Sexual and Gender Issues In Healthcare

Afza.Malik GDA

Healthcare and Sexual & Gender Issues

Sexual and Gender Issues In Healthcare

Sex and Gender Research,Sexual Research in Health Care,Public Sexual Education,Type of Literature and Affect on Sexual Health,Boarding School Life and Homosexuality,Sexual Interaction.

Sex and Gender Research

    Sex and gender research has exploded over the course of the past half century and consequently traditional ideas have been challenged and, in many cases, radically modified. 

    Two factors seemed to be the driving forces behind modern sex research: the need to explain the existence of sexual variation, eg, prostitution, homosexuality, transvestic, and bisexuality on the one hand, and the desire to find some scientific means of family planning or control of reproduction and disseminating information about this on the other hand. 

    Germany was the home of early researchers such as Magnus Hirschfeld and Richard von Krafft Ebing, who explored what Krafft-Ebing called sexual pathology. Both authors are still reading today although the key writings of Hirschfeld on homosexuality and transvestic were not translated into English until the 1990s. 

    In England, the leading figure was Havelock Ellis, who used historical and sociological data to challenge many of the sexual beliefs of his generation. All three were data collectors about human sexual variation but were not able to explain why there was so much variation in human behavior (Bullough, 1994).

Sexual Research in Health Care

    In the 20th century two Americans, John D. Rockefeller II and Margaret Sanger, a nurse, were extremely influential in establishing the United States as a center for sexual research. 

    Rockefeller originally was concerned with understanding why prostitution and prostitutes existed, while Margaret Sanger was concerned with family planning. Rockefeller in the 1920s established and financially supported the Committee for Research in the Problems of Sex, which concentrated on research about the biological and psychological sources of human sexuality. 

    Sanger in her campaign for effective birth control realized the importance of changing public attitudes about sexuality, since actual dissemination of any kind of information about birth control or many other kinds of sex information across state lines was illegal in the United States. 

Public Sexual Education

    For her, educating the public about what science knew was all important, while Rockefeller felt finding out about what people did sexually as well as the reasons for doing it was the key. 

    One result of Rockefeller's efforts were the books by Kinsey and colleagues (1948, 1953), which revolutionized the understanding of human sexuality, and the ultimate result of Margaret Sanger's work was the development of the pill for contraception which contributed immeasurably to a changing role and status for women in the United States. 

    Some sexual topics are more controversial than others. For example, concern over the effects of pornography has led to many studies on the topic, with the majority of them concluding that it seems to have little correlation with the actual conduct of the viewer or reader.

Type of Literature and Affect on Sexual Health

    It is a sort of a fantasy literature, an adult Superman comic, which almost all research indicates is not particularly harmful to the adult reader (Elias et al., 1999). One of the most intensely studied topics in childhood is that of gender identity. 

    Usually by the time children begin to talk they can apply the appropriate gender identity to themselves, although they do not necessarily understand the concept of gender constancy. A little boy may believe, for example, that at some later point in life he will be a girl or vice versa. 

    Gradually as their gender identity becomes stronger, they also learn gender roles, what is expected of females or males in the culture, and begin to acquire a gender role identification (Money & Ehrhardt, 1972). Not all children accept or adopt the norms expected of them. 

    One study of this nonconformity was by Richard Green (1987). He recruited 66 families in which there was a boy (age 4 to 10 years) who was regarded as extremely feminine and in a longitudinal study over a period of 15 years he compared them with a sample of other boys. 

    He started with the assumption that socialization and parental treatment were the main determinants of gender but found that this was not the case. Most of the feminine boys in his study later identified as homosexuals, a development which did not take place in his control study. 

    This study and similar studies tended to give growing credibility to biological factors in the development of homosexuality, bisexuality, and transgender behaviors, resulting in a deemphasis on psychodynamic theories. There is still a lot that remains unknown. 

    The Bulloughs (1993) in their studies of transvestites and transsexuals argued that there were variations in gender and sexual behavior which had some biological basis and that, instead of one standard of definition of what was male and what was female, individuals appeared on different levels of two bell-shaped curves which had considerable overlap. 

    There were in essence females who had a strong masculine component and males with a strong feminine one. These differences were not due to genetic factors per se (although this might have entered in) but more to developmental factors in the fetal period. 

    Studies have shown that adults who as children witnessed parents engaging in sex were not harmed by so doing (Okami, Olmstead, Abramson, & Pendleton, 1998; Lewis, RJ, & Janda, 1988).

 Boarding School Life and Homosexuality

    Interestingly, boys and girls who engage in consensual same sex experiences in boarding schools or other sex-segregated institutions do not seem to become homosexual and lesbian as adults in any greater proportion than those who do not. There are also gender differences. 

    Women as a group seem to have their sexual feelings more strongly influenced by considerations of love and intimacy than men do, and this might result in greater fluidity in their sexual orientation than that of men (Peplau, LA, & Garnets, 2000; Peplau, LA, Spaulding, Conley, & Veniegas, 1999). Girls seem to be more traumatized by child sexual abuse than are boys, but the reason why is still not clear.

 Sexual Interaction

    One of the most difficult problems for researchers to study is that of adult child sexual interaction. One reason for the difficulty is the intense emotions involved by the general public to such behavior. Perhaps the easiest way to do so is to survey adult collections of such experience. 

    Even here results are contradictory. One major study found about 15% of women and 7% of men had at least one childhood sexual experience involving physical contact with an adult (Gorey & Les lie, 1997). 

    But the definition of what physical contact was is unclear. Other contemporary estimates based on random samples of adults indicate different rates, ranging from 12% to 55% for females and from 3% to 6% for males. Figures vary to some extent as a function of the population being sampled, the definition of sexual abuse, and the cut-off age employed (eg, before 14, 16, or 18). 

    In the national sample by Finkelhor (1990), 9% of the males and 22% of the females who reported being victims of attempted or completed sexual relations during childhood had experienced them with relatives aunts or uncles, siblings, parents or step  parents, or cousins. 

    In general, it appears that children in disrupted, isolated, and economically poor families are at higher risk of sexual abuse than youngsters in more stable and high-in-come families. 

    The effect of such relationships is not clear. Although most people vehemently condemn them and claim that associations have direct effects on the child that last into adulthood, the data did not necessarily support such a view (Rind, Tromo, Viten, & Bauserman, 1998). 

    This finding, which was a summary of numerous studies, went contrary to popular beliefs and was quickly denounced by the US Congress.

    One of the areas in which current research is focused is sexual function in physically compromised, the blind, the deaf, the severely physically handicapped; it is only in the past few years that the sexual problems have begun to be understood (Knuth & Smith, 1984; Rubin, E., 1997). 

    Research into sexuality has revealed a wide variety of sexual behaviors and society is adjusting its attitudes towards the people involved. There are, however, many questions that sex research has not yet answered, particularly in how some of these paraphilias develop and what is the prognosis of many of them.


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