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Development of Sexuality

Development of Sexuality. Perry, pp. 1022, 1049-1052, 1092-1093, 1105-1109, 1113-1115, 1122-1123. Infant (1-12 mo): Development of Body Image. By end of first year, recognize that they are distinct from parents Likes to look in mirror and begins to understand that it is him

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Development of Sexuality

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  1. Development of Sexuality Perry, pp. 1022, 1049-1052, 1092-1093, 1105-1109, 1113-1115, 1122-1123

  2. Infant (1-12 mo): Development of Body Image • By end of first year, recognize that they are distinct from parents • Likes to look in mirror and begins to understand that it is him • Begins to understand that body parts are useful • First finds out that body and mouth produce pleasure

  3. Toddler (1-3 yrs): Development of Sexuality • Recognizes sexual differences by age 2 • Gender roles are understood and gender identity established by age 3 • Child imitates actions of same gender parent. • Touching body feels good--exploration of genitalia is common—do not condemn or refer to genitals as “dirty.”

  4. Preschooler (3-6 yrs): Development of Body Image • Increasing comprehension of “desirable” appearances • Aware of racial identity, differences in appearances, and biases • Poorly defined body boundaries—fear that if skin is “broken” all blood and “insides” can leak out; intrusive experiences are frightening

  5. Preschooler: Development of Sexuality • Form strong attachment to the opposite sex parent while identifying with the same-sex parent • Modesty becomes a concern • Sex role imitation, “dressing up like Mommy or Daddy” • Sexual exploration more pronounced • Masturbation is common in this age—teach child it is a private act and don’t condemn

  6. Preschooler: Sex Education • Questions arise about sexual reproduction • Find out what children know and think • Be honest • Avoid “over-answering” the question

  7. School-Age (6-12 yrs): Self-Concept and Body Image • A conscious awareness of a variety of self-perceptions (abilities, values, appearance, etc.) • Generally children like physical selves less as they grow older • Increased awareness of “differences” may influence feelings of inferiority

  8. School-Age cont’d • Importance of significant adults in shaping child’s self-concept; body image influenced by significant others • Positive self-concept leads to feelings of self-respect, self-confidence, and happiness

  9. School Age: Prepubescence • Defined as 2 years preceding puberty • Typically occurs during preadolescence • Males and females differ little in size until prepubescence in girls • Varying ages from 9-12 (girls about 2 years earlier than boys) • Average age of puberty is 12 in girls and 14 in boys

  10. School-Age: Sex Education • Sex play as part of normal curiosity during preadolescence • Middle childhood is ideal time for formal sex education—info could include sexual maturity and process of reproduction, menstrual cycle, STDs, pregnancy, HIV

  11. Sex Education cont’d • Info from peers contains lots of myths. • Effective communication with parents to get correct info • Parents need to let child know they are available for questions. • Books may help

  12. School-Age: Nurse’s Role in Sex Education • Treat sex as normal part of growth and development • Questions and answers with boys and girls separated may encourage more interaction • Differentiation between “sex” and “sexuality” • Values, problem-solving skills • Open for communication with parents

  13. Adolescent Period (12-18 yrs): Terminology • Prepubescence—preliminary physical changes occur • Puberty—development of secondary sex characteristics • Post pubescence—1-2 yrs after puberty; skeletal growth is complete, reproductive functions

  14. Sex Differences in General Growth Patterns • Appear to be result of hormonal effects at puberty • Muscle increases in boys due to testosterone • Fat deposits are sex-related • Obesity associated with early onset of menarche in girls • Obesity effects less predictable in boys

  15. Biologic Sexual Development • Primary sex characteristics • External and internal organs necessary for reproduction • Secondary sex characteristics • Result of hormonal changes: for example, voice changes, hair growth, breast enlargement, fat deposits • Tanner’s Stages on pp. 1107-1108 • Usual sequence of changes on p. 1106

  16. Hormonal Changes of Puberty • Hypothalamus stimulates anterior pituitary • Anterior pituitary stimulates gonads • Gonads produce and release gametes • Gonads secrete sex-appropriate hormones • Estrogen and testosterone are present in both sexes during childhood, but jumps during puberty appropriate to gender

  17. Sexual Maturation: Girls • Thelarche: appearance of breast buds—age 9-13½ yrs • Adrenarche: Growth of pubic hair on mons pubis—2-6 months after thelarche • Menarche: initial appearance of menstruation approximately 2 yrs after 1st pubescent changes —avg age 12 yrs 9½ months in North America

  18. Sexual Maturation: Boys • First pubescent changes: testicular enlargement, thinning, reddening, and increased looseness of scrotum—age 9½ to 14 yrs • Penile enlargement, pubic hair growth, voice changes, facial hair growth • Temporary gynecomastia in 1/3 of boys; disappears within 2 yrs

  19. Development of Self-Concept and Body Image • Sex-role identity—adolescents are influenced by peers and adults, but will vary acc’d to culture, geographics, and socioeconomics • Feelings of confusion in early adolescence—may feel strange about rapid body changes

  20. Self-Concept cont’d • Acute awareness of appearance, comparison of appearance with others • Blemishes/defects and growth differences magnified out of proportion—want “perfect body” • Frequently pose and primp especially in private

  21. Thrill-Seeking Behaviors • Adolescents have a sense of indestructiveness accompanied by the “it won’t happen to me syndrome” • Causes them to take chances in areas of: • Driving • Sexual relationships • Drugs and alcohol • “Daredevil” activities • Defying authority

  22. Sexual Relationships • Dating—starts with crushes, then to group, then double, then single • Sexual experimentation—wide range; ½ have intercourse by age 18. • Sex before 14 could mean abuse in past

  23. Sexual Experimentation • Reasons for experimentation: • Curiosity • Pleasure • Conquest • Affection, belonging • Peer pressure to conform

  24. Homosexuality in Adolescents • Full development of sexual identity occurs during adolescence • Risk of health damaging behaviors by homosexual and bisexual youths: • Early initiation of sex behaviors • STDs • Running away from home • Suicide and suicidal ideation

  25. Sexuality Education and Guidance • Knowledge often acquired from peers, TV, movies, magazines and is often inaccurate • Need for factual info, presentation based on developmental maturity

  26. Sex Ed Topics for Nurses • Sexual attitudes and values • STI transmission • Birth control • Physiology and body changes • Menstruation • Pregnancy, and birth. • Personal hygiene needs include education re: frequent bathing, deodorant, menstrual hygiene, douching

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