the Sexual Self

1. STUDY GUIDE – SEXUAL SELF
Development of secondary sex characteristics and the human reproductive system
Soon after the fertilization of an egg, the development of the reproductive system begins.
For example, approximately one month after conception primordial gonads also begin to develop.
Rapid reproductive development happens inside the mother’s womb; but when the child is born
up until puberty, there is little change in the reproductive system.
Development of the Sexual Organs in the Embryo and Fetus
The female sex is considered the “Fundamental” sex because if a particular chemical
prompting was absent, all fertilized egg will develop into females. For a fertilized egg to become
male, a cascade of chemical reactions must be present initiated by a single gene in the male Y
chromosome called the SRY (Sex determining Region of the Y chromosome). Females do not
have a Y chromosome, hence, they do not have the SRY gene. (Lumen Learning Courses, WEB)
Both the male and female embryos have the same group of cells that will potentially
develop into male or female gonads or sex glands. However, the presence of the SRY gene
initiates the development of the testes while suppressing the vital genes for female
development.
Further Sexual Development Occurs at Puberty
Puberty is the stage of development at which individuals become sexually mature. The
outcome of puberty is different for boys and girls, but the hormonal process is similar. Moreover,
though the timing of these changes varies for every individual, the sequence of changes for boys
and girls is predictable resulting in adult physical characteristics and the capacity to reproduce.
Puberty can be separated into five stages. The characteristics for each stage vary for girls
and boys.
Stages PUBERTY STAGES IN GIRLS PUBERTY STAGES IN BOYS
1
Approximately between the ages of 8
and 11:
The ovaries enlarge and hormone
production starts, but external
development is not yet visible.
Approximately between ages 9 and 12:
No visible signs of development occur;
but internally, male hormones become a
lot more active. Sometimes a growth
spurt begins at this time.

2. 2
Approximately between the ages of 8
and 14:
The first external sign of puberty is
usually breast development.
At first breast buds develop. The
nipples will be tender and elevated.
The area around the nipple (the
aureole) will increase in size.
The first stage of pubic hair may also
be present at this time. It may be
coarse and curly or fine and straight.
Height and weight increase at this
time. The body gets rounder and
curvier.
Approximately between ages 9 to 15:
Height increases and the shape of the
body changes.
Muscle tissue and fat develop at this
time.
The aureole, the dark skin around the
nipple, darkens and increases in size.
The testicles and scrotum grow, but the
penis probably does not.
A little bit of pubic hair begins to grow at
the base of the penis.
3
Approximately between the ages of 9
and 15:
Breast growth continues and pubic hair
gets coarser and darker.
During this stage, whitish discharge
from the vagina may be present.
Approximately between ages 11 and 16
The penis starts to grow during this
stage. It tends to grow in length rather
than width.
Pubic hair is getting darker and coarser
and spreading to where the legs meet
the torso.

3. For some girls, the first menstrual
period begins at this time.
Also, boys continue to grow in height,
and even their faces begin to appear
more mature.
The shoulders broaden, making the hips
look smaller.
Muscle tissue increases and the voice
starts to change and deepen.
Finally, facial hair begins to develop on
the upper lip.
4
Approximately from ages 10 to 16:
Some girls notice that their aureoles
get even darker and separate into a
little mound rising above the rest of the
breast.
Pubic hair may begin to have a more
adult triangular pattern of growth.
If it did not happen in Stage Three,
menarche (first menstruation) should
start now.
Ovulation may start now, too. But it will
not necessarily occur on a regular
basis. (It is possible to have regular
Approximately 11 to 17:
At this time, the penis starts to grow in
width, too.
The testicles and scrotum also continue
to grow. Hair may begin to grow on the
anus.
The texture of the penis becomes more
adult-looking. Underarm and facial hair
increases as well.
The first fertile ejaculations typically
appear at approximately 15 years of

4. periods even if ovulation does not
occur every month.)
age, but this age can vary widely across
individual boys.
Skin gets oilier, and the voice continues
to deepen.
5
Approximately between ages 12 and
19:
This is the final stage of development.
Full height is reached, and young
women are ovulating regularly.
Pubic hair is filled in, and the breasts
are developed fully for the body.
Approximately 14 to 18:
Boys reach their full adult height.
Pubic hair and the genitals look like an
adult man's do.
At this point, too, shaving is a necessity.
Some young men continue to grow past
this point, even into their twenties.
http://www.healthofchildren.com/P/Puberty.html
What are the erogenous zones of the body?
The term erogenous zones was popularized in the 1960s and 1970s to describe areas
of the body that are highly sensitive to stimuli and are often (but not always) sexually exciting. In
this context, “highly sensitive” means these areas of the body have a high number of sensory
receptors or nerve endings that react to stimuli. These are places where a person is generally
more sensitive to both pain and pleasure than in other areas of the body. Professionals usually
discuss sensuality in terms of the complex stimuli and associations that give rise to an
appreciative response.
The Skin
The skin serves as primary erotic stimulus. Two types of erogenous zones exist in the skin
(Winkelmann, 2004):

5. • Nonspecific type
o It is similar to any other portion of the usual haired skin.
o The nerves supplying it are composed of the usual density of dermal-nerve
networks and hair-follicle networks.
o The learned and anticipated pleasurable sensations when a stimulus is presented
in these regions produce the amplified sensation.
o The pleasurable sensation felt from these regions is simply an exaggerated form
of tickle.
o Examples of this type of skin are the sides and back of the neck, the axilla (armpit,
underarm) and the sides of the thorax (chest).
• Specific type
o It is found in the mucocutaneous regions of the body or those regions made both
of mucous membrane and of cutaneous skin.
o These regions favor acute perception.
o These specific sites of acute sensation are the genital regions including the
prepuce, penis, the female external genitalia (vulva), the perianal skin, lips,
and nipples.
The prepuce is the retractable fold of skin covering the tip of the penis. Nontechnical
name: foreskin. It is also a similar fold of skin covering the tip of the clitoris. (Collins English
Dictionary)
The penis is a male erectile organ of copulation by which urine and semen are discharged
from the body (Splendorioand Reichel, 2014).
Female external genitalia (vulva) include:
• The mons pubis.
• The clitoris. A female sexual organ that is small, sensitive, and located in front of
the opening of the vagina.
• The labia majora and labia minora. The labia majora are fleshy lips around the
vagina. These are larger outer folds of the vulva.The labia minora also known as
the inner labia, inner lips, vaginal lips or nymphae are two flaps of skin on either
side of the human vaginal opening in the vulva situated between the labia majora.
• Vaginal introitus is the opening that leads to the vaginal canal.
• The hymen is a membrane that surrounds or partially covers the external vaginal
opening.
(Human Reproductive Biology, 2012)
Perianal skin refers the area of the body surrounding the anus, and in particular, the skin.
The perianal skin is very sensitive. It is also susceptible to injury and damage.
The lips are soft, movable, and serve as the opening for food intake and in the articulation
of sound and speech. Human lips are designed to be perceived by touch, and can be an
erogenous zone when used in kissing and other acts of intimacy.

6. Nipples are the raised region of tissue on the surface of the breast. A recent study found
that the sensation from the nipples travels to the same part of the brain as sensations from the
vagina, clitoris, and cervix. (Pappas, 2011)
Bear in mind though that not only is individual sensitivity different (what feels great for you
or one person does not mean others will like it too) but how your brain interprets what is happening
with the given part of the body influences your sexual response as well. For example, even if a
particular part of the body is packed with sensory nerve receptors, stimulation of this part may
feel unpleasant if you had negative experiences or you have negative ideas about that given part
of the body.
Understanding the Human Sexual Response
What is the sexual response cycle? The sexual response cycle refers to the sequence
of physical and emotional occurrences when the person is participating in a sexually stimulating
activity such as intercourse or masturbation (Cleveland Clinic, WEB).
Knowing how the body responds during each phase of the cycle can help enhance a
couple’s sexual relationship and it can also help address the cause of sexual dysfunction.
In general, both men and women experience these phases. However, they do not
experience it at the same time. For example, it is unlikely that a couple will orgasm simultaneously.
Moreover, the intensity of the sensation and the time spent in each phase also vary from person
to person.
In the late 1950s, William Masters and Virginia Johnson pioneered research to understand
human sexual response, dysfunction, and disorders. Masters and Johnson have been widely
recognized for their contributions to sexual, psychological, and psychiatric research, particularly
for their theory of a four-stage model of sexual response (also known as, the human sexual
response cycle).
4 phases of the human sexual response cycle:
1. Excitement
2. Plateau
3. Orgasm
4. Resolution
Phases General Characteristics
• Muscle tension increases.
• Heart rate quickens and breathing is accelerated.

7. Phase 1:
Excitement
• Skin may become flushed (blotches of redness appear on the chest
and back).
• Nipples become hardened or erect.
• Blood flow to the genitals increases, resulting in swelling of the
woman’s clitoris and labia minora (inner lips), and erection of the
man’s penis.
• Vaginal lubrication begins.
• The woman’s breasts become fuller and the vaginal walls begin to
swell.
• The man’s testicles swell, his scrotum tightens, and he begins
secreting a lubricating liquid.
Phase 2:
Plateau
• The changes begun in phase 1 are intensified.
• The vagina continues to swell from increased blood flow, and the
vaginal walls turn a dark purple.
• The woman’s clitoris becomes highly sensitive (may even be painful
to touch) and retracts under the clitoral hood to avoid direct stimulation
from the penis.
• The man’s testicles are withdrawn up into the scrotum.
• Breathing, heart rate and blood pressure continue to increase.
• Muscle spasms may begin in the feet, face and hands.
• Tension in the muscles increases.
Phase 3:
Orgasm
This phase is the climax of the sexual response cycle. It is the shortest of the
phases and generally lasts only a few seconds. General characteristics of this
phase include the following:
• Involuntary muscle contractions begin.
• Blood pressure, heart rate and breathing are at their highest rates,
with a rapid intake of oxygen.
• Muscles in the feet spasm.
• There is a sudden, forceful release of sexual tension.
• In women, the muscles of the vagina contract. The uterus also
undergoes rhythmic contractions.
• In men, rhythmic contractions of the muscles at the base of the penis
result in the ejaculation of semen.
• A rash or "sex flush" may appear over the entire body.
Phase 4:
Resolution
During this phase, the body slowly returns to its normal functioning level.
The swelled and erect body parts return to its previous size and color. This
phase is marked by a general sense of well-being; intimacy is enhanced; and
often, fatigue sets in.
With further sexual stimulation, some women can return to the orgasm
phase. This allows them to experience multiple orgasms. Men, on the other

8. hand, need recovery time after orgasm. This is called the refractory period.
How long a man needs a refractory period varies among men and his age.
Source:https://my.clevelandclinic.org/health/articles/the-sexual-response-cycle
Sex and the Brain. What parts are involved?
Primarily, sex is the process of combining male and female genes to form an offspring.
However, complex systems of behavior have evolved the sexual process from its primary purpose
of reproduction to motivation and rewards circuit that root sexual behaviors.
Ultimately, the largest sex organ controlling the biological urges, mental processes, as
well as the emotional and physical responses to sex is the brain.
Roles of the brain in sexual activity:
1. The brain is responsible for translating the nerve impulses sensed by the skin into
pleasurable sensations.
2. It controls the nerves and muscles used in sexual activities.
3. Sexual thoughts and fantasies is theorized to lie in the cerebral cortex, the same area
used for thinking and reasoning.
4. Emotions and feelings (which are important for sexual behavior) is believed to originate in
the limbic system.
5. The brain releases the hormones considered as the physiological origin of sexual desire.
Roles of hormones in sexual activity:
The hypothalamus is the most important part of the brain for sexual functioning. This small
area at the base of the brain has of several groups of nerve-cell bodies that receive input from
the limbic system. One reason why the hypothalamus is important in human sexual activity is its
relation to the pituitary gland. The pituitary gland secretes the hormones produced in the
hypothalamus.
1. Oxytocin
Also known as the “love hormone” and believed to be involved in our desire to
maintain close relationships. It is released during sexual intercourse when orgasm is
achieved.
2. Follicle-stimulating hormone (FSH)
It is responsible for ovulation in females. The National Institute of Environmental
Health Sciences in Durham, N.C., discovered that sexual activity was more frequent
during a woman’s fertile time.
3. Luteinizing hormone (LH)

9. The LH is crucial regulating the tested in men and ovaries in women. In men, the
LH stimulates the testes to produce testosterone. In males, testosterone appears to be
a major contributing factor to sexual motivation.
4. Vasopressin
Vasopressin is involved in the male arousal phase. The increase of vasopressin
during erectile response is believed to be directly associated with increased motivation to
engage in sexual behavior.
5. Estrogen and progesterone
Estrogen and progesterone typically regulate motivation to engage in sexual behavior for
females, with estrogen increasing motivation and progesterone decreasing it.
(Boundless Psychology, courses.lumenlearning.com)
Understanding the Chemistry of Lust, Love, and Attachment
Falling in love can be a beautifully wild experience. It is a rush of longing, passion, and
euphoria. Fast forward a few years, and the excitement would have died down (though the levels
vary for every couple). For couples who remain together through the years, the rush would have
been replaced by a warm, comfortable, and nurturing feeling.
Each stage of this cycle can actually be explained by your brain chemistry – the
neurotransmitters that get stimulated to release hormones throughout your body.
Anthropologist Helen Fisher of Rutgers University proposed three stages of falling in love;
and for each stage, a different set of chemical run the show.
The three stages of falling in love:
1. Lust (erotic passion)
2. Attraction (romantic passion)
3. Attachment (commitment)
Lust
The first phase of falling in love is the lust or the desire phase. Lust is the craving for sexual
satisfaction which is a feeling that evolved in humans to motivate union with a single
partner. During this phase, men and women both release healthy amounts of testosterone
and estrogen.

10. In females, estrogen plays a role in vaginal health, longing for physical closeness with a
mate, and the desire for sex. In both male and females (but more so in men), testosterone
drives sexual desire, openness and seductiveness.
Regardless of gender when these hormones are present at healthy levels, the reproductive
system is regulated, energy levels increase, and sex drive is heightened. Pheromones,
which are odorless chemicals produced by humans and detected by the nose of other
humans, also play a role in the lust phase because they help to initiate the initial desire.
During this phase, the primary objective is to have sex rather than form an emotional
connection.
Attraction
Scientists have found evidence that adrenaline, dopamine and serotonin are involved in
the attraction phase.
Adrenaline is a hormone that is released during the human stress response and also plays
a role in enhancing attraction and arousal of humans. This hormone causes the heart to
beat faster and stronger, results in a surge of energy and focuses attention onto solely
onto your potential mate. It can also heighten feelings of anxiety or nervousness and
butterflies in the stomach.
Dopamine is a hormone that plays a role in motivation, addiction, attention and desire.
Once released, this chemical messenger produces a feeling of happiness and bliss.
Dopamine is also released in response to cocaine and sugar which are both incredibly
addictive. During the lust phase, dopamine levels increase which may essentially lead to
an addiction to the person that is desired. High levels of dopamine are also associated with
norepinephrine which is another chemical messenger that increases excitement and focus
on another individual.
Serotonin is a hormone which acts as a neurotransmitter and plays a role in maintaining
mood balance, appetite, sleep, memory, sexual desire and sexual function. During the
attraction phase, serotonin levels decrease which can result in sleeplessness. Low levels
of serotonin have also been linked to individuals with Obsessive-Compulsive Disorder and
may also be the reason why individuals in the attraction phase of love obsessively thinks
about their potential partner. Even though this hormone decreases during the attraction
phase, sex can actually cause serotonin levels to increase again.
During this attraction phase one may experience a feeling of euphoria or exhilaration and
a craving for union the other human that they desire. Since hormones associated with the
stress response are released during the attraction phase, individuals also may experience
physiological changes such as sleeplessness, increased energy, loss of appetite, or rapid
heart rate and accelerated breathing. Often considered the “honeymoon phase” between

11. two partners, this phase usually only lasts a few months or less before the attraction fades
or the attachment phase takes over.
Attachment
Once the attraction phase has settled down dopamine, serotonin and adrenaline levels
return to normal and another phase begins. The two major hormones involved in the
attachment (or long-term bonding) phase are oxytocin and vasopressin which both play a
role in social and reproductive behaviors in humans.
Oxytocin, also referred to as the “love hormone” is released during the attachment phase
in correlation with physical touch and results in an increase in dopamine (the happy
hormone). This is perhaps why the area of the brain which is associated with the feeling
of reward and pleasure is activated when oxytocin is released during contact with another
human. Gestures such as hugging, kissing, cuddling and sex can boost oxytocin levels
which enhances the monogamous bond between both partners. Oxytocin is also released
in mothers while breast feeding their infant which facilitates a deep mother-infant bond.
Vasopressin is another hormone released after physical touch that initiates the desire to
stay with that particular individual and develops a strong emotional attachment.
The attachment phase brings a feeling of calmness, security, a desire to protect one
another, emotional union and comfort. This attachment phase doesn’t just exist in
romantic relationships, but can also be present with other types of bonds such as family
and friends.
Psychological Aspect of Sexual Desire
Sexual desire is typically viewed as an interest in sexual objects or activities. More
precisely, it is the subjective feeling of wanting to engage in sex. Sexual desire is sometimes, but
not always, accompanied by genital arousal (penile erection in men and vaginal lubrication in
women). Sexual desire can be triggered by a large variety of cues and situations including private
thoughts, feelings, and fantasies, erotic materials (such as books, movies, photographs), and a
variety of erotic environments, situations, or social interactions.
Sexual desire is often confused with sex drive, but these are fundamentally different
constructs. Sex drive represents a basic, biologically mediated motivation to seek sexual activity
or sexual gratification. In contrast, sexual desire represents a more complex psychological
experience that is not dependent on hormonal factors.
However, developmental research suggested that the capacity to experience sexual
desire though not hormone-dependent, are probably still facilitated by hormones. For example,
due to adrenal gland development and the subsequent secretion of adrenal hormones, some 9-
year old children may experience sexual desires. Researchers noted that despite this

12. development, children who experienced such desires generally are not motivated to seek sexual
gratification or activity. Such motivation typically develops after 12 years old, when puberty
produces notable surges in levels of gonadal hormones. Thus, physiological arousal is not a
necessary element of sexual desire and should not be considered a more valid marker of sexual
desire than individual self-reported feelings.
Gender differences on sexual desire
Factors that influence the notable gender difference on sexual desire include:
• Culture
• Social environment, and even
• Political situations
One of the most notable gender differences on sexual desire was that women place great
emphasis on interpersonal relationships as part of the experience. Males, on the other hand, enjoy
a more casual sexual behavior.
Alternatively, some researchers attributed that due to the different evolutionary pressures
men and women face through time early human females practiced selective mating with carefully
chosen males to achieve maximum reproductive success, while no such pressure was evident on
men. This may have favored the evolution of stronger sexual desires in men than in women.
The Diversity of Sexual Behavior
Like food, sex is an important part of our lives. From an evolutionary perspective, the
reason is obvious - perpetuation of the species. Sexual behavior in humans, however, involves
much more than reproduction.
Sexual orientation is defined as an individual’s general sexual disposition toward partners
of the same sex, the opposite sex, or both sexes. There has been much interest in sexual desire
as an index of sexual orientation. Historically, the most important indicator of same-sex (i.e., gay,
lesbian, or bisexual) orientation was same-sex sexual desire. Contemporary scientific studies,
however, found that same-sex desire and sexual orientation are more complicated than previously
thought.
Past studies thought that gay, lesbian, and bisexual individuals were the only people who
ever experienced same-sex sexual desires. It was found though that completely heterosexual
persons periodically experience same-sex sexual desires, even if they have little motivation to act
on those desires. It also did not appear to indicate that a completely heterosexual individual will
eventually want to pursue same-sex sexual behavior or will eventually consider himself or herself
lesbian, gay, or bisexual.
Thus, researchers now generally believe that lesbian, gay, and bisexual orientations are
characterized by persistent and intense experiences of same-sex desire that are stable over time.
Gender Identity

13. Many people fuse sexual orientation with gender identity into one group because of
stereotypical attitudes that exist about homosexuality. In reality, although these are two related,
they are actually different issues. Sexual orientation is a person’s emotional and erotic attraction
toward another individual. On the other hand, gender identity refers to one’s sense of being male
or female. Generally, our gender identities correspond to our chromosomal and phenotypic sex,
but this is not always the case.
WHAT IS LGBTQ+?
LGBTQ+ is an umbrella term for a wide spectrum of gender identities, sexual orientations
and romantic orientations.
• L stands for lesbian. These are females who are exclusively attracted to women.
• G stands for gay. This can refer to males who are exclusively attracted to other males. It
can also refer to anyone who is attracted to his or her same gender.
• B stands for bisexual or someone who is sexually/romantically attracted to both men and
women.
• T or Trans*/Transgender is an umbrella term for people who do not identify with the gender
assigned to them at birth. Trans woman is an identity label adapted by male to female
trans people to signify that they identify themselves as women. A Trans man is an identity
label adapted by female to male trans people to signify that they identify themselves as
men.
• Q stands for queer. It is a useful term for those who are questioning their identities and
are unsure about using more specific terms, or those who simply do not wish to label
themselves and prefer to use a broader umbrella term.
• +The plus is there to signify that many identities are not explicitly represented by the
letters. This includes (but is not limited to) intersex or people who are born with a mix of
male and female biological traits that can make it hard for doctors to assign them a male
or female sex; and asexual or a person who is not interested in or does not desire sexual
activity.
Regardless of how sexual orientation is determined, there is preliminary empirical
research that strongly suggests sexual orientation is not a choice. Rather, it is a relatively stable
characteristic of a person that cannot be changed. Just as majority of the heterosexual people do
not choose to be attracted to the opposite sex, the large majority of the LGBTQ+ people also do
not choose theirs. The only real choice that the LGBTQ+ community has to deal with is whether
to be open about their orientation.
Sexual Orientation and Gender Identity Issues
There’s a lot more to being male, female, or any gender than the sex assigned at birth.
Your biological or assigned sex does not always tell your complete story.
Sex is a label — male or female — that you’re assigned by a doctor at birth based on the
genitals you’re born with and the chromosomes you have. It goes on your birth certificate.

14. Gender is defined by Food and Agriculture Organization of the United Nations as “the
relations between men and women, both perceptual and material. Gender is not determined
biologically, as a result of sexual characteristics of either women or men, but is constructed
socially. It is a central organizing principle of societies, and often governs the processes of
production and reproduction, consumption and distribution” (FAO, 1997).
According to the United Nations Commission on Human Rights, gender identity is one's
innermost concept of self as male, female, a blend of both or neither – how individuals perceive
themselves and what they call themselves. One's gender identity can be the same or different
from their sex assigned at birth. On the other hand, sexual orientation is an inherent or
immutable enduring emotional, romantic or sexual attraction to other people. This attraction can
be for someone from the same sex or someone from the opposite sex.
Sociocultural factors
Sociocultural factors influence the various issues related to sexual orientation and
gender identity. For example, the Philippines and most of its South East Asian neighbors view
heterosexuality as the norm. However, there are countries that are culturally not as restrictive with
their human sexual/romantic relationships attitudes. For example, in New Guinea, young boys are
expected to engage in sexual behavior with other boys for a given period because it is believed
that doing so is necessary for these boys to become men (Baldwin & Baldwin, 1989). In the
Philippines, an individual is classified as either male or female only. However, Thailand
recognizes more than two categories – male, female, and kathoey. A kathoey is an individual
who would be described as transgender in Western cultures (Tangmunkongvorakul, Banwell,
Carmichael, Utomo, & Sleigh, 2010).
Family influences
There are also studies that asserted how children's upbringing and social environments
influences their developing gender identities. In summary, this work found that children's interests,
preferences, behaviors and overall self-concept are strongly influenced by parental and authority
figure teachings regarding sexual stereotypes. Thus, children whose parents adhere to strict
gender-stereotyped roles are, in general, more likely to take on those roles themselves as adults
than are peers whose parents provided less stereotyped, more neutral models for behaving.
Urban setting
Another research also discovered that homosexuality positively correlated with
urbanization. The correlation though was more substantial in men than in women. The study
surmised that large cities seem to provide a friendlier environment for same-gender interest to
develop and be expressed (Laumann, et al., 1994) than in rural areas. These cities host venues
or areas where people with specific sexual orientations socialize and become a support group.The
number of gays and lesbians residing in large cities may function protectively to generate
resiliency among the LGBTQ+ community in the face of stigmatization, discrimination, and
harassment thus potentially resulting to positive consequences for their wellbeing.

15. On the other hand, existing literature highlighted that the challenges of rural living for
LGBTQ+ people are:
• high levels of intolerance
• limited social and institutional supports
• higher incidence of social isolation
There are studies that also countered the popular notion of urban versus rural living for
the LGBTQ+ - that is, rural life is actually more beneficial to their well-being than urban life.
However, these studies are newer and less supported than existing literature on LGBTQ+ life,
challenges, and issues.
History of sexual abuse
Previous published studies claimed that abused adolescents, particularly those victimized
by males, are more likely to become homosexual or bisexual in adulthood. These studies
werecriticized for being non-clinical and unreliable. Other findings suggest no significant
relationship that child abuse is a cause in same-sex sexual orientation in adulthood (Wilson and
Wisdom, 2009).
Sexually Transmitted Diseases (STD’s)
What are STD’s? STD stands for sexually transmitted diseases. It is also known as STI or
sexually transmitted infection. In general, STD is a disease or infection acquired through sexual
contact where the organisms that cause STD were passed on from person to person in blood,
semen, and vaginal or other bodily fluids.
STD can also be transmitted non-sexually such as:
• from mother to infant during pregnancy
• blood transfusion, and
• people share needles for injection
It is possible to contract sexually transmitted diseases from people who seem perfectly
healthy, and who may not even be aware of the infection. STDs do not always cause symptoms,
which is one of the reasons experts prefer the term "sexually transmitted infections" to "sexually
transmitted diseases."
The Responsible Parenthood and Reproductive Health Act of 2012
Responsible Parenthood and Reproductive Health Act of
2012
An Act providing for a national policy on Responsible Parenthood and
Reproductive Health

16. Citation Republic Act No. 10354
Enacted by House of Representatives of the Philippines
Date enacted December 19, 2012
Enacted by Senate of the Philippines
Date enacted December 19, 2012
Date signed December 21, 2012
Signed by Miriam Defensor Santiago
Date commenced January 17, 2013
The Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act No.
10354), informally known as the Reproductive Health Law or RH Law. It is a law in the Philippines
that guarantees access to contraceptive methods such (i.e. fertility control), sexual education, and
maternal care.Passage of the legislation was controversial and highly divisive. Experts,
academics, religious institutions, and major political figures declared support or opposition while
it was just a Bill. After the (then) RH Bill was passes into law, the Supreme Court delayed its
implementation in response to challenges. On April 8, 2014, the Court ruled that the law was "not
unconstitutional" but struck down eight provisions partially or in full.
Goals, Objectives and Strategies of Reproductive Health Law
Specific objectives:
• Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio.
• Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.
• To have halted by 2015 and begun to reverse, the spread of HIV/AIDS.
Regional objectives:
• Improve access to the full range of affordable, equitable and high-quality family planning
and reproductive health services to increase contraceptive use rate and reduce unwanted
pregnancies and abortions.
• Making pregnancy safer.

17. • Support countries and areas in developing evidence-based policies and strategies for the
reduction of maternal and newborn mortality.
• Improve access to the full range of affordable, equitable and high-quality family planning
and reproductive health services to increase contraceptive use rate and reduce unwanted
pregnancies.
• Improve the health and nutrition status of women of all ages, especially pregnant and
nursing women.
• Gender, women and health:
• Integrate gender and rights considerations into health policy and programs, especially into
reproductive health and maternal health care.
• Improve the health and nutrition status of women of all ages,
(WHO Western Pacific Region, WPRO©2017)
Advantages & Disadvantages of Family Planning
Family planning allows both men and women to make informed choices on when and if
they decide to have children.Knowing both the advantages and disadvantages of family planning
methods may help you decide what option is right for you.
Methods of contraception:
• long-acting reversible contraception, such as the implant or intra uterine device (IUD)
• hormonal contraception, such the birth control pill and the birth control injection
• barrier methods, such as condoms
• emergency contraception
• fertility awareness
• permanent contraception, such as vasectomy and tubal ligation
Benefits of family planning / contraception according to the WHO
• Prevent pregnancy-related health risks in women
• Reduce infant mortality
• Help prevent HIV/AIDS
• Empower people and enhance education
• Reduce adolescent pregnancies
• Slowing population growth
(WHO Western Pacific Region, WPRO©2017)
Benefits of using family planning according to DOH
Family planning provides many benefits to mother, children, father, and the family.
Mother

18. • Enables her to regain her health after delivery
• Gives enough time and opportunity to love and provide attention to her husband and
children
• Gives more time for her family and own personal advancement
• When suffering from an illness, gives enough time for treatment and recovery
Children
• Healthy mothers produce healthy children
• Will get all the attention, security, love, and care they deserve
Father
• Lightens the burden and responsibility in supporting his family
• Enables him to give his children their basic needs (food, shelter, education, and better
future)
• Gives him time for his family and own personal advancement
• When suffering from an illness, gives enough time for treatment and recovery
Disadvantages
• Birth control health risks
Some forms of birth control pose health concerns for women and men, such as allergies
to spermicides or latex. For some women, oral contraceptives can lead to hair loss and weight
gain, and the use of diaphragms can lead to urinary tract infections.
• Possibility of pregnancy
Family planning methods are not one hundred percent reliable. Other than abstinence,
there is no birth control method(including the natural rhythm method) that is completely effective.
Couples who are engaging in sexual activity should always consider the possibility of an
unexpected pregnancy.
• Pregnancy after birth control
All bodies are different. There is no way to know how long it will take a woman to conceive,
and that is true whether you have been using birth control or not.It is possible to get pregnant
almost right away after stopping hormonal contraceptives such asbirth control pillsor after having
the IUD removed. On the other hand, it might take months for ovulation and the menstrual period
to return to normal. How long the menstrual period takes to return to its normal cycle is entirely
individual, and has nothing to do with how long the woman has been using birth control.The most
important thing to know about stopping your preferred method of birth control is that ovulation can
return immediately. Hence, a woman can get pregnant right away.
The natural family planning method

19. Natural family planning (NFP) is the method that uses the body’s natural physiological
changes and symptoms to identify the fertile and infertile phases of the menstrual cycle. Such
methods are also known as fertility-based awareness methods.
Once a month an egg is released from one of a woman’s ovaries (ovulation). It can stay
alive in the uterus for about 24 hours. Men can always produce sperm cells, and these can stay
alive in the female reproductive system for about two to five days after being deposited in the
vagina during sexual intercourse. This means women have certain time during their cycle when
they are unlikely to conceive, whereas men have no ‘safe period’.
Natural family planning methods are generally the preferred contraceptive method for
women who do not wish to use artificial methods of contraception for reasons of religion; or who,
due to rumors and myths, fear other methods.
However, natural family planning methods are unreliable in preventing unwanted
pregnancy. It also takes time to practice and use NFP properly; and this adds to its unreliability.
Moreover, natural family planning methods do not protect a person against sexually transmitted
diseases (STDs), including the human immunodeficiency virus (HIV).
The effectiveness of any method of natural family planning varies from couple to couple.
All these methods become less effective if couples do not follow the method carefully.
Types of natural family planning methods
1. Periodic abstinence (fertility awareness) method
2. Use of breastfeeding or lactational amenorrhoea method (LAM)
3. Coitus interruptus (withdrawal or pulling out) method
Periodic abstinence (fertility awareness) methods
During the menstrual cycle, the female hormones estrogen and progesterone cause some
observable effects. Observation of these changes provides a basis for periodic abstinence
methods. There are three common techniques used in periodic abstinence methods, namely:
a) Rhythm (calendar) method
b) Basal body temperature (BBT) monitoring
c) Cervical mucus (ovulation) method
With rhythm (calendar) method, the couple tracks the woman’s menstrual history to
predict she will ovulate. This helps the couple determine when they will most likely conceive.
Basal body temperature monitoring is a contraceptive method that relies on monitoring a
woman’s basal body temperature on a daily basis. A woman’s body temperature changes
throughout the menstrual cycle and changes in body temperature coincide with hormonal
changes. This indicates fertile and non-fertile stages of the cycle. By monitoring temperature
every day, a woman can determine the periods of her menstrual cycle when she is, or is not,
fertile. The cervical mucus (ovulation) method, also called the Billing’s method as this was

20. devised by Drs. John and Evelyn Billings in the 1960s, involves examining the color and viscosity
of the cervical mucus to discover when ovulation is occurring.
Lactation Amenorrhea Method
Through exclusive breastfeeding, the woman is able to suppress ovulation. This method
is called lactation amenorrhea method. However, if the infant were not exclusively breastfed, this
method would not be an effective birth control method. Generally, after three months of exclusive
breastfeeding, a woman must choose another method of contraception.
Coitus Interruptus
This is one of the oldest methods of contraception. The couple proceeds with coitus;
however, the man must release his sperm outside of the vagina. Hence, he must withdraw his
penis the moment he ejaculates. This method is only 75% effective because pre-ejaculation fluid
that contains a few spermatozoa may cause fertilization.
Hormonal Contraception/Artificial Family Planning
Hormonal contraceptives are an effective family planning method that manipulates the
hormones that directly affect the normal menstrual cycle so that ovulation will not occur.
Oral Contraceptives
It is also known as the pill. Oral contraceptives contain synthetic estrogen and
progesterone.• Estrogen suppresses ovulation, while progesterone decreases the
permeability of the cervical mucus to limit the sperm’s access to the ova.
Transdermal Contraceptive Patch
A transdermal patch is a medicated adhesive patch that is placed on the skin to deliver a
specific dose of medication through the skin and into the bloodstream. In this case, a transdermal
contraceptive patch has a combination of both estrogen and progesterone released into the
bloodstream to prevent pregnancy.
Vaginal Ring
It is a birth control ring inserted into the vagina and slowly releases hormones through the
vaginal wall into the bloodstream to prevent pregnancy.
Subdermal Implants
Subdermal contraceptive implants involve the delivery of a steroid progestin from polymer
capsules or rods placed under the skin. The hormone diffuses out slowly at a stable rate, providing
contraceptive effectiveness for 1-5 years.
Hormonal Injections

21. It is a contraceptive injection given once every three months. It typically suppresses
ovulation, keeping the ovaries from releasing an egg. Hormonal Injections also thickens cervical
mucus to keep sperm from reaching the egg.
Intrauterine Device
An IUD is a small, T-shaped plastic device wrapped in copper or contains hormones. A
doctor inserts the IUD into the uterus.IUD prevents fertilization of the egg by damaging or killing
sperm. It makes the mucus in the cervix thick and sticky, so sperm cannot get through to the
uterus. It also keeps the lining of the uterus (endometrium) from growing very thick making the
lining a poor place for a fertilized egg to implant and grow.
Chemical Barriers
Chemical barriers such as spermicides, vaginal gels and creams, and glycerin films
are also used to cause the death of sperms before they can enter the cervix. It lowers the pH level
of the vagina so it will not become conducive for the sperm. However, these chemical barriers
cannot prevent sexually transmitted infections.
Diaphragm
Diaphragms are dome-shaped barrier methods of contraception that block sperm from
entering the uterus. They are made of latex (rubber) and formed like a shallow cup.It is filled with
spermicide and fitted over the uterine cervix.
Cervical Cap
A cervical cap is a silicone cup inserted in the vagina to cover the cervix and keep sperm
out of the uterus. Spermicide is added to the cervical cap to kill any sperm that may get inside the
protective barrier. However, this is not a widely used method and few health care providers
recommend this type of contraception. The most common side effect from using a cervical cap is
vaginal irritation. Some women also experience an increase in the number of bladder infections.
Male Condoms
The male condom is a latex or synthetic rubber sheath placed on the erect penis before
vaginal penetration to trap the sperm during ejaculation. Condoms can prevent STDs.
Female Condoms
It is a thin pouch inserted into the vagina before sex serving as protective barrier to prevent
pregnancy and protection from sexually transmitted diseases, including HIV. Female Condoms
creates a barrier that prevents bodily fluids and semen from entering the vagina.
Surgical Methods
One of the most effective birth control methods is the surgical method. This method
ensures conception is inhibited permanently after the surgery.

22. Two kinds of surgical methods:
• Vasectomy
A surgical operation wherein the tube that carries the sperm to a man’s penis is
cut. It is a permanent male contraception method. This procedure preserves ejaculation
and does not cause impotence or erectile dysfunction since the vasectomy does not
involve anything in the production of testosterone.
• Tubal Ligation
It is a surgical procedure for female sterilization involving severing and tying the
fallopian tubes. A tubal ligation disrupts the movement of the egg to the uterus for
fertilization and blocks sperm from traveling up the fallopian tubes to the egg. A tubal
ligation does not affect a woman’s menstrual cycle. A tubal ligation can be done at any
time, including after normal childbirth or a C-section. It is possible to reverse a tubal ligation
— but reversal requires major surgery and is not always effective.