about normal human sexuality

1. NORMAL
SEXUALITY
Dr. Subodh Sharma
Resident
Department of Psychiatry
NMCTH, Birgunj, Nepal

2. Introduction
Human sexuality is the way people experience and express
themselves sexually.
This involves biological, psychological, physical, erotic, emotional, social,
or spiritual feelings and behaviors.
Because it is a broad term, which has varied with historical contexts over
time, it lacks a precise definition.

3. Sexuality is determined by anatomy,
physiology, the culture in which a
person lives, relationships with
others, developmental experiences
throughout the life cycle
Normal sexual behaviour brings
pleasure to oneself and one's partner,
involves stimulation of the primary
sex organs including coitus.
Introduction

4. PSYCHOSEXUAL FACTORS
sexual
identity
gender
identity
sexual
orientation
sexual
behaviour.

5. Cultural factors

6. • Most sexual learning
experiences in childhood
occur without the parents'
knowledge, but awareness of
a child's sex does influence
parental behaviour.
• Male infants, for instance,
tend to be handled more
vigorously and female infants
tend to be cuddled more.
Childhood
Sexuality

7. Sexual Identity and Gender Identity
• Sexual identity is the pattern of a person's biological sexual
characteristics.
• chromosomes, external genitalia, internal genitalia, hormonal
composition, gonads, secondary sex characteristics
• Gender identity is a person's sense of maleness or femaleness.

9.  Differentiation of male and female
external genitalia from indifferent
primordia.
o Male differentiation occurs only in
the presence of androgenic
stimulation during the first 12
weeks of fetal life.

10. Classification of
Intersexual Disorders

11. Gender Role
A gender role is not established at birth but is built up cumulatively
through
• experiences encountered and transacted through casual and unplanned learning
• explicit instruction and inculcation
• spontaneously putting two and two together to make sometimes four and sometimes five.
Persons' gender roles can seem to be opposed to their gender identities.
Persons may identify with their own sex and yet adopt the dress, hairstyle,
or other characteristics of the opposite sex

13. • Sexual orientation
describes the object of a
person's sexual impulses:
• heterosexual (opposite
sex),
• homosexual (same sex),
• bisexual (both sexes).
• A group of people have
defined themselves as
asexual and assert this as
a positive identity.
Sexual
Orientation

16. The Brain Cortex - is involved both in controlling sexual impulses and in
processing sexual stimuli that may lead to sexual activity
The limbic system - is directly involved with elements of sexual functioning.
The anterior thalamic nuclei have all elicited penile erections.
Brainstem - sites exert inhibitory and excitatory control over spinal sexual
reflexes.
Brain Neurotransmitters - including dopamine, epinephrine, norepinephrine,
and serotonin, are produced in the brain and affect sexual function.
• Dopamine - increase libido.
• Serotonin - inhibitory effect on sexual function.
• Spinal Cord Sexual arousal and climax are ultimately organized at the spinal level.
The Central Nervous System and Sexual Behavior

17. Physiological Responses
Phase 1
Desire
Phase 2
Excitement
Phase 3
Orgasm
Phase 4
Resolution
o William Masters and Virginia Johnson observed that the physiological process
involves increasing levels of vasocongestion and myotonia (tumescence) and the
subsequent release of the vascular activity and muscle tone as a result of orgasm
(detumescence).

18. • The classification of the desire (or appetitive) phase,
which is distinct from any phase identified solely
through physiology, reflects the psychiatric concern
with motivations, drives, and personality.
• The phase is characterized by sexual fantasies and
the desire to have sexual
Phase 1:
Desire
• The excitement and arousal phase, brought on by
psychological stimulation (fantasy or the presence of
a love object) or physiological stimulation (stroking
or kissing) or a combination of the two, consists of a
subjective sense of pleasure.
Phase 2:
Excitement

19. • The orgasm phase consists of a peaking of sexual pleasure, with the
release of sexual tension and the rhythmic contraction of the
perineal muscles and the pelvic reproductive organs.
• A subjective sense of ejaculatory inevitability triggers men's
orgasms. The forceful emission of semen follows
• In women, orgasm is characterized by 3 to 15 involuntary
contractions of the lower third of the vagina and by strong sustained
contractions of the uterus, flowing from the
Phase 3:
Orgasm
• Resolution consists of the disgorgement of blood from the genitalia
(detumescence), which brings the body back to its resting state.
• Women do not have a refractory period and are capable of multiple
and successive orgasms.
Phase 4:
Resolution

20. Sexual Response Cycle

21. Hormones and Sexual Behavior
• Substances that increase dopamine levels in the brain increase desire, whereas
substances that augment serotonin decrease desire.
• Progesterone mildly depresses desire in men and women as do excessive
prolactin and cortisol.
• Oxytocin is involved in pleasurable sensations during sex and is found in higher
levels in men and women following org

23. • Masturbation is usually a normal precursor of object-
related sexual behaviour.
• When coitus is unsatisfactory or is unavailable because
of illness or the absence of the partner, self-stimulation
often serves an adaptive purpose, combining sensual
pleasure and tension release.
• Kinsey reported that when women masturbate, most
prefer clitoral stimulation.
• Masters and Johnson stated that women prefer the shaft
of the clitoris to the glans because the glans is
hypersensitive to intense stimulation.
• Most men masturbate by vigorously stroking the penile
shaft and glans.
Masturbation

24. Homosexuality
The term homosexuality often describes a person's overt behaviour,
sexual orientation, and sense of personal or social identity.
Many persons prefer to identify sexual orientation by using terms such
as lesbians and gay men, rather than homosexual, which may imply
pathology and etiology based on its origin as a medical term, and refer
to sexual behavior with terms such as same sex and male female.
• 2 to 4 percent of the population
• According to Kinsey's data, about half of all
prepubertal boys have had some genital
experience with a male partner.
Prevalence

25. • Psychological Factors
• According to psychodynamic theory, early-life
situations that can result in male homosexual
behaviour include
• a strong fixation on the mother
• lack of effective fathering
• inhibition of masculine development by the
parents;
• fixation at, or regression to the narcissistic
stage of development
• losses when competing with brothers and
sisters
Theoretical
Issues of
Homosexuality

26. • According to Richard Isay, gay men have
described same- sex fantasies that occurred
when they were 3 to 5 years of age, at about
the same age that heterosexuals have male-
female fantasies.
• The child's perception of, and exposure to,
these erotic feelings may account for such
atypical behaviour as greater secretiveness
than other boys, self-isolation, excessive
emotionality.
New Concepts
of
Psychoanalytic
Factors

27. • Gay men - lower levels of circulatory
androgens
• higher incidence of homosexual
concordance among monozygotic
twins
• a familial distribution
• a group of cells in the hypothalamus
was smaller in women and in gay
men
• Women with hyperadrenocorticalism
are lesbian and bisexual
Biological
Factors

28. • The behavioural features of gay men and lesbian
women are as varied as those of heterosexuals
Sexual Behavior
Patterns
• The range of psychopathology that may be found
among distressed lesbians and gay men parallels
that found among heterosexuals.
• Some gay men and lesbians with major depressive
disorder may experience guilt and self- hatred that
become directed toward their sexual orientation
Psychopathology

29. • Mature love is marked by the
intimacy that is a special attribute of
the relationship between two persons
• Sex frequently acts as a catalyst in
forming and maintaining intimate
relationships.
• The quality of intimacy in a mature
sexual relationship is what Rollo
May called active receiving in which
a person, while loving, permits
himself or herself to be loved
Love
and
Intimacy

30. • Medicine and the law both assess the
impact of sexuality on the individual
and society and determine what is
healthy or legal behaviour.
• Include abortion, pornography,
prostitution, sex education, the
treatment of sex offenders, and the
right to sexual privacy, among other
issues.
Sex
and
the
Law

31. References
• Kaplan and Sadock’s Synopsis of Psychiatry; 12th edition.
• The Psychology of Human Sexuality, Justin J. Lehmiller, 2014 1st edition.
• Images from internet.

32. Thank You!