Sexual Health

It is sometimes argued that the non-therapeutic, non-consensual alteration of children’s genitals should be discussed in two separate ethical discourses: one for girls (in which such alterations should be termed ‘female genital mutilation’ or FGM), and one for boys (in which such alterations should be termed ‘male circumcision’). In this article, I call into question the moral and empirical basis for such a distinction, and argue that all children—whether female, male, or intersex—should be free from having parts of their genitals removed unless there is a pressing medical indication.

Despite efforts to identify masturbation as a strategy to improve sexual health, promote relational intimacy, and reduce unwanted pregnancy, STIs, and HIV transmission, masturbation as a context for healthy sexual development has been met with silence or trepidation in the scientific and educational communities. Relegated to the realm of commercial media, rather than rational discourse in families, schools, and the general public, young people receive mixed messages about this non-reproductive sexual behavior. In order to explore how young adults have learned about masturbation and currently perceive masturbation, we conducted a grounded theory study of 72 college students (56 females; 16 males) enrolled in a human sexuality class. Findings revealed that a young adult's perceptions of and feelings toward masturbation were the result of a developmental process that included: (1) learning about the act of masturbation and how to do it, (2) learning and internalizing the social contradiction of stigma and taboo surrounding this pleasurable act, and (3) coming to terms with this tension between stigma and pleasure. Although nearly all participants learned about masturbation through the media and peers (not parents or teachers), gender was salient in coming to terms with the contradiction of stigma and pleasure. Most of the women reported either still struggling with the contradiction or accepting it as normal. Most of the men recognized the beneficial aspects for healthy sexual development that result from masturbation. Both male and female participants identified differential sexual scripts as contributing to the double standard.

The spectrum of practices termed “Female Genital Mutilation” (or FGM) by the World Health Organization is sometimes held up as a counterexample to moral relativism. Those who advance this line of thought suggest the practices are so harmful in terms of their physical and emotional consequences, as well as so problematic in terms of their sexist or oppressive implications, that they provide sufficient, rational grounds for the assertion of a universal moral claim—namely, that all forms of FGM are wrong, regardless of the cultural context. However, others point to cultural bias and moral double standards on the part of those who espouse this argument, and have begun to question the received interpretation of the relevant empirical data concerning FGM as well. In this article I assess the merits of these competing perspectives. I argue that each of them involves valid moral concerns that should be taken seriously in order to move the discussion forward. In doing so, I draw on the biomedical “enhancement” literature in order to develop a novel ethical framework for evaluating FGM (and related interventions—such as female genital “cosmetic” surgery and non-therapeutic male circumcision) that takes into account the genuine harms that are at stake in these procedures, but which does not suffer from being based on cultural or moral double standards.

In 2012, the politician Todd Akin caused a firestorm by suggesting, in the context of an argument about the moral permissibility of abortion, that some forms of rape were “legitimate” (i.e., carried out with great force or violence). This seemed to imply that other forms of rape must be “illegitimate” (i.e., carried out with less force or violence). In response, several commentators emphasized that rape is a “heinous crime” and that there are “no varying degrees of rape.” While the intention of these commentators was clear, I argue that they may—inadvertently—have played into the very stereotype of rape (implicitly) endorsed by Akin. Such a response, I claim, actually obscures a range of sexual harms, including some that may not rise to the level of being a crime. I also offer some thoughts on the moral psychology behind anti-abortion arguments of the kind advanced by Akin.

The Centers for Disease Control and Prevention (CDC) has announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. In this brief comment, I highlight a few of the key scientific and ethical issues worth considering in interpreting the CDC recommendations.

What are the effects of circumcision  on sexual function and experience? And what does sex—in the sense related to gender—have to do with the ethics of circumcision? Jacobs and Arora (2015) give short shrift to the first of these questions; and they do not seem to have considered the second. In this commentary, I explore the relationship between sex (in both senses) and infant male circumcision, and draw some conclusions about the ongoing debate regarding this controversial practice.

According to Brian Morris (2013), “Science supports infant circumcision” and “so should skeptics.” It would be more accurate to say that ‘Brian Morris supports infant circumcision,’ and that skeptics can think for themselves. In this paper, we critically assess the arguments and evidence presented by Morris in his recent article, and draw some general lessons for the ongoing debate about the science and ethics of infant male circumcision.

Health promotion should be evidence-based, needs driven, subject to evaluation, and ecological in perspective. How can this be achieved in the context of school-based sex education? Adopting new behaviors and giving up old habits involves common decision-making, planning, motivational control, and goal prioritization processes. Consequently, despite the particular nature of sexual behavior, models of cognitive change applied to other health-related behaviors also apply to the promotion of safer sex practice. Young people are less likely to have unprotected sexual intercourse if they have acquired a variety of social skills relevant to dealing with romantic and sexual relationships. Many of these social skills and the methods employed to facilitate their development are also important to the promotion of other health behaviors. However, teaching social skills relevant to sexual behavior in classroom settings requires specialist expertise both in program design and in delivery by teachers or facilitators. Theory-and evidence-based programs designed to promote such skills and modified on the basis of effectiveness evaluations are most likely to have an impact on the rate of pregnancies and sexually transmitted infections among young people. Yet, such programs may not be used in schools because of policy and cultural constraints. When this is the case, optimally effective health promotion cannot be delivered. Health promoters should acknowledge these challenges and facilitate the adoption and implementation of effective sexual health promotion programs by targeting communities and legislators.

As medical technology continues to progress, we are able to correct deficiencies in the body through means such as cochlear implants and prosthetic limbs. This has led some scholars to argue that we are creating technologized, cyborg bodies. However, these technologies have also enabled us to correct perceived cultural flaws in the body. This article explores the nature of the body through the lens of posthumanism, examining ways that individuals attempt to reshape their bodies through cosmetic surgery and other forms of body modification. Specifically, this article examines the practice of hymen restoration, Genesis Breyer P-Orridge’s artistic endeavours in cosmetic surgery and Stelarc’s cybernetic experimentations. These cases yield three potential visions of the body: the body must be restored; bodies must be unified; and the body must evolve. Such visions have consequences; the ways in which the body is rhetorically constructed influence how people choose to alter their own bodies. By considering the body itself as medium and as an interface with other technologies, we can better theorize what it truly means to be human.

The non-therapeutic alteration of children’s genitals is typically discussed in two separate ethical discourses: one for girls, in which such alteration is conventionally referred to as “female genital mutilation” (or FGM), and one for boys, in which it is conventionally referred to as “male circumcision.” The former is typically regarded as objectionable or even barbaric; the latter, benign or beneficial. In this paper, however, I call into ques- tion the moral and empirical basis for such a distinction, and I argue that it is untenable. As an alternative, I propose an ethical framework for evaluating such alterations that is based upon considerations of bodily autonomy and informed consent, rather than sex or gender.

Some contemporary moral panics orbit around youth sexuality and new media use. This article addresses those moral panics by investigating teenagers' practices regarding new media and sexuality. New media technologies are central parts of young people's social, romantic, and sexual lives. These communication technologies are important in their practices of meeting, dating, and breaking up. New media technologies also provide important resources about sexual health and identities. However, these informational and relational resources are not equally available to all young people. Indeed use and access to new media technologies often mirrors the contemporary ordering of economic, racialized, and gendered power. Additionally, while youth are aware of online safety practices, some youth are more vulnerable to online risks than others.

Arora and Jacobs (2016) assume that liberal societies should tolerate non-therapeutic infant male circumcision, and argue that it follows from this that they should similarly tolerate—or even encourage—what the authors regard as ‘de minimis’ forms of female genital mutilation (as defined by the World Health Organization). In this commentary, I argue that many serious problems would be likely to follow from a policy of increased tolerance for female genital mutilation, and that it may therefore be time to consider a less tolerant attitude toward non-therapeutic infant male circumcision. Ultimately, I suggest that children of whatever sex or gender should be free from having healthy parts of their most intimate sexual organs either damaged or removed, before they can understand what is at stake in such an intervention and agree to it themselves.

Social media and social network sites (SNS) are an evolving area for sexual health communication with young people. They present opportunities and challenges for sexual health professionals and young people alike, such as learning through interactivity and addressing concerns about privacy. In this article, we present and discuss the findings from six rural and urban focus groups with young people in Australia about the use of social media and SNS for sexual health communication. We discuss a number of issues related to the use of social media and SNS for sexual health communication, such as concerns about bullying, privacy, and the stigma attached to sexual health.

Healthy People 2020 includes an objective to increase the proportion of elementary, middle, and senior high schools that provide comprehensive school health education to prevent health problems in the following areas: unintentional injury; violence; suicide; tobacco use and addiction; alcohol or other drug use; unintended pregnancy, HIV/AIDS, and sexually transmitted infections (STI); unhealthy dietary patterns; and inadequate physical activity. These specifıc goals are part of the efforts of Healthy People 2020 to increase the proportion of elementary, middle, and senior high schools that have health education goals or objectives that address the knowledge and skills articulated in the National Health Education Standards. A focus on Pre-K through 12 health education is a prerequisite for the implementation of a coordinated, seamless approach to health education as advocated by the Healthy People Curriculum Task Force and incorporated into the Education for Health framework.

This study examines women's social representations of female orgasm. Fifty semi-structured interviews were conducted with British women. The data were thematically analysed and compared with the content of female orgasm-related writing in two women's magazines over a 30-year period. The results indicate that orgasm is deemed the goal of sex with emphasis on its physiological dimension. However, the women and the magazines graft onto this scientifically driven representation the importance of relational and emotive aspects of orgasm. For the women, particularly those who experience themselves as having problems with orgasm, the scientifically driven representations induce feelings of failure, but are also resisted. The findings highlight the role played by the social context in women's subjective experience of their sexual health.

The first question that is faced by every individual after birth is if the newborn is male or female. For most of us that is the identity we carry out throughout the life until death. But that is not the same for everybody. There are some amongst us who can not answer that question with certainty. These are the people who can not identify themselves as either male or female. The individuals who are neither male nor female constitute the third gender category known as ‘Hijra’ in Bangladesh.
This research has been conducted on such individuals or Hijras. These people are mostly isolated and marginalized in our society. Hijras usually live in small communities and scattered all around the country. Normally they do not share their social customs with anybody outside their community because of stigmatization and social exclusion. They have formed their own society within the larger society. Within their own community they have a strong social structure. This social structure has given rise to some aspects like special customs, languages and sexual practices.
As they are a part of the larger society, they had to adapt with it. The adaptation process has given rise to some other customs and activities. But in the context of the larger society, they have been stigmatized because of their relatively unusual customs.
This research was carried out in two different areas, Dhaka, the capital city of Bangladesh and in Sarishabari, Jamalpur; a sub-urban area. In this research, their social structure has been shown. Their customs and adaptation processes along with sexual behavior has also been discussed at length.

This paper demonstrated that laws that criminalise sex work or aspects thereof are associated with negative outcomes for sex workers’ right to health under international law. It also showed that the right to health is an underused mechanism in judicial challenges to these laws.

The objective was to analyse, at practical and judicial levels, the relationship between prohibitory prostitution laws and the right to health. International treaties were examined to establish the relevant content of the right. Studies of the health-related effects of these laws, in various jurisdictions, were reviewed. Existing research into the effects of legalising prostitution under specified circumstances, and the effects of decriminalisation, was also examined. Case law was reviewed of judicial challenges to prostitution laws, and health-related aspects of relevant cases were discussed. The reasons that each court did or did not reach a decision protecting sex workers’ right to health were also considered.

The dissertation found that prohibitory laws lead to negative consequences for sex workers’ health by increasing their risk of violence and sexually-transmitted infections; adversely affecting their mental health, through these risks and through stigmatisation; denying them occupational health and safety; and excluding them from the process by which health-affecting decisions are made. It found positive health outcomes from removal of these laws, although excessive regulation of legal prostitution can have negative effects. It also found insufficient justification for health-based arguments in favour of prohibitory laws.

It showed that only a small number of challenges to these laws have highlighted their relationship to health, and the basis of these challenges has not been the right to health itself, although a breach of a derivative right has sometimes been asserted. Health has also, at times, served as a defence to these laws.
It concluded that sex workers’ right to health can best be protected through a legal framework that decriminalises consensual commercial sex and explicitly protects their occupational health and safety rights. This must be accompanied by efforts to ameliorate stigmatisation. Judicial action can play a role, although it may require the assertion of a derivative right rather than the right to health.

Expanding on my investigation of the role played by sexuality in police infiltration by examining sexual assault.

The background research can be found:

https://www.academia.edu/5401087/_2014_When_Cops_Go_Native_Policing_Revolution_Through_Sexual_Infiltration_and_Panopticonism

https://www.academia.edu/10346405/_2014_6_Ways_Cops_Have_Used_Sex_to_Infiltrate_and_Disrupt_Protest_Groups

Sexuality is the ultimate union of mind and body. Sexual dysfunction is often the first manifestation of physical illness but is often not inquired about on routine review of symptoms. This is, in large part, due to the health care providers' lack of knowledge in diagnosis and treatment of sexual impairment as well as their discomfort with this sensitive topic. However, sexual well-being is an important determinant of quality of life and many medically ill patients find sexual intimacy to be an essential mode of communication with their partners. This chapter attempts to methodically delineate physical illnesses causing sexual dysfunction by organ system. Neurologic, endocrinologic, cardiovascular and pelvic illnesses are discussed as to their impact on sexual health. Diagnostic and established treatment strategies are also reviewed. Breast cancer, rheumatoid arthritis and psoriasis are touched upon. Although not a disease, pregnancy and its unique impact on sexuality is also di...

Hypospadias is a relatively common genital condition in which the urethral opening forms on the underside of the penis, as opposed to at the tip of the glans. Patients with hypospadias are typically referred for surgery during infancy or early childhood. Recent evidence, however, indicates that many individuals with hypospadias do not experience the functional or psychosocial difficulties that are commonly attributed to the condition, and that surgical intervention for hypospadias carries substantial risk of adverse outcomes. In this article, we review published outcomes data and conduct an in-depth analysis of the typical rationales for hypospadias surgery, taking into consideration both the potential benefits and harms of the procedure, as well as the existence of non-surgical alternatives. We argue, firstly, that most childhood surgeries for hypospadias are performed for anticipated future problems concerning function and cosmesis, rather than extant problems that serve to undermine the child’s well-being. Secondly, we contend that the surgery can be safely performed after an age of consent without increasing the absolute risk of surgical complications to an ethically meaningful degree. We conclude that surgery for hypospadias should typically be performed only if requested by the affected individual, under conditions of informed consent.

This article conceptually and theoretically explores, in particular, gay male rape victims' experiences and silences. This is done through examining and bringing together empirical findings from different studies relating to gender, sexuality, masculinity, police and policing, and, more broadly, sexual violence. The theoretical backdrop for this article is hegemonic masculinity to help elucidate gay male rape victims' experiences and silences. This article will also take into consideration social attitudes to these types of victims and the different ways wherein such attitudes discourage men who have been raped from coming forward to not only report, but also to seek help, whether that help comes from family, friends, and relatives or from the criminal justice system. Rather than considering all types of male rape victims, this article will predominantly focus on gay male rape victims to understand, more specifically, gay masculinity and how it differs to hegemonic masculinity. In short, this article recognizes that these two masculinities can be antithetical, but they can also have some commonalities. The author argues that gay male rape victims' enactment of gay and hegemonic masculinities is in constant negotiation, flux and fluidity through social and power relations, shaped by social structures, institutions, scripts and ideologies.

The self-reports of individuals who claim that they have changed their sexual orientation are either dismissed as false or relied upon to promote sexual orientation change efforts. However, these reactions do not capture the complexity of the sexual reorientation phenomenon. This article provides an overview regarding the promise and effort of sexual reorientation and how this knowledge may inform our current understanding of human sexuality. Specifically, a brief history is given of the interventions used to change attractions to same-sex adults and the assumptions underlying these efforts. Information will be given regarding which conclusions can be derived from sexual reorientation studies. The limitations of these studies will be explained to strengthen future research. Hypotheses will be presented regarding the motivations and needs of those distressed by a same-sex erotic orientation and the impact that the hope of sexual reorientation may have for family members, religious leaders, and policy makers. A multivariate model of sexuality and sexual orientation, including scales of attraction and aversion, will be proposed based upon current understanding of sexuality and the distinctions found in sexual reorientation research. In the end, a therapeutic framework will be highlighted that may be used (and researched) to help those distressed by their sexual orientation.

Purpose: To investigate the possibility that the mass media (television, movies, music, and magazines) serve as a kind of super peer for girls who enter puberty sooner than their age-mates. Multiple studies have demonstrated significant associations between earlier pubertal timing and earlier transition to first sex. Does puberty also stimulate interest in sexual media content that is seen as giving permission to engage in sexual behavior? Methods: White and African-American female adolescents (n ϭ 471; average age 13.7 years) recruited from public middle schools in central North Carolina completed two self-administered surveys in their homes about their pubertal status, interest in and exposure to various media, and perceptions of sexual media content. Results: Earlier maturing girls reported more interest than later maturing girls in seeing sexual content in movies, television, and magazines, and in listening to sexual content in music, regardless of age or race. Earlier maturing girls were also more likely to be listening to music and reading magazines with sexual content, more likely to see R-rated movies, and to interpret the messages they saw in the media as approving of teens having sexual intercourse.

Non-therapeutic infant male circumcision is a permanent surgical alteration to the penis that may cause significant physical, sexual and psychological harm. Physical harms include unintended adverse effects of the surgery itself (e.g., complications such as bleeding, infection, excessive removal
of foreskin leaving insufficient shaft skin to accommodate erections, etc.), as well as the inherent loss of healthy, functional tissue. Sexual harms that necessarily follow from circumcision include the loss of all sensation in the foreskin itself, and the loss of all sexual functions that involve the physical manipulation of the foreskin. Additional sexual harms that may follow circumcision include reduced sexual sensation in the remaining penile structures, difficulty with masturbation, increased chafing in both the circumcised man and his sexual partner, as well as reduced overall psychosexual/psychological tension relief and subjective satisfaction. Psychological harms include short-term trauma as well as the potential for long-term emotional disturbances, including sadness, frustration, distress, and anger—akin to post-traumatic stress disorder
(PTSD). In this paper, the extent and severity of these various harms are considered and it is argued that they are more serious and more widespread than is commonly believed.

This article argues that the use of sexual infiltration by police and criminal collaborators represents a strategic deployment of surveillance technology by the state with the aim of creating Foucault’s “docile bodies” through the development of totalising omnipresence. The insertion of police into the private sphere of activists’ sexual relationships – a site presumed to be outside of state gaze – serves to not only disrupt the target communities but also to reverberate throughout social networks and create inactivity. By exposing informants from within one’s own “family”, the state is able to collect intelligence, spread insecurity and display totalising disciplinary power to the social movement under observation.

We thank C. S. I. Jenkins and Neil Levy for their thoughtful comments on our article about love and addiction (Earp, Wudarczyk, Foddy, & Savulescu, in press). While we do not have room for a comprehensive reply, we would like to touch on a few main issues.

The evolutionary paradigm has provided psychology with a different perspective on human behavior, and with beneficial results. Sexual Strategies Theory (SST; Buss and Schmitt 1993) has been the primary evolutionary theory for studying human sexual behavior. A review of some SST-related research suggests that some of the paradigm’s anticipated female-male differences are supported. However, closer examination of this research also reveals substantial female-male similarities in sexual behavior, inconsistent or unclear definitions of several important SST concepts, and the functional omission of several important topics from the SST research agenda. Further, male-female differences in sexuality may be driven by a subset of males. Directions for future research are suggested, including greater attention to individual and contextual factors.

Purpose: Controversy about school-based sexuality education in public schools has continued over the past decade, despite mounting evidence that comprehensive sexuality education effectively promotes sexual health and that parents support these programs in public schools. The present study replicates and expands upon previous findings regarding public views on school-based sexuality education. Methods: One thousand six hundred five parents of school-age children in Minnesota responded to telephone surveys in 2006 -2007 (63% participation rate), including items regarding general sexuality education, 12 specific topics, the grade level at which each should be taught, and attitudes toward sexuality education. Results: The large majority of parents supported teaching about both abstinence and contraception (comprehensive sexuality education [CSE]; 89.3%), and support was high across all demographic categories of parents. All specific sexuality education topics received majority support (63.4%-98.6%), even those often viewed as controversial. Parents believed most topics should first be taught during the middle school years. Parents held slightly more favorable views on the effectiveness of CSE compared to abstinence-only education, and these views were strongly associated with support for CSE (odds ratio [OR] CSE ϭ 14.3; OR abstinence ϭ 0.11). Conclusions: This study highlights a mismatch between parents' expressed opinions and preferences, and actual sexuality education content as currently taught in the majority of public schools. In light of broad parental support for education that emphasizes multiple strategies for prevention of pregnancy and sexually transmitted infections (including abstinence), parents should be encouraged to express their opinions on sexuality education to teachers, administrators, and school boards regarding the importance of including a variety of topics and beginning instruction during middle school years or earlier.