Nocturnal emissions (wet dreams) are spontaneous orgasms during sleep that includes ejaculation
for a male. They begin to occur when the male reproductive organs have become developed in
function. This can be seen when boys have a sexually exciting dream, when they have a full
bladder, are constipated, when wearing tight undergarments, or when they are too warmly
covered.

For the female: the ovaries, fallopian tubes, uterus, cervix, vaginal canal, Bartholin’s
and Skenes glands, vagina, clitoris, and clitoral hood are all considered as sex organs. All parts of
the female reproductive system grow during puberty, but in different rates. The uterus weighs 5.3
grams with the average eleven- or twelve-year-old girl; by the age of sixteen, the average weight
is 43 grams. During this time, the sex organs grow rapidly The menarche, or first menstrual flow, is
the first real sign of sexual maturation in girls. This starts a series of regular discharges of blood,
mucus, and broken-down cell tissue from the uterus that occurs every 28 days until the
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menopause, in the late forties or early fifties. The clitoris is part of the vulva, the name for the
external parts of female genitalia. The vagina is the tube connecting the vulva and the cervix.

https://www.google.com/search?biw=1280&bih=689&tbm=isch&sa=1&ei=4PsOXbf8EdOGoAT_hLmICA&q=fem
ale+reproductive+organs&oq=female+reproductive+organs&gs_l=img.3..0l10.130137.134292..134647...0.0..0.695.4336.0j12
j2j1j1j2......0....1..gws-wiz-img.nkg77AaYeiw#imgrc=E861OWGmHP7arM:

Secondary Sexual Characteristics

Secondary sexual characteristics emerge at puberty. These physical


characteristics are not used in sexual reproduction, but are important for attracting a mate or
being able to provide care for offspring - such as human breasts. These features distinguish males
from females and make members of one sex appealing to members of the opposite sex.
Hormones secreted through the hypothalamus initiate the development of classically male or
female secondary sexual traits (Reid, 2018). The appearance of secondary sexual characteristics
makes one “sexually appealing”. Changes caused by the gradual development of these
characteristics, like other developments at puberty, follows a predictable pattern. The following
table shows the secondary sexual characteristics of boys and girls:

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Important Secondary Sex Characteristics:

BOYS GIRLS
Hair Pubic hair appears about one Hips The hips become wider and
year after the testes and penis have started rounder as a result of the enlargement of the
to increase in size. Axillary and facial hair pelvic bone and the development of
appears when the pubic hair has almost subcutaneous fat.
completed its growth, as does body hair. At Breasts Shortly after the hips start to
first, all hair is scanty, lightly pigmented, and enlarge, the breasts begin to develop. The
fine in texture. Later it becomes darker, nipples enlarge and protrude and, as the
coarser, more luxuriant, and slightly kinky. mammary gland develops, the breast
become larger and rounder.
Skin The skin becomes coarser, less Hair Pubic hair appears after hip and
transparent, and sallow in color, and the breast development is well underway. Axillary
pores enlarge. hair begins to appear after the menarche, as
does facial hair. Body hair appears on the
Glands The sebaceous, or oil- limbs late in puberty. All hair except facial hair
producing, glands in the skin enlarge and is straight and slightly pigmented at first and
become more active, which may cause then becomes more luxuriant, coarser, darker,
acne. The apocrine glands in the armpits and slightly kinky.
start to function, and perspiration increases Skin The skin becomes coarser, thicker,
as puberty progresses. and slightly sallow, and the pores enlarge.
Glands The sebaceous and apocrine
Muscles The muscles increase glands become more active as puberty
markedly in size and strength, thus giving progresses. Clogging of the sebaceous glands
shape to the arms, legs, and shoulders. can cause acne, while the apocrine glands in
the armpits produce perspiration, which is
Voice Voice changes begin after especially heavy and pungent just before and
some pubic hair has appeared. The voice during menstrual period. Muscles The muscles
becomes husky and later drops in pitch, increase in size and strength, especially in the
increases in volume, and acquires a middle of puberty and toward the end, thus
pleasant tone. Voice breaks are common giving shape to the shoulders, arms, and legs.
when maturing is rapid. Voice The voice becomes fuller and more
melodious. Huskiness and breaks in the voice
are rare among girls.

EROGENOUS ZONES OF THE HUMAN BODY

The previous topic introduced you to knowing and understanding your physical self in
relation to self-esteem and beauty. To deeply know yourself, this topic enables you to explore your
sexual self. Sexual awakening takes place through the different parts of your body where they
lead to sexual stimulation due to their sensitivity to touch. These body parts are known as
erogenous zones – sensitive areas on the body that cause sexual arousal when they are touched
(Merriam-Webster). Your awareness of these body parts will lead you to being responsible – as to
know your limits and capabilities, and will give you control over your desires and sexual urges.

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https://www.pinterest.at/pin/324188873171462719/

1. Clitoris – this is the female body part contributing most to sexual arousal. It is extremely
sensitive due to nerve endings. Research shows that stimulating the clitoris is the fastest and easiest
way for many women to achieve orgasm through pressure and vibration.

2. Vagina – it is where the “G-spot” is located. The interior of the vagina contain nerve
endings, and women report that deep stimulation leads to more intense orgasms. The outer edge
of the vagina, on the other hand, tends to respond to light touch.

3. Cervix – located at the lower end of the uterus, has its own feel-good nerve pathways.
In fact, some research suggests that the vagina, clitoris, and cervix all respond separately and
distinctly to sexual stimuli. Nerves in the cervix respond most to pressure stimulation, but light touch
has been shown to elicit a response as well.

4. Mouth and Lips – surveys found kissing to be more important in relationship-building than
in sexual arousal. Studies suggest that many women rank the lips and mouth highly as erogenous
areas.

5. Neck - according to a large international survey of women, both the nape and back of
the neck are among the top 10 erogenous zones. One study found that the neck is very sensitive
to light touch, especially among people with low body fat. Another study found that women with
spinal cord injury can get pretty turned on by neck stimulation alone.

6. Breasts and Nipples – both men and women have breasts for evolutionary purposes
especially women; and they play a role in sexual arousal as well. Nipple stimulation sets fireworks
off in the same region of the brain that processes sensations from the clitoris and vagina. Just as
with the clitoris, pressure and vibration stimulate them.

7. Ears – are super sensitive to touch, probably due to a large number of nerve endings.

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https://www.pinterest.at/pin/604326843725439530/

1. Penis - both survey and lab-based scientific experiments demonstrate that penile
stimulation significantly contributes to sexual satisfaction. And while this can be a sensitive subject,
circumcision doesn’t appear to decrease sensation or sexual satisfaction.

2. Mouth and Lips – they are highly sensitive; male lips respond to light touch, temperature,
or pressure. Kissing also triggers a release ofhormones involved in intimacy – especially oxytocin,
the so-called “love hormone.”

3. Scrotum - it is one of men’s most notable erogenous zones. Lots of nerves mean that this
area is super-sensitive to touch.

4. Neck – while touching the neck doesn’t appear to be quite as much of a turn-on for
men as for women, it’s still ranked pretty highly on the erogenous zones list. The neck has great
sensitivity to low-frequency vibration, making it a prime spot for light erotic touch.

5. Nipples – as with women, men rank nipples as a definite hot spot. While male nipples
don’t appear to serve any real purpose (they’re basically by-products of evolution), that doesn’t
mean they’re totally useless – they still have plenty of nerve endings.

6. Perineum – is the area between the anus and scrotum and is hooked up to perineal
nerves, which help convey sensations of sexual pleasure from the genitals to the brain.

7. Ears – highly sensitive to touch because of a high number of sensory receptors on the
skin, the ears are ranked just behind the scrotum for body parts that help men orgasm when
touched or otherwise stimulated.

Source: https://greatist.com/play/guide-to-male-female-erogeneous-zones#7

UNDERSTANDING THE HUMAN SEXUAL RESPONSE

What turns you on? What attracts you the most? Are you aware of your body’s reaction
whenever you see intimate scenes in movies, videos, television shows, or in advertisements or

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books that you happen to see or read? Your answer would be a yes – and this is a sign that you
are a normal person who is considered as a sexual being. Your reaction speaks of the human
sexual response. But if you happen to have no reaction at all, then you may be asexual – having
no sexual feelings at all. The body reacts when something is perceived to be sexually pleasurable.
All human beings have desires. Desiring for somebody is normal, and it leads to sexual intimacy
that may lead to sexual reproduction. As sexual beings, humans have desires for sexual pleasure
and satisfaction.

Desire and sexuality cannot be separated. Libido is a person's overall sexual drive or desire
for sexual activity. Libido is influenced by biological, psychological, and social factors (Wikipedia).
Understanding your sexual self will lead you to a better view of your sexuality – making you
responsible and educated with your actions and decisions.

The Brain – Its Role and Function in the Human Sexual Response

Our brains are involved in all steps of sexual behavior and in all its variations, from feelings
of sexual desire and partner choice, to arousal, orgasm and even post-coital cuddling (Clark,
2014). The brain impacts the sequence of physical and emotional changes that occur as a person
participates in sexually stimulating activities (Wiley, 2015). The brain is responsible in translating
nerve impulses from the skin into pleasurable sensations. It controls nerves and muscles used during
sexual activity. It regulates the release of hormones, which are believed to be the physiological
origin of sexual desire. The adult human brain weighs between 1300 and 1400 grams and is divided
into two parts, or hemispheres, connected by a thick bundle of nerves called the corpus collosum.
As described by Rita Carter (1999, p.6) “the human brain is as big as a coconut, the shape
of a walnut, the color of uncooked liver, and the consistency of chilled butter” The human brain
is the most complex organ in the body. It is divided into four hierarchically organized, interacting
levels:

1. The brain stem

The evolutionarily oldest structure; controls primitive responses associated with sexual behaviour
and facial expressions; contains circuits for many emotions, including love/attachment, joy, and
sexual excitement (Lewis, 2005).

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http://www.neurosurgerypa.com/anatomy/neuro_br_brainstem.html

2. The hypothalamus

It controls most body systems by regulating the production of hormones in response to both
internal and environmental events; it controls the pituitary gland, which is the master gland that
controls all the other endocrine glands in the body; the hypothalamus plays a key role in
connecting the endocrine system with the nervous system.

http://brainmadesimple.com/hypothalamus.html

3. The limbic system

It mediates learning, memory, and emotion; it contains the:

a. Amygdala – helps generate associations between experiences and emotions – Was this
an experience that felt good, that resulted in a good meal, or a loving touch? Or was this an
experience that produced fear or pain?

http://brainmadesimple.com/hypothalamus.html
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b. Hippocampus – located near the amygdala, it plays an important role in organizing and
storing memories for events.

*** The amygdala and hippocampus seem to work together, so that emotions associated
with past experiences influence the storage and retrieval of specific memories.

The cerebral cortex

Sometimes referred to as the neocortex (neo means “new”, a relative latecomer,


evolutionarily speaking (MacLean, 1990). It is the outermost layer of the brain; its function is
responsible for thinking and processing information from the five senses.

The Cerebral Cortex is made up of tightly packed neurons and is the wrinkly, outermost
layer that surrounds the brain. It is also responsible for higher thought processes including speech
and decision making. The cortex is divided into four different lobes:

a. frontal lobe – for cognitive functions and control of voluntary movement/activity

b. parietal lobe – processes information about temperature, taste, touch and movement

c. temporal lobe – processes memories, integrating them with sensations of taste, sound,
sight and touch

d. occipital lobe – primarily responsible for vision

*** Each area is responsible for processing different types of sensory information.

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http://brainmadesimple.com/cortex-and-lobes-of-the-brain.html

https://www.mayoclinic.org/brain-lobes/img-20008887 The Sexual Response Cycle

Your sexual motivation – libido, is your overall sexual drive or desire for sexual activity. This
is affected by biological, psychological, and social factors. A person’s ability to engage in sexual
behaviors is controlled and influenced by sex hormones, social factors – work and family, internal
psychological factors – personality and stress, medical conditions, medications, pregnancy, and

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relationship issues. According to William Masters and Virginia Johnson, the sexual response cycle
is a model that describes the physiological responses that take place during sexual activity.
According to the cycle, it consists of four phases:

1. Excitement – the intrinsic (inner) motivation to pursue sex arises; it includes increased
heart rate, blood pressure, and muscle tension;

2. Plateau – sets the stage for orgasm; heart rate quickens, blood pressure rises, muscle
tension increases, and breathing becomes faster;

3. Orgasm – the release of tension; also known as the “climax or peak” of the sexual
excitement; heart rate increases dramatically, blood pressure rise, breathing becomes rapid and
shallow, muscles throughout the body contract, and perspiration is evident; there is an intense,
pleasant, or pleasurable psychological feeling associated with the release of sexual tension; and

4. Resolution – the return to the unaroused state before the cycle begins again; heart rate,
blood pressure, and breathing return to normal state, and muscle tension decreases.

Now that you are aware of your body’s sexual responses and behaviors, your knowledge
of these intimate reactions should lead you to your appreciation of your body, mind, and sexuality.
As teenagers, curious of your body changes and sensations, you should be aware of your
responsibilities to control and to not go beyond your limits when it comes to the practice of
engaging sexually. Sex is beautifully expressed and experienced in the state of love, commitment,
and marriage. Ways of Dealing with Sexual Energies Sexual energy is a life-energy. Your sexual
impulses have the power to influence so much of what you do, how you act, and the choices
that you make. It takes part in your everyday dealings in the field of human interaction. Sex, as
one of the greatest motivational forces in life, if not properly controlled, can lead to great
destruction. The aim of this topic in knowing your sexual self is to empower you to put into good
"use" and avoid "abuse" in all your male and female relationships and interactions. More so, sex, is
not the only method of releasing your sexual energy. You can convert your sexual energy into
productive energy. The following are ways on how to deal with your sexual energies:

1. Repression – involves keeping certain thoughts, feelings, or urges out of conscious


awareness. The goal of this is to keep unacceptable desires or thoughts out of the conscious mind
in order to prevent or minimize feelings of anxiety ***Repression is subconscious.

2. Suppression – the person consciously and deliberately pushes down any thoughts that
leads to feelings of anxiety.

ex. An older man has sexual feelings towards a teenager and quickly suppresses the
thought.***Suppression is conscious.

3. Sublimation - allows us to act out unacceptable impulses by converting these behaviors


into a more acceptable form.

ex. A person experiencing sexual urges/thoughts might take up sports as a means of


expressing these forces.

4. Genital satisfaction – giving in to one’s sexual desires through sexual gratification; it


includes sexual intercourse – the likes of premarital sex, marital sex, and extramarital sex.

5. Integration – integrate one’s sexual energies into friendships, marriage, vocation, and all
levels of relationships.
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Once you find your duty, purpose, and responsibility, you will be able to handle well and
proper your sexual energies. Try to establish your goal in life, focus on it, and learn well from your
experiences in dealing with the opposite sex. Maintain your standards and learn how to say no
beyond your limits. Embrace yourself. Celebrate your strengths and learn to accept your
limitations and weaknesses. How do we prevent premarital sex?

Sex comes with responsibility. Premarital sex in young adults is an act out of curiosity,
making them unaware of the consequences of this behavior – committing a mortal sin with your
God, early/unwanted pregnancy, the gossips and condemnations from the community/society,
and the risk of acquiring sexually transmitted infections or HIV/AIDS. Adolescence should be a time
to form oneself as a mature and responsible individual being, and not at all a time to rush into
procreation. So, how do we prevent premarital sex? Learn how to say NO! One of the ways to
prevent premarital sex is to start from educating and empowering yourself – learning the truths
about sex and evaluating the consequences of premarital sex. And it is through your parents and
the school that you should find and seek guidance and knowledge in this very sensitive and
personal issue of how you can prevent yourself from engaging in premarital sex. In the pleasure of
a moment, you can be blinded by your sexual desire. In the moment of lust and passion, your
future can be destroyed. In the moment of foolishness and self-gratification, your bright future can
turn into darkness. Sex should be saved as a gift for marriage. “Why save sex for marriage” is really
a question of understanding God’s purpose and design for sex. We can choose to do things God’s
way, and experience the beauty of His plan, or we can choose to do things our way, and
experience harm and destruction (Proverbs 16:25). Sex is from God. He gave it to us as a gift. It's a
wedding gift.—Bill Shannon

Read the following site as an additional reading material on how to manage and deal
with the sexual urges/energies. Additional readings: A Practical Guide to Sexual Transmutation (A
Complete Guide to the Secrets of Sexual Transmutation) by Scott Jeffrey

https://scottjeffrey.com/sexual-energy-transmutation/

After reading, you should be able to answer the following questions.

a. What is sexual transmutation?

b. How can you benefit from sexual transmutation?

c. How is sexual energy transformed to achieve higher spiritual development?

THE CHEMISTRY OF LOVE: THE SCIENCE BEHIND LUST, ATTRACTION, AND COMPANIONSHIP

What is LOVE? Who is your first crush? Have you experienced feeling a rush of euphoria,
embarrassed yet excited, awkward, or even tongue-tied when you see your crush or someone
you really find attractive, especially of the opposite sex?

This topic will try to explain LOVE through chemistry by exploring the science behind lust,
attraction, and attachment. So, if there’s really a “formula” for love, what is it, and what does it
mean?

According to anthropology professor Helen Fisher, there are three stages of falling in love.
In each stage, different brain chemicals influence your brain chemistry - the neurotransmitters that
get you all excited and the hormones that carry the feeling all throughout your body.

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1. Lust - driven by the desire for sexual gratification; evolutionary basis for this is our need to
reproduce; through reproduction, organisms pass on their genes, and thus contribute to the
perpetuation of their species.

The hypothalamus of the brain plays a big role by stimulating the production of the sex
hormones:

a. Testosterone – from the testes; being “male”; increases libido

b. Estrogen – from the ovaries; being “female”; increases sexual motivation in women
during ovulation (peak of estrogen production)

2. Attraction (Falling in love)– involves romantic or passionate love, characterized by


euphoria; physical symptoms of falling in love include loss of appetite, inability to sleep, lack of
concentration, wet palms, and butterflies in the stomach.

These symptoms are caused by surging brain chemicals called monoamines:

a. Dopamine - produced by the hypothalamus, released when we do things that feel


good to us like spending time with loved ones and having sex.

b. Norepinephrine – high dosage are released during attraction; these chemicals make us
giddy, energetic, and euphoric, even leading to decreased appetite and insomnia; also known
as noradrenalin, it plays a large role in the “fight or flight” response, which kicks into high gear
when we’re stressed and keeps us alert.

c. Phenylethylamine– a natural amphetamine; gives the feeling of being on-top-of-the-


world that attraction can bring; and gives the energy to stay up day and night when in love.

d. Serotonin – a hormone that’s known to be involved in appetite and mood; this gives the
overpowering infatuation that characterizes the beginning stages of love.

3. Attachment (Staying together)- the predominant factor in long-term relationships. While


lust and attraction are pretty much exclusive to romantic entanglements, attachment mediates
friendships, parent-infant bonding, social cordiality, and many other intimacies as well.

The two primary hormones here appear to be

a. Oxytocin - often nicknamed as “cuddle hormone”; it is produced by the hypothalamus


and released in large quantities during sex (peaks during orgasm), breastfeeding, and childbirth,
all of these events are precursors to bonding.

b. Vasopressin – also called the “monogamy chemical”; researchers have found out that
suppression of vasopressin can cause male prairie voles to neglect their partners and not fight off
other male

c. Endorphins - are chemicals produced naturally by the nervous system to cope with pain
or stress; are often called "feel-good" chemicals because they can act as a pain reliever and
happiness booster.

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Figure 1. Love can be distilled into three categories: lust, attraction, and attachment.
Though there are overlaps and subtleties to each, each type is characterized by its own set of
hormones. Testosterone and estrogen drive lust; dopamine, norepinephrine, and serotonin create
attraction; and oxytocin and vasopressin mediate attachment.
http://sitn.hms.harvard.edu/flash/2017/love-actually-science-behind-lust-attraction-companionship/

A: The testes and ovaries secrete the sex hormones testosterone and estrogen, driving
sexual desire. B and C: Dopamine, oxytocin, and vasopressin are all made in the hypothalamus,
a region of the brain that controls many vital functions as well as emotion. D: Several of the regions
of the brain that affect love. Lust and attraction shut off the prefrontal cortex of the brain, which
includes rational behavior.

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http://sitn.hms.harvard.edu/flash/2017/love-actually-science-behind-lust-attraction-companionship/

DIVERSITY OF SEXUAL BEHAVIOR

Gender and sexual diversity (GSD), or simply sexual diversity, refers to all the diversities of
sex characteristics, sexual orientations and gender identities, without the need to specify each of
the identities, behaviors, or characteristics that form this plurality. Sexual Orientation

a. Heterosexuals - sexually attracted to people of the opposite sex; commonly referred to


as straight;

b. Homosexuals - sexually attracted to people of their own sex; gay or lesbian;

c. Bisexuals - sexually attracted not exclusively to people of one particular gender;


attracted to both men and women;

Gender identity

a. Transgender - denoting or relating to a person whose sense of personal identity and


gender does not correspond with their birth sex;

b. Cisgender - denoting or relating to a person whose sense of personal identity and


gender corresponds with their birth sex;

Related minorities – intersex, gathered under the acronyms:

a. LGBT or LGBTI – lesbian, gay, bisexual, transgender/transsexual people, and sometimes


intersex people

Kinsey Scale
The Kinsey scale, also called the Heterosexual–Homosexual Rating Scale, is used in
research to describe a person's sexual orientation based on one’s experience or response at a
given time. The scale typically ranges from 0, meaning exclusively heterosexual, to a 6, meaning
exclusively homosexual. In both the male and female volumes of the Kinsey Reports, an additional
grade, listed as "X", indicated "no socio-sexual contacts or reactions". The reports were first
published in Sexual Behavior in the Human Male (1948) by Alfred Kinsey, Wardell Pomeroy, and
others, and were also prominent in the complementary work Sexual Behavior in the Human
Female (1953).

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https://en.wikipedia.org/wiki/Kinsey_scale#/media/File:Kinsey_Scale.svg

UNDERSTANDING SEXUALLY TRANSMITTED INFECTIONS


Sexually transmitted infections (STIs) are infections that are passed from person to person
through sexual contact. HIV is an STI. There are more than 25 other sexually transmitted infections
that are mainly spread by sexual contact such as vaginal, anal, and oral sex.

Globally, the World Health Organization (WHO) estimates that more than one million
people get an STI every day. STIs are also sometimes called sexually transmitted diseases (STDs).
While “STD” is often used interchangeably with “STI”, they are not exactly the same.

A “disease” is usually an obvious medical problem with clear signs and symptoms.
“Infection” with an STI may or may not result in disease. This is why many individuals and
organizations working in health are moving toward using the term “sexually transmitted infection”
more than “sexually transmitted disease”. Most people with STIs do not have any symptoms and
are therefore often unaware of their ability to pass the infection on to their sexual partner(s).

If left untreated, STIs can cause serious health problems including cervical cancer, liver
disease, pelvic inflammatory disease (PID), infertility, and pregnancy problems. Having some STIs
(such as chancroid, herpes, syphilis, and trichomoniasis) can increase the risk of your getting HIV
if you are HIV-negative and get exposed to HIV.

People living with HIV may also be at greater risk of getting or passing on other STIs. If and
when people living with HIV get STIs, they can experience more serious problems from them or
have greater difficulty getting rid of the infections.
https://www.thewellproject.org/hiv-information/sexually-transmitted-infections-or-diseases-stis-or-
stds?gclid=Cj0KCQjw6cHoBRDdARIsADiTTzY2UKHBgftBg1woKuo-rOS_1S75qTZ4AILQ5l9vAWmnXtCU1-
D_CpEaAuLAEALw_wcB

1. CLAMYDIA

Definition : one of the most common STIs; caused by a bacterium that exists in vaginal
secretions and semen (“cum”); can be spread by vaginal, oral, or anal sex without a condom or
latex/polyurethane barrier; pregnant women can pass it on to their babies during delivery.

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Symptoms: may include vaginal discharge and burning during urination, but most women
do not have any symptoms

Treatment: with antibiotics; if left untreated, it can spread to a woman's upper, internal
reproductive organs (ovaries and fallopian tubes) and cause pelvic inflammatory disease (PID);
PID can lead to infertility and make it difficult or impossible to become pregnant.
https://www.google.com/search?q=chlamydia+examples&tbm=isch&tbs=rimg:CavNpFMbCAVlIjipCJL85TJJof1
2EGwMA4Ejhxo2pwaGDMuLyESR_108tAXW5Srcd7wie77LKFPOrFVhvncPy7M_1euCoSCakIkvzlMkmhEZYWzqCWk4BtKhIJ

2. GENITAL WARTS

Definition: are caused by viruses; HPV (Human Papillomavirus) is the name of a large group
of viruses; certain types of HPV cause warts on the hands or feet; other types cause infections in
the genital area that can lead to genital warts, cervical cancer, or cancer of the vulva, vagina,
anus, and penis;; people living with HIV are more likely to be infected with HPV than HIV-negative
people; people living with HIV and HPV are also more likely to develop genital warts, as well as
cervical or anal cancer;

Treatment: regular cervical screening tests are a good way to check for HPV; there are
also three effective HPV vaccines
https://www.google.com/search?biw=1264&bih=672&tbm=isch&sa=1&ei=cMUQXZ36BtumoATPwo6YAw&q=genital+war
ts+examples&oq=genital+warts+examples&gs_l=img.3...239996.243349..243788...0.0..0.236.2672.0j4j9......0....1..gws-wiz-
img.......0i7i30j0i7i5i30j0i8i7i30.2dL9m2SWYTI#imgrc=FFi8S46yRu1hTM:

3. GONORRHEA

Definition: often called “the clap”, this bacterial sexually transmitted infection exists in
vaginal secretions and semen; it can be spread through vaginal, anal, or oral sex without a
condom or latex/polyurethane barrier

Symptoms: may include a yellowish or greenish vaginal discharge and a burning feeling
when urinating; can also affect the anus and the throat.

Treatment: with antibiotics If left untreated, it can cause PID and infertility.
https://www.medicinenet.com/image-collection/the_clap_gonorrhea_picture/picture.htm

4. HERPES

Definition: caused by a virus that lives in the nerves.

There are two common types:

a) Herpes simplex type 1 (HSV-1) - usually causes cold sores around the mouth

b) Herpes simplex type 2 (HSV-2) - usually causes sores in the genital area. it is possible to
get HSV-2 in the mouth and HSV-1 in the genital area.

Symptoms: include itchy or painful blisters; spread through skin-to-skin contact with sores,
but it may also spread even before sores can be seen on the infected person. Genital HSV-2
infection is more common in women than men. There is no cure for herpes, but the antiviral drugs
Zovirax (acyclovir), Valtrex (valacyclovir), and Famvir (famciclovir) can reduce the number of
outbreaks if taken daily and can shorten outbreaks and make them less severe if taken as soon as
symptoms begin. Valtrex has also been shown to lower your risk of passing the infection to
someone else. Pregnant women can pass herpes to their babies.
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https://www.medicinenet.com/image-collection/herpes_simplex_virus_type_1_picture/picture.htm

5. HIV (HUMAN IMMUNODEFICIENCY VIRUS)

Definition: The virus that causes AIDS (Acquired Immunodeficiency Syndrome); present in
blood, vaginal secretions, semen, and breast milk; can be spread through vaginal, oral, or anal
sex without a condom or latex/polyurethane barrier; getting tested for HIV is part of routine
medical care;
https://www.medicinenet.com/image-collection/hivaids_picture/picture.htm

6. SYPHILIS

Definition: caused by a bacterium; it can be spread by vaginal, anal, or oral sex without a
condom or latex/polyurethane barrier.

- The disease has several phases

- a) primary syphilis (early disease) may have pain-free open sores, called chancres, in the
genital or anal area or around the mouth; the sores usually heal on their own in three to six weeks.

- b) secondary syphilis (a later stage of the disease) often have a rash and/or hair loss.

- c)latent stage during which it may have no visible symptoms but can cause damage to
the heart, brain, and other organs.

Treatment: can be successfully treated with antibiotics; without treatment, it can hurt your
body's organs, leading to severe illness and even death. Pregnant women can pass syphilis to their
babies during pregnancy and childbirth, so it is important that pregnant women get tested for
syphilis.
https://www.medicinenet.com/image-collection/syphilis_picture/picture.htm

7. OTHER SEXUALLY TRANSMITTED DISEASES

a. Chancroid

Definition: caused by a bacterium; it can be spread by vaginal or anal sex or skin-to-skin


contact with sores.

- Symptoms: may include genital sores, vaginal discharge, a burning feeling when
urinating, and swollen lymph nodes in the groin. Treatment: can be treated with antibiotics
https://www.medicinenet.com/image-collection/chancroid_picture/picture.htm

b. Hepatitis

Definition: an inflammation (irritation) of the

liver; some types of hepatitis are caused by viruses that exist in blood, vaginal secretions,
semen, and breast milk; these include hepatitis A (HAV), hepatitis B (HBV), and hepatitis C (HCV),
all of which can be sexually transmitted.

- Treatment: there is a vaccine to prevent HAV and HBV, but not for HCV. HAV goes away
on its own, but HBV and HCV can become chronic (long-term) and very serious.

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https://www.webmd.com/hepatitis/ss/slideshow-hepatitis-overview

c. Pubic Lice

Definition: they live in the pubic hair and can be transmitted by skin-to-skin contact; they
can also be spread through infected clothes and bedding.

Symptoms: may include intense itching and seeing lice or eggs in the hair. Treatment: can
be treated with over-the-counter medications; contaminated clothes, sheets, pillowcases,
blankets, and towels should be washed in hot water and laundry soap to kill lice and eggs and to
prevent being infected again.
https://www.google.com/search?q=pubic+lice+images&tbm=isch&source=univ&sa=X&ved=2ahUKEwjm2JKum
YLjAhUHat4KHWHxAUUQsAR6BAgFEAE&biw=1262&bih=672#imgrc=_3zCVF1suyzaaM:

d. Trichomoniasis

Definition: caused by a single-celled germ called a protozoa; can be spread during


vaginal, oral, or anal sex without a condom or latex/polyurethane barrier; common cause of
vaginal infections.

Symptoms: may include a foamy, foul-smelling vaginal discharge and itching Treatment:
with antibiotics
https://www.google.com/search?biw=1262&bih=672&tbm=isch&sa=1&ei=nswQXZWsOJvAoATvmK3gCg&q=tric
homoniasis+images&oq=trichomoniasis+images&gs_l=img.1.0.0j0i7i30l4j0i8i30.192402.195979..202446...0.0..0.480.3402.0j5j7j
1j1......0....1..gws-wiz-img.......0i67j0i8i7i30.cuGmCfa3VkM#imgrc=6TlKLiv0vc40LM:

FAMILY PLANNING AND CONTRACEPTION


(Source:https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception)

Key facts from the World Health Organization (As of 8 February 2018)

a. 214 million women of reproductive age in developing countries who want to avoid
pregnancy are not using a modern contraceptive method

b. Some family planning methods, such as condoms, help prevent the transmission of HIV
and other sexually transmitted infections

c. Family planning/contraception reduces the need for abortion, especially unsafe


abortion

d. Family planning reinforces people’s rights to determine the number and spacing of their
children

e. By preventing unintended pregnancy, family planning/contraception prevents deaths


of mothers and children

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Family planning allows people to attain their desired number of children and determine
the spacing of pregnancies. It is achieved through use of contraceptive methods and the
treatment of infertility (this fact sheet focuses on contraception).

Benefits of Family Planning/Contraception

Promotion of family planning – and ensuring access to preferred contraceptive methods


for women and couples is essential to securing the well-being and autonomy of women, while
supporting the health and development of communities.

Preventing Pregnancy-Related Health Risks in Women

A woman’s ability to choose if and when to become pregnant has a direct impact on her
health and well-being. Family planning allows spacing of pregnancies and can delay
pregnancies in young women at increased risk of health problems and death from early
childbearing. It prevents unintended pregnancies, including those of older women who face
increased risks related to pregnancy. Family planning enables women who wish to limit the size of
their families to do so. Evidence suggests that women who have more than 4 children are at
increased risk of maternal mortality. By reducing rates of unintended pregnancies, family planning
also reduces the need for unsafe abortion.

Reducing Infant Mortality

Family planning can prevent closely spaced and ill-timed pregnancies and births, which
contribute to some of the world’s highest infant mortality rates. Infants of mothers who die as a
result of giving birth also have a greater risk of death and poor health.

Helping to Prevent HIV/AIDS

Family planning reduces the risk of unintended pregnancies among women living with HIV,
resulting in fewer infected babies and orphans. In addition, male and female condoms provide
dual protection against unintended pregnancies and against STIs including HIV.

Empowering People and Enhancing Education

Family planning enables people to make informed choices about their sexual and
reproductive health. Family planning represents an opportunity for women to pursue additional
education and participate in public life, including paid employment in non-family organizations.
Additionally, having smaller families allows parents to invest more in each child. Children with
fewer siblings tend to stay in school longer than those with many siblings.

Reducing Adolescent Pregnancies

Pregnant adolescents are more likely to have preterm or low birth-weight babies. Babies
born to adolescents have higher rates of neonatal mortality. Many adolescent girls who become
pregnant have to leave school. This has long-term implications for them as individuals, their families
and communities.

Slowing Population Growth

Family planning is key to slowing unsustainable population growth and the resulting
negative impacts on the economy, environment, and national and regional development efforts.

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WHO PROVIDES FAMILY PLANNING/CONTRACEPTIVES?

It is important that family planning is widely available and easily accessible through
midwives and other trained health workers to anyone who is sexually active, including
adolescents. Midwives are trained to provide (where authorised) locally available and culturally
acceptable contraceptive methods. Other trained health workers, for example community health
workers, also provide counselling and some family planning methods, for example pills and
condoms. For methods such as sterilization, women and men need to be referred to a clinician.

CONTRACEPTIVE USE
Contraceptive use has increased in many parts of the world, especially in Asia and Latin
America, but continues to be low in sub-Saharan Africa. Globally, use of modern contraception
has risen slightly, from 54% in 1990 to 57.4% in 2015. Regionally, the proportion of women aged 15–
49 reporting use of a modern contraceptive method has risen minimally or plateaued between
2008 and 2015. In Africa it went from 23.6% to 28.5%, in Asia it has risen slightly from 60.9% to 61.8%,
and in Latin America and the Caribbean it has remained stable at 66.7%. Use of contraception
by men makes up a relatively small subset of the above prevalence rates. The modern
contraceptive methods for men are limited to male condoms and sterilization (vasectomy).

GLOBAL UNMET NEED FOR CONTRACEPTION

214 million women of reproductive age in developing countries who want to avoid
pregnancy are not using a modern contraceptive method. Reasons for this include:

a. limited choice of methods;


b. limited access to contraception, particularly among young people, poorer segments
of populations, or unmarried people;
c. fear or experience of side-effects;
d. cultural or religious opposition;
e. poor quality of available services;
f. users and providers bias;
g. gender-based barriers.

The unmet need for contraception remains too high. This inequity is fuelled by both a
growing population, and a shortage of family planning services. In Africa 24.2% of women of
reproductive age have an unmet need for modern contraception. In Asia, and Latin America
and the Caribbean – regions with relatively high contraceptive prevalence – the levels of unmet
need are 10.2 % and 10.7%, respectively (Trends in Contraception Worldwide 2015, UNDESA).

CONTRACEPTIVE METHODS
Modern methods:

Method Description How it works Effectiveness to Comments


prevent
pregnancy
Combined oral Contains two Prevents the >99% with Reduces risk of
contraceptives hormones (estrogen release of eggs correct and endometrial and
(COCs) or “the and progestogen) from the ovaries consistent use ovarian cancer
pill” (ovulation)
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92% as commonly used
Progestogen-only Contains only Thickens cervical 99% with correct Can be used
pills (POPs) or progestogen mucus to block and consistent use while
"the minipill" hormone, not sperm and egg breastfeeding;
estrogen from meeting and must be taken
prevents ovulation at the same
time each day
90–97% as commonly used
Implants Small, flexible rods Thickens cervical >99% Health-care
or capsules placed mucus to block provider must
under the skin of sperm and egg insert and
the upper arm; from meeting and remove; can be
contains prevents ovulation used for 3–5
progestogen years
hormone only depending on
implant;
irregular
vaginal
bleeding
common but
not harmful
Progestogen Injected into the Thickens >99% with Delayed return
only injectables muscle or under the cervical mucus to correct and to fertility
skin every 2 or 3 block sperm and consistent use (about 1–4
months, depending egg from meeting months on the
on product and prevents average) after
ovulation use; irregular
vaginal
bleeding
common, but
not harmful
97% as commonly used
Monthly Injected monthly Prevents the >99% with Irregular
injectables or into the muscle, release of eggs correct and vaginal
combined contains estrogen from the ovaries consistent use bleeding
injectable and progestogen (ovulation) common, but
contraceptives not harmful
(CIC)
97% as commonly used
Combined Continuously Prevents the The patch and the The Patch and
contraceptive releases 2 release of eggs CVR are new and the CVR
patch and hormones – a from the ovaries research on provide a
combined progestin and an (ovulation) effectiveness is comparable
contraceptive estrogen- directly limited. safety and
vaginal ring through the skin Effectiveness pharmacokineti
(CVR) (patch) or from the studies report that c profile to
ring. it may be more COCs with

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effective than the hormone
COCs, both as formulations.
commonly and
consistent or
correct use.

Intrauterine Small flexible Copper component >99% Longer and


device (IUD): plastic device damages sperm heavier periods
copper containing containing copper and prevents it during first
sleeves or wire that from meeting the months of use
is inserted into the egg are common
uterus but not
harmful; can
also be used as
emergency
contraception
Intrauterine A T-shaped plastic Thickens cervical >99% Decreases
device (IUD) device inserted into mucus to block amount of
levonorgestrel the uterus that sperm blood lost with
steadily releases and egg from menstruation
small amounts of meeting over time;
levonorgestrel each Reduces
day menstrual
cramps and
symptoms of
endometriosis;
amenorrhea (no
menstrual
bleeding) in a
group of users
Male condoms Sheaths or Forms a barrier to 98% with correct Also protects
coverings that fit prevent sperm and and consistent use against sexually
over a man's erect egg from meeting transmitted
penis infections,
including HIV
85% as commonly used
Female condoms Sheaths, or linings, Forms a barrier to 90% with correct Also protects
that fit loosely prevent sperm and and consistent use against sexually
inside a woman's egg from meeting transmitted
vagina, made of infections,
thin, transparent, including HIV
soft plastic film
79% as commonly used

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Male sterilization Permanent Keeps sperm out >99% after 3 3 months delay
(vasectomy) contraception to of ejaculated months semen in taking effect
block or cut the vas semen evaluation while stored
deferens tubes that sperm is still
carry sperm from present; does
the testicles not affect male
sexual
performance;
voluntary and
informed
choice is
essential
97–98% with no semen evaluation
Female Permanent Eggs are blocked >99% Voluntary and
sterilization (tubal contraception to from meeting informed
ligation) block or cut the sperm choice is
fallopian tubes essential
Lactational Temporary Prevents the 99% with correct A temporary
amenorrhea contraception for release of eggs and consistent use family planning
method (LAM) new mothers whose from the ovaries method based
monthly bleeding (ovulation) on the natural
has not returned; effect of
requires exclusive breastfeeding
or full on fertility
breastfeeding day
and night of an
infant less than 6
months old
98% as commonly used
Emergency Pills taken to Delays ovulation If all 100 women Does not
contraception prevent pregnancy used progestin- disrupt an
pills (ulipristal up to 5 days after only emergency already existing
acetate 30 mg or unprotected sex contraception, pregnancy
levonorgestrel 1.5 one would likely
mg) become pregnant.
Standard Days Women track their Prevents 95% with Can be used to
Method or SDM fertile periods pregnancy by consistent and identify fertile
(usually days 8 to avoiding correct use. days by both
19 of each 26 to 32 unprotected women who
day cycle) using vaginal sex during want to become
cycle beads or other most fertile days. pregnant and
aids women who
want to avoid
pregnancy.
Correct,
consistent use
requires partner
cooperation.
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88% with common use (Arevalo et al 2002)
Basal Body Woman takes her Prevents 99% effective If the BBT has
Temperature body temperature at pregnancy by with correct and risen and has
(BBT) Method the same time each avoiding consistent use. stayed higher
morning before unprotected for 3 full days,
getting out of bed vaginal sex during ovulation has
observing for an fertile days occurred and
increase of 0.2 to the fertile
0.5 degrees C. period has
passed. Sex can
resume on the
4th day until
her next
monthly
bleeding.
75% with typical use of FABM (Trussell, 2009)
TwoDay Method Women track their Prevents 96% with correct Difficult to use
fertile periods by pregnancy by and consistent if a woman has
observing presence avoiding use. a vaginal
of cervical mucus unprotected infection or
(if any type color or vaginal sex during another
consistency) most fertile days, condition that
changes
cervical mucus.
Unprotected
coitus may be
resumed after 2
consecutive dry
days (or
without
secretions)
86% with typical or common use. (Arevalo, 2004)
Sympto-thermal Women track their Prevents 98% with correct May have to be
Method fertile periods by pregnancy by and consistent used with
observing changes avoiding use. caution after an
in the cervical unprotected abortion,
mucus (clear vaginal sex during around
texture) , body most fertile menarche or
temperature (slight menopause, and
increase) and in conditions
consistency of the which may
cervix increase body
temperature.

Traditional methods

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Traditional Description How it Works Effectiveness to Comments
Methods prevent
pregnancy
Calendar method Women monitor The couple 91% with correct May need to
or rhythm method their pattern of prevents and consistent delay or use
menstrual cycle pregnancy by use. with caution
over 6 months, avoiding when using
subtracts 18 from unprotected drugs (such as
shortest cycle vaginal sex during anxiolytics,
length (estimated the 1st and last antidepressants
1st fertile day) and estimated fertile , NSAIDS, or
subtracts 11 from days, by certain
longest cycle length abstaining or using antibiotics)
(estimated last a condom. which may
fertile day) affect timing
of ovulation.
75% with common use
Withdrawal Man withdraws his Tries to keep 96% with correct One of the
(coitus penis from his sperm out of the and consistent use least effective
interruptus) partner's vagina, woman's body, methods,
and ejaculates preventing because proper
outside the vagina, fertilization timing of
keeping semen withdrawal is
away from her often difficult
external genitalia to determine,
leading to the
risk of
ejaculating
while inside
the vagina.

WORLD HEALTH ORGANIZATION (WHO) RESPONSE


WHO is working to promote family planning by producing evidence-based guidelines on
safety and service delivery of contraceptive methods, developing quality standards and
providing pre-qualification of contraceptive commodities, and helping countries introduce,
adapt and implement these tools to meet needs.

SUPPLEMENTAL READING

Section 2: The Sexual Self

This section tackles one of the most crucial aspects of human development, the sexual self. It
highlights biological and environmental factors that shape sexual development. Tips on regulating
sexual behavior are also provided.

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The Biology of Self

At birth, the sexual genital (penis for male, vagina for female) is a biological feature that
distinguishes males from females. Moreover, during puberty, observable changes in the human
body also known as secondary sexual characteristics begin.

When physiological changes are triggered within the adolescent’s reproductive system, he or she
is likely to experience sexual urges, become more sensitive to sexual stimuli, and feel sexual
arousal.

Humans are likely to engage in sexual activities to satisfy sexual urges. However, the kind of sexual
activities they engage in may vary.

A person should be aware of his/her sexuality and sexual attributes in order to make responsible
decisions. Adolescents need to realize the importance of having informed choices.

Sexual Identity and Gender Orientation

Biological sex is one’s assignment upon birth and is dependent on physical feature. On the other
hand, gender is an identity that is learned and embraced by individual.

Gender roles refer to societal expectations of how men and women should act. Everyone has a
basic idea of gender roles: men are assumed to be strong and dominant while women are
perceived to be submissive and demure.

Sexual identity and gender orientation underlie one’s concept of self. A person expresses his or
her sexuality through individuality; one’s belief and behavioral lifestyle are based on his or her own
perceptions of sexuality.

The Consequences of Sexual Choices

Sexual intercourse (copulation) is the reproductive act in which the male organ (penis) enters the
female’s reproductive tract (vagina). Adolescents couples who engage in sexual intercourse are
usually overwhelmed by the sensations they feel during the act.

However, if the woman is fertile during the time of intercourse, pregnancy is likely to occur and it
lasts approximately nine months before the birth of the child. Having a child entails a big
responsibility and should not merely be a consequence of an impulsive moment. Physical risks to
having an early pregnancy may impact an adolescent’s development, including miscarriage,
emotional stress, and health risks to both mother and infant.

Aside from pregnancy, another consequence of impulsive and careless sexual intercourse is the
risk of acquring sexually-transmitted diseases (STDs). Among common STDs are:

Syphilis

Gonorrhea

Chlamydia

Genital Warts

The most alarming sexually transmitted disease is the acquired immune deficiency syndrome
(AIDS) caused by the human immunodeficiency virus (HIV). It can be transmitted by contact

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between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-
contaminated body fluids.

It is important that everyone makes responsible decisions with regard to sexuality and sexual
behavior. Responsible sexual behavior entails the following:

Respect for one’s body. It means taking care of one’s body and avoiding activities that undermine
one’s worth and respect.

Maturity in thoughts and deeds. It refers to being objective, rational, and calm, instead of being
swept by one’s emotion.

Being guided by one’s personal beliefs and core values. Everyone, especially an adolescent,
should always be grounded by his/her personal principles and self-worth.

Being future-oriented. Instead of focusing on the present, a person should always weigh his or her
present actions with possible consequences in the future.
https://utsged101portfolio.wordpress.com/section-2-the-sexual-self/

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