Sexual Dysfunction Treatment Consent Assault Laws Morals and

• Sexual Dysfunction & Treatment • Consent & Assault • Laws, Morals, and Sexual Behavior

Sexual Dysfunction & Treatment

Defining dysfunction • Sexual satisfaction and expectations • Problems • Distress

43% of Women Have Sexual Dysfunction

Evaluation of problems • • Look at your attitudes and expectations Discussion Visit to doctor Attention to personal (not just sexual) health • Restructuring of sexual activities/expectations • Medication

Desire Phase Challenges • Hypoactive Sexual Disorder (women affected more often than men) • Sexual aversion disorder • Dissatisfaction with frequency mismatched libidos

Excitement Phase Difficulties • Female sexual arousal disorder • Persistant sexual arousal disorder (women, 400 cases since 2001) • Male erectile disorder (ED): persistant vs occasional

Orgasm Phase Difficulties • Female orgasmic disorder: situational, preorgasmic • Female orgasm during intercourse: gap between science and popular desire • Male orgasmic disorder: sometimes narrowed to activity • Premature ejaculation (PE): inability to control timing • Faking orgasms

Dyspareunia • Men: tight foreskin, bad hygiene, STIs, Peyronie’s disease • Women: lubrication, STIs, vulvar vestibulitis syndrome, lube/spermicides, allergies, vaginismus

Origins of disorders • Psychological: health habits, chronic illness • Medications: antidepressants (wellbutrin - no side effects), antihypertension

Sex and disabilities • Spinal cord injury • Cerebral palsy • Blindness and deafness

Coping strategies for sex & disability • • Acceptance Development of options Reducing shame Seeing sex as a human need

Cultural influences on disorders • • Negative childhood learning Sexual double standard Narrow view of sex Performance anxiety

Individual factors • • Self knowledge of desire and stimulation Self-concept/self esteem Emotional challenges Abuse and assault

Relationship factors • • • Communication Fear about pregnancy/STIs Sexual orientation Trust Respect Affection

Basics of sex therapy • Self awareness • Communication • Sensate focus

Controversies in Sex Therapy • • • Talk therapy Coaching Sex surrogacy Sex education Tantra

Fixing It!

Suggestions for Women • Learning orgasms and masturbation • Guided masturbation, mutual masturbation • Dealing with vaginismus • Desire issues • PC muscle exercise

Suggestions for Men • Prolonging erections • ED - exercise, drugs, mechanical, implants

Sexual Assault and Rape

A Short History of Modern Rape • Consciousness about rape raised in 1970 s due to feminism • National Organization for Women (NOW)

Fighting Back and Healing • • • Anti-rape devices Rape crisis centers established D. C. Rape Crisis Center, 1972 Hotlines and support networks Rape, Abuse, & Incest National Network

Public Awareness • Susan Brownmiller’s book “Against Our Will” published in 1975 • Laws and shifting ideas about rape and sexual assault

Consent • Saying "yes" to engaging in a particular act. Consent does not occur when one person says no, says nothing, is coerced, is physically forced, is mentally or physically helpless, is intoxicated, is under the influence of drugs, is unconscious, or any time that consent is not explicitly given. • Antioch Sexual Offense Prevention Policy

Survivor vs Victim • Victim - usually used by court system and media • Survivor - preferred term by sexual assault prevention and healing community

Sexual assault • Umbrella term for unwanted sexual interaction • Can include: exhibitionism, forcible sodomy, incest, molestation, rape, sexual abuse, sexual harassment, stalking, and voyeurism.

Abuse • • Emotional Mental Physical Sexual

Rape • • • Acquaintance Date Domestic/marital rape Gang Statutory - age of consent varies state to state

Dating and Domestic Violence • emotional, physical, or sexual abuse in an intimate relationship • Marital rape became a crime in South Dakota in 1975; July 5, 1993, marital rape became a crime in all 50 states • Protection & privacy

Who are victims? • 1 out of every 6 American women have been the victims of an attempted or completed rape in their lifetime (14. 8% completed rape; 2. 8% attempted rape). • 17. 7 million American women have been victims of attempted or completed rape. • 9 of every 10 rape victims were female in 2003. • About 3% of American men — or 1 in 33 — have experienced an attempted or completed rape in their lifetime. • 93% of juvenile sexual assault victims know their attacker.

Who are offenders? • 73% of sexual assaults were perpetrated by a non-stranger. • More than 50% of all rape/sexual assault incidents were reported by victims to have occurred within 1 mile of their home or at their home. • Only 6% of rapists ever spend a day in jail

Sexual Assault and Blame • Who is responsible for sexual violence?

Shifting the conversation: men and rape

• • When someone wants to, really wants to, have sex with us, we'll know because that person will be taking a very active role, will be saying -- if not yelling! -- "Yes!" or "Please!” or "Do me NOW!" We may know because that person is the one initiating sex, at least as often as we are. We'll know because it will feel like something we are absolutely doing together, that couldn't happen if the other person wasn't just as engaged as we are (imagine trying to dance with someone else when they’re just standing there or not really paying attention: same goes with sex). We'll know because our partners will absolutely not "just be lying there. ” [from Scarleteen]

Laws, Morals, and Sexual Behavior

Norm Enforcement • The norm: monogamous, same-race, heterosexual marriage

MORAL DECISION MAKING AND SEXUAL BEHAVIOR Commonly accepted ethical principles • Sexual behavior should not be forced on anyone • Sexual behavior between consenting adults is acceptable • You must be faithful in a marriage • Marriage partners and loved ones need to be respectful of each other’s needs

Complexity of Overlap • When is it ok to make and enforce laws that are about morality? • Whose morality is represented? • How has this changed over time in the US?

Sex Law in the US • Adultery and Fornication - laws against these are still on the books, though not enforced • Interracial Relationships - landmark case Loving v. Virginia in 1967 changed these laws • Sodomy - non-procreative sex. Landmark case Lawrence v. Texas in 2003

• Sex toys - illegal in Alabama, Georgia, Mississippi, and Texas • Obscenity - judged by “community standards" • Prostitution - illegal throughout US except Nevada, RI, Prop K in San Francisco • Birth Control - landmark case Griswold v. Connecticut in 1965, illegal in some states until 1972 • Abortion - landmark case Roe v. Wade in 1973

• Age of consent/pedophilia - varies state by state. • Rape - varies state by state. marital rape first becomes illegal in 1975, nationally in 1993 • Incest - Laws typically protect minors • Criminal transmission of HIV - criminal, deliberate, reckless transmission are prosecutable. Informed consent is key