psychology
ELLERBEE1
SexualHealth.pptx
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Sexual Health (WHO 2006)
Sexual health is:
A state of physical, emotional, mental and social well-being related to sexuality
Not merely the absence of disease, dysfunction or infirmity
Relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion discrimination and violence.
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WHO = world health organization
Broad definition to cover broad range of topics. Has to be inclusive of multiple elements, not just one fact that can be misrepresented.
The Sexual Body
Social Construction of Body Image
Changes over time
Changes across culture
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Society is preoccupied with physical perfection, which can have both healthy and unhealthy consequences.
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Critics, including some health professionals, believed that corsets caused cancer, anemia, birth defects, miscarriages, and damage to internal organs. The tight restriction of the body did deplete lung capacity and caused fainting.
The popular concept of an obsession with a tiny waist is probably exaggerated. The competition of cinch in to improbable dimensions was more of a fetish or a fad and not the norm as depicted in the 1939 film, Gone With the Wind, when Scarlett O'Hara cinches her corset to a 17" waist
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Sexual Health Disparities
Exist on multiple dimensions:
Sexual Orientation
Race or Ethnicity
Class/Socioeconomic Status (SES)
Gender
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Lesbian issues--breast cancer, medical treatment (stigma), lifestyle, etc.
Race or ethnicity--lack of access to education for many, decreased access to health care
Class/SES--same as race/ethnicity
Gender--less focus in research, different dr-pt. Relationship, outright abuse in some cultures--female genital mutilation (in other cultures and in our own--as a cure for masturbation). Also male circumcision in our own culture.
Extreme Influence on Individuals certainly exists today, just in different forms
Plastic Surgery
Eating Disorders
Eating Disorders
Unfortunately, our standard of beauty tends to equate beauty and health, with thinness.
Eating Disorders
While we have moments of opposing messages, largely this has held true culturally
Over the past three decades eating disorder prevalence has risen rapidly
Eating Disorders
While most of those with eating disorders are women, we often stereotype the disorder as only belonging to women
10% of those with an eating disorder are men, and that number is rising rapidly in younger generations
Eating Disorders
Two main Diagnoses
Anorexia Nervosa
Bulimia Nervosa
Additionally, binge eating disorder
Eating Disorders
Eating Disorders/Sexuality
Retreating from sexuality
Eating-disordered patients have a higher than average history of abuse
May have been raised to be fearful of sex and view the body as sinful or dirty
Generally feel ambivalent about their sexual natures and bodies
Retreat from sexuality:
May also relate to the conflict regarding sexuality--may appear dangerous/evil and desirable/beautiful, which may cause a person to become disembodied.
Often develop during adolescence.
May be related to a need to control their bodies and lives.
Retreating from sexuality
Eating-disordered patients have a higher than average history of abuse
May have been raised to be fearful of sex and view the body as sinful or dirty
Generally feel ambivalent about their sexual natures and bodies
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Anorexia nervosa
Characterized by an all-controlling desire for thinness
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Often a symptom of an underlying psychological disturbance.
Afffects menstruation, hormonal levels, pubertal development, skin & hair, teeth & gums, & bones.
Two types of anorexia are restricting and binge eating/purging:
Restricting--diet & excessive exercise but no binging.
Binge/Purge--may do one or the other or both.
A refusal to maintain a healthy body weight
Intense fears of becoming overweight
Comorbidity with Body Dysmorphic Disorder
In women, amenorrhea occurs as well
Anorexia Nervosa
Restricting Type
Restrict foods, starting with unhealthy foods but then branching out to all types
Little variability in diet (a lot of order/repetition)
Anorexia - Typology
Binge-eating/purging type
Lose weight by purging after meals (through vomit, laxatives, excess exercise)
May engage in bouts of binge eating, but not necessary
Anorexia - Typology
Upwards of 90% of cases occur in women
Men feel stronger pressure in our society to make their body larger, more likely to have binge eating disorders, use steroids, etc.
Disorder occurs in 1-2% of women in western countries
More than that display symptoms however
Rates increasing in Western societies as well as Japan
Anorexia
Onset is usually in adolescence, or high school
Early onset usually looks like dieting behaviors or a “health focused” new attitude
Anorexia
Those initial behaviors tend to escalate usually after a stressful event
Separation/divorce
Big life changes (moving, death of a loved one, etc.)
Personal failure
Bullying
Anorexia
While its important to remember that most people recover from anorexia
2-6% become seriously ill and die as a result of complications
This makes it one of the psychological disorders with the highest mortality rate!!
Anorexia
The underlying drive for anorexics is an all-encompassing desire for thinness
This drive contains a lot of anxiety/fear for the individual
Fear of gaining weight
Fear of allowing one’s self to feed a hunger response
Importantly, fear of losing control
Anorexia
Many people at first believe they would “know” who is anorexic by seeing if they eat food
However, all anorexics eat food (unless their condition is critical)
You need some calories to even function as a result of burning calories daily
Anorexia
Anorexics are in fact obsessed and preoccupied with food
Think about food often (fantasize about it as well)
Read cookbooks, food magazines
Plan and cook meals (often very elaborate ones)
Anorexia
These symptoms are also seen in individuals who voluntarily starved themselves to help science/their country in WW2
“Minnesota Starvation Experiment”
Anorexia
Cognition is affected in those with the disorder
Poor body image (to an extreme)
High overestimations of weight/proportions
Tend to hold perfectionist attitudes
And false perceptions of how to attain perfection
Often don’t feel disordered, believe anorexia is healthy and being thin is perfection
Anorexia
Characterized by bouts of binging and purging
Bulimia Nervosa
Purging-type
Engage in ways of trying to make food/calories leave the body before they are absorbed into the body
Vomiting, laxatives, diuretics, enemas
Nonpurging-type
Try to compensate for calories taken in by going on fasts, or exercising excessively
Bulimia Typology
Upwards of 90% of those with the disorder are female
Men are more likely to engage in the binging…without the purging (binge eating disorder) in the hopes of gaining weight, or to “eat” away negative feelings
Bulimia
Onset is a bit older than anorexia typically
However, even childhood rates for both are on the rise
Typically in high school and early college years
Bulimia
Those with bulimia are not usually excessively thin like those suffering from anorexia
Weight fluctuates, sometimes rapidly
Can also have anorexia, or develop anorexia
Bulimia
Many youth have bulimia role-modeled for them by family or friends and take up the behaviors thinking it will help lose weight
Some studies suggest up to half of high school students have at some point engaged in binge eating or purging behaviors
For some people symptoms may be periodic, and not long lasting like those with anorexia
Bulimia Prevalence
Binging and Purging behaviors are usually secretive
The rate of these behaviors can vary, some as low as once a week with others performing them multiple times daily.
Bulimia
Food intake during a binge is rapid
Foods are usually chosen that are soft and easy on the stomach
Can take in 1000-3000 calories in a single binge
Bulimia - Binging
Binges are usually brought on by moments of anxiety/tension & feelings of helplessness
Eating the food feels great. Endorphin rush, pleasure, satisfaction...but is followed by:
Self-blame
Guilt
Depression
Health/weight fears
Bulimia - Binging
Anorexics often live in a reality where they believe what they are doing is healthy, bulimics often realize what they do is harmful
Guilt after binging leads to compensatory behaviors
Now tension is directing them to get rid of what they just took in
Bulimia
Most common are vomiting and the use of laxatives
Purging doesn’t really work
Vomiting only removes up to half the calories consumed
Usually produces more hunger
Laxatives really have no effect other than dehydration and psychologically feeling less guilt
Bulimia - Purging
Typically onset is often after a period of strict dieting.
First bouts of binge eating often occur during those periods of denial in a diet
Bulimia - Onset
Shocker: new research shows that in America, around HALF of ALL grade school girls are on diets currently. CURRENTLY!!!!!
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Health Disparity
When a demographic group experiences worse health outcomes compared to another demographic group that can’t be accounted for based on biology alone.
Extreme Makeover
Very popular today, as evidenced in the variety of reality television shows that specialize in makeovers that involve plastic surgery.
Extreme evidenced in plastic surgeries, brazilian waxing (and permanent hair removal).
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Can range from small procedures, to those who obsess with changing selves through surgery. For instance, the infamous “cat lady” Jocelyn Wildenstein
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Genital Plastic Surgery
Vaginal Rejuvenation
Labiaplasty
Hoodectomy (Clitoral unhooding)
Hymenoplasty (revirgination)
G-spot enhancement
Anal and vaginal (vulva) bleaching
Breast augmentation
Penis elongation and fat injections
Vaginal Surgeries have increased by more than 30% since 2006.
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Very popular today, as evidenced in the variety of reality television shows that specialize in makeovers that involve plastic surgery.
Extreme evidenced in plastic surgeries, brazilian waxing (and permanent hair removal).
Clinics marketing labiaplasty as “female genital rejuvenation”
Steroids
Anabolic steroids
Used to enhance body image and
athletic performance
Can cause serious and permanent body damage
Sterility, heart attacks, stroke, liver damage, and personality change.
Can cause the body to shut down production of testosterone.
Breasts will grow and testicles atrophy
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Research shows that women want their body size to be smaller, and men want their body size to be larger. Effect of masculinity/femininity dichotomy.
While we see most men wanting a larger frame, and most women wanting a smaller one…we do see those defying the numbers. And greater numbers of boys developing eating disorders
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Variations in sexual desire (fetishes/kinks)
Know very little about how they form
But many are thought to be conditioned (often highly contextual)
Fetishes and kinks are not considered disorders, just variations in sexual interest, and are perfectly healthy unless:
They remove the possibility of consent
They cause permanent injury
Pleasure cannot be gained from doing anything else (a healthy sexuality includes a little variation)
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