1 Session -4 Sex, Sexuality and Gender

Learning Objectives: Understanding Human Anatomy and concepts sexual pleasure Difference between Sex Sexuality and Gender Norms that influence sexual behavior in relationships Risk and vulnerability to HIV as an outcome sexual behavior. 2

Sex refers to the physiological attributes that identify a person as male or female: Type of genital organs (penis, testicles, vagina, uterus, breasts) Type of predominant hormones circulating in the body (e.g., estrogen, testosterone) Ability to produce sperm or ova (eggs) Ability to give birth and breastfeed children Gender refers to Economic, social and cultural attributes and opportunities associated with being male/ masculine or female/ feminine in a particular social setting at a particular point in time. 3

Femininity and Masculinity Femininity: Qualities and characteristics considered appropriate for women/girls Masculinity: Qualities and characteristics considered appropriate for men/boys 4

Manifestation of Gender Differences Gender Roles: what women and men do/ expected to do Gender Relations: relation of power between men and women, women and women and men and men. Gender Identity: how people perceive their own gender- whether they think of themselves as a man, a woman, both or as a different gender 5

Sexuality A comprehensive term which includes social roles, personality, gender and sexual identity, biology, sexual behavior, relationships, thoughts and feelings of an individual and the expressions of which are influenced by social, ethical, economic, spiritual, cultural and moral concerns 6

Key Elements of Sexuality Includes thoughts, attitudes and feelings along with sexual acts and behaviors Positive expression- enhances well-being, health and the quality of life Negative expressions- diminishes people’s dignity and self- worth, and cause long-term harm Strong social control through social norms, values and laws Social understanding considers men’s experiences and needs and ignores, negates and devalues those of women. 7

Sexual Behaviors and Practices Type of Behavior Characteristics AbstinenceRetaining from any sexual stimulation PettingStimulating other by touching MasturbationSelf stimulation by touching/rubbing one’s own genitals Mutual Masturbation Two stimulate own and each others by touching/rubbing Vaginal/sexual intercourse Erect penis penetrating vagina and ejaculation of semen after orgasm Anal SexPenetration of penis into partners anus OrogenitalUsing mouth/ tongue to stimulate penis 8

Sexual health A component of sexuality Women’s and men’s ability to enjoy and express their sexuality, free from risk of sexually transmitted diseases, unwanted pregnancy, coercion, violence and discrimination. Enhances life, personal relations and the expression of one’s sexual identity. Enhances pleasure, communication and relationships. 9

Sexuality and gender - Vulnerability to HIV 10 Physiological Vulnerability is more for female Unequal and Poor Access to and Control over Resources Difficulties in Promoting Consistent Safer Sex Measures Unequal power balances in sexual relations Sexuality norms reduces chances for being informed

Summary 11 This session covers issues relating to gender, sex and sexuality in the context of HIV. Gender and sexuality are two important determinants of an individual’s vulnerability to HIV. Working with stigmatized and marginalized groups the counsellor/ANMs should hold a gender sensitive approach. They should also be comfortable discussing and counselling on such issues.