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This document contains chapters 4 to 6 Chapter 4 Human Sexual AROUSAL and Response TOTAL TEACHING PACKAGE OUTLINE Lecture Outline Resources Reference Chapter 4: Human Sexual Response MODELS OF SEXUAL AROUSAL: INTERACTION OF MIND AND BODY Teaching Suggestions: 4(A), 5(B) Learning Objectives: #1,2,3,4,5,6,7,8,9,10 MODELS OF HUMAN SEXUAL RESPONSE Teaching Suggestions: 1(A), 2(A), 4(B), 5(A), 6(A), 7(B) Learning Objectives: #11,12,13,14,15, female sexual response Teaching Suggestions: 2(B), 2(C), 2(D), 3(A) Learning Objectives: #16,17,18,19,20,21,22, 23,24, male sexual response Teaching Suggestions: 2(C), 2(D) Learning Objectives: #25,26,27,28,29,30 HORMONES AND SEXUAL AROUSAL Teaching Suggestions: 7(A) Learning Objectives: #31,32,33 Effects of aging on sexual response Teaching Suggestions: 2(B), 4(C) Learning Objectives: #34,35 LEARNING OBJECTIVES After reading this chapter, students should be able to: Describe the general physiological similarities of the sexual responses of males and females. Describe common differences in sexual responses, between different genders, age-groups, and sexual orientations. Describe a concern regarding the concept of sex stimulation. Describe inhibitory and excitatory processes in the brain indicated in the dual control model. Describe the concept and variability of sexual excitation. Briefly describe the involvement of psychological arousal in sexual arousal. List and describe the stages of sexual response activation. Compare and contrast gender differences regarding sexual arousal. Describe phenomena surrounding self-perception of arousal. Describe gender stereotypes regarding sexual arousal. Briefly describe the cultural influence regarding sexual response. List and describe the Masters and Johnson four-phase model of human sexual response. Describe concerns in regards to the Masters and Johnson four-phase model. List and describe Helen Kaplan’s three-phase model of human sexual response. Describe the physiological responses of females during the excitement phase. Describe the physiological response in females in the plateau phase. Describe the physiological response in females during the orgasm phase. Describe the physiological response in females in the resolution phase. Describe what is known about multiple orgasmic females. Describe the controversy regarding types of female orgasms. Describe what is known about and the controversy about the “G spot.” Describe what is known about female ejaculation. Describe Kegel exercises and understand their purported benefits. Describe the physiological response of males in the excitement phase. Describe the physiological response of males in the plateau phase. Describe the physiological response of males in the orgasm phase. Describe the physiological response of males in the resolution phase. Describe physiological changes that occur during the refractory period. Describe the controversy regarding multiple orgasms in males. Describe the influence of, and controversy about, hormones regarding sexual arousal response. Describe organizing and activating effects of hormonal secretions. Describe the effect of testosterone in male and females. Describe the physiological effect of aging regarding female sexual response. Describe the physiological effect of aging regarding male sexual response. CHAPTER OVERVIEW This chapter introduces students to current knowledge concerning the human body’s mechanisms of sexual arousal and response. It builds on the anatomical descriptions of Chapters 2 and 3 and begins to personalize some of the new sexual information. The chapter also places sexual response in a broader cross-cultural context, confirming again how important our own culture is in determining our sexual values and behaviors. It represents an opportunity to contrast Western and Eastern values relating to sexuality and to introduce the concept of a perceived connection between sexuality and spirituality. The Eastern spiritual traditions have honored sexuality in very positive ways. It may also be worth the time to explore in more detail some of the controversial issues described in this chapter: the different forms of orgasm in women, the G spot, female ejaculation, and multiple orgasms in both women and men. The debates on these issues have cooled somewhat in the popular media and professional journals, but many unanswered questions and unrealistic expectations remain. Many individual differences occur in human sexual response, and good communication is essential to developing mutual understanding in a sexual relationship. Arousal stimuli may be internal or external, roughly corresponding to a central arousal system located in the brain, and a peripheral arousal system that picks up cues from the genitals, senses, and spinal reflexes. Emotions and other psychological processes play a significant role in activating or deactivating sexual response. When the mind ascribes sexual meaning to some stimulus, the genital physiological response may be quite automatic. Masters and Johnson were among the first researchers to scientifically study the body’s physiological changes during sexual response. They developed a four-phase model involving excitement, plateau, orgasm, and resolution. A three-phase model proposed by Kaplan views sexual response as beginning with psychological desire with a subsequent buildup of blood and muscular tension, followed by reversal of these states as triggered by orgasm. In females, the vagina becomes lubricated during sexual excitement, and an orgasmic platform develops with the swelling of the clitoris and labia. The clitoral gland eventually retracts under its foreskin. Resolution refers to the return of the body to its unexcited state. Some women have the potential for more than one orgasm during a single sexual experience. Women report clitoral, vaginal, uterine, and “blended” orgasms. Some researchers claim that a particularly sensitive spot on the inner front part of the vagina swells during female arousal. This has been called the “G spot.” Kegel exercises can keep the urogenital musculature in good tone and may increase the intensity or pleasure of orgasm. In males, penile erection is a major sign of excitement, and the size of the testes and scrotum also increase. The testes move upward in the scrotum. In both women and men, sexual response involves increases in respiration, heart rate, blood pressure, and general muscular tension. A reddish “sex flush” appears on the skin of the upper body in some individuals, and nipple erection may also occur. Orgasm is the pleasurable release of sexual tension, involving a series of muscular contractions in both sexes. Ejaculation usually accompanies orgasm in men. During resolution, at the end of sexual response in men, a refractory period generally occurs, during which, for most men, there can be no restimulation to orgasm. It is still not completely clear what role hormones may play in sexual response. Testosterone, an androgen present in both men and women, acts as an activator for sexual desire. In humans, sexual arousal and responsiveness seem to be controlled by both hormonal and social factors. Both men and women may experience slower arousal and somewhat less intensity of response as they age. People who have been more sexually active during their younger years tend to maintain a higher level of sexual activity. TEACHING SUGGESTIONS 1. Small Group Activities A) A New Vision of Women’s Sexuality Objective: To have students think beyond the physical domain of sexual response and to explore the psychological and emotional response during sexual activity. Method: Have each student read the commentary “A new vision of women’s sexuality.” Break into small groups of four. Have each group develop a sexual response model that incorporates the physical, psychological, and emotional responses during sexual activity. Let each group report on their model. Discuss the variety, similarities, and differences among the models. Upon completion: Students should have a better understanding of the psychological and emotional complexities involved in sexual response. 2. Discussion Topics A) Sexuality and Spirituality: The Relevance of Eastern Traditions What are some of the advantages of Eastern philosophy regarding sexuality? Why do you think the Western philosophy toward sex is so goal oriented? What do you think is meant by “an inevitable flaccid vulnerability”? Ask students how their sexual values are dealt with in their own spiritual and religious traditions. How do those ways differ from the information on Eastern traditions? B) Effects of Aging on Sexual Response What are some of the physiological changes of aging? How might these changes affect one’s sexual self-esteem? In what ways could the medical community provide assistance? Sexual Response Quiz Game Objective: To test students’ knowledge on female and male sexual response as per Table 4-1 (Female and Male Sexual Response) in the main text Method: Divide students into groups of four to five per group. Instructor establishes an order of which group answers first to last. Instructor reads a sexual response from Table 4.1. The first group tries to answer which phase the statement comes from; if they answer incorrectly, the instructor may choose to read the same statement to the next group or read a new statement. For each correct answer, the group will receive 1 point. The group with the most points wins. This activity might be best served as a review for the test. Upon completion: Students will have a gauge of their knowledge on the sexual response cycle Orgasm Description Objective: Students will gain a better understanding of the descriptive similarities of male and female orgasms. Method: Have students write an anonymous, gender-free description of their orgasmic experiences. Besides describing the physical sensations, encourage students to include the psychological and emotional aspects. Be aware that some students may not have had an orgasm. They would write on their anonymous paper “Do not know yet.” State that this paper is not for a grade. Have students write an M or F at the top of the paper so that you, the instructor, will know if a male or female wrote the paper. Collect the papers, then read several out loud and let the students vote as to whether they think a male or female wrote it. What usually occurs is that most students pick a paper that they think is written by a male; however, it turns out that it was written by a female and vice versa. Upon completion: Students will become aware that how they describe orgasm is quite similar compared to the stereotypical view. 3. Case Study The case study of Angelina in Chapter 4 (of the main text) relates to understanding one’s own sexual response patterns and the kinds of efforts that are part of building and maintaining a satisfactory sexual life. It deals with a young woman whose expectations about her own orgasmic capacities turn out to be unrealistic. What factors led Angelina to believe that something was wrong with her sexually? Why does our culture emphasize performance? Why do you think the boyfriend is persistent in Angelina having more than one orgasm? 4. Guest Speakers Organize a panel discussion of couples who are willing to discuss some aspects of how they developed a satisfactory sexual relationship. Invite a yoga teacher who could discuss the place of sexuality in traditional yogi practice. Invite a physician to discuss medical treatments for those experiencing age-related sexual difficulties. 5. Media If your institutional setting will allow it, show a slide, video, film, or videodisc program that portrays the stages of sexual response. Make certain that you check the degree of explicitness for its appropriateness. B) Design a media campaign (television commercial, magazine layout, radio public service announcement) addressing the benefits of a healthy and enjoyable sex life for adults. How would you convey the following elements: knowledge of anatomy and physiology, emotional connection with partner, pleasure and enjoyment with physical bonding, creating a safe and stimulating environment, the concept of privacy, and other items that would lead to a joyful outcome for both/all partners. 6. Questionnaires Sexual Arousal and Response in your Life (located at the end of Chapter in the text) This assessment can help the student evaluate and understand reactions to and feelings about sexual responsiveness. 7. SexSource Video Bank The SexSource video bank provides an excellent array of short videos that may serve as discussion starters. In order to elicit the best responses, it is advisable to pair students in groups of two for “pair sharing.” Give them the initial starter questions below, and then show the videos after some initial discussion. Instructors should preview videos for time and content. Additionally, you may want to download clips prior to class to ensure they are ready for viewing regardless of network connectivity. All video clips may be found at: http://www.mhhe.com/sexsource Hormones video clip – Ask paired students: What role to hormones play in determining our sex, our sexuality, and our sexual response? Once students have been given some time to share their initial answers, show the Hormones video clip and continue discussion. This video clip is primarily concerned with the sexual differentiation caused by the X and Y chromosomes. It is an excellent springboard for discussion of other hormonal differences beyond biological sex. B) Sexual Response Research video clip – Ask paired students: What happens when our genitalia are stimulated? How would you study this? Who would you go to if you and your partner were having sexual difficulty? Afterward show the Sexual Response Research video clip. This clip shows original footage by Masters and Johnson, describes the stages of sexual response, and illustrates the stigma often associated with studying sexuality. It serves as an excellent discussion starter for any of these topics and may also be used as an introduction to sex therapy. GLOSSARY activating effect: the direct influence some hormones can have on activating or deactivating sexual behavior. androgen (AN-druh-juhn): a male hormone, such as testosterone, that affects physical development, sexual desire, and behavior. Testosterone is produced by both male and female sex glands and influences each sex in varying degrees. central arousal system: internal components of sexual arousal that come from the cognitive and emotional centers of the brain, forming the foundations for sexual response. climax: another term for orgasm. desire phase: Kaplan’s term for the psychological interest in sex that precedes physiological sexual arousal. Dual Control Model: a theoretical model emphasizing an understanding that sexual desire and arousal are controlled by the interaction of both excitatory and inhibitory processes in the brain. excitement: the arousal phase of Masters and Johnson’s four-phase model of the sexual response cycle. G spot: a vaginal area that some researchers believe is particularly sensitive to sexual stimulation when its underlying spongy tissues are engorged with blood. organizing effect: manner in which hormones control patterns of early development in the body. orgasm (AWR-gaz-uhm): a rush of pleasurable physical sensations associated with the release of sexual tension. orgasmic release: reversal of the vasocongestion and muscular tension of sexual arousal, triggered by orgasm. penile strain gauge: a device placed on the penis to measure even subtle changes in its size due to sexual arousal. peripheral arousal system: external components of sexual arousal that reach the brain and spinal cord from the skin, genitals, and sense organs. plateau phase: the stable, leveled-off phase of Masters and Johnson’s four-phase model of the sexual response cycle. plethysmograph: (pleh-THIZ-muh-graf) a laboratory measuring device that charts physiological changes over time. Attached to a penile strain gauge, it can chart changes in penis size. This is called penile plethysmography. refractory period: time following orgasm during which a man cannot be restimulated to orgasm. resolution phase: the term for the return of a body to its unexcited state following orgasm. sexual arousal: the psychological and physiological mechanisms that activate sexual response. sexual dysfunctions: difficulties people have in achieving sexual arousal and in other stages of sexual response. Skene’s glands: secretory cells located inside the female urethra. Chapter 5 Developmental and Social Perspectives on Gender TOTAL TEACHING PACKAGE OUTLINE Lecture Outline Resources Reference Chapter 5: Developmental and Social Perspectives on Gender HOW MANY SEXES ARE THERE? Teaching Suggestions: 3(A), 7(B) Learning Objectives: #1,2,3,4,5 Sexual differentiation Teaching Suggestions: 7(A), 7(C) Learning Objectives: #6,7,8,9,10,11,12,13,14, 15,16,17,18, 19,20,21,22,23,24, Masculinity and femininity Teaching Suggestions: 1(A), 2(A), 2(C), 3(B), 5(C), 6(A) Learning Objectives: #25,26,2728,29,30,31,32,33, 34,35,36, 37,38,39 Transgender identities Teaching Suggestions: 2(D) Learning Objectives: #40,41,42,43,44,45,46 gender in society and culture Teaching Suggestions: 2(B), 4(A), 5(A), 5(B) Learning Objectives: #47,48,49,50,51,52,53,54, 55,56 LEARNING OBJECTIVES After reading this chapter, students should be able to: Briefly describe controversies regarding the perception of the sexes. List and describe the types of intersexuality. Describe three cross-cultural views of intersexuality and examples of third genders. Describe the controversy regarding intersexuality in Western cultures. Describe the concepts of gender identity and gender role. Describe biological essentialism and social constructionism. List and describe the general components of the factors of sexual differentiation. List and describe the four levels of biological sex. Describe the process of creating a personal perspective of one’s gender. Consider how gender roles may become self-fulfilling prophecies. Describe the chromosomal prenatal factors of sexual differentiation. Describe the fetal gonadal factors regarding sexual differentiation. Describe the fetal hormonal factors involving sexual differentiation including the H-Y antigen. Describe possible genetic factors in regard to fetal development that challenge it as the “default” gender. Describe rare genetic problems seen in early stages of sexual differentiation. Describe the influence of dihydrotestosterone (DHT) in genital development. Describe the perceived influence of hormones of brain development and sex differentiation. Describe the influences of sex hormones that result in sexual differentiation variations. Describe the characteristics of fetally androgenized females, and describe the process by which this occurs. List and describe the effects of two synthetic hormones on sexual differentiation. Describe the effect of Andro genital syndrome on male and female sexual differentiation. Describe the physiological effects of androgen insensitivity syndrome. Describe the effects of differential socialization. Describe the multiplier effect of hormones at the social environmental level. List and describe three findings of sexual differentiation at puberty. Describe two general factors regarding adult gender identity. List and briefly describe three models regarding the concept of masculinity and femininity. List and describe “exaggerated” extremes of the bipolar model of masculinity and femininity. Compare and contrast qualities of androgyny with qualities of traditional femininity. Describe general qualitative differences between males and females. Describe the difference in males and females in cognitive and motor function. Describe the facts of brain differentiation in males and females. Briefly describe the learning process in gender role development. Describe the psychodynamic gender differentiation model. Describe social learning theory when applied to gender development. Describe cognitive development theory as it applies to gender development. Briefly describe gender schema theory. Briefly describe multifactorial theories in gender roles. Describe how transgendered individuals are perceived both socially and professionally. Briefly describe what is known about transsexualism. Describe the continuum for transgenderism. Briefly describe sex reassignment processes and procedures for transsexuals. Describe cultural influences regarding the acceptance of gender difference in males and females. Describe gender influences of educational institutions on gender discrepancies. Briefly describe the changing perception and standing discrepancies of gender in the work place. Describe how the field of academia and the field of science continue to perpetuate gender disparity. Describe the general nature of the feminist movement in America. Describe two waves of feminist activities in American history. Describe how contemporary feminists have influenced perceptions of sexuality. List three traditional male roles that may make men uncomfortable. Describe objectives and outcomes of asserting masculinity as a cultural movement in North America. Describe the general consequences of the level of male interaction within a culture. Describe how gender roles are influenced by cultural values. Describe the influence of gender roles on mate selection. Describe cross-cultural understandings of gender. CHAPTER OVERVIEW One of the basic concepts to be taken from this chapter is that biological and environmental factors interact to make us the men and women we become. Another is that being a female or male, a woman or a man may not be as straightforward as is often thought. Finally, the chapter clarifies how cultural and social influences interact with gender, impacting differently on females and males as they grow and develop. These basic concepts form a foundation on which other aspects of our sexuality should be viewed. Western culture emphasizes the existence of two sexes, but there are forms of intersexuality such as hermaphroditism or pseudohermaphroditism. In other cultures and times of history, intersexuality has been accepted. The development of our gender identity and gender role is determined by a complex interaction of genetic, physiological, and sociocultural factors. Sexual differentiation is the process by which organisms develop into the different genders. Gender is determined biologically in four developmental arenas: genetic, gonadal, body, and brain. Gender is also influenced by the following developmental factors: prenatal, infancy, childhood and puberty. During prenatal life (before birth), the combining of chromosomes sets into motion a genetic program for producing a male, a female, or some ambivalent anatomical structure. The pairing of sex chromosomes is normally XX for females and XY for males, but there can be abnormal combinations (for examples, XXX, XXY, XYY) that produce unusual characteristics. After about one month of embryonic development, an undifferentiated set of fetal gonads appears, along with Müllerian ducts (potential female organs) and Wolffian ducts (potential male organs). If the Y chromosome is present, with its SRY gene, then H-Y antigen is produced, transforming the gonads into testes, which in turn produce testosterone and anti-Müllerian hormones. They promote development of male organs from the Wolffian ducts and suppress further development of Müllerian ducts. If the Y chromosome is absent, then the fetal gonads become ovaries and the Wolffian ducts disintegrate. The DAX-1 gene on the X chromosome may control a mechanism by which this gene inhibits the development of male genitals and promotes development of female structures. Male and female genitals and inner reproductive structures then develop. The presence or absence of the male hormones affects development of the nervous system. These hormones have a masculinizing effect, while an independent process of defeminization is going on. The absence of androgens results in the processes of demasculinization and feminization. A multiplier effect may exist between biological and social factors that eventually lead to masculine and feminine behaviors. During infancy and childhood, boys and girls are treated in particular ways, and social influences along with anatomy begin to help the child form a core gender identity. Adult gender roles may be conceptualized by bipolar, orthogonal, and oblique models; each one offers different views of the relationship between femininity and masculinity. People who exaggerate culturally accepted gender roles are called hypermasculine or hyperfeminine. Androgyny reflects high frequencies of both masculine and feminine traits in the same individual. Transgenderism has often been interpreted as pathological and considered a gender identity disorder, but transgender individuals have been asking for increased recognition in society. Evolutionary psychologists believe biological bases may exist for some broad categories of gender-related behaviors. Masculinity and femininity are defined by the behaviors that are found in average men and women. Some average differences occur between females and males in a few cognitive and motor functions. Several theoretical positions exist concerning gender role development. The psychodynamic approach involves complex unconscious interactions between children and their parents. Social learning theory emphasizes socialization and the modeling of gender behaviors by children. Cognitive-developmental theory emphasizes how human thought processes reinforce and perpetuate the gender roles learned from socialization. Gender schema theory highlights the complex network of associations that people hold with regard to gender. Behavioral genetics emphasizes an interaction of nature and nurture in the development of gender roles. The feminist movement in American history began with an outcry for women’s rights in 1848 by Elizabeth Cady Stanton and Susan B. Anthony. Feminists want to see men and women treated, and compensated, equally and without discrimination. Men have examined the limiting and unhealthy effects of the roles expected of them in our culture. TEACHING SUGGESTIONS 1. Small Group Activities Men, Women, and Awareness Objective: To gain knowledge of the issues and complexities of being male or female. Method: Put students into small groups of males and females. Ask the men to make lists of what they want women to know about men. Ask the women to make lists of what they want men to know about women. After representatives from the different groups present their lists to everyone, open up dialogue and discussion on what has been reported. Upon completion: Students may have developed a greater understanding of what it means socially, psychologically, and emotionally to be male and female. 2. Large Group Activities A) “Act like a Man” Box Objective: To examine traditional and contemporary characteristics and stereotypes of gender. Method: Divide the classroom into two large groups; the groups can be segregated by gender or mixed. Draw on the board two large squares and label on top of the square “Act like a Man” and “Act like a Woman”. One large group per box. Tell the students that you want one representative to write (scribe) inside the box all responses to the following: use descriptive terms to define what a real man/real woman is like. The two large groups should stand around their respective boxes. Make sure the scribe understands that this is a brainstorming exercise and all answers get written in the box regardless of who agrees. If students get stuck, prompt them with the following: what does a real man/real woman do for work? Dress like? Hygiene and grooming habits, family construct, personality traits, behaviors, etc. should be listed until the box is full. Stereotypes will be listed and these are part of our cultural perceptions. When the boxes are complete, have students return to their seats and address the first teaching point: what is the implication of using the term “lady” instead of “woman”? You will then ask the following and write student responses to the right of the square for both gender boxes: When you were in 6th, 7th, and/or 8th grades and you and your friends met a kid that didn’t fit in the box, what names were they called? List all terms no matter the intensity of the slang or disrespectful nature. You will then ask the following and write student responses to the left of the square for both gender boxes: as this kid who didn’t fit in the box and was subject to this language and ridicule grew into an adult, what behaviors and choices and personality characteristics might he/she experience? In other words, what might a person be like if they don’t fit in the box? It is important to note that just because someone was called a “fag” in the 7th grade, they wouldn’t necessarily commit suicide; however, someone who has been ostracized and subject to intense cruelty might (man box) = suicide, domestic violence, feel depressed, sad, isolated, resort to drugs/alcohol, be aggressive, misunderstood, have unhealthy relationships, be passive, etc. (woman box) = same as man box with more gender specific behaviors such as unplanned pregnancies, too early sexual activity, eating disorders, low self-esteem, etc. Again, this is reasonable speculation, not an “if – then” set-up. Processing exercise: Review the terms to the right of the boxes. Two distinct categories should be found: man box = 1. sexual orientation [fag, gay, queer, pansy] 2. female-ness [girl, sissy, mama’s boy, panty waist] woman box = 1. sexual orientation [dyke, lesbo, butch, 2. female sexual expression [slut, whore, skank, frigid, tramp] And of course there will be terms listed that do not fit into those categories, but every time (for the last ten years) I’ve worked this exercise, those terms and similar ones emerge. Ask the following: Is it ok that sexual orientation and female-ness are the biggest insults in this country? How do you feel about this? Is there anything that should be done? What will you do when you are raising your children or working with children to change this phenomenon? Is it ok or not ok that we have gender boxes? Can we live without them? If your gender box is different than your neighbors, can you find common ground? Do you want others to have the same gender boxes as you? How do your gender boxes influence your relationships? Choices? Politics? Upon completion: Students will realize that their culture has conditioned them to some degree in their views on what it means to be male and female. Ideally, this activity will help them to see the bigger picture of gender issues. * Excerpted from Paul Kivel, Men's Work: How to Stop the Violence That Tears Our Lives Apart, 1992, rev. 1998. Social/Cultural Advantages of being Male or Female Objective: To develop an awareness of the advantages and inequalities in society regarding the genders. Method: This activity is designed to complete individually; however, it could be done in small groups. Ask the males to write a list of the social/cultural advantages of being female. Ask the females to write a list of the social/cultural advantages of being male. Instructor asks for responses one at a time going back and forth from female to male. Allow for discussion/debate time on each response given. Upon completion: Students will be able to evaluate the distribution of power in reference to the specific gender and how that may have its advantages and drawbacks. Pressures of Gender Objective: To explore the concepts of masculinity and femininity. Method: In a large group setting, pose the following questions: How do women feel about the pressures to be feminine? 2. How do men feel about the pressures to be masculine? 3. What do students think these two terms really mean? Upon completion: Students will be able to look beyond the cultural boundaries of gender and begin to discover themselves. Gender Theory Debate Objective: To examine two perspectives on gender theory. Method: Have students organize a debate between the social constructionist perspectives on gender and the concepts of evolutionary theory. Aside from the formal differences raised by the debate, are there areas where the two groups might find consensus? Upon completion: A thorough examination of the two theories will have provided a unique learning experience for students. 3. Guest Speakers Invite a gender-aware therapist (sometimes called a feminist therapist) to the class to explain the perspectives from which she or he approaches counseling or therapy. The students may be invited to think of questions for the guest ahead of time. Contact your local PFLAG, transgender support/social group or community counselors/therapists specializing in gender concerns and invite a speaker to class. A post-operative transsexual would make an ideal candidate to speak to the specific social and biological theories about gender. 4. Case Study The case study of Ricardo in the text (Ricardo Expresses His Attitudes about “Male-Bashing”) represents a common campus theme. Partly as a reaction to feminism, and partly because of what they see as inequity, many men have begun to resist what they see as “male-bashing.” They want to believe that it is no more acceptable to degrade or make jokes about males than it is any other gender or ethnic group. Ask your students about examples of male-bashing, which some may have experienced. Discuss the comment “men were only getting back what they had been dishing out for years” and its potential negative impact upon society. 5. Essays/Papers Ask students to research gender-related expectations and customs in other cultures; and then have students report on their findings. Have students research gender inequalities in the workplace. Ask students to research theories on transsexuality. 6. Questionnaires Use the various exercises in the self-evaluation at the end of the chapter in the main text as the basis for classroom discussion. 7. SexSource Video Bank The SexSource video bank provides an excellent array of short videos that may serve as discussion starters. In order to elicit the best responses, it is advisable to pair students in groups of two for “pair sharing.” Give them the initial starter questions below, and then show the videos after some initial discussion. Instructors should preview videos for time and content. Additionally, you may want to download clips prior to class to ensure they are ready for viewing regardless of network connectivity. All video clips may be found at: http://www.mhhe.com/sexsource Women Talk Sex video clip – Ask paired students: How do women like to be stimulated? Are there differences in what women prefer? Once students have been given some time to share their initial answers, show the Women Talk Sex video clip and continue discussion. This is often a very lively discussion, since men have many misconceptions about what women find pleasurable. It is advisable to pair men and women up in same-sex groups and have the men go first, before showing the video. First Do No Harm video clip – Ask paired students: If you were born with both male and female genitalia, how would you want to grow up? Should parents choose a gender for intersex children? After some initial discussion show the First Do No Harm video clip. This may elicit a very charged debate among students, many of whom will be unaware of the prevalence of intersex individuals. Be prepared to moderate, as this is almost guaranteed to start a lively debate. This is an excellent discussion starter on intersex individuals and the issues they deal with. Denise Talks about her Transgender Experience video clip – Ask paired students: Have you always felt you should be a woman or man? What does the term ‘transsexual’ mean? Would you date someone who is transsexual? After some initial discussion show the video clip of Denise and continue. You may want to begin with a still image of Denise and ask if there is anything unique about her. It is unlikely that the class will be aware she is transgendered. This is an excellent clip for starting a discussion on transgender issues, and it is important to remind the class that while they may not believe they have ever known a transgendered person, it’s more likely that a transgendered individual hasn’t shared that information with them. GLOSSARY androgen insensitivity syndrome: a developmental condition in which cells do not respond to fetal androgen, so that chromosomally male (XY) fetuses develop external female genitals. There also is a feminization of later behavioral patterns. androgyny (an-DROJ-uh-nee): the presence of high frequencies of both masculine and feminine behaviors and traits in the same individual. anti-Müllerian hormone: secretion of the fetal testes that prevents further development of female structures from the Müllerian ducts. biological essentialism: a theory that holds that human traits and behaviors are primarily formed by inborn biological determinants such as genes and hormonal secretions, rather than by environmental influences. conception: the process by which a sperm unites with an egg, normally joining 23 pairs of chromosomes to establish the genetic “blueprint” for a new individual. The sex chromosomes establish its sex: XX for female and XY for male. congenital adrenal hyperplasia: a genetic disorder that masculinizes chromosomal females and seems to lead to a masculinization of behavior as well. core gender identity: a child’s early inner sense of its maleness, femaleness, or ambivalence, established prior to puberty. DAX-1: the region on the X chromosome that seems to play a role in sexual differentiation. DHT-deficiency syndrome: a condition in which chromosomally male fetuses have underdeveloped male genitals and may be identified as girls at birth; however, at puberty they begin to develop masculine secondary sex characteristics, and seem to maintain masculine patterns of behavior. differential socialization: the process of treating boys and girls differently as they are growing up. dihydrotestosterone (DHT): a chemical produced by the fetal testes that promotes further development of the testes, scrotum, and penis in the fetus. disorders of sex development (DSD): a more scientific term now being applied to those with combinations or ambiguities of female and male anatomical structures. fetally androgenized females: a condition in which hormones administered during pregnancy caused chromosomally female (XX) fetuses to have masculinization of genitals and perhaps of later behavioral patterns, even though they were raised as girls. gender dysphoria (dis-FOR-ee-a): another term sometimes used to describe a gender identity disorder. gender identity: a person’s inner experience of gender: feelings of maleness, femaleness, or some ambivalent position between the two. gender identity disorder: the expression of gender identity in a way that is socially inconsistent with one’s anatomical sex. gender role: the outward expression and demonstration of gender identity through behaviors, attire, and culturally determined characteristics of femininity and masculinity. gender schema: a complex cognitive network of associations and ideas through which the individual perceives and interprets information about gender. gonads: sex and reproductive glands, either testes or ovaries, that produce hormones and, eventually, reproductive cells (sperm or eggs). H-Y antigen: a biochemical produced in an embryo when the Y chromosome is present; it plays a role in the development of fetal gonads into testes. hyperfemininity: a tendency to exaggerate characteristics typically associated with femininity. hypermasculinity: a tendency to exaggerate manly behaviors, sometimes called machismo. intersexuality: a combination of female and male anatomical structures so that the individual cannot be clearly defined as male or female. Müllerian ducts (myul-EAR-ee-uhn): embryonic structures that develop into female sexual and reproductive organs unless inhibited by male hormones. multiplier effect: the combining of biological and socioenvironmental factors more and more with one another in the process of human development. pseudohermaphrodite: a person who possesses either testes or ovaries in combination with some external genitals of the other sex. social constructionism: a theory that holds that human traits and behaviors are shaped more by environmental social forces than by innate biological factors. secondary sex characteristics: the physical characteristics of mature women and men that begin to develop at puberty. sexual differentiation: the developmental processes—biological, social, and psychological—that lead to different sexes or genders. SRY: the sex-determining region of the Y chromosome. transgenderism: a crossing of traditional gender lines because of discomfort and nonconformity with gender roles generally accepted by society. transsexualism: a strong degree of discomfort with one’s identity as male or female, characterized by feelings of being in the wrongly sexed body. true hermaphrodite: a person who has one testis and one ovary. External appearance may vary. Wolffian ducts (WOOL-fee-uhn): embryonic structures that develop into male sexual and reproductive organs if male hormones are present. Chapter 6 Sexuality IN INFANCY, CHILDHOOD, AND ADOLESCENCE TOTAL TEACHING PACKAGE OUTLINE Lecture Outline Resources Reference Chapter 6: Sexuality in Infancy, Childhood, and Adolescence Psychosexual development Teaching Suggestions: 5(B), 6(D) Learning Objectives: #1,2,3,4,5,6,7,8,9,10,11, 12,13,14,15,16 sexuality in infancy and childhood Teaching Suggestions: 3(A), 5(A) Learning Objectives: #17,18,19,20,21,22,23 sexuality in adolescence Teaching Suggestions: 2(A-E), 4(A-B), 5(B), 6(B) Learning Objectives: #24,25,26,27,28,29,30, 31,32,33,34,35,36,37 Adolescent sexual health Teaching Suggestions: 1(B), 2(A-C), 3(B) Learning Objectives: #38,39,40,41 42,43,44,45 sexuality education Teaching Suggestions: 1(A), 2(A-D), 3(B), 6(A, C) Learning Objectives:#46,47,48,49,50,51,52,53,54,55, 56, 57 LEARNING OBJECTIVES After reading this chapter, students should be able to: 1. Describe, in general terms, the concept of psychosexual development. 2. Describe the concept of the biopshychological drive and Instinct Theory. State challenges to these ideas proposed by sex researchers. 4. Describe the origins and major assumption of psychodynamic theory. 5. Describe how psychodynamic theory views libido, including the latency period. 6. Discuss challenges proposed by sex researchers to the psychodynamic theory. 7. Describe the principle of conditioning theory, and its application to psychosexual development. 8. Describe the processes of generalization and discrimination, and their interrelatedness. 9. Describe the principles of social learning theory and its application to psychosexual development. 10. Describe the principles of developmental theory and its application to psychosexual development. 11. List and describe the stages of Erickson’s psychological development theory. 12. List and describe the three strands of Bancroft’s unified theoretical model. 13. List and describe three labeling stages of sexual development. 14. Describe the principles of Sexual Script Theory. 15. List and describe three different types of sexual scripts. 16. Describe choice theory, as well as two major components of the theory. 17. Describe the principles of social network theory. 18. Describe fetal and infant physiological responses of arousal. 19. Describe the psychosexual foundations and developmental tasks of infancy. 20. Describe the findings of the UCLA study regarding childhood sexuality. 21. Describe the tentative outline of sexual behaviors associated with different stages of development, from the Mayo Clinic study on childhood sexuality. 22. Describe the influence of parents on childhood sexuality. 23. Describe the body of research regarding nudity in the home. 24. Describe the sexual and romantic interests of children. 25. Describe the sexual concept of adolescence, including its ambiguous nature in Western culture. 26. Describe the physiological changes that early adolescents experience and the impact those changes have on perceptions of gender. 27. Describe what is known regarding early adolescent ejaculation and orgasm, as well as erotic fantasies. 28. Define cognitive susceptibility and how this relates to adolescents’ age of first intercourse. 29. Describe the influence of parent-adolescent communication. 30. Describe the contradictory messages about sexuality for young people. 31. Describe attitudes surrounding masturbation in adolescence. 32. Describe influences regarding reported first sexual intercourse experience. 33. Describe life factor influences regarding first sexual experience and consequences of delaying sexual intercourse. 34. Define the term “risky behavior” in terms of sex acts. 35. Describe trends in oral and anal sex in adolescence. 36. Describe the gender differences in adolescent masturbation. 37. Describe how the process of social development applies to adolescent relationships and sexual intimacy. 38. Describe trends in adolescent same-gender sexual activity. 39. Describe social obstacles to sexual development for adolescents with same-gender sexual orientation . 40. Describe the similarities and differences in adolescent sexual behavior between cultures. 40. Describe the social influence and consequence of teenage pregnancy. 41. Describe concerns regarding adolescent sexual activity and sexually transmitted diseases (STDs). 42. Describe characteristics of sexually healthy adolescents. 43. Compare and contrast comprehensive sexuality education with abstinance-only sexuality education (both in terms of application and in terms of common outcomes). 44. Describe eight concerns about abstinence-only sexuality education. 45. List and describe four steps for promoting sexual health in adolescents. 46. Discuss teenage pregnancy and the use of birth control. 47. Briefly explain why programs providing access to contraception are more effective in preventing pregnancy than abstinence programs. 48. Discuss the impact of legislation on contraception, and other barriers to sexuality education. 49. Explain both sides of the current debate regarding sexuality education in the USA. 50. Describe the position of the American Public Health Association regarding sexuality education. 51. Describe four types of sexuality education. 52. Briefly describe future needs regarding sexuality education, including needs related to cultural competancy. 53. Describe cross-cultural concerns involving sexuality education. 54. Describe the need for, and limitation of, sexuality education for professionals, teachers, and parents. CHAPTER OVERVIEW This chapter establishes the foundation for a full understanding of sexual behavior and its place in infancy, childhood, and adolescence. After offering some opening statistics about the changing nature of demographics in the United States, it offers an overview of the most widely accepted theories of psychosexual development. It is worth noting that theories of a biopsychological sex drive or inborn sexual instinct are probably the most often accepted by students. Recent research, including the National Health and Social Life Survey (NHSLS), has begun to clarify the nuances of such theories. It does seem clear that many different factors interact as human beings develop psychosexually. Individual patterns of sexual orientation and behavior probably develop through the interaction of biological, social, cultural, and psychological factors. The process is called “psychosexual development.” Biopsychological drive of instinct theories of psychosexual development state that a natural, instinctual drive exists toward sexual behavior. Psychodynamic theory has taught that the sexual instinct, or libido, becomes invested in different bodily areas through stages in human development: oral, anal, latency, and genital. It is believed that boys and girls resolve unconscious sexual issues with their parents during their development. This theory has seen much revision in recent years. Conditioning theorists believe that positive and negative reinforcement play a role in how people learn to behave sexually. Social learning theory is an extension of conditioning theory, which emphasizes the importance of identification with other people and modeling behavior after them. Developmental theory expresses the importance of stages in the emergence of behavior patterns, including those relating to sexuality. Erik Erikson described eight stages, each of which has particular tasks to be completed and crises to be resolved. A unified model of psychosexual development considers the crucial strands that eventually integrate to form adult sexuality: gender identity, sexual response and orientation, and the capacity for dyadic intimacy. Contemporary social process theory focuses less on individual persons as the unit of analysis, and more on the social processes in which the individual is immersed in shaping sexuality. Social script theory teaches that human behavior is controlled by complex social scripts. Sexual scripts have cultural, interpersonal, and intrapsychic dimensions that shape people’s patterns of sexual behavior. Choice theory explains how individuals decide which sexual behaviors to participate in, factoring in the resources, risk management, and the “market” of accessible partners. Social network theory focuses on how sexual connections and relationships are negotiated within a social context. In infancy and childhood, the sex organs respond to many stimuli. Babies are sensitive over the entire surface of their bodies. Children become more curious about their bodies and sex-related matters. At first, children’s sexual preferences are vague or multisexual. Sex play with other children, masturbatory behavior, and educational efforts by parents can play a significant role in how children feel about sexuality and their own bodies. Adolescence is the period of life between childhood and adulthood. At puberty, the body becomes capable of reproduction and develops its secondary sex characteristics. It is a time for exploring masturbation and relationships. Understanding and coping with emotional intimacy is important during the adolescent years and is crucial to the establishment of effective social relationships. In early adolescent sexuality, physical changes (puberty) and emotional changes (that occur because of the influx of sexual feelings) influence how that adolescent views gender - one’s own gender and that of others. Many different factors seem to influence the likelihood of intercourse and the use of condoms, including social dominance, appearance, and testosterone levels in males. Our society sends many powerful and contradictory messages about sexuality. Those messages focus heavily on either encouraging or discouraging sexual activity. Rarely do those messages acknowledge the pleasure component to healthy sexual expression choosing to strongly present messages of risk and negative outcomes. Most males and females learn about their own sexual functioning through masturbation. Adolescent social development occurs with both genders and is necessary to develop skills regarding intimacy. Same-gender sexual activity among adolescents may be experimental, or it may reflect later sexual orientation. A significant proportion of adolescents have at least one same-gender sexual experience. Although rates of teen pregnancy have been decreasing, teenage pregnancy continues to be a problem in the United States creating consequences for teen parents and for the larger society. Adolescent sexual health has become a more pressing concern with the risk of HIV infection, increases in sexually transmitted diseases, and the high rate of unintended pregnancy. The National Commission on Adolescent Sexual Health has established clearer guidelines on the subject. Sexuality education has evolved since the early 1960s, when its aim was largely to prevent unwanted pregnancy and disease by giving young people knowledge. The next stage of education emphasized the need for values clarification and communication skills. We now have to evaluate the role of the Internet in this. The attitude among the general public has tended to be favorable toward sexuality education in schools, although studies show that young people still get most of their sex information from peers or the media. Parents usually cannot provide all of the education that young people need. A debate is going on between groups who advocate providing comprehensive sexuality education, emphasizing sex-positive concepts, and preparing young people for possible sexual activity and those who want abstinence-only until marriage sexuality education, which is often based on fear tactics or particular religious biases. Other programs are focusing on postponing sex, but still being prepared with information on contraception, protection, and the need to prevent transmission of HIV are referred to as “integrated sexuality education” programs. To be successful, sexuality education must recognize cultural differences. Cultural competence on the part of sexuality educators can help them communicate effectively with people from cultural traditions that differ from their own. Other countries of the world are attempting to shape sexuality education programs. Sexuality education can change attitudes, but there is less research on behavioral change. Programs that devote adequate time to issues, are frank, make their goals clear, and discuss contraception, and safer sex does seem to change the onset of sexual intercourse. There is an effort to assist other countries with developing comprehensive sexuality education programs to effectively educate the youth. SIECUS has been a major influence in this endeavor. There is attention being paid to the training that professional sexuality educators, clergy people, and health care professionals may or may not receive. TEACHING SUGGESTIONS 1. Small Group Activities “Sex is for…” Objective: To identify personal motivations for saying “yes” to sex. To explore perceptions about why teenagers say “yes” to sex. Method: Put students into groups of four and state that this activity is called “Sex is for…” One does not have to actually have been sexually active in order to participate. Distribute index cards that have the phrases listed below written (one per card) and ask them, as a group, to rank why they would say “yes” to sex. Individuals must discuss their opinions and the group must come to an agreement in order to rank 1 (being the best reason to say “yes”) – 12 (“no way, not ever!”). One card per number - a group cannot have two cards in the position. Each group should tell the larger group what their top five reasons are. Discuss, after all the groups have identified, the similarities with responses. Pose some questions that encourage critical thinking about why individuals are motivated to say “yes” to sex. Are there more than 12 reasons? What’s missing from the list? Identify the bottom of the list…are these viable reasons for having sex? Where is the line for illegal, coercive, and non-consenting sex behavior? Discuss sexual violence. Ask them to think about adolescents (13-16 year olds). Look at the “Sex is for...” cards and identify the top three reasons why teens would say “yes.” When this activity has been done with teen participants, the top three have consistently been affection, bonds and pleasure. Releasing tension and reproducing are usually in the top five – the same outcome that adults list. One phrase per index card: Sex is… …for reproducing. …for selling things. …for creating bonds. …for proving identity. …for proving popularity and being part of the crowd. …for releasing tension. ….for furthering terror and oppression. …for rebelling. …for establishing power over another person. …for expressing affection. …for pursuing pleasure. …for earning money/luxuries or for paying back a debt. Upon completion: Students will learn from each other, as well as from the instructor, about the reasons for engaging in sexual activity. *This activity has been adapted from the Unitarian Universalist sexuality education curricula. Teenage Pregnancy Objective: To gain knowledge of reasons for teenage pregnancy and the impact on society. Method: Put students into groups of four. Have them discuss reasons why the U. S. has higher rates of teenage pregnancy compared to other developed countries. Examine and list social/cultural factors that may influence the rates of teenage pregnancy. Examine the cost to society. What prevention measures could be employed? Upon completion: Students will better understand the societal factors involved with teenage pregnancy. 2. Role-Plays This is a good chapter with which to use some role-playing if your group setting is adaptable to it. You may assign particular roles to students and ask them to communicate as they imagine this person would. A) A mother who has just discovered birth control pills in her 16-year-old daughter’s dresser. B) A father who wants to suggest to his college-age son that he use condoms during any sexual activities. C) A husband and wife who are trying to sort through what to do about their daughter’s unwanted pregnancy. D) College students who have been involved in a loving relationship and later one has decided that he or she no longer wants the relationship. E) A mother and father walk in on their six-year-old masturbating in the living room. F) A child sees his or her parents having sex and wants to know what is happening. 3. Guest Speakers You might ask a parent to bring in a baby and discuss the kinds of developmental patterns that have been evident so far during the baby’s life. Contact the campus GLBT group and/or PFLAG to organize a panel presentation. Invite a lesbian, gay man, a person who identifies as bisexual and parents/siblings of g/l/b people to talk about their personal stories. Encourage an open and direct dialogue to educate and raise awareness about g/l/b experiences in your area. 4. Case Study Ernest: A college student questions his sexuality (in main text). Discuss societal factors that influenced Ernest to be concerned about masturbation. Discuss whether Ernest’s fantasies seemed normal or abnormal. 5. Essays/Papers Ask students to describe briefly and anonymously in writing any romantic feelings they had prior to the age of 11. Emphasize that this is meant to focus neither on sexual behavior nor on forms of sexual abuse. Instead, the essays should be about loving and romantic feelings that they experienced as children, toward other children, or perhaps toward a somewhat older adolescent. In small groups, they could be exchanged and read aloud; in larger groups, the instructor might collect them and then read or duplicate several interesting ones. Ask students to do some thinking and writing about how social process theory might be applicable to their lives. What social scripts have they learned to follow? How have their personal choices been influenced by the opportunities open to them? How have their social networks affected their selection of friends, partners, and behaviors? You may find students somewhat resistant to the idea that larger social forces contribute to shaping their lives, and that is another reason why these discussions could be particularly valuable. 6. SexSource Video Bank The SexSource video bank provides an excellent array of short videos that may serve as discussion starters. In order to elicit the best responses, it is advisable to pair students in groups of two for “pair sharing.” Give them the initial starter questions below, and then show the videos after some initial discussion. Instructors should preview videos for time and content. Additionally, you may want to download clips prior to class to ensure they are ready for viewing regardless of network connectivity. All video clips may be found at: http://www.mhhe.com/sexsource Period Piece video clip – Ask paired students: What would you tell your daughter regarding menstruation? What did your parents tell you during your first period? Should young women be worried about menstruation, should it be celebrated, or do you have another idea? This video shows women discussing what they would tell their daughters regarding menstruation. Corey Johnson video clip – Ask paired students: When did you choose to be straight? What would you do if your best friend came out to you? Should gay people be treated differently then straight people? This video shows Corey Johnson coming out to the rest of the members of his football team. It can evoke a lively discussion of the need for sexual orientation education and the prejudices and discrimination that often impact gay and lesbian people. Learning to be Straight video clip – Ask paired students: If you were gay, what experiences would be different in elementary and high school? What does it mean to be a “heterosexist?” This video shows mostly straight individuals discussing how life is different for their gay and lesbian friends/students. The term heterosexist is also introduced. It may be useful to show the clip before students share their thoughts. Evolutionary Psychology video clip – Ask paired students: Is love learned or biological? Is there a reason that men want women, but women want relationships? What role do our genes play in our sexuality? This video introduces research from evolutionary psychologists and shows them discussing human sexuality. It is an excellent discussion starter on universals in human sexuality and the role genetics play. GLOSSARY abstinence-only until marriage education: an approach to educating young people that emphasizes the need to abstain from sexual relations until marriage. It is essentially the "just say no" philosophy. adolescence: period of emotional, social, and physical transition from childhood to adulthood. comprehensive sexuality education: an approach to educating young people about human sexuality that includes information about sexuality but also encourages clarifying values and developing decision-making skills. cognitive susceptibility state of mind, identified by psychological and situational factors. discrimination: the process by which an individual extinguishes a response to one stimulus while preserving it for other stimuli. dyadic withdrawal (dahy-AD-ik): the tendency of two people involved in an intimate relationship to withdraw socially for a time from other significant people in their lives. erogenous zone (i-ROJ-uh-nuhs): any area of the body that is sensitive to sexual arousal. generalization: application of specific learned responses to other similar situations or experiences. integrated sexuality education programs: this concept emphasizes the possibility of combining education to prevent pregnancy and the transmission of diseases with realistic approaches to educating young people about sexuality and how to make safer decisions about sex. latency period: Freudian concept that during middle childhood, sexual energies are dormant; recent research tends to suggest that latency does not exist. libido (li-BEE-doh or LIB-a-do): a term first used by Freud to define human sexual longing, or sex drive. psychosexual development: factors that form a person’s sexual feelings, orientations, and patterns of behavior. reinforcement: in conditioning theory, any influence that helps shape future behavior as a punishment or reward stimulus. Instructor Manual for Sexuality Today Gary Kelly 9780078035470

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