Dr Adarsh Tripathi MBBS, MD (KGMU) MIPS, MIASP Assistant Professor (Psychiatry)

1. Dr Adarsh Tripathi MBBS, MD (KGMU) MIPS, MIASP Assistant Professor (Psychiatry) Human sexuality

2. Sexuality • Sexuality has been a consistent focus of curiosity, interest, and analysis to humankind • Depictions of sexual behavior have existed from the time of prehistoric cave drawings (Ajanta) through da Vinci's anatomical illustrations of intercourse, literature (Kamsutra to MM Jayasi) to current pornographic sites available on the Internet

3. Sexuality • Sexual behavior is diverse and determined by a complex interaction of factors. • relationship with others • life circumstances • culture • personality traits • biological makeup • general sense of self • the perception of being a man or a woman • reflects developmental experiences with sex throughout the life cycle

4. Sexuality encompasses all those thoughts, feelings, and behaviors connected with sexual gratification and reproduction, including the attraction of one person to another. • Something more than physical sex, coital or noncoital, and something less than all behaviors directed toward gaining pleasure

5. Plays a central role in most of our lives. It is a key factor in our principal relationships and the formation of our families. It is also a common source of problems. • People may also use sexual activities to gratify nonsexual needs, such as dependency, aggression, power, and status

6. Why to study • Reason for studying human sexuality is that we may face various personal and social problems involving sexuality, such as, sexually transmitted diseases, unwanted pregnancies, and sexual harassment

7. Psychosexuality • Sexuality and total personality are so entwined that to speak of sexuality as a separate entity is virtually impossible. • Psychosexual is used to describe personality development and functioning as these are affected by sexuality • Primary source of motivation. Just consider the amount of time spent thinking and planning for sex, let alone the time spent in sexual behavior itself

8. Abnormal Sexuality • Sexual behavior that is destructive to oneself or others, that is markedly constricted, that cannot be directed toward a partner, that excludes stimulation of the primary sex organs, and that is inappropriately associated with guilt or anxiety.

9. Normal sexuality • Normal sexual behavior brings pleasure to oneself and one's partner, involves stimulation of the primary sex organs including coitus • It is devoid of inappropriate feelings of guilt or anxiety and is not compulsive. • Recreational, as opposed to relational sex, that is sex outside a committed relationship, masturbation, and various forms of stimulation involving other than the primary sex organs

10. ;kSu bPNk &;kSu bPNk Hkw[k dh rjg ,d lkekU; vko';drk gS A Hkw[k dh rjg dqN yksxksa es vf/kd gksrh gS] dqN es de A ;kSu bPNk ifjfLFkfr ds vuqlkj ?kV c<+ ldrh gSA A

11. ;kSu fdz;k dh vof/k & vkSlr vof/k 60 lsds.M ls 3 feuV dh gksrh gS A lk/kkj.kr;k lEHkksx es le; ?k"kZ.k dh nj ij fuHkZj djrk gS A ;fn iq#"k vkSj L=h nksuks mRrsftr gksa rks yxHkx 15 ls 20 ckj ?k"kZ.k djus ls oh;Z Lo[kyu gks tkrk gS A

12. Male Sexual response

13. Female sexual response

14. Psychosexual factors • Sexual identity is the pattern of a person's biological sexual characteristics • Gender identity is an individual's sense of maleness or femaleness. By the age of 2 or 3 years, almost everyone has a firm conviction that “I am a boy” or “I am a girl.” • Gender role • A child's sex affects parental tolerance for aggression and reinforcement or extinction of activity and of intellectual, aesthetic, and athletic interests

15. Psychosexual factors (cont.) • Sexual orientation describes the object of a person's sexual impulses: heterosexual (opposite sex), homosexual (same sex), or bisexual (both sexes). • Sexual behavior includes desire, fantasies, pursuit of partners, autoeroticism, and all the activities engaged in to express and gratify sexual needs. It is an amalgam of psychological and physiological responses to internal and external stimuli

16. Masturbation • Masturbation usually is a normal precursor of object-related sexual behavior • Masturbation is a psychopathological symptom only when it becomes a compulsion beyond an individual's willful control. Then, it is a symptom of disturbance not because it is sexual, but because it is compulsive. • It is also symptomatic of sexual problems when it is the only sexual activity of a person who has an available intimate partner • Masturbation is a universal and healthy component of psychosexual development.

17. lkekU; ;kSu ftKklk,a • fyax dh yackbZ & ruko dh fLFAfr esa lkekU; yackbZ 8 ls 12 lsUVhehVj gksrh gS A ;ksfu dh yackbZ yxHkx 7 lsUVhehVj gksrh gS]tks fyax ds izos'k ds le; fyax ds vkdkj ds vuqlkj c<+ tkrh gSA

18. oh;Z dk xk<+kiu & oh;Z ds xk<+siu ;k irysiu ls ;kSu vkuan ,oa iztuu dh 'kfDr ij dksbZ vlj ugha iM+rk gSA

19. /kkr~jksx • is'kkc ds lkFk /kkr~ fudyuk dksbZ chekjh ugh gS A blds fudyus ls fdlh Hkh izdkj dk 'kkjhfjd vkSj ekufld fodkj ugha gksrk A • /kkr~~ izksLVsV XyS.M rFkk ;wjsFkjy XyS.M dk L=ko gksrk gS A ;g oh;Z dk ,d Hkkx vo'; gks ldrk gSA • /kkr~~ nks izdkj dh gksrh gS & • 1- cgq/kk [kkuk [kkus ds ckn is'kkc djus ij dHkh dHkh is'kkc es lQsnhiu vk tkrk gS tks QklQsV yo.k ds dkj.k gksrk gS ] ftles dksbZ gkfu ugha gksrh A • 2- dHkh dHkh vf/kd ;kSu mRrstuk ;k dCt ds dkj.k vf/kd tksj yxkus ls ikjn'kZd fpifpik xk<+k inkFkZ izksLVsV xzfUFk ls fudyrk gS A ;g rjy inkFkZ oh;Z ugha gksrk u blls dksbZ gkfu gksrh gS A

20. LoIu nks"k üLoIu nks"k +,d LokHkkfod izfdz;k gS A ;g fd'kksj voLFkk ls vkjEHk gksdj fdlh Hkh vk;q es gks ldrk gS A üLoIu nks"k nch gqbZ ;kSu bPNkvksa dh ,d vfHkO;fDr gS A tks fd uhan es iwjh gkssrh gS A ü'kkjhfjd ifjiDork ds i'pkr oh;Z fuf'pr ek=k es yxkrkj curk jgrk gS Avxj O;fDr gLreSFkqu ;k laHkksx ugha djrk gS rks LoIu nks"k ds :i es fudy tkrk gS A üLoIu nks"k dk gksuk O;fDr dh 'kkjhfjd vkSj ekufld fLFkfr ij fuHkZj djrk gS A 'kkjhfjd :i ls ;fn cgqr le; rd oh;Z L[kyu u gqvk gks rks LoIu nks"k dh laHkkouk c< tkrh gS A üLoIu nks"k dksbZ jksx ugha gS vkSj bldh fpfdRlk dh dksbZ vko';drk ugh gS A

21. HkzkfUr;kWa iq#"kksa es ü'kknh ds igys gLreSFqku djus ls Hkkoh oSokfgd thou ij cqjk izHkko iM+rk gS &fd'kksjkoLFkk es vf/kdrj ckyd gLreSFkqu djrs gSa A ;g gkfudkjd ugh gS ] gLreSFkqu ;kSu mRrstuk ls eqfDr ikus dh ,d LokHkkfod fdz;k gS A ;g ;kSu fodkl ,oa ;kSu vkuUn dk izFke pj.k gS A 'kknh ds igys ;k ckn es ,slk djus ls fdlh Hkh izdkj dk 'kkjhfjd ;k ekufld uqdlku ugha gksrk gS A üfdlh Hkh izdkj ds oh;Z L[kyu ls detksjh vuqHko djuk vFkok 'kjhj es nnZ dk vuqHko gksuk &;s mUgh O;fDr;ks dks vuqHko gksrk gS tks oh;Zgkl ds lacU/k es fpafrr jgrs gSa ] vkSj ;s detksjh blh fpark ds dkj.k vuqHko gksrh gSA ü,d cwan oh;Z 100 cwan jDr ds cjkcj gksrh gS A blfy, izR;sd L[kyu es gtkjks cwan jDr u"V gks tkrk gS &;g rF; iw.kZr;k xyr gS D;ksafd oh;Z ds cuus es jDr u"V ugha gksrk gSA ü;kSu fdz;k ls igys u'khyh oLrqvksa ds lsou ls ;kSu bPNk @ vkuUn c<+ tkrk gS &blls {kf.kd vkuUn rks fey ldrk gS ysfdu lk/kkj.kr;k vf/kd u'kk djus ij lsDl bPNk ,oa {kerk de gks tkrh gSA üiq#"kksa es ulcUnh ds ckn ;kSu bPNk o {kerk es deh vk tkrh gS vkSj oh;Z L[kyu ugha gksrk gS & ;g ,d xyr /kkj.kk gS] ulcUnh ds ckn iq#"k dh {kerk vkSj bPNk ij dksbZ izHkko ugha iM+rk gSA

22. üxats iq#"kksa es ckyks okys iq#"kksa dh vis{kk vf/kd ;kSusPNk gksrh gS &;g ,d xyr /kkj.kk gS ] ;g iq#"k dh viuh 'kkjhfjd rFkk ekkufld fLFkfr ij fuHkZj djrk gSA ütks yksx lEHkksx vFkok oh;Z L[kyu ugha@de djrs gSa og T;knk LoLFk gksrs gSa &LokHkkfod :i ls ;kSu bPNk dh iwfZrZ djus ls 'kjhj vkSj eu nksuks LoLFk jgrs gSa A oh;Z L[kyu ls dksbZ detksjh ugha gksrh A üoh;Z cgqr egRoiw.kZ ,oa 'kfDr'kkyh inkFkZ gS ] oh;Z 'kjhj es lhfer ek=k es gksrk gS &'kjhj ds vU; nzO;ksa dh rjg oh;Z Hkh fujUrj cuus okyk lkekU; inkFkZ gS A 14 ls 15 lky dh mez ls e`R;q rd iq#"k es ;g yxkrkj curk jgrk gS A bldh ek=k ,d izdkj ls vlhfer gksrh gS ] 'kjhj es blds fudkl ls pkgs lEHkksx ] gLreSFkqu ] ;k Loiunks"k dksbZ Hkh nq"izHkko ugha iM+rk gSA üvkneh ds fyax dh cukoV mlds 'kjhj ds cukoV ij fuHkZj djrh gS&'kkjhfjd cukoV vkSj fyax dh cukoV dk dksbZ lacU/k ugha gksrk gS A ,d nqcys o NksVs O;fDr dk fyax cM+k vkSj eksVk gks ldrk gS ] vkSj ,d etcwr dn dkBh ds O;fDr dk fyax NksVk ;k iryk gks ldrk gS A ücM+s fyax ls L=h vkSj iq#"k dks vf/kd ;kSu vkuUn izkIr gksrk gS &fyax ds vkdkj vkSj ;kSu vkuUn es dksbZ lacU/k ugh gSA üLdwyksa es ;kSu f'k{kk nsus ls ;kSu fdz;k c<+ ldrh gS &,slk ugha gS cfYd lsDl fo'ks"kK }kjk nh xbZ tkudkjh fd'kksjksa dks lsDl dk lgh Kku nsdj mUgsa xyr jkLrs ij tkus ls cpk,xk A üftu iq#"kksa dk [kruk gks pqdk gS os vU; dh vis{kk tYnh mRrsftr gks tkrs gSa &,slk lkspuk xyr gS ] ;g dsoy xyr /kkj.kk gS A

23. HkzkfUr;kWa fL=;ksa es üigyh ckj lEHkksx ij jDrL=ko dqvkWajsiu dh fu'kkuh gS vr% ;g vko';d gS &igyh ckj lEHkskx ij jDrL=ko vko';d ugha gS ] dkj.k ;g gS fd ;ksfu }kj ds vUnj ,d f>Yyh gksrh gS ftles ,d ;k nks Nsn gksrs gSa ] dHkh dHkh blds Nsn brus cM+s gksrs gSa fd fyax mues ls izos'k dj tkrk gS rFkk dHkh dHkh ;g f>Yyh Lor% gh VwV tkrh gSa ] fo'ks"k :i ls mu fL=;ksa es tks [ksy dwn bR;kfn es vf/kd Hkkx ysrh gSa ] vr% jDrL=ko izFke laHkksx ds igys gks pqdk gksrk gSA üL=h ds fookg iwoZ xHkZfujks/kd xksfy;ka [kkus ls fookg ds i'pkr ekWa cuus es #dkoV vkrh gS &,slk ugh gS ] D;ksafd xksfy;ksa ds yxkrkj ysus ls ;g rks lR; gS fd ;g L=h es v.Ms ds mRiknu dks jksd nsrh gS ijUrq budk mi;ksx cUn dj nsus ls iqu% v.Ms cuuk 'kq# gks tkrs gSa ] vkSj og ekWa cu ldrh gS A üekfld /kEkZ ds nkSjku laHkksx djuk vlqjf{kr rFkk gkfudkjd gS &ekfld /keZ ,d LoLFk izfdz;k gS ] bl nkSjku lEHkksx djuk lsgr ds fy, gkfudkjd ugh gS A üjtksfuo`fRr ds i'pkr L=h es ;kSusPNk lekIr gks tkrh gS &;kSusPNk lekIr rks ugha gksrh ] gka ;g vo'; gS fd de gks tkrh gS A ijUrq tks fL=;kaW yxkrkj laHkksx djrh jgrh gSa mudh ;kSu bPNk vkSj laHkksx {kerk yacs le; rd cuh jgrh gS A

24. fL=;ksaespjekuUndsoylaHkksxdsnkSjkughfeyrkgS &;g lR; ugh gSfL=;ksadks ;g dYiukLi'kZ ] vkfyaxu ] pqaculsHkhizkIrgkstkrkgS A • xHkZdsnkSjkulEHkksxdjukgkfudkjdgS& blesdksbZlPpkbZ ugh gS A vfUrenks ;k rhugQrksasdksNksM+djckdh le; ;kSufdz;ktkjh j[khtkldrhgS A • iq#"kksaesfL=h;ksa dh vis{kkvf/kd ;kSusPNkrFkk le> gksrhgS ] vr% ges'kklsDl dh igymUghadksdjuhpkfg, &,slk ugh gS ];kSusPNkrFkklsDl dh le> nksuksescjkcjgksrhgS ] clmldh L=hxryTtkrFkklkekftdlaLdkjmlslsDl dh igydjuslsjksdrsgSaA • cM+sLruokyhfL+=;ksaesvU; fL=;ksa dh vis{kkvf/kd ;kSusPNkgksrhgS &fL=;ksa dh ;kSusPNkmudsLrudsvkdkj ;k vU; fdlh ;kSuvax dh cukoVijfuHkZjughadjrhcfYd ;g L=h ds Loa; dsLoHkkoijfuHkZjdjrkgSk ;kSuvaxks dh [kkfl;r ns[kusokys dh fuxkgksaesgksrhgS A • Lruikudjkusokyh L=h xHkZ/kkj.kughadjldrh &,slkughagS ] cPpsdkstUensusdsi'pkrLruikudsnkSjkuHkh L=h xHkZ/kkj.kdjldrhgS A ü  L=;ksaesvkijs'kudsckn ;kSubPNk o {kerkesdehvktkrhgS &blvkijs'kulsfdlhHkhizdkjls ;kSubPNk ;k {kerkesdeh ugh vkrhgS A bldsfoijhrvupkgkxHkZBgjusdsHk; lseqfDrfeyus dh otgls ;kSufdz;k,aT;knkfuf'pUrvkSjvkuUniw.kZgkstkrhgS A

25. Differences in more than practice… Sex for procreation or recreation? For physical pleasure or spiritual union? Daily? Weekly? Every five years? Monogamy or Polygamy? The text provides examples of each occurring in different cultures.

26. Thank You