Human Sexuality and Sex Education

1. Human Sexuality and Sex Education Pia-Marie Kawagoe Cesar Mireles Juan H. Arredondo Christian Pacpaco Steven Weiger Truc Ta HSC 425 Spring, 2014 (Tu/Th)

2. What is Circumcision? • The surgical removal of the foreskin which covers the glands of the penis.

3. What is the Circumcision procedure?

4. How do you feel about male circumcision? Support Circumcision Against Circumcision

5. Anatomy of Circumcision • Foreskin – retractable double layered fold of skin and mucous membrane and uniquely constructed for sexual purpose • Inner Foreskin - ring of specialized tissue (ridged band) that is extraordinarily rich in nerve endings

6. When is circumcision done? • Usually performed on the 1st or 2nd day of birth. • The procedure becomes more complicated and riskier in older babies, children and men • Operation for newborn takes about 10 minutes and about an hour for adults.

7. Adult Circumcision Common reasons for adult circumcision: • Phimosis – Inability to retract the foreskin because of excessive tightness often resulting in tearing and painful sexual activity • Paraphimosis - inner foreskin is trapped behind the corona (rim)of the penis (medical emergency)

8. How about female circumcision?

9. AKA Female Genital Mutilation • Types 1B & 2 are the most common • Type III ~ 20% of affected women, most likely in: Somalia, northern Sudan and Djibouti

10. Pros and Cons of Male Circumcision Pros: Medical: • reduce the risk of urinary tract infection • reduce risk of HIV in heterosexual boys • reduce risk of human papillomavirus (HPV) • provide protection against penile cancer Relationship: • help minimize risk of transferring HPV to female partners • religious reasons ( Jews and Muslim boys are circumcised) • some woman may prefer a circumcised man

11. Cons: Medical: • risk of bleeding and infection at the site of circumcision • risk of injury to the penis • pain • irritation of the glands • Relationship: • some partners may not like a circumcised penis • traumatic experience for the infant, may disrupt or harm mother-infant bonding relationship • some research show that circumcised penis may induce vaginal dryness during intercourse

12. Statistics U.S. • Though the incidence of male circumcision has decreased from 90% in 1979 to 60% in 1999, CDC data show that circumcision rate declined from 56% in 2006 to 32.5% in 2009 in the US Canada • The Canadian Pediatric Society (CPS)'s neonatal circumcision policy since 1975 has been that there is no medical indication for male neonatal circumcision. •   In fiscal 1996/97, circumcision was performed as a primary procedure on about 20% of Canadian male neonates, however by 2005, this had declined to 9.2%

13. New Zealand: • The incidence of male neonatal circumcision in New Zealand rose to about 95% in the 1940s • At the present time the incidence of neonatal circumcision in New Zealand is very low. A circumcision rate of 0.35% was reported in 1995 in public hospitals *According to the World Health Organization (WHO), global estimates suggest that 30% of males are circumcised, of whom 68% are Muslim.

18. Religious Reasons • Started in lands south & east of Mediterranean • Practiced by the ancient Egyptians/Semites then forwarded by the Jews/Muslims.

19. Jewish Circumcision (britmilah ) • Religious setting by a “Mohel” on 8th day • Genesis chapter 17 & Moses

20. Converts must be circumcised • Originally only tip of foreskin was cut => entire foreskin • Religion or Cultural?

21. Muslims (Khitan) • Not in Quran - religious bases for some Genesis 17 • For majority its tradition • Purification, control, confirmation of relationship with God

22. As religion spread so did this practice (Africa, Asia) • ~ 90% of Muslims • Needed for pilgrimage to Mecca • Prophet's tradition

23. When does it get done? between birth or up to 15 years of age • Frenulum is either intact, or removed • Party Time?

24. Cultural Reasons

25. Coming of Age • Test of bravery and endurance • Tradition

26. Health and Sexual Benefits Maintaining hygiene Cleansing after birth Enhanced sexual pleasure

27. Rite of passage to womanhood • Prepare her for adulthood and marriage • Age group varies from infancy into adolescence.

28. Female Genital Mutilation • I-Partial or total removal of the clitoris • II-Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora • III-Narrowing of the vaginal opening through the creation of a covering seal. • IV-All other harmful procedures to the female genitalia for non-medical purposes.

29. Complications • Most common difficulties are bleeding, infection and deformation. • Some cases extremely severe. • Anesthesia, mostly in newborns. • Physical sensory loss - can lead to: erectile problems, ejaculation problems, anorgamia(inability to orgasm during sexual function) and reduced stimulation during intercourse. • Psychological issues can include: rage, resentment and depression.

30. Severe Cases • Bruce Reimer – “the boy who was raised as a girl”. http://www.youtube.com/watch?feature=player_detailpage&v=GazeE8KHIfE • 100+ Deaths in the U.S. per year(1 out of 77 infant deaths) • Bleeding related deaths. • Infection related deaths. • Anesthesia related deaths.