Sexuality and Sexual Health

This page contains explicit adult sex education. It is not for minors or those who would be offended by such content.

Human Development and Sex Education

Infancy-0-2

  • Survival skills of sucking, attention getting, responding, biting, weaning, crawling, walking, reflex control.
  • Social skills of dependency on parent figures.
  • Sex education: touch and its meaning, rhythmic movement, responsive affect, fundamental gender identity.

Early Childhood-2-5

  • Muscular control, impulse control, family relationships, beginning social skills, beginning control of environment, major language development, beginning imagination.
  • Sex education: naming of body parts, active self-touch, beginning concept of pregnancy, some grasp concept of coitus, toilet skills, public versus private behavior, beginning concept of safe versus unsafe touching, clearer concepts of male and female.

Middle Childhood- 5-8

  • Increasing muscular development and control, increasing language development including reading and writing, increasing development of imagination, social relationships extend well beyond the family, developing social coping skills. Sex education: Beginning modesty, curiosity increases, more interest in impregnation and pregnancy, creates myths regarding the manufacturing of babies, know sex related words but not necessarily the meanings, increasing ability to give as well as receive affection. Often very close to opposite sex parent.

Older Childhood -9-12

  • Continuing refinement of physical and social skills, increasing ability to cooperate and compete, turning from family centered relationships to peer relationships.
  • Sex education: pre-adolescent growth spurts, some have miniature person concept of fetal development, increasing self-consciousness: some enter puberty, especially girls.Need information regarding physical, and emotional changes of puberty such as genital changes of size and color, breast development, body and facial hair growth, menstruation, and nocturnal emissions.
  • Girls begin hormonal changes at about 10 years old, or about 68 pounds. About 11, or one year after 68 pounds breast development begins, breasts often do not develop symmetrically nor simultaneously. Approximately one year after the beginning of breast development some pubic and underarm hair begins to grow. About one year after pubic hair growth or about 105 pounds menstruation often begins. Menstruation is often irregular for the first one to three years.
  • Boys around 11 have an episode of body fat retention signaling hormonal changes. About one year later, the penis and scrotum begin to increase in size and darken. Spontaneous erections are more frequent. One year later, pubic, body, and facial hair appear. Ejaculation and nocturnal emissions may begin. Voice changes begin.
  • Boys and girls need increasing guidance regarding hygiene and body odors as they enter puberty.
  • Both boys and girls who will eventually be both homosexual and heterosexual tend to engage in some same sex play during these years.

Adolescence-10/12-18

  • Peer groups are central. They seek role models. They turn inward as they define their identities. They expand their social skills. They develop increasing sophistication in their coping skills. This is often a turbulent time as the child metamorphoses into an adult.
  • Sex education: During these years being available as a resource person is essential. All of the above physical information may need to be clarified but during these years the clarification of values and social relationships should be central to sex education. Adolescents are concerned about body changes, masturbation, relationships, social skills, partner choices, genetics, values and value differences, kissing, sensual and sexual touching, coitus, disease prevention, pregnancy prevention.

Young Adulthood-18-30

  • Transition to full adulthood. Higher education may continue for some. Work/career choices, peer group development, partner choices are often made. Through this period all of these areas begin and develop. Sometimes parenthood is begun.
  • Sex education: Support for social development, individual variations, partnering and non-partnering, transition to fully independent life, emotional support for fully independent life and shared adulthood.

Adulthood-30-65

  • Maturation continues, partnerships and family life develop, family responsibilities grow and change. Patterns of relationships develop and change. Parenting behavior develops when persons have chosen parenthood. Recreation patterns develop and change. Health problems sometimes begin to emerge.
  • Sex education: Sexual adaptation to life developments such as enduring relationships, as well the ending and beginning of new adult relationships, pregnancy, postpartum, breastfeeding, body changes of aging, normal sexual changes of aging, adaptation to health problems.

Older Adulthood-65+

  • This period of life is searching for a socially sanctioned role in modern America. In traditional societies and some families, older adulthood is a period of time when the elders are part of the extended family. They are looked to for advice in a variety of areas, as well as for assistance in raising and guiding children. Healthy older adults sometimes develop a second career or an active recreational or volunteer pursuit. This is often a period of coping with increasing physical limitations.
  • Sex education: Adaptation to aging, adaptation to physical changes, adaptations to social relationships, adaptation to partner loss or absence of partner availability. Continued search for sense of purpose and identity as a man or woman.

 

Teens and Young Adults

Readiness for Sexual Involvement

Consider if you are personally ready to be sexually involved. Don’t base it on how old you are or how many dates you have had, but rather on a serious evaluation of yourself and your relationship.

  • Are your sexual actions consistent with your beliefs?
  • As you imagine being sexually involved with this person, do you feel happy and relaxed, or nervous and apprehensive?
  • Do you have any fears about the possible outcome of this relationship, or sexual involvement in this relationship?
  • Are you choosing to be involved because you want to be, or because your partner or your friends expect you to be?
  • What does sexual involvement with this person represent to each of you?
  • Does it represent an exclusive commitment?
  • Does it represent an expectation of marriage?
  • Is it “just for fun”?
  • Are you comfortable with being naked with this person? If the thought makes you uneasy, maybe you are not ready to be sexual.
  • Is this person critical or judgmental outside the bedroom? If he or she is, then you should expect that they will be critical and judgmental sexually.
  • Have you discussed safe sex? Have you discussed pregnancy prevention? If you are uneasy, or if it would “spoil the mood” maybe you are being impulsive and are not ready for sexual involvement.
  • Is this potential partner someone with whom you can trust your thoughts and feelings? If not, should you trust them with your intimate self?

 

Ten Reasons for Having Sex That No Smart Teen Would Use

  1. You would if you loved me. When people love each other they respect each other’s needs and wishes
  2. Everybody does it. No, lots of people wait until they are older and have a more mature relationship.
  3. Come on, prove you are grown up. Giving in to pressure proves you are grown up? Come on!
  4. I don’t know what else to do. Really? There are lots of other things to do; don’t give up and give in.
  5. Aren’t you curious what it would be like? Sure, but there are better times and ways to find out.
  6. You owe me for taking you out to the dinner/concert/prom. This sounds like blackmail or prostitution; things no one who cares would demand.
  7. I won’t date you unless you do. Who wants dates with people who pressure you or want to use you?
  8. You can’t get pregnant the first time. Oh yes you can, and too many do.
  9. We can just do it a little. There is no such thing as a little intercourse or a little pregnant.
  10. ???

Enjoy being a teen. Enjoy getting to know and care about the people you date. Look forward to an interesting and exciting future. Sex is really a pleasure when you are relaxed, responsible for yourself and your partner and really care about each other. Wait until you and your partner are ready, and then prevent guilt, sadness, illness and pregnancy.

 

Sexual Self-Help

Sexual problems can be solved! Sexual feelings and behavior are normal and natural. Sometimes problems can develop in those normal and natural feelings and behavior. A person can feel anxious or worried about his or her sexual thoughts and fantasies. A person can wonder if he or she is normal. Sometimes people worry that they are too interested in sex, or not interested enough, or have a difference in interest from their partner. Sometimes people have difficulty becoming aroused (turned on) or staying aroused. Sometimes people have difficulty with orgasm, either reaching orgasm sooner than they would like or much later than they would like. Sometimes both men and women experience some pain when they try to make love. These problems are called sexual dysfunctions and you can try self-help. Most sexual problems respond to a combination of information, specific suggestions and reconditioning habits. (Jack Annon, M.D.)  I am aways surprised, and sorry to hear that people have struggled with sexual problems for years, because the vast majority are so solvable.

A good place to begin is with a general health check up with a trusted physician. Tell the doctor what does or does not happen and what your concern is. The doctor needs to know so he or she can ask the right questions and do the right tests.

Sexual dysfunctions can occur for a variety of reasons. They can be a manifestation of:

  1. Lifestyle or medical problems, such as exhaustion or diabetes If you are drinking too much, or not sleeping enough-you know what to do. If there might be a medical problem, see your doctor! Ask your pharmacist if any of the medications have sexual side effects. If so, go back to your doctor and ask if there is an alternative medicine.
  2. Preexisting emotional problems such as anxiety or depression Anxiety and depression can be treated, sometimes without medication-do some reading and then get help.
  3. Lack of, or incorrect sexual information. Read For Yourself by Barbach or A Patient’s Guide to Male Sexual Dysfunction by Lue. Sometimes a little information makes a big difference!
  4. Ambivalence regarding pregnancy, birth control or child rearing You and your partner need to have an honest conversation about what each of you wants. Talk with a doctor or therapist or a sexual health educator to make sure you both have correct information about what your concerns are.
  5. An unresolved relationship problem Get a referral from a trusted friend or your doctor to a therapist who is experienced in working with couples.
  6. A different, preexisting sexual dysfunction

Go see a knowledgable counselor or therapist. Solving sexual problems requires working with someone who has additional training in specific ways to solve sexual problems. No sexual behavior should ever take place in front of the counselor or therapist, so don’t worry!

Dr. Jack Annon developed a way to look at the different levels of sex therapy. He called it PLISSIT, which stands for:

  • Permission-to be sexual, permission to take time to relax and enjoy yourself and each other.
  • Limited Information-Sometimes people need a little information or corrected information.
  • Specific Suggestions-There are techniques that can solve some sexual problems with minimal sex therapy
  • Individual or Couple Therapy-If those techniques haven’t solved the problem then a good therapist works with the individual or the couple by taking a systematic history of the problem, formulating a plan to solve the problem.

Psychology has found that sexual problems respond to direct problem solving beginning with instruction, then desensitization and successive approximation. This is the way we learn many things that involve the mind and the body, such as dance or sports. Finally the counselor or therapist works with the individual or couple to integrate what they have learned into real life. You do not need to suffer with sexual problems. You do not need to let your relationship become sad, or angry. You do not need to end your relationship. Almost all sexual problems can be solved if you and your partner are both willing.

 

An Eight Step Program for Men Who Want to Improve Their Sex Life

Before advancing to any given step the man should have successfully completed all the previous steps. He should focus on, and vary the type and tempo of the stimulation. He should make sure he is well-rested and alcohol-free. He should use relaxation techniques such as breathing and muscle relaxation to help himself achieve each step. The objective of the self-stimulation/masturbation is to focus on the sensation rather than rush to orgasm. Do not use erotic visual stimulation or fantasy while you are working on improving your sexual function. They will not help you increase your control. While this is a highly successful method, it can take several weeks of practice. It is not foolproof. Men should not consider themselves failures if they need additional professional assistance!

  1. Take some time to be well-rested and relaxed. Slowly touch and massage non-sexual areas of your body. Progress to stimulate your genitals with a dry hand using a variety of types of stimulation, increasing and decreasing the amount of speed and intensity until you can last 15 minutes.
  2. When you have achieved the first step, do the same thing using a non-menthol, hypo-allergenic oil or lotion.
  3. After relaxing and cuddling with your partner, ask your partner to touch you in the ways that you have been touching yourself. Pay attention to your sensations and ask your partner to increase and decrease the stimulation, the place, intensity and tempo, according to your requests, until you can control the degree of arousal for 15 minutes.
  4. Once you have been successful with the previous step, repeat it using the oil or lotion you used in step 2. If you use a condom with your partner, do the exercise with a condom so your body gets used to the sensation.
  5. After relaxing and holding or cuddling with and satisfying your partner, ask her to sit or kneel astride your thighs and do the previous step. Once your are aroused and feel you have good control of your erection ask her to move her body over your genitals and insert your lubricated penis. She should be asked to move only enough to maintain your erection for 15 minutes. She could use vaginal muscle squeezes, rotational movements or slow, gentle thrusting. Use lubrication. Give clear instructions.
  6. Repeat the previous step with increased and decreased stimulation. The man should use the relaxation techniques he practiced in order to gain control. He should give clear instructions to his partner to increase and decrease the intensity of stimulation until he can sustain arousal for 15 minutes.
  7. In this step the partners repeat all the instructions above, with the man taking turns with the woman in the movements.
  8. Use all the principles and techniques above, while making love in a more mutual manner. When trying out other positions, go back to the fifth step and gain control before beginning any movements. Take your time. Talk! Give each other suggestions of what would feel good. Don’t rush. This is not a performance; good sex is a form of good communication. If your partner is angry or critical, find out what the problem is. Focus on finding the right way for you to make love for both of you.

 

Sexual Myths

Recently, I spoke at a conference about Sex in the Twenty-first Century. I began with a true/false quiz participants asked me to post. Read the quiz below and see what you think the answers are.

  • Most normal women have orgasms with intercourse.
  • Viagra, Cialis and Levitra cure E.D. Reparative psychotherapy changes sexual orientation. Sex education increases sexual experimentation by adolescents.
  • Most physicians have had professional level sex education or training.
  • Smoking cigarettes is harmful to women trying to conceive but smoking does not affect sperm in male smokers.
  • All normal adults instinctively know how to have sexual relations.
  • There is no such thing as too much masturbation.
  • At this time in history any woman who wishes to become pregnant can do so with medical help.
  • Sexual addiction is a myth.
  • Religious people are sexually repressed.
  • One can always recognize if someone is gay or lesbian.
  • Human beings are the only species that have sexual dysfunctions.
  • Testosterone and E.D. ads on t.v. and radio are truthful and accurate.
  • Psychological stress predicts failure to become pregnant.
  • Orgasm is a complex reflex that usually lasts 2-3 seconds in chimpanzees, 8-12 seconds in humans and 30 minutes in pigs.

In case you haven’t guessed, all the statements are false, except the last one, which is true!

 

In Sickness and In Health:

Intimate Communication and Serious Illness

Serious illness can cause people to be so concerned and distracted that they forget some important principles of couple communication. Some suggestions that couples have found helpful are outlined below.

  • Speak for and about oneself, rather than assume you know, or tell each other how he or she should think, feel or act.
  • Ask the person with the illness how he or she would like to handle communicating about health matters. Accept the requests, if possible. Some people process out loud; others, internally. Couples do best when they match styles. If your partner is an internal processor and you are not, find a trusted friend or professional with whom you can talk.
  • Listen to each other, really listen without preparing your response. Describe rather than dramatize. People with strong feelings sometimes state their feelings and fears as if they are actions or facts.
  • Share information from physicians and other professionals as a couple. Secrets, even when motivated by a desire to protect a loved one, create confusion and distrust.
  • Express sympathy and empathy, and tell the truth to each other. Decide together who will be told what. The person with the illness might not want to discuss personal matters with certain friends and family members.
  • Partners of those with serious illness need support, but be selective so you and they do not become overwhelmed.
  • There really isn’t only one best way to handle serious illness. You have to find the way that works for you and your family. Focus on solutions, rather than repeatedly talking about the problems.
  • If the illness interferes with certain aspects of sexual interaction focus on affection and sensuality rather than sexual interaction.
  • Continue to discuss things other than illness and treatment: children, grandchildren, politics, movies, memories. The illness should not be allowed to take over.
  • Designate certain “illness free” times.
  • Always remember the positive things that brought you together and celebrate those.