Updates on sexual related issues

Registered Nurse
Jun. 26, 2013

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Updates on sexual related issues

  1. UPDATES ON SEXUAL RELATED ISSUES University of Northern Philippines Graduate School Master of Arts in Nursing
  2. SEXUAL HEALTH ISSUES Sexual health is a broad area that encompasses many inter-related challenges and problems. Key among the issues and concerns are human rights related to sexual health, sexual pleasure, eroticism, and sexual satisfaction, diseases (HIV/AIDS, STIs, RTIs), violence, female genital mutilation, sexual dysfunction, and mental health related to sexual health. During a meeting held in Antigua, Guatemala in May 2000, an expert group convened by the Pan American Health Organization and WHO in collaboration with the World Association for Sexology (WAS) compiled an overview of sexual concerns and problems that should be addressed in order to advance sexual health (PAHO/WHO 2000). Sexual health concerns are life situations that can be addressed through education about sexuality and society-wide actions in order to promote the sexual health of individuals. The health sector has a role to play in assessment, and in providing counseling and care.
  4. A. CHILD SEXUAL ABUSE Sexual abuse - rape, incest and acts of lasciviousness continue to plague our children. The same goes true for children victims of commercial sexual exploitation – child trafficking, child prostitution and child pornography.
  5. Statistics: The Department of Social Welfare and Development has served the following in 2010: • 1,247 sexually abused children, 1,168 or 93 % of which were female • 127 sexually exploited, 120 or 94 % of which were female • 390 victims of child trafficking, 368 or 94% of which were female • Children victims of pornography are lumped within those sexually exploited. In 2010, there were eight 8 victims, seven of which were female.
  6. •The Department of Justice reports a total of 15,830 cases involving sex and commercial exploitation of children as of December 2010 based on a nationwide case inventory in 2006 to 2007. •As of December 2009, a total of 20 establishments were permanently closed by the Department of Labor and Employment from 2005 – 2009 for employing minors in prostitution or in obscene or lewd shows pursuant to Republic Act 9231. A total of 58 victims of child labor have been reported.
  7. Key Facts: • Majority of the offenders are family members or someone close to the family. • Both males and females sexually offend, however males represent a higher percentage of known sex offenders. • While media reports cases of abuse and exploitation, many other cases remain unknown to the general public either because information isn‘t publicized or because the offenses have not been reported.
  8. • Child sexual abuse usually begins with a sex offender gaining both the parent‘s and the child‘s trust and friendship. Once a relationship has been established, the offender will begin to test the child‘s knowledge and ability to protect themselves • Children who are well informed and empowered to act, and who have someone who will listen to them can, in many cases, prevent or stop sexual abuse. Offenders do not usually choose victims who are likely to resist or tell. • Sexual exploitation and abuse can lead to unwanted pregnancies among girls and put them at risk to HIV/AIDS infection.
  9. • Sexual abuse and exploitation can cause long- lasting problems well into adulthood. It is important to get your child into counseling after abuse has been disclosed. It is necessary and healthy for child victims to seek immediate professional help. • Sexual exploitation of children may come in various forms -child pornography, child trafficking or child prostitution. • Children and young people are primary users of internet and mobile technology. • Accessibility of children and young person to technology makes them highly vulnerable to child pornography and other forms of cyber-abuse.
  10. • There is an Increasing incidence of child pornography and cyber-related crimes. • Cybersex is viewed as a source of income, it can be operate even within the family. • There are small-scale and large-scale international organized networks operating inside through and outside of the Philippines. • There are already a number of laws pertinent to the protection of children. Among them is Republic Act 9775 or the Anti-Child Pornography Act was enacted in 2009.
  11. • Awareness on child pornography and child protections laws is low. • Efforts/initiatives of both government and non- government are on-going, encourage/expand partnerships to other sectors like ISP, civic, business group, media others.
  13. B. RAPE TRAUMA • Rape is one of the most prevalent forms of violence against women (VAW) in the Philippines. • Reported rape cases ranked third (13.1%) of the total reported VAW cases in the country from 1999 to 2009. • The hard fact is that this is not yet the true representation of the problem. • Due to cultural and social stigmatization associated with rape, many women victims prefer to maintain their silence and not report their ordeal to the authorities.
  14. • The government with the aid of NGOs have taken initiatives to set up crisis centers for rape survivors in collaboration with the different sectors of the community to help victims deal with the trauma and encourage them to report rape. • Several rape-related laws have also been passed to address the concern. • Through the provision of suitable legal support and health services, it is hoped that women victims of rape be encouraged to come forward for proper intervention and justice to be served accordingly.
  15. Rape is committed under the following circumstances: A man has sexual intercourse with a woman: • Through force, threat or intimidation; • When the victim is deprived of reason or is unconscious; • Through fraudulent machination or grave abuse of authority; and • When the victim is under 12 years of age or is demented, even if none of the above conditions are present.
  16. Any person who, under any of the above conditions, commits an act of sexual assault through oral or anal sex or by inserting an instrument or object into the anal or genital orifice of another person. In the Philippines, there are two laws enacted that directly address rape namely: • R.A. 8353: The Anti-Rape Law of 1997 • R.A. 8505: The Rape Victim Assistance and Protection Act of 1998
  17. Rape Crisis Center The Department of Social Welfare and Development (DSWD), the Department of Health (DOH), the Department of the Interior and Local Government (DILG), the Department of Justice (DOJ), and a lead non-government organization (NGO) with proven track record or experience in handling sexual abuse cases, shall establish in every province and city a rape crisis center located in a government hospital or health clinic or in any other suitable place for the purpose of:
  18. • Providing rape victims with psychological counseling, medical and health services, including their medico-legal examination; • Securing free legal assistance or service, when necessary, for rape victims; • Assisting rape victims in the investigation to hasten the arrest of offenders and the filing of cases in court; • Ensuring the privacy and safety of rape victims; • Providing psychological counseling and medical services whenever necessary for the family of rape victims;
  19. • Developing and undertaking a training program for law enforcement officers, public prosecutors, lawyers, medico-legal officers, social workers, and barangay officials on human rights and responsibilities; gender sensitivity and legal management of rape cases; and • Adopting and implementing programs for the recovery of rape victims. The DSWD shall be the lead agency in the establishment and operation of the Rape Crisis Center.
  20. There are many influences on the manner in which each individual survivor of sexual violence copes and on the length of time the symptoms may be present. These factors include: • Support systems • The relationship with the offender • The degree of the violence used • Social and cultural influences • Previous experience with stress
  21. • Ability to cope with stress • Attitude of those immediately contacted after the assault • The age and developmental stage of the survivor (adolescent survivors are more vulnerable) It is essential that all legal, medical and police procedures must not cause further trauma to survivors who must be given all possible support to overcome and survive the ordeal.
  23. C. DOMESTIC VIOLENCE Domestic violence is threatening behavior, violence or abuse inflicted upon a woman or her child. It may be caused by the husband, ex-husband, live-in partner, boyfriend, ex-boyfriend, the father of her child or anyone with whom she has had an intimate (sexual or dating) relationship with. Acts of domestic violence are punishable by law, specifically under The Violence Against Women and their Children Act of 2004.
  24. The law enumerates certain acts which can be a ground for a criminal case. These include acts that: • cause physical harm to the woman or her child • compel a woman or her child to do something which they can choose not to do • restrict a woman or her child‘s freedom of movement through force or intimidation. This may be by depriving or threatening to deprive the woman and/or her children of financial support which they are legally entitled to
  25. • inflict physical harm on one‘s self to control a woman‘s actions or decisions • force a woman or her child to engage in any sexual activity (other than rape) • cause emotional or psychological distress to the woman or her child, such as stalking, harassing, destroying the woman‘s personal belongings, infidelity • cause mental or emotional anguish, public ridicule or humiliation. This includes verbal abuse.
  26. How widespread is domestic violence? • In 2009, the Philippine National Police (PNP) has recorded a 37.4 percent increase in reports on violence against women (VAW) from the previous year. • Physical injuries and/or wife battering account for 45.5 percent of all reported VAW cases in the last 12 years. • More than half of physical violence cases is committed by a husband or domestic partner. Sexual violence committed by the husband or domestic partner of a woman represents 60.5 percent of the reported cases.
  27. What can I do about domestic violence? • Seek immediate protection from the proper authorities. Every police station has a Women and Children Protection Desk that you can go to for help. • The DSWD can also offer you a safe place to stay if you need to leave your home for protection. There are a number of government-run shelters that can provide you with the support you need. • If you feel that reporting the incident to the proper authorities or staying in a shelter is not enough to ensure your safety, you may apply for a protection order at your barangay or in court.
  28. • While you may apply for a protection order on your own, it is best to consult with a lawyer. You may also go to the DOJ Public Attorney‘s Women‘s Desk at the Public Attorney‘s Office in your area for legal help. • Anyone who has witnessed violence against a woman and/or her child may also file a complaint. This is because the law considers violence against women and children as a public crime. This means that the victim is not the only one who may file a complaint against the abuser.
  29. Where can I go for help? • Crisis Intervention Unit • Department of Social Welfare and Development (DSWD) • Women and Children‘s Concern Division • Philippine National Police (PNP) • Violence Against Women and Children Protection Desk • National Bureau of Investigation (NBI) • Public Attorney‘s Office Women‘s Desk
  30. • Department of Justice (DOJ) • Women‘s Desk • Philippine General Hospital (PGH) • Women and Children Crisis Care and Protection Unit • East Avenue Medical Center (EAMC) There is also a Women and Children‘s Protection Desk in the police station nearest you which can provide immediate help when needed.
  31. INCEST
  32. D. INCEST • In 1995, the DSWD defined incest as sexual abuse committed against children and adults by persons related to the victims by blood. • The Bureau of Child and Youth Welfare (BCYW) expanded its definition in 1996 by including sexual abuse committed against a person by any member of the household.
  33. • The 1998 Family Code is so far the only existing legislation that has no reference to incest. But its pertinent provision (Article 37) pertains to incestuous marriages, not to incest itself: ―Marriages between the following are incestuous and void from the beginning, whether the relationship between the parties be legitimate or illegitimate: (1) Between ascendants and descendants of any degree; and (2) Between brothers and sisters, whether of full or half blood.‖
  34. • The only official document in the Philippines that defines incest is the Philippine Plan for Gender Development (PPGD). The PPGD defines incest as: ―the commission of sexually inappropriate acts or acts with sexual overtones, with a child or adolescent, by an older person or adult who wields authority through emotional bonding with that child or younger person.‖ There are three elements that recur in the existing understanding of incest. These are: • Age • Relationship • Sexual abuse
  35. Despite the varying perspectives on the abuser- victim/survivor relationship that qualifies an abuse as incest, there is a common recognition that an essential element of incest is betrayal of trust. Compared with stranger abuse, incest has a different psychological and emotional impact on the victim because of the relationship of trust between the victim- survivor and the abuser. “A child molested by a stranger can run home for help and comfort. A victim of incest cannot.”
  36. Philippine Situation: • A recent joint study by the United Nations Children's Fund (UNICEF) and the University of the Philippines Center for Women's Studies Foundation found that the culprits in a third of the reported cases of child sex abuse were relatives — usually the father or uncle. • The research indicated that 70 percent of children did not report the abuse; they suffered in silence.
  37. • A DSWD study in 2000 showed that the majority of the perpetrators of child abuse are acquaintances, followed by neighbors, and one-third are fathers of the victims. Uncles, brothers, employers, and cousins follow in the ranking. • In a report to the Philippine Congress, the DSWD disclosed: 62.5 per cent of child-abuse cases reported in the last years were not filed in court by the children's families because of loss of interest in the case. • The main reason is that the victims are ashamed of people knowing of their situation because it does not only put them to shame but all of those in the family.
  38. Senate Bill: SBN-1500: Anti-Incest Act An Act Criminalizing Incestuous Sexual Relations Filed on July 15, 2010 by Defensor Santiago, Miriam Legislative status: Pending in the Committee (9/1/2010)
  40. E. SEXUALLY TRANSMITTED INFECTIONS Sexually transmitted infections (STIs) are a public health issue • According to 2005 WHO estimates, 448 million new cases of curable STIs (syphilis, gonorrhoea, chlamydia and trichomoniasis) occur annually throughout the world in adults aged 15-49 years. • This does not include HIV and other STIs which continue to adversely affect the lives of individuals and communities worldwide. • In developing countries, STIs and their complications rank in the top five disease categories for which adults seek health care.
  41. Infections and transmission • STIs are infections that are spread primarily through person-to-person sexual contact. • Several, in particular HIV and syphilis, can also be transmitted from mother to child during pregnancy and childbirth, and through blood products and tissue transfer. • STIs are caused by bacteria, viruses and parasites. Some of the most common infections are below.
  42. Common bacterial infections: • Neisseria gonorrhea (causes gonorrhea or gonococcal infection) • Chlamydia trachomatis (causes chlamydial infections) • Treponema pallidum (causes syphilis) • Haemophilus ducreyi (causes chancroid) • Klebsiella granulomatis (previously known as Calymmatobacterium granulomatis causes granuloma inguinale or donovanosis).
  43. Common viral infections: • Human immunodeficiency virus (causes AIDS) • Herpes simplex virus type 2 (causes genital herpes) • Human papillomavirus (causes genital warts and certain subtypes lead to cervical cancer in women) • Hepatitis B virus (causes hepatitis and chronic cases may lead to cancer of the liver) • Cytomegalovirus (causes inflammation in a number of organs including the brain, the eye, and the bowel).
  44. Parasites: • Trichomonas vaginalis (causes vaginal trichomoniasis) • Candida albicans (causes vulvovaginitis in women; inflammation of the glans penis and foreskin [balano-posthitis] in men).
  45. The main syndromes of common STIs are: • urethral discharge • genital ulcers • inguinal swellings (bubo, which is a swelling in the groin) • scrotal swelling • vaginal discharge • lower abdominal pain • neonatal eye infections (conjunctivitis of the newborn).
  46. STI syndromic approach to patient management: • The traditional method of diagnosing STIs is by laboratory tests. However, these are often unavailable or too expensive. • Since 1990 WHO has recommended a syndromic approach to diagnosis and management of STIs in patients presenting with consistently recognized signs and symptoms of particular STIs. • The syndromic approach uses flowcharts to guide diagnosis and treatment is more accurate than diagnosis based on clinical tests alone, even in experienced hands.
  47. • The syndromic approach is a scientific approach and offers accessible and immediate treatment that is effective. It is also more cost- effective for some syndromes than use of laboratory tests. • The pathogens causing any particular syndrome need to be determined locally and flow charts adapted accordingly. Furthermore, regular monitoring of the organisms causing each syndrome should be conducted on a regular basis to validate the treatment recommendations.
  48. Prevention • The most effective means to avoid becoming infected with or transmitting a sexually transmitted infection is to abstain from sexual intercourse or to have sexual intercourse only within a long-term, mutually monogamous relationship with an uninfected partner. • Male latex condoms, when used consistently and correctly, are highly effective in reducing the transmission of HIV and other sexually transmitted infections, including gonorrhea, chlamydial infection and trichomoniasis.
  49. WHO response: • The control of STIs is a priority for WHO. The World Health Assembly endorsed the global strategy for the prevention and control of STIs in May 2006. • More recently, the United Nations Secretary- General Global Strategy for Women's and Children's Health highlighted the need for a comprehensive, integrated package of essential interventions and services.
  50. • The Strategy urges partners to ensure that women and children have access to a universal package of guaranteed benefits, including family-planning information and services, antenatal, newborn and postnatal care, emergency obstetric and newborn care and the prevention of HIV and other sexually transmitted infections. • Such a package could accelerate the response towards meeting the lagging health-related Millennium Development Goals.
  52. F. ILLEGAL SEX • Prostitution in the Philippines is illegal. It is a serious crime with penalties ranging up to life imprisonment for those involved in trafficking. • It is covered by the Anti-Trafficking in Persons Act. • Prostitution is sometimes illegally available through brothels (also known as casa), bars, karaoke bars (also known as KTVs), massage parlors, street walkers and escort services. • As of 2009, one source estimated that there were 800,000 women working as prostitutes in the Philippines, with some of them believed to be underage.
  53. Violence and coercion against prostitutes • Women and children involved in prostitution are vulnerable to rape, murder, AIDS and other sexually transmitted diseases. • Surveys of women working as masseuses indicated that 34 percent of them explained their choice of work as necessary to support poor parents, 8 percent to support siblings and 28 percent to support husbands or boyfriends. • More than 20 percent said the job was well paid, but only 2 percent said it was easy work and only 2 percent claimed to enjoy the work.
  54. • Over a third reported that they had been subject to violence or harassment, most commonly from the police, but also from city officials and gangsters. • A survey conducted by the International Labor Organization revealed that in the experience of most of the women surveyed, prostitution is one of the most alienating forms of labor.
  55. • Over 50 percent of the women surveyed in Philippine massage parlors said they carried out their work ―with a heavy heart,‖ and 20 percent said they were ―conscience-stricken because they still considered sex with customers a sin.‖ • Interviews with Philippine bar girls revealed that more than half of them felt ―nothing‖ when they had sex with a client, the remainder said the transactions saddened them.
  57. G. SEXUAL HARASSMENT As defined by the Philippine Anti-Sexual Harassment Act of 1995, sexual harassment is ―a request for a sexual favor, accepted or not, from an employer, employee, manager, teacher, instructor, professor, coach, trainer or other persons who have authority, influence or moral ascendancy over another.‖ It is committed by anyone who demands a sexual favor in exchange for work, promotion or other privileges. The Sexual Harassment Act not only covers those who are directly involved but also those who cooperate ―in the commission of‖ the violation.
  58. In a work-related environment, sexual harassment is committed when: • The sexual favor is made as a condition in the hiring or in the employment, re-employment or continued employment of an individual; • Granting an individual favorable compensation, terms, conditions, promotions or privileges, or • The refusal to grant sexual favor results in the limiting, segregating or classifying the employee which in any way would discriminate, deprive or diminish employment opportunities or otherwise adversely affect said employee.
  59. What to do in case of sexual harassment? 1. Say ‗No‘ or ‗Stop it‘ firmly and loud enough for someone to hear. 2. Document the event/s. 3. Inform someone about what happened. 4. File a complaint. ***If your case is ignored and you wish to pursue it, then you might want to go to the police and file a report. Be prepared for a more taxing process, though. If you want justice, you‘ll need a lawyer and the judicial procedures can take a while.
  61. H. SEPARATION ANNULMENT, DIVORCE AND LEGAL SEPARATION IN THE PHILIPPINES Is divorce allowed under Philippine laws? No, divorce is not allowed in the Philippines. However, there are certain instances wherein the divorce secured abroad by the foreigner-spouse, and even by former Filipinos, are recognized under Philippine laws. .
  62. Is “annulment” different from a “declaration of nullity” of marriage? Yes. In essence, ―annulment‖ applies to a marriage that is considered valid, but there are grounds to nullify it. A ―declaration of nullity‖ of marriage, on the other hand, applies to marriages that are void or invalid from the very beginning. In other words, it was never valid in the first place.
  63. So, if a marriage is void from the very beginning (void ab initio), there’s no need to file anything in court? For purposes of remarriage, there must be a court order declaring the marriage as null and void. Entering into a subsequent marriage without such court declaration means that: (a) the subsequent marriage is void; and (b) the parties open themselves to a possible charge of bigamy.
  64. What are the grounds for annulment? • Lack of parental consent in certain cases. • Insanity. • Fraud. • Force • Impotence • STD
  65. What if a spouse discovers that his/her spouse is a homosexual or is violent, can he/she ask for annulment? Homosexuality or physical violence, by themselves, are not sufficient to nullify a marriage. At the very least, however, these grounds may be used as basis for legal separation. How is “legal separation” different from annulment? The basic difference is this – in legal separation, the spouses are still considered married to each other, and, thus, may not remarry
  66. What are the grounds for legal separation? • Repeated physical violence or grossly abusive conduct directed against the petitioner, a common child, or a child of the petitioner. • Physical violence or moral pressure to compel the petitioner to change religious or political affiliation. • Attempt of respondent to corrupt or induce the petitioner, a common child, or a child of the petitioner, to engage in prostitution, or connivance in such corruption or inducement.
  67. • Final judgment sentencing the respondent to imprisonment of more than six years, even if pardoned. • Drug addiction or habitual alcoholism of the respondent. • Lesbianism or homosexuality of the respondent. • Contracting by the respondent of a subsequent bigamous marriage, whether in the Philippines or abroad.
  68. • Sexual infidelity or perversion. • Attempt by the respondent against the life of the petitioner. • Abandonment of petitioner by respondent without justifiable cause for more than one year. The term ―child‖ shall include a child by nature or by adoption.
  69. If you’re separated from your spouse for 4 years, is that a sufficient ground for annulment? No. De facto separation is not a ground for annulment. However, the absence of 2 or 4 years, depending on the circumstances, may be enough to ask the court for a declaration of presumptive death of the ―absent spouse‖, in which case the petitioner may again re-marry.
  70. What are the grounds for declaration of nullity of marriage? • Minority • Lack of authority of solemnizing officer • Absence of marriage license (except in certain cases). • Bigamous or polygamous marriages (except in cases where the other spouse is declared as presumptively dead). • Mistake in identity (those contracted through mistake of one contracting party as to the identity of the other).
  71. • After securing a judgement of annulment or of asolute nullity of mariage, the parties, before entering into the subsequent marriage, failed to record with the appropriate registry the: (i) partition and distribute the properties of the first marriage; and (ii) delivery of the children‘s presumptive legitime. • Incestous • Void by reason of public policy • Psychological Incapacity.
  73. LOSS Abortions in the world • An abortion is the termination of a pregnancy by the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. An abortion can occur spontaneously due to complications during pregnancy or can be induced. • Abortion as a term most commonly - and in the statistics presented here - refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages.
  74. • The data on abortions displayed on the Worldometers' counter is based on the latest statistics on worldwide abortions published by the World Health Organization (WHO). • According to WHO, every year in the world an estimated 40-50 million women faced with an unplanned pregnancy decide to have an abortion. This corresponds to approximately 125,000 abortions per day. • In the USA, where nearly half of pregnancies are unintended, and four in 10 of these are terminated by abortion there are over 3,000 abortions per day. Twenty-two percent of all pregnancies in the USA (excluding miscarriages) end in abortion.
  75. Abortion in the Philippines • The basic status of Abortion in the Philippines is that it is illegal, or banned by rule of law. • Article II of the 1987 Philippine Constitution says, in part, "Section 12. The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception.
  76. • The act is criminalized by the Revised Penal Code of the Philippines, which was enacted in 1930 and remains in effect today. Articles 256, 258 and 259 of the Code mandate imprisonment for the woman who undergoes the abortion, as well as for any person who assists in the procedure, even if they be the woman's parents, a physician or midwife. Article 258 further imposes a higher prison term on the woman or her parents if the abortion is undertaken "in order to conceal [the woman's] dishonor".
  77. • There is no law in the Philippines that expressly authorizes abortions in order to save the woman's life; and the general provisions which do penalize abortion make no qualifications if the woman's life is endangered. • Proposals to liberalize Philippine abortion laws have been opposed by the Catholic Church, and its opposition has considerable influence in the predominantly Catholic country. • One study estimated that, despite legal restrictions, in 1994 there were 400,000 abortions performed illegally in the Philippines and 80,000 hospitalizations of women for abortion-related complications.
  78. • It was reported in 2005 that official estimates then ranged from 400,000 to 500,000 and rising, and that the World Health Organization estimate was 800,000. Seventy percent of unwanted pregnancies in the Philippines end in abortion, according to the WHO. • Approximately 4 in 5 abortions in the Philippines are for economic reasons, often where a woman already has several children and cannot care for another. • While some doctors secretly perform abortions in clinics, the 2,000 to 5,000 peso (USD $37 to $93) fee is too high for many Filipinos, so they instead buy abortifacients on the black market, e.g. from vendors near churches.
  79. • Two-thirds of Filipino women who have abortions attempt to self-induce or seek solutions from those who practice folk medicine.100,000 people end up in the hospital every year due to unsafe abortions, according to the Department of Health , and 12% of all maternal deaths in 1994 were due to unsafe abortion. • Some hospitals refuse to treat complications of unsafe abortion, or operate without anesthesia, as punishment for the patients. • The Department of Health has created a program to address the complications of unsafe abortion, Prevention and Management of Abortion and its Complications.
  81. I. DESEXUALIZATION • Women‘s sexuality has been used to remove women‘s power for decades. Desexualization of women take away a woman‘s power by only focusing on her sexuality instead of her whole self. • A very severe, yet common case of the desexualization of women is female genital mutilation. .
  82. • About 140 million girls and women worldwide are currently living with the consequences of FGM. • FGM is mostly carried out on young girls sometime between infancy and age 15. • In Africa an estimated 101 million girls 10 years old and above have undergone FGM. • FGM is a violation of the human rights of girls and women. • Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.
  83. Female genital mutilation Key facts: • Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. • The procedure has no health benefits for girls and women. • Procedures can cause severe bleeding and problems urinating, and later cysts, infections, infertility as well as complications in childbirth increased risk of newborn deaths.
  84. • The practice is mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirths. However, more than 18% of all FGM is performed by health care providers, and this trend is increasing. WHO response • In 2008, the World Health Assembly passed a resolution (WHA61.16) on the elimination of FGM, emphasizing the need for concerted action in all sectors - health, education, finance, justice and women's affairs.
  85. WHO efforts to eliminate female genital mutilation focus on: • strengthening the health sector response: guidelines, training and policy to ensure that health professionals can provide medical care and counseling to girls and women living with FGM; • building evidence: generating knowledge about the causes and consequences of the practice, how to eliminate it, and how to care for those who have experienced FGM; • increasing advocacy: developing publications and advocacy tools for international, regional and local efforts to end FGM within a generation.
  86. WHO is particularly concerned about the increasing trend for medically trained personnel to perform FGM. WHO strongly urges health professionals not to perform such procedures.
  87. AGING PROCESS (Sexuality and Aging)
  88. J. AGING PROCESS (Sexuality and Aging) Sexual health is important at any age. And the desire for intimacy is timeless. While sex may not be the same as it was in your 20s, it can still be as fulfilling as ever. Communication is key To maintain a satisfying sex life, talk with your partner. Set aside time to be sensual and sexual together. When you're spending intimate time with your partner, share your thoughts about lovemaking. Help your partner understand what you want from him or her. Be honest about what you're experiencing physically and emotionally.
  89. Aging and men's sexual health • Testosterone plays a critical role in a man's sexual experience. • Testosterone levels peak in the late teens and then gradually decline. • Most men notice a difference in their sexual response by age 60 to 65.
  90. • The penis may take longer to become erect, and erections may not be as firm. • It may take longer to achieve full arousal and to have orgasmic and ejaculatory experiences. • Erectile dysfunction also becomes more common. Several medications are available to help men achieve or sustain an adequate erection for sexual activity.
  91. Aging and women's sexual health • As women approach menopause, their estrogen levels decrease, which may lead to vaginal dryness and slower sexual arousal. • Women may experience emotional changes as well. • While some women may enjoy sex more without worrying about pregnancy, naturally occurring changes in body shape and size may cause others to feel less sexually desirable.
  92. Medical conditions and sexual health • Any condition that affects your general health and well-being may also affect your sexual health. • Illnesses that involve the cardiovascular system, high blood pressure, diabetes, hormonal problems, depression or anxiety — and the medications used to treat these conditions — can pose challenges to being sexually active.
  93. • High blood pressure, for instance, can affect your ability to become aroused, as can certain medications used to treat high blood pressure. • In addition, any surgical procedure that affects your pelvis and your central nervous system will have a temporary — but often significant — impact on your sexual response. • The body, however, is resilient. Given time to heal and some loving attention, you can become sexually responsive again
  94. Looking forward not back Many couples want to know how to get back to the sexual arousal and activity levels they experienced in their 20s, 30s and early 40s. Instead, find ways to optimize your body's response for sexual experiences now. Ask yourselves what's satisfying and mutually acceptable. Many books are available about how to maintain a healthy sex life as you get older. In addition, many couples find consulting with an expert helpful. Your doctor may be able to provide useful suggestions or refer you to a specialist.
  95. Thank you!!! BARROGA, Marilyn Richelle DIGUEL, Brenda Lee GRAGERA, Jennifer C. LA MADRID, Cyprene Grail MASIGMAN, Mary Ann PAESTE, Gloria SERRANO, Cecille VALENTON, Kathleen Anne Marie