Relationships and Human Sexuality

We all come from various families of origin. Families do not just consist of individuals related by blood. Blended families are a result of remarriage. Families can also consist of adopted family members. We also have single parent families and families with gay and lesbian parents. The methods of relating and communicating by the adults in our household when we are growing up usually has a significant impact on our relationships and communication styles with others. Some individuals may have been raised in a household where yelling, criticism, and put-downs were seen as the only method of communication. Some individuals grew up in households where no one expressed any feelings or emotion. These extremes can predispose individuals to difficulties in relationships. However, as adults, awareness of these influences can help us to move in a positive direction.

Before we can develop a truly healthy relationship with another individual, we need to have a level of maturity and be comfortable with ourselves.  We need to demonstrate self-care before we can care for someone else. We need to know that we could stand on our own to be able to freely give and receive from another.

What is a Healthy Relationship?

Characteristics of Healthy Relationships

• Each person feels responsible for his or her own well-being and happiness and doesn’t depend on the other person to provide it.
• A balance between togetherness and separateness.
• An ability to communicate effectively.
• Being honest and assertive and willing to listen.
• Supporting growth for each person.
• Noticing the positives.
• The ability to accept the other as they are
• A willingness to negotiate differences and compromise.
• A willingness to recognize when the relationship is changing.

To build healthy relationships:

• Share your feelings honestly.
• Ask for what you need from others.
• Listen to others without judgement or blame. Be caring and empathetic.
• Disagree with others respectfully. Conflicts should not turn into personal attacks.
• Avoid being overly critical, angry outbursts, and violent behavior.
• Expect others to treat you with respect and honesty in return.
• Compromise. Try to come to agreements that work for everyone.
• Protect yourself from violent and abusive people. Set boundaries with others. Decide what you are and aren’t willing to do. It’s okay to say no.

Human sexuality is a broad term that involves the way people experience and express themselves sexually. The biological and physical aspects of sexuality largely concern the human reproductive functions. Sexual health can be defined as a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.

Sexuality is a big part of being human. Love, affection and sexual intimacy all play a role in healthy relationships. They also contribute to your sense of well-being.

Factors that can affect sexual health include

• Fear of unplanned pregnancy
• Concerns about infertility
• Sexually transmitted diseases/infections
• Chronic diseases such as cancer or heart disease
• Medicines that affect sexual desire or performance

There are a number of terms and concepts related to human sexuality.  Some of our perceptions of these topics can be influenced by cultural or religious belief systems.  In this text, the topics will be presented from a scientific research perspective.

Addressing human sexuality with children can be challenging and potentially stressful.  There may be a tendency to think that if we don’t talk about it, nothing will happen.  However, research shows us that providing accurate information and resources is very helpful in helping youth to prevent negative outcomes. Providing non-judgmental information at an age appropriate level will be most beneficial.  Utilizing additional supports for connecting with youth can be helpful as well.  There is a lot of information regarding human sexuality, and luckily we do not have to convey all of the information to youth at once.

Although the opportunity for formal sexual health education does not begin until children have been in school, children begin learning about their sexuality from the time that they are born.  They learn about what feels pleasurable to their touch and they learn about basic anatomy. Responding in a calm, matter of fact way with regard to these natural things and using accurate terminology helps children begin to develop a mature understanding of human sexuality.

What is the difference between sex and gender?

According to the American Psychological Association, sex is assigned at birth, refers to one’s biological status as either male or female, and is associated primarily with physical attributes such as chromosomes, hormone prevalence, and external and internal anatomy. Gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for boys and men or girls and women. These influence the ways that people act, interact, and feel about themselves. While aspects of biological sex are similar across different cultures, aspects of gender may differ. Various conditions that lead to atypical development of physical sex characteristics are collectively referred to as intersex conditions.

What does intersex mean?

A variety of conditions that lead to atypical development of physical sex characteristics are collectively referred to as intersex conditions. These conditions can involve abnormalities of the external genitals, internal reproductive organs, sex chromosomes or sex-related hormones. Some examples include:

• External genitals that cannot be easily classified as male or female.
• Incomplete or unusual development of the internal reproductive organs.
• Inconsistency between the external genitals and the internal reproductive organs.
• Abnormalities of the sex chromosomes.
• Abnormal development of the testes or ovaries.
• Over- or underproduction of sex-related hormones.
• Inability of the body to respond normally to sex-related hormones.

According to the American Psychological Association, “intersex” was originally a medical term that was later embraced by some intersex persons. Many experts and persons with intersex conditions have recently recommended adopting the term “disorders of sex development” (DSD). They feel that this term is more accurate and less stigmatizing than the term intersex.

How common are intersex conditions?

There is no simple answer to this question. Intersex conditions are not always accurately diagnosed, experts sometimes disagree on exactly what qualifies as an intersex condition and government agencies do not collect statistics about intersex individuals. Some experts estimate that as many as 1 in every 1,500 babies is born with genitals that cannot easily be classified as male or female.

Are intersex conditions always apparent at birth?

Not always. Some intersex conditions cause babies to be born with genitals that cannot easily be classified as male or female (called ambiguous genitals). These intersex conditions are usually recognized at birth. Congenital adrenal hyperplasia, 5-alpha-reductase deficiency, partial androgen insensitivity syndrome and penile agenesis would be recognizable at birth. Other intersex conditions, complete androgen insensitivity, Klinefelter syndrome, Turner syndrome and vaginal agenesis usually do not result in ambiguous genitals and may not be recognized at birth. Babies born with these conditions are assigned to the sex consistent with their genitals, just like other babies. Their intersex conditions may only become apparent later in life, often around the time of puberty.

What is sexual orientation?

Sexual orientation is about who you’re attracted to and want to have relationships with. Sexual orientations include gay, lesbian, straight, bisexual, and asexual. Someone’s sexual orientation can influence that person’s sexual interest and attraction for another person. There are a range of sexual orientations and sexual orientation is actually thought to be on a continuum and not confined to one category or another. This is referred to as sexual fluidity.

Sexual orientation is different from gender and gender identity. Sexual orientation is about who you’re attracted to and who you feel drawn to romantically, emotionally, and sexually. It’s different than gender identity. Gender identity isn’t about who you’re attracted to, but about who you ARE — male, female, genderqueer, etc. This means that being transgender (feeling like your assigned sex is very different from the gender you identify with) isn’t the same thing as being gay, lesbian, or bisexual. Sexual orientation is about who you want to be with. Gender identity is about who you are. Gender Expression is the part of a person’s identity that is about expressing masculinity or femininity as influenced by society, culture and individual expectations.

There are a variety of identities associated with sexual orientation:

• People who are attracted to a different gender (for example, women who are attracted to men or men who are attracted to women) often call themselves straight or heterosexual.
• People who are attracted to people of the same gender often call themselves gay or homosexual. Gay women may prefer the term lesbian.
• People who are attracted to both men and women often call themselves bisexual.
• People whose attractions span across many different gender identities (male, female, transgender, genderqueer, intersex, etc.) may call themselves pansexual or queer.
• People who are unsure about their sexual orientation may call themselves questioning or curious.
• People who don’t experience any sexual attraction for anyone often call themselves asexual.

How Is Sexual Orientation Determined?

There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay, or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientists to conclude that sexual orientation is determined by any particular factor or factors. Many think that nature and nurture both play complex roles; most people experience little or no sense of choice about their sexual orientation.

Both heterosexual behavior and homosexual behavior are normal aspects of human sexuality. Both have been documented in many different cultures and historical eras. Despite the persistence of stereotypes that portray lesbian, gay, and bisexual people as disturbed, several decades of research and clinical experience have led all mainstream medical and mental health organizations in this country to conclude that these orientations represent normal forms of human experience. Lesbian, gay, and bisexual relationships are normal forms of human bonding. Therefore, these mainstream organizations long ago abandoned classifications of homosexuality as a mental disorder.

What about therapy intended to change sexual orientation from gay to straight?

All major national mental health organizations have officially expressed concerns about therapies promoted to modify sexual orientation. To date, there has been no scientifically adequate research to show that therapy aimed at changing sexual orientation (sometimes called reparative or conversion therapy) is safe or effective. Furthermore, it seems likely that the promotion of change therapies reinforces stereotypes and contributes to a negative climate for lesbian, gay, and bisexual persons. This appears to be especially likely for lesbian, gay, and bisexual individuals who grow up in more conservative religious settings.

What is “coming out” and why is it important?

The phrase “coming out” is used to refer to several aspects of lesbian, gay, and bisexual persons’ experiences: self-awareness of same-sex attractions; the telling of one or a few people about these attractions; widespread disclosure of same-sex attractions; and identification with the lesbian, gay, and bisexual community. Many people hesitate to come out because of the risks of meeting prejudice and discrimination. Some choose to keep their identity a secret; some choose to come out in limited circumstances; some decide to come out in very public ways.

Coming out is often an important psychological step for lesbian, gay, and bisexual people. Research has shown that feeling positively about one’s sexual orientation and integrating it into one’s life fosters greater well-being and mental health. This integration often involves disclosing one’s identity to others; it may also entail participating in the gay community. Being able to discuss one’s sexual orientation with others also increases the availability of social support, which is crucial to mental health and psychological well-being. Like heterosexuals, lesbians, gay men, and bisexual people benefit from being able to share their lives with and receive support from family, friends, and acquaintances. Thus, it is not surprising that lesbians and gay men who feel they must conceal their sexual orientation report more frequent mental health concerns than do lesbians and gay men who are more open; they may even have more physical health problems.

What does transgender mean?

Transgender is an umbrella term for persons whose gender identity, gender expression or behavior does not conform to that typically associated with the sex to which they were assigned at birth. Gender identity refers to a person’s internal sense of being male, female or something else; gender expression refers to the way a person communicates gender identity to others through behavior, clothing, hairstyles, voice or body characteristics. “Trans” is sometimes used as shorthand for “transgender.” While transgender is generally a good term to use, not everyone whose appearance or behavior is gender-nonconforming will identify as a transgender person. The ways that transgender people are talked about in popular culture, academia and science are constantly changing, particularly as individuals’ awareness, knowledge and openness about transgender people and their experiences grow.

Transgender people may be straight, lesbian, gay, bisexual, or asexual, just as nontransgender people can be. Some recent research has shown that a change or a new exploration period in partner attraction may occur during the process of transition. However, transgender people usually remain as attached to loved ones after transition as they were before transition. Transgender people usually label their sexual orientation using their gender as a reference. For example, a transgender woman, or a person who is assigned male at birth and transitions to female, who is attracted to other women would be identified as a lesbian or gay woman. Likewise, a transgender man, or a person who is assigned female at birth and transitions to male, who is attracted to other men would be identified as a gay man.

How does someone know that they are transgender?

 Transgender people experience their transgender identity in a variety of ways and may become aware of their transgender identity at any age. Some can trace their transgender identities and feelings back to their earliest memories. They may have vague feelings of “not fitting in” with people of their assigned sex or specific wishes to be something other than their assigned sex. Others become aware of their transgender identities or begin to explore and experience gender-nonconforming attitudes and behaviors during adolescence or much later in life. Some embrace their transgender feelings, while others struggle with feelings of shame or confusion. Those who transition later in life may have struggled to fit in adequately as their assigned sex only to later face dissatisfaction with their lives. Some transgender people, transsexuals in particular, experience intense dissatisfaction with their sex assigned at birth, physical sex characteristics, or the gender role associated with that sex. These individuals often seek gender-affirming treatments.

Lesbian, Gay, Bisexual, and Transgender Health Disparities

Challenges to achieving health equity stem primarily from the “invisibility” of LGBT individuals and communities, the forms of stigma and social and legal discrimination to which they are susceptible, and the scarcity of data on the factors influencing LGBT health. The social determinants of health are particularly influential drivers of LGBT health disparities. High rates of unemployment or underemployment, limited access to appropriate health care, and social discrimination affect the behaviors in which LGBT people engage and the strategies needed to improve health.

Recent civil rights gains have helped to increase LGBT visibility, reduce stigma, and facilitate access to health insurance and health care; however, standardized competencies on LGBT health for health professionals and health care organizations are not always mandated. Therefore, the care that LGBT persons receive may not yet reflect an awareness of LGBT-specific concerns.

How to Be Supportive of the Sexual Health of All Individuals

• Educate yourself.
• Be aware of your own attitudes about issues of sex and gender and sexuality.
• Learn how to talk about issues of sex and sexuality in an age-appropriate manner.

• Language is dynamic, continually growing and changing. This is particularly true with the language we use to identify ourselves. We should strive to use language that does not demean, exclude or offend, by respectfully allowing others to self-identify and by mirroring those terms and identities.

• Work to ensure that people are not teased, harassed or subjected to discrimination.

• Be an Ally: A person who does not identify with a group, but still advocates for that group’s rights.

• Get support, if necessary, to help deal with your feelings. Individuals who are different, and their families, friends and partners often benefit from talking with mental health professionals about their feelings and their implications.
• Consider connecting with support groups.