Talking About Sex is Like Rolling the Dice: You Never Know What Will Come Up !

1. Talking About Sex is Like Rolling the Dice:You Never Know What Will Come Up! RCPA Conference Rehabilitation & Community Providers Association October 9, 2014 Presented by Beverly L. Frantz, PhD Institute on Disabilities, Temple University

2. Pandora’s Box Disability & Sexuality Everyone not on the same page Anxiety/stress Fear Uncertainly Personal experiences Lack of “how do”

3. Understanding the ConnectionSexual Health – Sexual Violence

4. The Cost of Sexual Violence • Each rape costs approximately $151,143 (DeLisi, 2010) • Traumatic experiences such as sexual violence can interfere with the ability to hold a job. (Bassuk, Meinick, & Browne, 1998). • Between 50% and 95% of women develop post-traumatic stress disorder (PDST) after being raped. (Johns Hopkins University School of Public Health, 1999) • What does this look like in terms of women with developmental and intellectual disabilities?

5. It’s About Us! Our experiences, personal and professional, shape the perspective we ultimately bring to bear on how we provide services and supports to people with intellectual and developmental disabilities.

6. The acceptance of sexuality and its manifestations has changed in recent decades to being considered a normal feature of the identity of each individual. Franco, Cardodo, Neto, 2012 However, people with intellectual disabilities have not benefited from this change in attitudes.

7. Times Have Changed Sexuality has long been closely related with the genital aspects, and its expression related only to marriage, regulated by moral and religious precepts. However, because of the 20th Century social and cultural revolutions, sexuality is no longer understood as merely biological, but became inseparable from the basic identity of a person.

8. Person Centered Planning uses a series of charts/maps/symbols to engage the focus person and their family/community in planning.

9. This includes an interest in sexual expression over the life .

10. From Childhood Curiosity…

11. … to Adolescent/Adult Curiosity

12. Impact of Our Silent Assumptions …there are certain “silent assumptions” that probably still lurk in your mind. David Burns, 1980 aka: bias, stereotype, discrimination, belief, value, etc.

13. What’s the Difference: Sex or Sexuality? Anna Freud wrote: “Sex is something you do, sexuality is someone you are.” Parent of a Self-advocate said: “Sexuality is between your ears, and sex is below your waist.”

14. Sexuality Is a continuous experience Is an integrated experience Is shaped by family, culture, religion, education, personal experience, the media Institute on Disabilities, Temple University

15. What is Sex? Dictionary definitions: • Sex is a way of distinguishing male and females members of a species…usually by their reproduction functions. • Sex refers to intercourse or coitus, an act that can result in reproduction. • Sex refers to the genitals.

16. Memory Road Trip • In high school, how did you demonstrate your sexuality? • How did you learn about sex? • How would you have liked to learn about sexuality and sex?

17. Professionals Said Sex Is… • complex • a main avenue for reproduction • a strong emotional bonding between people • an expression of love • consent of two people to kiss, touch and share an intimate experience together

18. Professionals Said Sex Is… • a boy and a girl • not until you are married • the physical interaction of two individuals for the pleasure or stimulations of one or both of them • physical intercourse between animals • an intimate relationship between a married man & woman

19. COMPONENTS OF SEXUALITY

20. Five Components of Sexuality EMOTIONS & RELATIONSHIPS SEXUAL HEALTH HUMAN DEVELOPMENT SEXUAL BEHAVIOR SEXUAL VIOLENCE

21. FIVE COMPONENTS OF SEXUALITY All aspects of sexuality are influenced by a person’s self-esteem and personal sexual beliefs, attitudes, values and knowledge. It is also influenced by ethical, spiritual, cultural and moral concerns. HUMAN DEVLOPMENT: Human development is characterized by the interrelationship between physical, emotional, social and intellectual growth. SEXUAL BEHAVIOR: Sexuality is a natural and healthy part of life and individuals express their sexuality in a variety of ways. HUMAN DEVLOPMENT Reproductive Physiology & Anatomy Growth and Development • Puberty• Reproduction• Climacteric & Menopause Body ImageSelf-Esteem Sexual Identity and OrientationGender Identity and Roles EMOTIONS AND RELATIONSHIP: All human beings have the ability and need to experience emotional closeness to other and have it returned. SEXUAL BEHAVIOR MasturbationShared Sexual BehaviorAbstinenceHuman Sexual ResponseFantasy EMOTIONS AND RELATIONSHIP FamiliesFriendshipsLoving, Liking and CaringFeelings of Attraction & DesireFlirtingDatingIntimacyMarriage & Lifetime CommitmentsRaising Children SEXUAL VIOLENCE Sexual Abuse and IncestRapeManipulation through SexSexual Harassment SEXUAL HEALTH ContraceptionAbortionInfections and STis and HIV Reproductive Health: • Genital Care• Breast Self Exam• Testicular Self Exam• Prenatal Care• Infertility Sexual Dysfunction SEXUAL HEALTH: Sexual health requires specific information, attitudes and actions to avoid the unwanted consequences of sexual behavior. It includes the care and maintenance of the sexual organs, attitudes and behaviors related to reproduction and health consequences of sexual behavior. SEXUAL VIOLENCE: Sexual violence is any violence (abusive or unjust use of power) that has a sexual aspect or element. Sexuality can be used to influence, control or manipulate others.

22. Erogenous Zones Areas of the body that has heightened sensitivity, the stimulation of which may result in the production of erotic sensations or sexual excitement. Erogenous zones are generally found on all humans, they are not specific from one person to another, and may not work depending on a personal sensitivity.

23. Erogenous Zones…(employment) are areas of the body that are particularly responsive to sexual stimulation. ________________________________ Primary: areas that contain dense concentration of nerve ending Secondary: other areas of the body that become eroticized because they are touched within the context of sexual intimacies.

24. Armpits Mouth (lips, tongue, entire oral cavity) Neck Ears Navel Inside of thighs Wrists Feet/toes Primary Secondary Genitals Vagina/clitoris Penis/frenulum Scrotum/testicles Buttocks Anus Perineum Breast (especially nipples)

25. Sex and Mind The mind is the greatest sex organ. How we think and feel about our bodies and ourselves, and how we interpret the physical contact we have with others is really what distinguishes good sex from bad sex.

26. Sex and Spirit For Some…sex is spiritual because they feel like it brings them closer to a “higher power” For Others…it is their personal religious beliefs that guide their sexual behavior Regardless…of how it impacts you, your religious or spiritual beliefs and convictions make up part of your personal definition of sex.

27. Sex and Health The World Health Organization defines sexual health as: “…a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”

28. Pause! It’s time for a Fun Fact.

29. Fun Fact What was the date of the “Free Love Movement?” a. 1820 b. 1920 c. 1960 d. 2003 Institute on Disabilities, Temple University

30. Friendship and Relationships Institute on Disabilities, Temple University

31. Healthy RelationshipMutual and Consensual Mutual Interest Communication Touching Kissing Fondling Sexual Intercourse

32. Friendships and Relationships Come in all Forms and Many will Change Over Time.The meaning of friend & touch also changes over time.

33. Relationship Skills Developing successful relationships can be difficult, particularly for individuals with disabilities. Everyone enjoys being chosen as a boyfriend or girlfriend. Successful relationships don’t all lead to marriage or sexual intercourse.

34. What’s the Difference? Friend Friendly Friendship Girl friend Girlfriend Boy friend Boyfriend Institute on Disabilities, Temple University

35. TOUCH Institute on Disabilities, Temple University

36. TOUCH is the “mother of all senses” Our tactile system is the earliest sensory system to become functional (in the embryo) and be the last to fade (Fosshage, 2000). It is our only reciprocal sense – we can not touch another without being touched ourselves

37. Touch, Ethnicity, Culture • The meaning of touch can only be understood in its cultural context. (Halbrook & Duplechin, 1994) • People from different cultures were observed in casual conversation and the number of times they touched in one hour were counted.(Jourard, 1996) • Puerto Rico – 180 times Paris – 110 times • United States – 2 times London – 0 times

38. Good Touch/Bad Touch Touch is tangible and reciprocal (concrete). Describing touch is based on speech, vocabulary, experience, culture, and more (abstract). When describing touch both the sender and receiver must be on the same page, understand the intensity and emotion of the touch.

39. When is an Embrace a Hug or a Hold? How do you tell the difference? • Personal experience • Professional experience Are the consequences the same? Is a “label” created?

40. Case Scenario___________________________ • A 20 year old young woman with Down syndrome attends a public school and discloses to her mother that the boy “bothered” her. • The young woman’s behavior changed. Family physician and psychologist recommended medication. • Six months later the young women stated the boy “hurt” her. • Police are called.

41. Time, February 23, 2009

42. The Full Frontal Total body contact, heart- To-heart embrace and firm Squeeze. For parents, children And good friends Time, February 23, 2009

43. The Ass-Out Hug Nothing touches below the Shoulders. Reserved for the Office, bad dates and references To Vince Vaugn Time, February 23, 2009

44. The Hip-Hop Hug A.k.a. the man hug and the Hetero hug. Shake with right Hand and hug with left, two Slaps on back Time, February 23, 2009

45. SOCIAL SKILLS And SEXUAL ETIQUETTE

46. Social Skills/Sexual Etiquette Social skills/etiquette are behaviors and convention that let others know what we want without being rude, disruptive, etc. They are the passport to acceptance.

47. Social/Sexual Contract, Expectations,and Manners Social contacts and expectations are more than manners. Example: Stopping for a cup of coffee Stand in back of line Move up in line Decide what you want to order Get your money ready Place your order Pay for your order Receive your order

49. Pause! It’s time for another Fun Fact.

50. Sex Fun Fact # 2 Were Kellogg's Cornflakes developed to support the medical model of self-restraint and abstention from masturbation. True or False