2. What is Normal Sexuality?
… perception of being male or
female and all those thoughts,
feelings, behaviours, connected
with sexual gratification and
reproduction, including the
attraction of one person to
another
involves feelings of desire,
behavior that brings pleasure
to oneself and one’s partner….
Devoid of guilt or anxiety…
and not compulsive
3. Human Sexuality
• Expression of sexual sensation and
intimacy between persons
• Expression of identity through sex
• Comprises a broad range of behavior and
processes
4. Human Sexuality
• Determined by anatomy, physiology,
psychology, culture, relationship with others,
and developmental experiences
SEXUALITY PERSONALITY
PSYCHOSEXUAL
5. Physiological Aspects of Human
Sexuality
• Influenced by hormonal changes during
pregnancy/ genetic predisposition
• Sexual Dysfunction:
– libido diminution
– erectile dysfunction
6. Social Aspects of Human
Sexuality
• Governed by rules of behavior and status
quo
• Influenced by social norms and vice versa
– Example: gender identity
7. Psychological Aspects of Human
Sexuality
Sexual Identity
• Gender Identity
• Orientation
• Intention
Sexual Function
• Sexual Desire
• Sexual Arousal
• Orgasm
Sexual Satisfaction
8. Gender Identity
• Sense of self as
masculine or feminine
• Gender in which a
person identifies
• Gender that other
people attribute to the
individual on the basis
of gender role
• Is affected by a variety
of social structures
9. Gender Identity and Sexual
Identity
• Majority it is
congruent
• Human beings are
cisgendered based
on their biological sex
• Gender is social and
sex is biological
10. Gender Role
• Usually related to and derived from gender
identity
• Includes all disclosures of a person as
having the status of a man or a woman
11. Sexual Orientation
• Describes the direction of an individual’s
sexuality
• AKA: sexual preference
• Markers:
– Self-labelling
– Actual sexual behavior
– Sexual fantasy
– Erotic arousal pattern
13. Sexual Orientation and Mental
Illness
• Psychiatric disorders were more prevalent
among homosexually active people
– Depression/ anxiety
– Suicide
– Substance abuse (alcohol/ smoking)
• Sense of alienation predisposes them to
mental illness
14. Sexual Intention
• What a person wants to do to his/ her partner
during the sexual behavior and what is done to
him or her
Sexual Desire
• Interest that a person experiences
– Drive – biological aspects
– Motive – psychological aspects
– Wish – social aspects
15. Sexual Arousal
• The emotion of sexual excitement based on
pelvic vasocongestion and autonomic arousal
Orgasm
• Stimulated by high levels of arousal that
results to brief, intense pleasure and
release of pelvic congestion
17. Factors Affecting Sexuality
A. Developmental Considerations
- sexuality is the only distinguishing trait
present at conception
- gender, or sex, influences behavior
throughout life
18. Stages: Birth – 12 yrs = gender related
By 3 yrs. = gender identity
- obtain pleasure from
touching/fondling genitals
- toys are gender related
- able to identify own gender
19. Preschooler = increased awareness of body parts
- sexuality has been internalized and
preference for sexual partners determined
- enjoys exploring body parts of self and
playmates
- engages in masturbation
School Aged = gender role behaviors
- tendency toward having same-sex friends
- increasing self-awareness
20. Adolescence = need information regarding
changes; information obtained based on myths
- develop opposite-sex relationships
- masturbation is common
- girls concerned w/reputations and
self-image
- become “hippy” and w/small waist
- boys preoccupied w/competitiveness
of sexual activity
- increase in testes size and they drop
further into place
- increased perspirations and vaginal
secretions
21. Young / Middle Adulthood = premarital sex is
common
- may experiment w/various sexual
expressions
- develop own value system and
respects values of others
- women are in “childbearing” mode
and searching for a mate; become
menopausal w/an increased sex drive
- men begin graying, having decreased
ejaculations and sex drive
22. Older Adulthood = orgasms may become
shorter and less intense in both
sexes
- vaginal secretions decrease and
period of resolution in men
lengthens
- fear loss of sexual abilities
23. B. Culture
- every culture has its own norms dictating duration
of sexual intercourse, methods of sexual
stimulation and sexual positions
- some cultures promote childhood sexual play,
polygamy/monogamy, and puberty rites including
male circumcision
- religious beliefs promote beliefs on premarital /
extramarital coitus, homosexuality, and decisions on
circumcision (male and female)
24. C. Religion
- some view organized religion as having a generally
negative effect on expression of sexuality
- sexual expression other than male-female coitus
are considered unnatural by some
- concept of virginity came to be synonymous with
purity, and sex became synonymous with sin
- double standards and rigid regulations exists in
many religions
- sexual dysfunctions can be related to anguish over
negative connotation of sex dictated by religion
- many have recognized the importance of sold sex
education w/in the realm of church
- new interest in spirituality of marriage, supporting
the intimate/sexual relationship of married couples
- provides guidelines
25. D. Ethics
- healthy sexuality depends on freedom from
guilt and anxiety
- what one views bizarre, perverted or wrong
may be natural and right to another
- if sexual expression is performed by
consenting adults, is not harmful to them and
is practiced in privacy, it is not considered a
deviant behavior
- many accept sexual expression of various
forms
26. E. Lifestyle
- both men and women are exposed to stress, and
many are under considerable strain to perform and
function in workplace as well as at home
- stressors may be external (job, financial demands)
or internal (competitive)
- although some couples view sexual activity as a
release from stressors of everyday life, most place
sex far from the top of the list of things to do
- crucial for relationships to set aside priority time - -
if not for lovemaking, then for intimate,quiet contact
- sexual expressions from heterosexual,
homosexual, bisexual, and transsexual
27. F. Health State
1. Chronic Pain
2. diabetes
3. cardiovascular diseases
4. Diseases of Joints and Mobility
5. Surgery and Body Image
6. Spinal Cord Injuries
28. 7. Mental Illness
8. Sexually Transmitted Disease
G. Medications
- some meds have side effects that affect sexual
functioning
- some people use illegal drugs because of their
reputed ability to heighten sexual experience,
but can have serious and even deadly side
effects
29. Sexual Dysfunction
Men – erectile failure (impotence) = history of
diabetes, spinal cord trauma, cardiovascular disease,
surgical procedure, alcoholism
- use of antihypertensions, antidepressants, or illicit
drugs
- mental depression that may be present premature
ejaculation = pt defines dysfunction and ability to
control
- causative relationship factors like anxiety, guilt,
lack of time, new partner
retarded ejaculation = history of neurologic
disorders, Parkinson’s disease, certain meds
30. Women – inhibited sexual desire = use of
oral contraceptives or hormonal therapy,
alcohol or certain meds
- history of sexual abuse, rape or incest,
depression, or other sexual dysfunctions
orgasmic dysfunction =
communication pattern between pt and
partner
- usual sexual pattern and behavior
31. • dyspareunia = history of diabetes,
hormonal imbalance, vaginal infection,
endometriosis, urethritis, cervisitis or rectal
lesions
- use of antihistamines, alcohol,
tranquilizers, or illicit drugs
- ability for vaginal lubrication during sex
- use of coital positions
- use of cosmetic or chemical irritants to
genitals
32. • vaginismus = pattern of sexual activity
(how often, level of arousal, orgasm)
- presence of other sexual
dysfunctions
- history of sexual abuse,
trauma or rape
- feelings regarding partner
- causative factors (fear of
pregnancy, anxiety, guilt)
35. The sexual response cycle refers to
the sequence of physical and emotional
changes that occur as a person
becomes sexually aroused and
participates in sexually stimulating
activities, including intercourse and
masturbation. Knowing how your body
responds during each phase of the
cycle can enhance your relationship
and help you pinpoint the cause of
sexual dysfunction.
40. Normal Sexual Behavior
• Sexual response is a true psychophysiological
experience
• There is….
– Arousal
– Experience of tension
– Orgasm
• Four phase response cycle in relation to
stimulation
– Phase 1: Desire
– Phase 2: Excitement
– Phase 3: Orgasm
– Phase 4: Resolution
42. Phase 1: Excitement
The excitement phase (also known as the
arousal phase or initial excitement phase) is
the first stage of the human sexual response
cycle. It occurs as the result of any erotic
physical or mental stimulation, such as kissing,
petting, or viewing erotic images, that lead to
sexual arousal. During the excitement stage, the
body prepares for coitus, or sexual intercourse.
43. Four Phase Response Cycle
• Phase 1: Desire
– Motivation, drives, and personality towards
the love object
– Sexual fantasies and desire to have sexual
activity
44. Phase 1: Excitement
Signs Present in Both
Sexes
Signs Present In Males
Only
Signs Present In
Females Only
Increased muscle
tension
Moderate increase in
heart rate,
respiration, and blood
pressure
Sex flush (less
prevalent in men than
in women; present in
75% of women)
Nipple erection ( 60%
of men and most of
women)
Penile erection
Tensing, thickening,
and elevation of the
scrotum
Partial elevation and
increase in size of
testicles
Enlargement of the
clitoral glands
Vaginal lubrication
Widening and
lengthening of the
vaginal barrel
Separation and
flattening of the labia
majora
Reddening of the
labia minora and
vaginal wall
Breast enlargement
and enlarge areolae
45.
46.
47. Phase 2: Plateau
The period during which sexual
tension increases to levels nearing
orgasm, may last from 30 seconds to
3 minutes
48. Four Phase Response Cycle
•Phase 2: Excitement
–Subjective sense of pleasure from
•Psychological stimulation (fantasy, presence of the love object)
•Physiological stimulation (Stroking or kissing)
•Combination of both
Male Female
-Lasts several minutes to several hours
-Penile tumescence (increase in diameter/
length)
-Tightening & lifting of the scrotal sac and
elevation of the testes; 50% increase in the
size of the testes
-2-3 drops of mucoid fluid that contain viable
sperm are secreted at the height of
excitement
-Increase in heartbeat and respiration rates
-Heightened excitement lasts 30 secs to
several minutes
-Lasts several minutes to several hours
-Vaginal lubrication, nipple erection
-Clitoral enlargement, thickening of the labia
minora
-Increase in breast size (25%)
-Vaginal color change to dark purple; vaginal
transudate appears 10-30 secs after arousal
-Labia minora changes color to bright and
deep red
-Increase in the heartbeat and respiration
rates
-Heightened excitement lasts 30 secs to
several hours
49. Phase 2: Plateau
Signs Present in Both
Sexes
Signs Present In Males Only Signs Present In Females
Only
Increased voluntary and
involuntary myotonia
Abdominal, intercostal,
anal, and facial muscle
contraction
Accelerated heart rate
and respiratory rate and
blood pressure
Sex flush ( appearance in
some men late in the
phase; spread over the
entire body in women)
Increased in penile
circumference, at the
coronal ridge, and
deepening in color
50% increase in testicular
size, and elevation close
to the perineum
Appearance of a few
drops of mucoid
secretions from the
bulbourethral glands at tip
of penis; may contain
sperm
Retraction of the clitoris
under the hood
Appearance of the
orgasmic platform,
increased in the size of
the outer one-third of the
vagina and the labia
minora
Slight increase in width
and depth of the inner
two-thirds of the vagina
Farther reddening of the
labia minora
Appearance of few drops
of mucoid secretion from
the Bartholin’s glands to
lubricate the inner labia
Farther increase in breast
size and areolar
enlargement
50.
51.
52. Phase 3: Orgasmic
This phase is the climax of the sexual
response cycle. It is the shortest of
the phases and generally lasts only a
few seconds.
53. Four Phase Response Cycle
•Phase 3: Orgasm
–Peaking of sexual pleasure with subsequent release of sexual tension
and rhythmic contraction of the perineal muscles and the pelvic organs
Male Female
-3-15 seconds
-Forceful emission of semen (ejaculation) (12-
20 inches at age 18, decreasing with age to
seepage at 70)
-4-5 rhythmic spasms of the prostrate, seminal
vesicles, vas, and urethra
-Loss of voluntary muscle control (facial
grimacing; carpopedal spasm)
-BP up to 40-100 mm systolic, 20-50 mm
diastolic
-HR up to 180 beats per minute
-Respiration up to 40 respirations a minute
-3-15 seconds
-Breasts may become tremulous
-Uterine contractions throughout orgasm
-Contractions of the lower third of the vagina
-Loss of voluntary muscle control (carpopedal
spasm; facial grimacing)
-Hyperventilation and tachycardia
54. Phase 3: Orgasmic
Signs Present in Both Sexes Signs Present In Males Only Signs Present In Females Only
Involuntary spasms of
muscle groups
throughout the body
Diminished sensory
awareness
Involuntary contraction
of the anal sphincter
Peak heart rate (110-
180bpm), respiratory
rate (40/min or greater)
Rhythmic, expulsive
contractions of the penis
at 0.8 seconds interval
Emision of seminal fluid
into the prostatic urethra
Closing of the internal
bladder sphincter
Orgasm may occur
without ejaculation
Ejaculation of semen
through the penile
urethra and expulsion
from the urethral
meatus.
Approximately 5-12
contractions in the
orgasmic platform at 0.8
seconds interval
Contractions of the
muscles of the pelvic
floor and uterine
muscles
Varies pattern of orgasm
including minor surges
and contractions,
multiple orgasms, or a
simple intense orgasms
similar to that of the
male
55.
56.
57.
58. Phase 4: Resolution
Occurs after orgasm and allows the
muscles to relax, blood pressure to
drop and the body to slow down from
its excited state.
59. Four Phase Response Cycle
• Phase 4: Resolution
– Disgorgement of blood from the genitalia
(detumescence)
– With subjective feelings of well-being, general
relaxation and muscle relaxation
– If it does not occur, may take 2-6 hours
associated with irritability and discomfort
– Women do not have a refractory period
60. Phase 4: Resolution
Signs Present in Both
Sexes
Signs Present In Males
Only
Signs Present In Females
Only
Reversal of
vasocongestion in 10-30
minutes; disappearance
of all signs of myotonia
within 5 minutes
Genital and breast
return to their
preexcitement states
Sex flush disappears in
reverse order of
appearance
Heart rate, respiratory
rate, blood pressure
returns to normal
Other reactions include
sleepiness, relaxation,
and emotional outbursts
such as crying or
laughing
A refractory period
during which the body
will not respond to
sexual stimulation;
varies, depending on
age and other factors,
from a few moments to
hours or days
65. Masturbation
•Nearly all men and three
fourths of all women
masturbate sometime
during their lives
•Moral taboos have
generated myths that
masturbation causes
mental illness or a
decrease in sexual
potency
66. Masturbation
• Form of release from excessive sexual
tension
• is probably a universal and inevitable
aspect of psychosexual development, and
in most cases……..
• ADAPTIVE
• Becomes pathologic if it becomes a
compulsion
67. Homosexuality
•What would your reaction
be if you found out that
your best friend is
homosexual?
•Homosexuality is a
disorder…..?
69. Homosexuality
•An alternative lifestyle
•A variant of human
sexuality
•Definition:
–A person’s overt behavior,
sexual orientation, and a
sense of personal or social
identity.
•Lesbian or gay men
•Same sex or male female
70. Homosexuality
• Prevalence
– 1948 : 10% of men
5% of women
37% had a homosexual
experience
– 1988 : 2-3% of men
– 1989 : < 1% of either sex
– 1993 : 1% exclusively homosexual
72. REVIEW: ERIK ERIKSON’S STAGES
OF THE LIFE CYCLE
STAGE 5: Identity vs. Role Diffusion
– 11 years through end of adolescence
– Struggle to develop ego identity
– Danger of role confusion, doubts about sexual
and vocational identity
73. Some of the expressions of human
sexuality in adolescents are the following:
• Dating Behavior
• Pre-marital Sex
74. Definition: Dating Behavior
• DATE- is defined as any activity that
involved going out with someone of the
opposite sex whether in a group or as a
couple
– Group date
– Single date
75. Proportions ever Dated
• Most Filipino youth aged 15-24 years have
dated
• 60% or 3 out of 5 have experienced going
out on a date
• 49% of the teenagers claimed to have
gone out on a date
76. Proportions ever Dated
• Dating either in groups or alone with
someone of the opposite sex occurs quite
early 10-13 years for only a few youth
• By the age 15 the propensity to date picks
up
• At 16, more than a third of boys and 2 out
of 5 girls date
77. GROUP DATES OR SINGLE
DATES
• 3 out of five-group date
• Girls more likely to start with group date
• Boys immediately launched into a single
date
78. TIMING OF THE FIRST DATE
• First date can trigger a series of events
that might change the subsequent life of a
person
• During teens, boys date twice as much as
girls
• Age 15, 1/5 of the girls have dated while
only 1/10 in boys have dated
79. FIRST SINGLE DATE
PARTNER
• Irrespective of gender, the partner was a
classmate or officemate introduced by a
friend or a neighbor
• At the time of the first date:
• 46% already a boyfriend/girlfriend
• 28% friend
• 16% admirer or crush
• 10% acquaintance
80. DATING WITH A STEADY
PARTNER
• Boys revealed that their partners became
their girlfriends after only 3 months
• Girls report the same after 6 months
• Favorite dating places: movie houses,
restaurants, parks and shopping malls
81. CHAPERONES
• Traditional role: ensure that no untoward
incident happens during a date
• Nowadays: chosen to assuage and
persuade the parents or partner to agree
to the date and leaves the couple during
the actual date
82. BEHAVIOR DURING first
DATES
• 36% Kissed
• 3% sexual intercourse
• *17 % of the girls confided intercourse
happened without their consent
83. IN THE SUBSEQUENT DATES
• the number of those engaging in very
intimate behaviors (petting and
intercourse) increased dramatically from
15-28%
84. Dating and related events
• The urban youth have their first crushes at
14
• Admiring the opposite sex at 15
• Group date at 16
• Single dates with BF and GF at 17-18
85. Differentials in dating
behavior
• Those who have had exposure to urban
life were prone to date about a quarter
more than those who have always
remained in the rural setting.
• Having lived in a dorm, studied in a private
school and living away from parents
increase tendency to date
86. Determinants of dating
behavior
• Live away from parents
• Older age
• Lived in the city
• Attends private school
• Fathers are college graduates
• Less strict parents
• Unstable marriage of parents
91. INITIAL EXPERIENCE WITH
PREMARITAL SEX
• Occurs at 18 years old
• 18% of today’s youth engage in premarital sex
• Most popular venue for sexual encounters is the
HOME
• Majority of the youth did not use contraception
because they did not expect to have sex at that
time
• In those who practiced contraception, withdrawal
and condom were them most commonly used
92. • DESPITE THE ACCEPTANCE OF
PREMARITAL SEX, VIRGINITY IS STILL
GENERALLY VALUED.
» ZABLAN, 1995:
• 91.5% CONSIDER VIRGINITY AS AN
IMPORTANT VIRTUE
93. Conclusion
• 49% HAVE GONE OUT ON A DATE
DATING OCCURS AS EARLY AS 10 YRS OLD
GIRLS MORE LIKELY TO GROUP DATE FIRST
FIRST DATE CAN TRIGGER EVENTS THAT MAY
CHANGE THE PERSON’S LIFE
• INITIAL EXPERIENCE WITH PREMARITAL SEX
OCCURS AT AGE 18
• MOST COMMON FIRST SEXUAL EXPERIENCE WITH
BOYS IS CASUAL SEX
94. Conclusion
• MAJORITY OF THE YOUTH DID NOT USE
CONTRACEPTION BECAUSE THEY DID NOT
EXPECT TO HAVE SEX AND DESPITE ACCEPTANCE
OF SUCH PRACTICES, VIRGINITY IS STILL A HIGHLY
REGARDED VIRTUE
• SEXUALITY is at it’s peak in adolescence
as expressed in dating behavior and
premarital sex
95. Types of Sexual orientation
1.Heterosexuality-one who finds sexual
fulfillment w/a member of opposite gender
2.Homosexuality-a person who finds sexual
fulfillment w/ a member of his or her own
sex.
3.Bisexuality-people who achieve sexual
satisfaction from both heterosexual &
homosexual
4.Transexuality -example is sex change
operation .
96. Types of sexual expression
1.Celibacy-abstinence from sexual activity
2.Masturbation-self stimulation for erotic pleasure
3.Erotic stimulation -use of visual materials such as
magazine or photographs for sexual arousal
4.Fetishism-sexual arousal by use of certain objects
or stimulations.
5.Transvestism-individual who dresses to take on the
role of opposite sex.
6.Voyeurism-Sexual arousal by looking at others
body
99. Disorder of sexual functioning
Primary sex dysfunction(life long condition)
1.Erectile Dysfunction -inability to produce an erection
enough for vaginal penetration formerly called as
impotence.drug of choice is Sildenafil(Viagra)
2.Premature Ejaculation -ejaculation before penile
contact.
3.Failure to achieve orgasm -can be due to poor sexual
technique or concentration.
4.Vaginismus -involuntary contraction of the muscles at
the outlet of vagina when coitus is attempted,prohibits
penile penetration usually occurs w/ raped trauma
victims
5.Dyspareunia-pain during coitus
6.Inhibiting Sexual Desire -lack of desire for sexual
relations.
100. Secondary sexual dysfunction
• Chronic disease,such as peptic
ulcer,or chronic pulmonary disease
that cause frequent pain or discomfort
may interfere with a man or woman’s
overall well being.
• Obese men and women may have
difficulty achieving deep penetration
because of bulk in their abdomen
102. SEXUAL DISORDER
» These are disorders that are related to
human sexuality due to psychological
causes
103. » Types:
1. Alteration in gender identity
2. Alteration in sexual orientation
3. Alteration in sexual behavior
4. Alteration in sexual functioning
5. Painful sexual disorders
104. ALTERATION IN GENDER
IDENTITY
1. Transexualism
• Persistent discomfort about one’s sex
assignment
• Caused by confused learning about
gender roles
• Feeling of being trapped in the wrong
body
105. 2. Gender Identity Disorder of Childhood
• Persistent and intense distress at one’s
sexual identity
• Client insist that he/she is an opposite
sex
• Assertion that he/she will grow up to
have transsexual surgery
106. 3. Nontranssexual Cross Gender
Disorder
• Persistent discomfort about one’s sex but
with no preoccupation with getting rid
of the genitalia
107. ALTERATION IN SEXUAL ORIENTATION
1. Ego-Dystonic Homosexuality
• Weak heterosexual arousal with desire to
have heterosexual relationship
• Client experience inappropriate
homosexual arousal pattern
108. ALTERATION IN SEXUAL
BEHAVIOR
1. Sexual Acting Out
- Disturbed conduct or poor impulse control
- May create a sexually provocative remarks
- Have extramarital affairs and promiscuous
- Have high sexual drive
- Presence of inadequate coping and
interpersonal skills
109. 2. Paraphilias
- Sexual urges or fantasies that are
directed toward nonhuman objects pain to
self, partner, or children, or other non-
consenting individuals
- This may be asymptomatic
- Behavior often followed by guilt, shame.
low-esteem, or anxiety
- Not due to other mental disorder
110. Types of Paraphilias:
1. Fetishism- substitution of an inanimate
object for the genitals
2. Transvestism- wearing clothes of the
opposite sex to achieve sexual pleasure
3. Exhibitionism- sexual pleasure obtained
by exposing the genitals
4. Pedophilia- attraction to children as sex
objects
111. 5. Voyeurism- sexual gratification obtained
by watching the sexual plays of others
6. Frotteurism- sexual obtained by touching
or rubbing against a non-consenting
person
7. Telephone Scatologia- sexual
gratification form during telephone
conversation
8. Dendrophilia – sexual gratification in
woods
112. ALTERATION IN SEXUAL FUNCTIONING
1. Sexual Dysfunction- individuals is
unsatisfied in his sexual function
2. Hypoactive sexual desire- absence of
sexual fantasies and desires
3. Sexual aversion- avoidance of genital
sexual contact with partner
113. 4. Sexual arousal disorder- failure to attain
and maintain erection in males
• Lack of lubrication
• Persistent or recurrent lack of subjective
sense of sexual excitement and pleasure