Sexuality in Children

Sexuality in Adolescents

 

As teen pregnancies are generally considered unplanned, teen pregnancy rates are one indicator of female sexual and reproductive control and health.

In 15- to 17-year-olds, teen regnancy rate was 33.8 per 1,000 in 1974 and 21.6 in
2000. Among 18- to 19-year-olds over the same period, the rate declined from 83.7 per 1,000 to 62.8.

 

Age of consent

Below 12, all sex is reportable to the Department of Community Services. Between 12 and 14, sexual consent is permissible for people under two years of age older, except with people of authority. Between 14 and 18, sex is ok, except for with people of authority. After the age of 18, all's fair.

 

 

You are at an age when many teens are thinking about if they will have sex. If you're not having sex, you don’t have to worry about pregnancy or sexually transmitted infections (STIs). But when and if you do become sexually active it is very important for you to be protected against both pregnancy and STIs. That means using a condom every time and if you decide that you want to use the birth control pill or some other kind of contraception, you still need to use condoms for STI protection. Are we clear about that? Are there any questions you want to ask me about protecting yourself?

 

Furthermore, as noted in Health Canada’s (1998b)
Canadian STD Guidelines it is critical for physicians to
Discuss with patients the widespread belief
that STD prevention is not necessary in
“monogamous relationships” or with partners
who are “known and trusted”. STD risk
behaviours occur at exceedingly high rates
within “monogamous” (actually serially
monogamous) relationships with “known and
trusted” partners (whose STD or HIV status
actually is not known) (p. 32).

 

 

INFORMATIONAL MESSAGES TO PROMOTE DUAL
PROTECTION
“Most people will have more than one monogamous
relationship during their teenage and young adult
years.”
“Sexually transmitted infections are very common
among young people and they can seriously damage
your health.”
“In most cases of sexually transmitted infection, there
are no visible signs or symptoms and the person does
not know they are infected.”
“Oral contraceptives are very effective in preventing
pregnancy but they do not prevent sexually transmitted
infections. Condoms reduce the risk of infection.”
MOTIVATIONAL MESSAGES TO PROMOTE DUAL
PROTECTION
“I have seen patients who stop using condoms once
they have gone on the pill and some of them end up
getting an STI.”
“As your doctor I strongly recommend that now that
you are on the pill that you also continue to use
condoms. That way you can be comfortable that you
are doing the things you need to do to be protected.”
“You can tell your boyfriend that I strongly recommend
that all my patients on the pill continue to use
condoms.”
BEHAVIOURAL SKILL MESSAGES TO PROMOTE DUAL
PROTECTION
“Let’s talk about how you are going to discuss the
issue of dual protection with your partner.”
“You can say to your partner, ‘I’m happy with my
decision to start taking the pill but my doctor
said we should continue using condoms. That
way we are fully protected and do not have to
worry about it and can just enjoy ourselves.’”
“If he says, ‘If you’re on the pill, we don’t need
condoms,’ you can say, ‘I want to use them
anyway so that we are protected from infections
we may not realize we have. My doctor said it’s
important to use both.’”
“If he says, ‘I know I’m clean. I haven’t had sex
in X number of months,’ you can say, ‘As far as I
know I don’t have an STI either, but either one
of us could have an infection without knowing it
so I want to use condoms.’”
“If he says, ‘You don’t trust me,’ you can say, ‘This
is not about trust, it’s about protecting each
other.’”
“If he says, ‘I don’t have a condom with me,’ you
can say, ‘I do.’”

Sexuality in Adults

Sexuality in Seniors

Seniors have the same needs and desires as others when it comes to sexuality.

Three myths: senoirs are not sexually desirable, sexually desirious, and sexually capapble. If these are not dispelled, seniors can experience a breakdown in their sexuality.

The NCOA 1998 survey found that 48% of people over 60 are sexually active.

• physical changes in women
• physical changes in men
• intimacy and dementia
• intimacy in long term care facilities

 

Effects of Aging on Sexuality

Some medical conditions or drugs affect sexuality.

 

Physical Changes in Women

• lower levels of estrogen
• thinning of vaginal walls and decreased lubrication
• decreased duration and intensity of orgasm

 

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Physical Changes in Men

• less elasticity and harding of blood vessels can lead to erections that take longer and are less ...I don't know what the adjective would be
• ejaculation

 

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Intimacy and Dementia

Changes in the brain, a lack of insight of appropriate place and time, loss of judgment, or the effects of medications on libido can lead to inappropriate behavior.

 

Inappropriate Intimate Expression:

• uninhibited behavior
• exposure
• unwanted fondling
• paranoia with sexual connotations, ie of rape

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Intimacy in Long Term Care Facilities

Current LTC facilities are shared accomodations. Lack of privacy/personal space is an important thing.

Consent of congitively impaired people is amajor concern, especially when trying to promote expressions of intimacy.

 

Consent:

volumtary participation in the absecne of physical/phychological force. Can the resident say 'no'?

COnflicts can arise with the values of staff and family.

Guidelines for dealing with sexually expressed behaviour:

 

SOmething tricky is when a demented spouse begins a relationship in a LTC facility when their spouse with normal congitive function is living at home.

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