Human Sexuality Exam 3

civil union

(also called domestic partner- ship) A legal contract between two members of the same sex that imparts all or most of the legal benefits of marriage but is not socially or religiously equated with heterosexual marriage. laws that allow same-sex couples some or all of the rights and privileges that come with legal marriage (these are in green on the map). However, as has been proclaimed in many civil rights movements historically, "separate but equal" is not seen by most gay and lesbian individuals as truly equal to heterosexual marriage. States with remaining civil union laws are the most likely to legalize same-sex marriage in the near future. The legal status of same-sex marriage in the United States remains a work in progress that is changing virtually month-to-month. same sex marriage is legal in most states

umbilical cord

A structure approximately 22 inches in length, consisting of one large vein and two arteries that transport nutrients, oxygen, and fetal waste products back and forth between the fetus and the placenta. Throughout pregnancy, the placenta is attached to the abdominal wall of the fetus by the umbilical cord, which reaches an average length of approxi- mately 22 inches during pregnancy and consists of one large vein and two arter- ies. Its function is to transport nutrients, oxygen, and fetal waste products back and forth between the fetus and the placenta. When a baby is born, the umbili- cal cord is tied off near the baby's belly and severed. The small portion still attached to the infant shrinks and detaches within about two weeks, leaving a scar we all know as the navel.

nurse-midwife

A registered nurse who has com- pleted an accredited midwifery program and has been certified by the state to deliver babies.

gender roles

A set of behaviors, attitudes, and emotions that are generally socially expected for men and women in a given culture. sex roles

postpartum psychosis

A severe postpartum psychological disorder that may include delusions, hallucinations, and extreme mental disorganization.

embryo

A blastocyst that has implanted in the uterine wall.

Turner syndrome

A female genetic condition characterized by short stature, slow or no sexual development at puberty, heart abnormalities, and lack of ovarian function. is caused by a lack of or damage to one ofthe pair of X chromosomes. This condition is far less common than Klinefelter syn-drome, affecting only one in 2,000 to 2,500 female births. Nearly all cases of Turner pattern syndrome (99%) result in miscarriage of the afflicted fetus in the first or second trimester of pregnancy the symptoms and effects of Turner syndrome tend to be more physically and psychologically serious than those of Klinefelter syndrome, although a wide range of symptomology exists, from mild to severe. The most com- mon conditions associated with Turner syndrome (see Figure 10.3) are short stature (average height of 4 feet, 7 inches in adulthood), slow or no sexual development at puberty, puffy hands and feet, kidney malformations, hearing problems, extra folds of skin at the sides of the neck, heart abnormalities, lack of ovarian function (hormone and ovum production), and soft upturned fingernails Because of hormonal abnormalities, virtually all Turner syndrome individuals are infertile. As they age, women with the syndrome are at a significantly increased risk of bone thinning (osteoporosis). Underdevelopment of the kidneys or the lack of one kidney is also quite common. Most worrisome are the 20% of Turner syndrome individuals who have heart valve and vessel malformations. These conditions may be life-threatening and require careful monitoring and treatment throughout life. As with Klinefelter syndrome, Turner syndrome patients have twice the incidence of diabetes of the general population. Cognitively, Turner syndrome individuals are of normal intelligence but may have learn- ing difficulties, especially associated with math and spatial relationships with awareness and proper treatment, most of the effects can be controlled and mitigated successfully.

lesbian

A female with a homosexual orientation. refers to homosexual women.

zygote

A fertilized ovum (or egg) moving down the fallopian tube.

birthing center

A hospital-like facility with basic medical care equipment, focus- ing on a natural, family-centered approach to the birth process in a home-like setting. These centers tend to promote midwife-tended births (typically with on-call physicians readily available) and encourage less use of pain medications during labor and delivery (epidural and certain other medical analgesics are ordinarily not avail- able). Birthing centers offer more choices of food and drink (no alcohol, of course), more activities are permitted and even encouraged during labor (walking, stretching, etc.), and various comfort measures such as massage, relaxation exercises, and even warm tub soaks are often available.

Klinefelter syndrome

A male genetic condition characterized by a rounded body type, lack of facial hair, breast enlargement in puberty, and smaller-than-normal testicles. one out of every 500 male babies is born with an additional X sex chro- mosome (Wattendorf & Muenke, 2005). These males, instead of the typical XY pairing, have an XXY chromosome configuration and are referred to in the medical community as XXY males. Not all XXY males will develop the characteristics of Klinefelter syndrome, some may not be diagnosed until puberty, and some may never even know they have the extra X chromosome. How- ever, when the syndrome is activated, common physical signs and symptoms include a rounded body type, lack of facial hair, breast enlargement in puberty (often temporary), smaller-than-normal testicles, osteoporosis, and a tendency to be taller and heavier than average Most, but not all, XXY males fail to produce enough sperm in adulthood to be fer- tile. They also appear to have a somewhat higher risk of autoimmune diseases such as diabetes and lupus. XXY males who develop breast tissue have a risk of breast cancer equal to that of women, which is twenty to fifty times greater than the risk to normal XY men An early developmental concern for XXY males is that they often display delayed development of language and may have learning difficulties, especially in reading and writing. These children are not mentally retarded and eventually learn to speak and converse normally. Furthermore, their learning difficulties are treatable with proper guidance and attention. usually able to live normal

dilation and evacuation (D&E)

A method of abortion commonly used when a pregnancy has progressed beyond the first trimester, involving scraping of the uterine walls and suctioning out of the contents. If pregnancy has progressed beyond the first trimester, the usual ter- mination procedure is dilation and evacuation, commonly called D&E. D&E is a more invasive and extensive procedure than MVA, largely because by the second trimester (which is 13 to 26 weeks, although only about 1% are performed after 23 weeks of gesta- tion), the pregnancy is more firmly established, and the developing fetus in the uterus is larger. The procedure therefore typically requires greater dilation of the cervix than a first-trimester abortion. Prior to the procedure, the woman is usually given sedatives and a local or general anesthetic. Then the cervix is dilated so that a vacuum tube may be inserted to remove the fetus and most of the remaining contents of the uterus. Next, a curved surgical instrument called a curette is inserted to scrape the lining of the uterus to free any additional tissue. Finally, suction may be applied to be sure the uterus has been fully emptied.

vacuum aspiration

A method of abortion in whicha small tube is inserted through the cervix to extract the contents of the uterus, including the endometrium lining and embedded embryo. An older method of abortion called "dilation and curettage" or a "D&C" is rarely used today because it presents a greater chance of com- plications. The vacuum aspiration technique incorporates a syringe device that is oper- ated by hand (called manual vacuum aspiration) or a small hand-held electrical medical vacuum device (do not ever try this with other types of vacuums!). Both vacuum meth- ods have been shown to be equally safe and effective Vacuum aspiration, as the term implies, incorporates a small tube that is inserted through the cervix to which suction is applied, creating a slight vacuum that draws out the contents of the uterus, including the endometrium lining and the embedded embryo. The procedure takes 5 to 15 minutes and, where abortion is legal, is typically performed in a doctor's office or medical clinic under local anesthetic. Usually, over- the-counter pain relievers (such as ibuprofen) are adequate for postsurgical pain and cramping. Normal side effects of the procedure include abdominal cramping and usu- ally some bleeding.

medical abortion

A method of abortion using drugs rather than surgery to terminate a pregnancy. The medications used in abor- tions are either mifepristone (brand name Mifeprex; formerly referred to as RU-486) or methotrexate, both of which are combined with misoprostol (a synthetic form of the hormone prostaglandin). Medical abortions are most appropriate for pregnancies of less than nine weeks. When a woman chooses to have a medical abortion, the doctor administers either mife- pristone or methotrexate to the pregnant woman during an office visit. Mifepristone is administered either orally or as an injection. Misoprostol is administered concurrently either orally or as a vaginal insert

neonate

A newborn infant.

midwife

A person (usually a woman) who has been trained in most aspects of pregnancy, labor, and delivery and who is not a physician or registered nurse.

androgynous

A person who embodies both masculine and feminine traits and behaviors

homosexual

A person who is attracted emotionally, romantically, and sexually primarily to persons of his or her own sex. applies to those whose primary attraction is to members of their own sex.

bisexual

A person who is attracted emotionally, romantically, and sexually to members of both sexes. individuals are those who are attracted to members of both sexes. The excerpt just presented recounts one student's journey as he discovered and accepted his sexual orientation.

heterosexual

A person who is attracted roman- tically and sexually primarily to persons of the opposite sex. refer to individuals who are primarily attracted in all those ways to members of the opposite sex.

birth defect

A physical abnormality or metabolic dysfunction that is present at birth and may result in physical or mental deficits. A birth defect is a physical abnormality or a dysfunction of metabolism (body chemistry) that is pres- ent at birth and results in physical or mental disability. Testing of the fetus while in the uterus for various abnormalities is becoming ever safer and more accurate, which is even fur- ther decreasing the chances of an infant being born with a serious problem

ectopic pregnancy

A pregnancy complication in which a fertilized ovum attaches and begins to grow outside the uterus, most commonly in the fallopian tube; also called a tubal pregnancy. (ectopic means "out of place") occurs when a zygote implants somewhere in the woman's body other than the uterus. Nearly all ectopic pregnancies occur in one of the fallopian tubes, where fertilization has just taken place, and are often referred to as tubal pregnancies ectopic pregnancies are short-lived and a health risk for the woman because, as you might imag- ine, the fallopian tube, although ideal for conception, is far too small for the developing embryo Among the most common causes of ectopic pregnancy is infection with one or more of various sexually transmitted infections, especially chlamydia and gonorrhea. these bacteria, if not properly treated, may lead to pelvic inflammatory disease (PID). In some women, PID may damage a woman's fallopian tubes, limiting passage of a fertilized ovum and increasing the risk of ectopic pregnancy often produces all the signs and symptoms of a normal pregnancy, including absence of the menstrual period, nausea, and positive results on a pregnancy test. Six to eight weeks after the missed period, however, as the zygote grows in the fallopian tube, symptoms begin to appear, most commonly vaginal bleed- ing and abdominal pain diagnose a tubal pregnancy using a combination of physical examination, hormonal blood tests, and ultrasound imaging techniques. A common treatment for ectopic pregnancies is a single injection of a medica- tion called methotrexate, which inhibits cell growth in the zygote and allows it to be expelled via the fallopian tube, uterus, and vagina. This treatment typically resolves approximately 90% of ectopic pregnancies. If the zygote is too large or the medication is ineffective, laparoscopic surgery will be performed to remove the cell mass and part or all of the fallopian tube. In the past, ectopic pregnancies usually caused the loss of the fallopian tube and sometimes reduced future fertility

postpartum depression (PPD)

A psychological depressive disorder that begins within four weeks after childbirth. Treatments for PPD are similar to established treatments for other forms of depressive illness and include psychotherapy and antidepressant medication. Any medication a nursing mother takes has the potential to enter the breast milk and pos- sibly the infant's system. Therefore, many physicians and new mothers avoid antide- pressants for PPD in nursing mothers. This has been one reason why some women with PPD have gone untreated or have been forced to stop nursing sooner than they wish so that they could start (or resume) medication. This creates a dilemma of weigh- ing the risks of PPD to the mother and the infant against the risks of the medications or not breast-feeding to the infant

APGAR score

A test that analyzes infant health at birth on the basis of skin color, pulse, reflexes, movement, and breathing. This test measures the crucial signs of infant health with respect to skin color, heartbeat, reflexes, movement, and breathing (colleagues of Dr. Apgar assigned the acronym of her name to the test as a way of teaching it to medical and nursing students, the letters APGAR standing for appearance, pulse, grimace, activity, and respiration, respectively) the maximum score is 10 (which is fairly rare because most newborns tend to be somewhat deficient in at least one area). However, most newborns will score between 7 and 9. This is a very basic test and, except for scores of under 4, does not predict problems in the future health or abilities of the child. Furthermore, with today's advances in neonatal care, even babies with relatively low APGAR scores, such as between 4 and 6, typically develop without major difficul- ties

transsexual

A transgender person who has transitioned or is transitioning from his or her biological sex to his or her self-identified gender through actions, dress, hormone therapy, or surgery.

fetal alcohol spectrum disorders

A variety of disorders than may occur in a person whose mother drank alcohol during pregnancy.

gender-conforming behavior

Behavior that is consistent with traditional cultural expectations for a child's sex. preferences in play behaviors track with the child's sex: Boys prefer male-typical activities such as rough-and-tumble play or com- petitive sports, whereas girls gravitate toward female-typical, quiet, cooperative play such as jacks or hopscotch. This is referred to as gender-conforming behavior. children will seek out other children who share the same play preferences; that is, children who like to play jacks or hopscotch will seek out girls to play with, while children who prefer rough, competitive sports will prefer to play with boys

gender stereotypes

An assumption, usually negative, made about a person's appearance, behavior, or personality, based solely on his or her gender without regard for the person's individuality as a person.

fetus

An embryo after eight weeks of pregnancy.

oocyte

An immature reproductive egg, or ovum.

placenta

An organ that develops on the uterine wall during pregnancy and joins the developing embryo to the mother's biological systems, trans- ferring nourishment, oxygen, and waste products between the fetus and the mother. As pregnancy is established, a temporary organ called the placenta begins to develop on the uterine wall adjacent to the embryo. The placenta contains a rich sup- ply of blood vessels and is, in essence, the life-support system that biologically unites the developing embryo to the mother. As it grows along with the embryo, the placenta serves as a "transfer station" for nourishment and oxygen from the mother's body to the fetus and for waste products from the fetus back to the mother's bloodstream for disposal. During childbirth, the placenta, often referred to as the afterbirth, is typi- cally expelled from the uterus following the newborn and (usually) examined for any abnormalities that could signal problems for the infant.

teratogen

Any agent that has the potential to cause a fetal abnormality. Any outside agent, whether it is a drug (including many prescription medications), a microbe (such as measles), a chemical (such as antifreeze), radiation, or certain metals (such as lead or mercury), that has the potential to cause a fetal abnormality is called a teratogen. Teratogens can be ingested by a pregnant woman by any means, including eating, smoking, injecting, or coming into contact with the teratogenic substance.

gender-nonconforming behavior

Behavior that is inconsistent with traditional cultural expectations for a child's sex and considered more appropriate for children of the other sex. , meaning that the child prefers play activities that are typical of opposite-sex children and will seek out those children as friends and playmates nonconforming children will then feel increasingly dif- ferent from their "outgroup" of peers. In other words, children who primarily have playmates of their own sex (the vast majority of children) will feel different from oppo- site-sex children, while children whose playmates are of the other sex (a small minor- ity) will feel different from same-sex peers. Each will see the other group as strange and exotic. These feelings of difference create increased levels of emotional (not sexual) arousal toward children of the outgroup sex that might be expressed in statements such as "I hate girls" or "Boys are so weird!" This arousal may occur below conscious aware- ness, or sometimes it might be very obvious. "A particularly clear example," Bem sug- gests, "is the 'sissy' boy who is taunted by male peers for his gender-nonconformity and, as a result, is likely to experience the strong physiological arousal of fear and anger in their presence" later, in puberty, as sexual feelings begin to surface, this perceived difference and "exoticness" in the gender outgroup and the accompanying emo- tional arousal transform into erotic feelings toward that group Bem maintains that his EBE conceptualiza- tion is a major cause of sexual orientation in adults to link the biological (whether genetic or hormonal) and environmental influences that lead to a person's sexual orientation in adulthood. He also argues that even though a child's environment plays a major role in the formation of sexual orientation, this does not imply that sexual orientation is a choice or that it is "changeable" in adulthood any more than if it were found to be exclusively biological Consistent child- hood experiences may be just as deeply ingrained in a person as genetic heritage. does not accurately represent the experiences of girls and women (as evidenced by his examples of playing jacks and hopscotch as female gender-conforming behavior), that it is not supported by the very scientific evidence Bem himself cites, and that it is too limited in its application of psychoanalytic theory because it omits the influence of early boyhood trauma the theory does leave open the possibility (although Bem refutes this) of altering a child's future sexual orientation by promoting gender-appropriate behavior in childhood, and many top researchers in the area of sexual orientation doubt that this would be possible

preterm birth

Birth of an infant less than 37 weeks after conception. also known as premature birth, is the birth of a fetus well before the 9-month, 280-day pregnancy period is complete. More specifically, preterm birth is defined as any delivery of a normally formed infant that occurs fewer than 37 weeks (259 days) after concep- tion, which is three weeks fewer than a full-term pregnancy premature infants require special and often highly intensive care in a hospital setting before they are strong and healthy enough to be taken home. a wide range of developmental difficulties for the child and consequently present extra challenges for the parents Preterm infants often exhibit early deficits in cognitive, attention, per- ceptual, and motor skills, some of which may continue into later childhood. Moreover, preterm infants are more prone to learning disabilities, diabetes, hearing impairment, coronary heart disease, and cerebral palsy tend to be less alert and slower to acquire early visual and auditory skills com- pared to full-term babies. higher risk of death Some of the factors found to be associated with pre- term birth are drug use, cigarette smoking, or various infectious agents, poor nutrition, and environmental toxins such as exposure to traffic-related air pollution A newly developed blood test appears to be able to predict with nearly 80% accuracy whether a preg- nant woman will give birth early. The test measures two proteins in her blood, combined with a cervical length measurement. Still in the research stages, if this test is approved, it will allow for targeted treatments for at-risk women to prevent preterm birth One often-mentioned "cause" of premature births relates to intercourse during pregnancy. Contrary to popular belief, however, sexual activity during preg- nancy does not increase the risk of preterm labor (or any other pregnancy problems). Research has dem- onstrated that sexual activity, including intercourse, throughout the duration of a normal pregnancy poses no risk to the developing fetus or to the mother. Sexual activity does not normally increase the chances of premature birth or birth defects, does not affect birth weight or birth length, and won't cause uterine mem- branes to rupture In fact, sexual intercourse and orgasm for the woman later in pregnancy appear to be associated with lower rates in preterm births but if the woman has or contracts a sexually transmitted infection such as gonorrhea, chla- mydia, or trichomoniasis during pregnancy then it will happen desire for sex is questionable and Heterosexual couples who choose to have intercourse during pregnancy may need to experiment with various positions to accommodate the changes in the woman's body as the fetus and the woman's abdomen grow

Embryonic and Fetal Testing

Blood tests per- formed on the expectant mother measure levels of proteins and hor- mones that can predict an increased risk of some disorders, such as spina bifida (a neural tube defect in which the spinal column fails to close completely during fetal development) and Down syndrome (a chromosomal condition characterized by some degree of intellectual disability, often combined with specific physical and medical prob- lems such as small stature, lowered resistance to infection, vision and hearing difficulties, and, in some, heart defects that are usually cor- rectable). Such tests are becoming increasingly accurate during very early stages of pregnancy electronic scans such as ultrasound, three-dimensional ultrasound, and magnetic resonance imaging (MRI) allow physi- cians to see the fetus in the uterus directly Ultrasonic visualization of the fetus inside the uterus lets doctors and parents literally see and monitor the progression of pregnancy and can alert them to the presence of any birth defects. Amniocentesis and chorionic villus sampling (CVS) are tests that require the extraction of a small amount of fluid from the sac surround- ing the fetus (in amniocentesis) or a sample of placental tissue (in CVS). The cells in these substances contain the full genetic code for the fetus and can be used to diagnose many genetic abnormalities, such as Down syndrome, cystic fibrosis, hydrocephalus (fluid pressure in the skull), sickle-cell anemia, and hemophilia. Amniocentesis requires that a long needle guided by ultrasound be inserted into the uterus through the abdomen (see Figure 9.14), and CVS uses a small tube inserted through the cervix or a thin needle passed through the abdominal skin. Most women report only minor discomfort from these procedures. It was long believed that the disruption to the uterine balance during the test carried a small increased risk of miscar- riage. However, newer research has shown that this risk has been reduced virtually to zero due primarily to more advanced procedural techniques and the ability to use ultra- sonic guidance in performing the tests (Kuehn, 2006). Therefore, these prenatal tests are no longer reserved only for women at higher risk of pregnancy complications (such as those aged 35 or older or those with a history of pregnancy problems). Although the risk of all birth defects, and especially Down syndrome, increases with maternal age, the American College of Obstetricians and Gynecologists now recommends that all pregnant women be offered the option of these tests, especially if an analysis of blood factors indicates an increased risk of fetal abnormalities ("Down Syndrome Screening," 2007). In addition, if other risk factors are present, such as a family history of abnor- malities or exposure to environmental toxins, these genetic tests are more likely to be prescribed. New research is also focusing on the father's role in contributing to fetal abnor- malities and birth defects (see Saey, 2008). In the past it was assumed that because men create new sperm cells throughout their lives the cells are "forever young" and therefore unlikely to cause any problems. However, evidence is mounting that increas- ing paternal age may contribute to birth defects. Recent research evidence points to the father's age as a potential factor in birth defects, miscarriage, and certain mental illnesses, especially schizophrenia

disorders of sex development (DSD)

Born with sexual anatomy that is neither completely male nor completely female but rather a combination with features of both that cannot be categorized as male or female. which is replaced by the term intersex Babies born with DSD typically have one of three conditions (see Gurney, 2007; Sax, 2002): (1) They are genetically male (XY chromosomes) but have external genitals that are completely female (vagina and clitoris); (2) they are genetically female (XX chromo- somes) but have external genitals that are completely male (penis and testicles); or (3) they are genetically female but have external genitals that are ambiguous, somewhere in between male and female hermaphrodite, usually portrayed as a person with a functional penis, a vagina, and female breasts. These individuals are often part of the mythology of pornographic literature, but some males do choose to alter their breasts with hormones or implants and leave their penises intact. It is also possible for an adult man to have both a penis and female- like breasts through naturally occurring hormone imbalances, such as may occur in Klinefelter syndrome. However, these are not examples of DSD individuals. Often in the first two conditions, if no genetic testing has been done, doctors and parents may be unaware of the condition until the child reaches puberty and begins to develop the secondary sexual characteristics of the sex opposite from how the child was raised. In the third case, however, when the baby's genitals are ambiguous, the usual response by parents and doctors has been to alter the child's exter- nal sexual anatomy surgically to resemble either a "normal" male or female. The selection of genital sex in these cases has typically been based on a combination of genetic sex and the child's anatomy so that the minimal amount of surgical reconstruction is required. The child is then raised as the sex that matches the surgically reconstructed genitals.

breech birth

Delivery of a fetus emerging with buttocks or legs first rather than head first. Although some breech babies are delivered vaginally without major complications, some research indicates that this position presents a greater chance for negative health outcomes for the infant (Gallagher, 2006). For the health of the baby and the mother, the majority of breech births are delivered by C-section

planned home birth

Delivery of an infant in a private home setting, usually with necessary equipment and personnel provided by a professional service. A home birth resembles a delivery in a birthing center in that the materials necessary for most normal births are present, including fetal monitors, oxygen, medications to slow bleeding, and sutures to repair tears or an episiotomy (if one is performed). A well-planned home birth requires backup plans, including prearranged transportation to a hos- pital and an on-call physician in case serious complications arise that may require medical attention beyond that available to the midwife in the home. Home births are recommended only for women who are deemed low risk for delivery problems. complications more common

many myths and misconceptions about gays

FALSE:Mostgaysandlesbiansareunabletoformclose,enduringromanticrela- tionships and prefer to be promiscuous. FALSE:Gayandlesbianrelationshipsaremorelikelythanheterosexualrelation- ships to be unhappy and dysfunctional. FALSE: In same-sex relationships, one partner chooses or is assigned the role of "husband" and the other takes on the role of "wife." FALSE: Most gay and lesbian couples are isolated from society and do not have meaningful social support networks.

gay

Homosexual; applied to both men and women. is generally preferred to refer to homosexual men or women,

Hormones

Hormonal changes or imbalances in adulthood may change sexual behavior, sexual desire, or even male and female sexual anatomy but they do not appear to alter a person's established sexual orientation. Hormonal explanations for gay, lesbian, and bisexual orientations focus on the exposure of the fetus while in the uterus to male or female hormones in combinations or levels that vary from those of heterosexuals Separating hormonal influences from other biological factors is extremely diffi- cult. Any physiological differences found in different sexual orientations, such as the brain differences discussed in the previous section, may be preprogrammed by genes (to be discussed next); influenced by behavior, environment, or illness; or caused by hormones during fetal development the researchers who have found the spatial ability and auditory differences in gay versus straight orienta- tions acknowledged the possibility of prenatal hormone exposure as a potential cause One example of the hormonal hypothesis for the development of nonheterosexual orientations involves the fingers. You are probably not aware of this, but the length of the ring finger is more similar in length to the index finger in women than in men. In other words, the difference in length between the index finger and ring finger is greater in men than in women. This difference is measurable at age two and is stable into adulthood. Seriously, beyond this male-female difference, a similar difference exists between lesbian and straight women. That is, the index-to-ring-finger ratio in lesbian women is more similar to that of men. Research has also revealed that the ratio is even smaller (meaning the difference in finger lengths is less) in lesbians who self-identify as "butch" (more masculine) than in those who self-identify as "femme" Add to this the fact that the index-to-ring-finger ratio is a marker for fetal exposure to male hormones, and you have evidence for a potential hormonal cause of sexual orientation—not conclusive proof but an interest- ing, suggestive correlation. Yet another study investigated women whose mothers were given the drug dieth- ylstilbestrol (DES) while pregnant DES is a form of synthetic estrogen that was thought to prevent miscarriage and premature labor and was widely prescribed to pregnant women between 1938 and 1971. Not only did the drug not work as advertised, but it caused an increased risk for cancer and infertility in the daughters of women who took the drug. The exposed daughters have been followed and studied extensively for years. One consistent find- ing has been that women exposed to DES in the womb are significantly more likely as adults to be bisexual or gay than nonexposed controls. This lends correlational evi- dence that hormonal exposure in the womb may indeed play a role in the develop- ment of sexual orientations. Researchers have also discovered a new possible biological basis of sexual ori- entation that has become known as the "older brother effect" A statistically significant association has been found dem- onstrating that as the number of older biological brothers a man has increases, so do his chances of being gay (regardless of the brothers' sexual orientations). This does not appear to be true of boys with older step- or adopted brothers. Each additional bio- logical older brother increases the odds of a gay sexual orientation by as much as one- third. Various scientific studies across cultures have confirmed this finding. No such relationship has been found for lesbians regardless of how many older sisters or broth- ers they may have. What might be the reason for the "big brother effect"? Obviously, the male fetus in the womb hasn't the slightest idea how many brothers he has. But the child's mother 's body does. Although the correlation between male birth order and sex- ual orientation is real, the reasons for it are more difficult to ascertain. The theory most often suggested by researchers relates to the immune system in women (Bogaert & Skorska, 2011). A few fetal cells can sometimes pass from the womb into the mother's bloodstream during pregnancy or the birthing process. Some researchers speculate that these cells interact with the mother's immune system and begin to develop anti- bodies against male fetal cells. The more male babies the mother has had, the stronger the immune response against them. Her body then, at least in some cases, may react by changing something (probably the hormonal balance) in the uterine environment for later-born males that in turn leads to a tendency toward a gay sexual orientation.

transgender

Individuals whose gender identity varies from their biological sex.

Sexual Orientation as Defined by Alfred Kinsey

Kinsey conducted large surveys of Americans in which participants were asked about virtually every aspect of their sexual practices. Yet, there were the Kinsey researchers asking respondents the extent to which they had ever engaged in same-sex behaviors. Based on responses from participants in the surveys, Kinsey asserted that very few people could be classified as totally heterosexual or totally homo- sexual. He maintained that most people fell some- where in between or, along a continuum. Kinsey found that most people who identified themselves as heterosexual had at least some same-sex experiences (including fantasies, dreams, thoughts, emotions, and behaviors) and, conversely, that many of those who perceived themselves as homosexual had some experiences involving the opposite sex. Therefore, Kinsey developed a sexual orientation rating scale that places each person on a scale of 0 to 6, where 0 indicates "exclusively heterosexual" and 6 reflects "exclusively homosexual" According to Kinsey, most people would fall somewhere above 0 but below 6 (rather than exactly on 0 or 6). Using this scale as a guideline, some people, based on their sexual feelings and experiences (rather than their overall self-identification), might be categorized as primarily homosexual (5 or 6 on the scale) or primarily heterosexual (0 or 1). Someone who falls in the middle categories (2, 3, or 4) might be categorized as bisexual.

postpartum

Literally "following birth"; typically refers to the months or first year following the birth of a child.

stage three labor

The final stage of the birth process, when the placenta is expelled from the uterus with the umbilical cord attached. within a few minutes following the completed birth of the infant, the placenta (which has joined the fetus and mother throughout pregnancy) is expelled from the uterus with the umbilical cord attached The doctor or midwife should carefully inspect the cord and both sides of the placenta to be sure that they are intact and that the placental tissue appears normal and shows no signs that might indicate problems for the mother or the baby. A placental examination typically takes about a minute, and if any serious abnormalities are discovered (which is rare), the placenta is sent on for further pathological examina- tion

Quickening

The first movement of the fetus that is felt by the mother.

heterocentric

The mistaken assumption of a "universal" heterosexual orientation. they usually take for granted and assume people are heterosexual, and have difficulty understanding and accepting nonheterosexual orientations

Experiential and Environmental Influences on Sexual Orientation

Myth (false): Homosexual men are more likely to have had domineering or overly protective mothers and weak, distant fathers (and hence no masculine role model). Myth (false): Homosexual women were more likely to have had cold, unloving, rejecting mothers, and absent fathers. Myth (false): Homosexuals grew up hating or fearing members of the opposite sex, which caused them to turn to members of their own sex for love and intimacy. Myth (false): Most homosexuals were molested during childhood by a same-sex adult, which turned them toward homosexuality as they became adults themselves. Myth(false):Homosexuals are more likely to have engaged in sex play as children with peers of their own sex. Myth (false): Homosexuals are more likely to have a gay mother or father. nonheterosexual individuals are just as likely or unlikely as straight people to have experienced any of the listed events and circumstances during their lifetime. Can sexual abuse in childhood lead to same-sex orientation in adulthood? The research evidence on this is inconclusive. Some studies have found that gay and lesbian adults are more likely to report childhood sexual abuse than het- erosexual individuals (although it is a small percentage in both groups). gay and lesbian adults appear to have engaged in greater gender non-conforming behavior as children and this is the truth

trimester

One of three periods of about three months each that make up the phases of a full-term pregnancy. the 40 weeks of a full-term pregnancy are often divided into phases of about three months each, called trimesters.

AIDS stigma

Prejudice and discrimination against nonheterosexual individu- als based on the erroneous belief that gay individuals are solely to blame for the AIDS epidemic and are the primary threat for the con- tinuing spread of the disease. the illness was given the name gay-related immune deficiency (GRID). That designation lasted less than a year before heterosexual men and women began to become infected, and the official name of the disease was quickly changed to acquired immune deficiency syndrome (AIDS). Today, although the majority of existing cases are still among males, everyone knows that HIV and AIDS are clearly not limited to any one sex or sexual orientation. In 2009, nearly 24,000 new cases of HIV infection in the United States were among men who have sex with men, and just under 13,000 new cases were transmitted through heterosexual contact Anyone who still believes that HIV is only spread through male-to-male sexual contact needs to face the reality that more than 90% of HIV infections worldwide are transmit- ted by heterosexual intercourse Although HIV is not a "gay disease," gay people, regardless of whether or not they are HIV-positive, are often discriminated against based on irrational and misinformed beliefs about the illness. This form of discrimination has become known as AIDS stigma. The belief that gay individuals are to blame for the AIDS epidemic and are an ongoing threat via spreading the disease increases the overall level of prejudice and discrimination that already exists in society.

exotic becomes erotic (EBE) theory

Psychologist Daryl Bem's explanation for the interaction of biology and environment in determining a person's sexual orientation. Bem suggests that people are not born with a genetic predisposition for a certain sexual orientation per se but rather for varying childhood temperaments such as aggression, activity level, or shyness. Indeed, these temperamental variables have received a great deal of scientific support outside the sex- ual orientation arena these temperamental variations prime the child to prefer some early childhood activi- ties over others.

gender dysphoria

Refers to stress or discomfort stemming from the self-knowledge that one's biological sex does not conform to, or is the opposite of, his or her personal gender identity. many transgender individuals do not experience distress with their gender identity and would not present any reason to be "diagnosed" with gender dysphoria.

cesarean section

Removal of a fetus from the mother's uterus surgically, through an incision in her abdomen; also called a C-section birth. (1) More mothers are choosing to have C-sections;(2) doctors are more willing to recommend them due to fears ofmalpractice litigation if any problems arise from a potentiallycomplicated vaginal birth; (3) the average age at which womengive birth has risen significantly, increasing the possibility forcomplications that may lead to cesarean births; and (4) C-sectionbirths are approximately twice as profitable for the hospital asuncomplicated vaginal births. Research has shown that womenare significantly more likely to deliver by C-section at privatecompared to nonprofit hospitals Pregnant women are choosing to have C-section births (called elective C-sections) for various reasons, including avoidance of labor and childbirth pain, the convenience of giving birth on a schedule set by the mother rather than "by the baby," or the ability to ensure the father's presence at the birth. In some countries, elective C-sections are even more common than in the United States.

gender identity

The sex (male or female) that a person identifies himself or herself to be. Virtually all people are quite sure about their gender identity, that is, which sex they perceive themselves to be, and they've known the answer since they were about four years old ("I'm a boy"; "I'm a girl"; "I'm always going to be this") Gender and your gender identity are more about who you are as a person than sim- ply about what sex you are.

American Psychological Association (2014) definition of sexual orientation

Sexual orientation refers to an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes. Sexual orientation also refers to a person's sense of identity based on those attractions, related behaviors, and membership in a community of others who share those attractions. Research over several decades has demonstrated that sexual orientation ranges along a continuum, from exclusive attraction to the other sex to exclusive attraction to the same sex [to be discussed next]. However, sexual orientation is usually discussed in terms of three categories: heterosexual (having emotional, roman- tic, or sexual attractions to members of the other sex), gay/lesbian (having emotional, romantic, or sexual attractions to members of one's own sex), and bisexual (having emotional, romantic, or sexual attractions to both men and women). ... Sexual orientation is distinct from other components of sex and gender, including biological sex (the anatomical, physiological, and genetic characteristics associated with being male or female), gender identity (the psy- chological sense of being male or female), and social gender role (the cultural norms that define feminine and masculine behavior).

OB/GYN

Short for obstetrician-gynecologist, a physician specializing in pregnancy and childbirth.

BRAIN STRUCTURE AND FUNCTION

Simon LeVay that he had found a measurable, con- sistent difference in the brains of a small group of heterosexual and homosexual men. It was a minute difference in the third interstitial nucleus, a very small part within the brain structure called the hypothalamus, which is known to play a central role in emotions and sexual urges The third interstitial nucleus is normally larger in men than in women. What LeVay found, in essence, was that this structure was larger in his sample of straight men than in gay men. The size of this section of the hypothalamus in his gay male sample was about the same as is typically found in women. Although this was not the first finding that the brains of men and women are different, it was the first to find a potential gay- straight variation. LeVay's research did not prove that sexual orientation is caused by a brain differ- ence, but it did suggest a biological difference that is, in his view, related in some way to a person's sexual orientation The findings were seen by many gay individuals, gay activists, and their supporters as proof that sexual ori- entation, whether gay or straight, is a natural biological variation in humans and not a lifestyle choice, in the same way that one is male or female, nearsighted or farsighted, tall or short. The most common criticism of LeVay's research is related to the discussion earlier in this chapter about sexual orientation as a continuum rather than a series of divisions into discrete categories of gay and straight. In his brain research, LeVay seemed to be dividing his subjects along a strict gay-straight dichotomy But, as we discussed earlier, sexual orientation is difficult to divide so clearly into "camps." The reasoning behind this criticism goes like this: If people cannot be divided into purely heterosexual or homosexual groupings, then what do variations in brain structure really mean? Would bisexual individuals, for example, have intersti- tial nuclei that are of a size in between gay and straight brains? the possibility that sexual orientation might be rooted in biological or genetic, rather than environmental, sources. other researchers have revealed various additional biological differences relating to sexual orientation For example, several studies have demonstrated that right- and left-handedness may be linked to sexual ori- entation lesbians are 91% more likely to be left-handed than heterosexual women, and gay men are 34% more likely than straight men to be left-handed, although the overall percent- ages of left-handed people regardless of sexual orientation is only about 10% Researchers have also found a connection between sexual orientation and how the brain processes sound All people's ears make faint noises in response to clicking sounds, called "click-evoked otoacoustic emissions." However, lesbians' ears make significantly softer sounds than the ears of heterosexual women. In addition, research has demonstrated that visual-spatial abilities may also be related to measures of sexual orientation in men When comparing MRI (magnetic resonance imag- ing) and PET (positron emission tomography) scans of the brains of homosexual and heterosexual individuals, researchers have found clear differences that are not likely to be due to environmental influences and, therefore, are probably present at birth. the degree of symmetry between brain hemispheres and the neural connections among right and left brain structures are not the same in gay and straight people Overall, the findings indicate that the brains of gay men are similar to those of straight women, and gay women's brains are similar to those of straight men. In other words, the researchers found "sex-atypical cerebral asymmetry and functional connections in homosexual subjects"

dangers and pitfalls of coming out

Some of the potentially nega- tive consequences faced by individuals grappling with coming out include harass- ment and ridicule from peers, fellow students, or coworkers; rejection by friends, parents and other family members, and even one's church; eviction from and denial of housing; loss of current job, denial of access to military service, and other forms of prejudice and discrimination; and intimidation or physical violence that may result in destruction of property, serious injury, or even death The reality or merely the expectation of these negative outcomes of choos- ing to live an openly gay life often takes a serious emotional toll For example, teens who are struggling with the realization that they may be gay and the prospect of coming out to themselves and others have a significantly higher rate of psychological and adjustment problems, including depression, drug abuse, eating disorders, homelessness, and rates of STIs The psychological effect of greatest concern is a significantly increased risk of suicide among gay and lesbian teens as they realize their true sexuality and face the prospect of how their sexuality will "play" in an intolerant world

Do the Origins of Sexual Orientation Matter?

Some researchers have suggested that the underpinnings of the search for the cause of sex- ual orientation lie in widespread prejudiced attitudes and hostile actions targeted at gays and lesbians in most Western cultures. It has been suggested that these negative attitudes and acts are based on four basic, unenlightened, and erroneous assumptions about homosexuality (Marmor, 1998): it is immoral and sinful, it is unnatural, it is a chosen behavior and therefore can be "unchosen," and it is potentially "contagious." sexual orientation is determined, by and large, naturally, biologically, and genetically, just like sex, hair color, and race. If you think about it, clear proof that sexual orientation is inborn could pose a dilemma for people who base their antigay attitudes on religious teachings, in that they also claim that humans are made in God's image. Many gay and lesbian individu- als themselves downplay the importance of finding the cause of homosexuality. Some researchers believe that placing people into categories of sexual orientation such as straight, gay, lesbian, or bisexual does all humans a disservice in that it implies a sameness or a lack of diversity among those in each group and in all the groups combined

protected classes

Specific groups of people legally protected from discrimination under federal and state anti discrimination laws, identified by race, religion, sex, age, sexual orientation, or other characteristics.

Historical Perspective of gender The Story of Christine Jorgensen

born a man thought he was a woman took female hormone estradiol which caused his breasts to enlarge, his skin to soften, his beard to stop growing, and his appearance to become softer and more feminine the only procedures Jorgensen received were a bilateral orchiec- tomy (removal of both testicles), removal of the scrotum, and penectomy (removal of the penis). No reconstructive surgery was done on Jorgensen at the time to create female genitals. Several years later, Christine returned for more surgery to construct a vagina, but that surgery was only moderately successful Jorgensen's sex-change operation was the first to receive worldwide media attention, and she did not shy away from the publicity. sex no choice its what your born with gender and gender identity you choose

sex reassignment surgery

Surgical procedures used to transform physically an individual from one sex to the other, commonly known as a sex-change operation.

coming out in college

Teens who endure the stresses and strains of working through their nonheterosex- ual orientation during adolescence sometimes find that the process of coming out and being themselves becomes easier upon entering college Specifically, nonheterosexual students tend to feel less accepted and respected by heterosexual students and by the campus environment in general. Lesbians have reported experiencing these feelings more strongly than gay men. Also, lesbian, gay, and bisexual students rate themselves as less confident than their heterosexual peers and perceive that they are treated less fairly in various academic settings, especially in dealings with administrators. Nonheterosexual students often feel the need to hide their orientation from other students, administrators, and campus health care provid- ers An antigay bias on campus appears to extend beyond attitudes directed toward gay, lesbian, and bisexual students to the teachers themselves. Some research has found that when students are aware that their instructor is gay, they perceive the teacher as less believable and feel that they will learn significantly less than students in a class taught by a straight professor

sexual orientation differs from gender

Term specifying the sex of those to whom a person is primarily romantically, emotionally, and sexually attracted. It means that a person may live life as any one of many potential combinations of biological sex, gender, and sexual orientation

sexual orientation

Term specifying the sex of those to whom a person is primarily romantically, emotionally, and sexually attracted. refers to the sex of the individuals to whom a person is roman- tically, emotionally, and sexually attracted.

abortion

Termination of a pregnancy;in common usage, assumed tobe the result of an a voluntary medical procedure as opposed to a miscarriage. which is used by most people to mean the voluntary termination of a pregnancy, or induced abortion. Although induced abortions are often unrelated to any physical health problems of the embryo or the mother, it is an important and common event that must be included in our examination of conception and pregnancy.

menarche

The beginning of menstruation during puberty; a girl's first period.

pro-choice

The belief that a woman has the moral and legal right to choose freely to abort her pregnancy.

pro-life

The belief that voluntary abortion is akin to murder and that it should be illegal.

blastocyst

The developing zygote, with cells surrounding a fluid-filled core, upon entering the uterus and before implanting in the uterine wall.

follicular phase

The early period during a woman's monthly fertility cycle when the pituitary gland secretes follicle-stimulating hormone (FSN) to enhance ovum development.

transition phase

The end of stage one labor as the fetus begins moving through the cervix and down the birth canal.

stage one labor

The first stage of the birth process, involving the beginning of contractions of the uterus. At the onset of labor, called stage one labor, contractions begin as the cells of the uterus, now the largest muscle in the mother's body, contract in sequence along its length, pulling and straightening the uterus and pushing the fetus down toward the cervix At this point, the cervical canal is beginning to dilate (become larger in diameter) and efface (become thinner). During the beginning of stage one labor, the cervix is about 1 to 2 inches dilated, and as stage one labor continues, it will continue to dilate to approximately 10 centimeters, or about 4 inches pains women experience during labor are primarily due to the muscles forcing open the cervix, which has been tightly closed until now to hold the fetus in the uterus. As stage one labor continues, it enters the transition phase, when her con- tractions begin to come more rapidly—typically 2 to 3 minutes apart—and the fetus begins its movement through the cervix and down the birth canal. top of the baby's head will "crown," that is, become visible in the vagina This phase is typically the most difficult physically and emotion- ally for the mother and may last 3 or more hours for a first-time vaginal birth Typically, the baby will turn in the uterus so its face is turned toward the mother's spine, slightly to the left or right of the spinal col- umn itself. This is the most common and best fetal position for moving through the birth canal, although not every infant follows the rules. About 3% to 4% of infants present themselves for birth in various other posi-tions, such as bottom first or leg first (called a breech birth The contractions continue, becoming increasingly frequent. Overall, first stage labor lasts, on average, about 12 to 14 hours for first-time mothers (although most women will tell you it seems considerably longer!); typically, the duration of labor decreases with subsequent births, down to eight or even fewer hours. Keep in mind, however, these are averages, and labor can in some cases proceed as quickly as a few hours or take longer than 20 hours, but these are exceptions rather than the rule. Usually, during the entire delivery process, the infant's heart rate is electroni- cally monitored for any signs of distress. This monitoring allows the doctor or mid- wife and the mother to know immediately if the infant is experiencing any major difficulties during the strenuous birth procedure; most often, it reassures everyone that all is well.

First Trimester

The first three months of pregnancy begin with the embryonic period: the initial eight weeks following implantation of the zygote in the wall of the uterus. At the end of this eight-week period, the embryo becomes known as a fetus. This first trimester is a critical time for the developing embryo. During these months, the woman is at highest risk of miscarriage (also referred to as spontaneous abortion) owing to various genetic, structural, hormonal, or environmental causes. Approximately 15% of con- firmed pregnancies (women who know they are pregnant) end in miscarriage

Genetics

The genetic theory proposes that a person's sexual orientation is preprogrammed at con- ception when the genes from the mother's egg and the father's sperm merge to cre- ate the blueprint for a new person. Historically, researchers had difficulty separating genetic from environmental influences on human characteristics because most people grow up in the same environment as their genetic donors, that is, their parents. Therefore, any behavior or personality similarities between children and parents might be either inherited or learned. However, over the past 30 years or so, research methods have become increas- ingly sophisticated, allowing researchers to tease apart the forces of environment and genes; consequently, researchers have been placing an increased focus on genes as a potential source of human behaviors and personality traits, including sexual orientation. Most influential genetic studies involve pairs of identical twins, some of whom were adopted at birth, or very soon after, into different families and therefore different environments. If two individuals with the same genetic makeup (i.e., identical or monozygotic twins) share certain personal- ity characteristics far more often than fraternal (dizygotic) twins or nontwin brothers and sisters, this argues that genetic influences most probably account for those shared characteristics. This avenue of research has been applied to sexual orientation, and the results have been quite consistent. Numerous studies have shown that when one member of a pair of identical twins is gay or lesbian, the chances are far higher (30% to 50%) that the other twin will share that same sexual orientation than would be expected among fraternal twins or nontwin siblings In other words, as the degree of genetic relatedness increases, the similarity of siblings' sexual orientation also increases, regardless of their environment. Figure 11.3 sum- marizes representative findings from two of these twin studies. In 2008, researchers conducted the largest twin study up to that time, involving 7,600 pairs of Swedish twins (Långström et al., 2008). Findings from this study indicated a smaller influence of genetic factors (18% to 39%), but a very small influence of environmental factors shared by twins (0-17%). Each twin's individual experiences (such as uterine and childbirth conditions) appeared to influence choice of partner (for all sexual orienta- tion) most strongly (approximately 60%). Today, widespread scientific support exists that genes play an important role in sexual orientation. But has science uncovered a true "gay gene?" No. However, this has not prevented the idea of a "gay gene" from entering medical literature as an assumed cause (however erroneous) of sexual orientation (O'Riordan, 2012). Although researchers have demonstrated that sexual orientation is influenced by a person's genetic makeup, finding the actual gene or complex of genes responsible for that influ- ence is far more difficult, if it exists at all. Furthermore, only about 40% to 50% of the variation in sexual orientation can be explained by genetic influences, so even if we accept the gay gene hypothesis, genes are not the whole story, and other influences cannot be ignored (see LeVay, 2010). Moreover, many scientists question the need to prove that a "gay gene" exists at all (we will return to this issue of the "necessity of causal conclusions" toward the end of this section).

embryonic period

The initial eight weeks of pregnancy following fertilization.

Third Trimester

The last three months of pregnancy are marked by a dazzling increase in the rate of growth of the fetus. During the third trimester, the fetus will typically add up to a foot in length and at least 7 more pounds. Also, changes will accelerate that prepare the baby for birth, including internal organ maturation, layers of fat, muscle tone, and rotation into a head-down position in the womb.

luteal phase

The later period of a woman's monthly fertility cycle, when the lining of the uterus thickens in preparation for receiving a fertilized ovum if conception has occurred.

miscarriage

The loss (without any purpose- ful intervention) of an embryo or fetus during the first 20 weeks of pregnancy; also called spontaneous abortion. or spontaneous abortion, is the loss (without any purposeful intervention) of an embryo or fetus during the first 20 weeks of pregnancy 10% to 20% of all known pregnancies end in miscar- riage. The actual number may be much higher (up to 75%) due to what are sometimes called silent miscarriages, which occur soon after uterine implantation and often before the woman is aware that she is pregnant. In these cases, the spontaneous abortion typ- ically manifests itself as a somewhat late and often unusually heavy menstrual period Cramping and pain in the abdomen Fluid discharge from the vagina Tissue discharge from the vagina Feeling faint or light-headed factors that have been linked to miscarriage include the mother's age (the chances of miscarriage increase as parental age increases), abnormalities of the uterus, hormonal imbalances, and envi- ronmental toxins such as recreational drug use by the mother (especially alcohol and cocaine), cigarette smoking, radiation, or heavy caffeine intake some risk factors that many people believe are related to miscarriage, such as stress and sexual activity during pregnancy,

gender

The masculinity-femininity dimension of our basic nature as humans. masculinity-femininity dimension of our basic nature as humans Gender and your gender identity are more about who you are as a person than sim- ply about what sex you are.

pregnancy

The period of growth of the embryo and fetus in the uterus.

midwifery

The practice of trained midwives assisting women through normal pregnancy and childbirth.

historical perspectives stonewall riot

The prohibitions went so far as to include a ban on serving alcohol to homosexuals. At that time, the Stonewall Inn in New York City was one of the few night spots where gay people could meet each other, flirt, hang out together, order drinks, dance, and just be uninhibited or romantic. June 28, the patrons fought back. They were fed up with being harassed, beaten, and arrested for simply being who they were. They began yelling at the police to get out and leave them alone. As the police punched, dragged, and otherwise forced the patrons out into the street toward the paddy wagons, the yelling turned into fist fighting, and then beer bottles and garbage cans were hurled at the police. As word of the Stonewall riot spread, gays and lesbians across the country were emboldened to resist and even fight the prejudice and discrimination they had endured for so long. Four months after the riot, both Time and Newsweek ran cover stories on homosexuality in America, gay "be-ins" began to be held in New York's Central Park, and the gay rights movement had been born

stage two labor

The stage of the birth process in which contractions occur closer together than in stage one, involve the muscles of the abdomen as well as the uterus, and continue until the infant has been expelled from the mother's body. leads to the birth of the baby. Contractions begin to involve the muscles of the abdomen as well as the uterus itself. The mother has somewhat more control over these contractions, and many women report that this sense of control seems to reduce the amount of pain they perceive Typically, the woman now feels the need to become an active participant in the delivery process: to bear down and to push the baby out (although the doctor or mid- wife will usually signal her when the best times occur for pushing). With each contrac- tion and each push, the infant rocks back and forth and inches slowly along until the head is ready to emerge from the vagina. The passage of the head is typically the most painful moment of the birth process, and once that is completed, the rest of the baby usually emerges with somewhat less difficulty. In the past, doctors at this stage would routinely perform an episiotomy, the surgical cutting of the perineum (the area between the vagina and the anus), presumed to expand the passageway for delivery. As stage two continues, the infant's head usually exits first fol- lowed by one shoulder and then the other, and at that point, the baby emerges rather quickly—so fast, in fact, that the job of the doctor or midwife is often referred to as "catching" the baby. Following delivery, the umbilical cord is cut, and the newborn infant is immedi- ately examined by the doctor, nurse, or midwife for any signs of difficulty. One widely used immediate assessment of a neonate (a newborn) is the APGAR score, devel- oped by Dr. Virginia Apgar

seminiferous tubules

Tightly wound microscopic tubes that comprise the testicles inthe male, where sperm cells are generated.

theory of coming out

Two of the more widely accepted models of the coming-out process—one pro- posed by Vivienne Cass and another by Richard Troiden (Cass, 1984; Troiden, 1989)— reflect this concept of a gradual, step-like progression (see Floyd & Stein, 2002). Both models share certain basic stages and challenges that many gay individuals must con- front on the path to coming out, such as "identity confusion" (feeling unsure about one's sexual orientation), "identity assumption" (acknowledging being gay to one- self), "identity acceptance" (becoming comfortable with one's sexuality), and "identity synthesis and commitment" (becoming openly gay and incorporating a gay sexual orientation into one's routine life with pride and without shame). Both models end with the person's acceptance and integration of his or her sexual orientation into an overall self-identity and healthy life adjustment.

Biological Influences on Sexual Orientation

brain structure and function, hormones, and genes

Sperms journey

Upon reaching puberty, boys normally begin to produce sperm cells in aston- ishingly large numbers and continue to produce them throughout their lives. Sperm cells are produced in the testicles. the testicles are made of tightly packed seminiferous tubules, literally "seed-bearing tubes" When these tubules are stimulated by male secretions of follicle-stimulating hormone (FSH, which is produced by the male system just as by the female) and testosterone, millions of primitive cells that line the tubules begin to develop into sperm cells. These cells then migrate from the testicles to the epididymis, the structure attached to the back side of each testicle Once in the epididymis, the sperm cells mature and develop their ability to swim. The length of time needed for the sperm cells to develop from formation in the tubules to migration to the epididymis and, finally, to ejaculation is approx- imately 68 to 72 days. the sperm cells that are beginning to develop in a man's testicles today will not be ready to be ejaculated and, poten- tially, fertilize an ovum for ten weeks. Sperm cells are minuscule, among the smallest cells in the human body And compared with the ovum, they are appear quite scrawny. What sperm lack in size, however, they make up for in sheer numbers. In normal adult men, the testicles produce about 50,000 sperm cells per minute; The sperm cells themselves make up only about 5% of the total volume of the ejaculate robably the most important reason is that, although sperm are numerous, they are not particularly hardy. Some may be abnormally formed, some may become trapped among other body cells, some may be attacked by antibodies in the woman's body, many will die in the normal acidic environment of the vagina, and many just don't have the necessary stamina to make the 3- to 4-inch trip (a long way for a microscopic sperm) from the vagina, through the cervix, into the uterus, and on into the fallopian tubes. Therefore, to help ensure the survival of the human species, we have evolved in such a way that the male produces more than enough reproductive cells.

Second Trimester

Usually, by the fourth month the pregnancy is firmly established and the risk of miscarriage decreases significantly. It is early in this second trimester that the mother will begin to feel the fetus move, which is called quickening. During these months, the growth of the fetus accelerates greatly.

Ovums journey

When a female fetus is born, her ovaries already contain approximately one to two million immature eggs (called oocytes) As the girl develops through childhood, the number of oocytes in her ovaries decreases until puberty, when the first mature ovum is released, at which point her ovaries contain approximately 400,000 oocytes. Most women today will have approximately 35 to 40 fertile years between the onset of puberty and menopause (when the release of ova and fertility ceases). Releasing one ovum each month (as is typical) amounts to a lifetime total of 400 to 500 ova released from a woman's ovaries. During puberty, a set of preprogrammed hormonal changes occur in a girl's body, triggering menarche and, soon after, the beginning of ovulation, the release of one ovum each month a combination of hormones released over the next two weeks promotes the growth of ovarian follicles, small sacs on the surface of the ovaries, each of which contains a developing ovum As this follicular phase of her fertility cycle begins, the pitu- itary gland at the base of the brain begins to secrete follicle-stimulating hormone (FSH), which further enhances follicle growth and ovum development. The many ovum- containing follicles that have been growing now release their own hormone, estradiol, a powerful form of estrogen At this point, the follicles are in a kind of "biological competition" because only one follicle will eventually rupture and release the ovum into the fallopian tube for possible fertilization (more than one ovum may be released in relatively rare cases, resulting, if fertilized, in fraternal twins or multiple births) By about a week after the first day of a woman's period, the follicle producing the most estrogen receives an extra dose of FSH, causing it to become the "dominant follicle," while the others deteriorate dominant follicle then continues to grow, produces increasing amounts of estrogen, forms a pouch that looks somewhat like a water-filled blis- ter on the ovarian wall, and will grow to nearly 0.75 inch in diameter just prior to rupturing and releasing the ovum The continuing rise in estrogen levels signals a further increase in secretion of FSH, along with the release of luteinizing hormone (LH). These two hormones now combine to cause the wall of the follicle at the edge of the ovary to break down, and about a day later, the fol- licle ruptures, releasing the ovum into the abdominal cavity. This is the precise moment of ovulation. A human ovum is the largest cell in the human body the fallopian tubes are not physi- cally connected to the ovaries; rather, the strand-like structures (the fimbriae) at the ovarian end of the tubes rest adjacent to and against the ovaries. The back-and-forth motion of these fimbriae set up a current in the abdominal fluid that draws the newly released ovum into the fallopian tube Once the ovum has entered the fallopian tube, the woman is "officially" fertile. For a natural pregnancy to occur, sperm cells and ovum must meet here, and one sperm must penetrate the ovum's outer membrane during its brief journey along the upper region of the fallopian tube After the ovum is released, estrogen production decreases and progesterone and LH secretions begin to rise. Over the next 14 days of a woman's cycle, called the luteal phase, the growth of new follicles in the ovaries is suppressed, and the lining of the uterus (the endometrium) thickens with tissue and blood in preparation to receive and nourish a fertilized ovum. If no fertilization occurs, changes in hormone secretions cause a breakdown in the lining of the endometrium, which then drains, typically over several days, through the cervix and out the vagina (see Figure 9.3). This draining of the uterine lining and fluid is what is commonly known as menstruation: a woman's period. if the ovum is not fertilized by a sperm cell, progesterone and estrogen levels diminish during the second half of a woman's cycle, blood flow to the uterus decreases, and the lining of the uterus is shed during the woman's period (this is what comprises her menstrual fluid). If fertilization has occurred, however, the lining of the uterine wall, the endome- trium, signaled by hormones, continues to thicken in preparation for the arrival of the zygote. About a week after fertilization, the zygote enters the uterus. It has already divided many times and consists of approximately 50-100 cells surrounding a fluid- filled core. It is now called a blastocyst. On the sixth or seventh day after fertiliza- tion, assuming that the endometrium lining has formed properly, the blastocyst may implant into the wall of the uterus. Once implantation occurs, the blastocyst is referred to as an embryo. The blastocyst's successful attachment to the uterine lining is the beginning of pregnancy

Biological sex is determined by

a person's biological sex is determined at the moment of conception based on the combination of chromosomes that result from fertilization. Normally the egg, or ovum, from the woman's ovary contains a single X sex chromosome, and the sperm cell that fertilizes the ovum carries either an X or a Y sex chromosome. Two X chromosomes combine to produce a female, but an XY combination produces a male. In the presence of the Y sex chromosome, male hormones called androgens are secreted, causing the fetus to develop testicles, a penis, and male internal sexual anatomy. With two X chromosomes, androgens are not produced, and the fetus develops a vulva, ovaries, a uterus, and other internal female sexual anatomy. The genitals of male and female human fetuses are indistinguishable until about the twelfth week of pregnancy. At that point, they have devel- oped to the point that the biological sex of the fetus is recogniz- able

conception

a single sperm cell to penetrate and fertilize an ovum (egg)

Bisexuality

bisexuality is a unique sexual orientation, different from being gay, lesbian, or heterosexual. Kinsey's efforts to place sexual orientation on a continuum notwithstanding, most people continue to see people as either straight or gay. It appears, however, that bisexuality is a clearly defined sexual orientation in which a person may be emotionally, psychologically, and physically attracted to members of either sex. many people and even some researchers believed that individuals who self-identified as bisexual were in reality trying to hide the fact that they were actually gay or lesbian or were simply on their way to coming out as gay or lesbian. Many people mistakenly assume that when bisexual individuals are in a relationship with someone of the other sex, they must be straight, but when they are involved with someone of their own sex, they are gay or lesbian.

historical perspectives pregnancy pain

earliest used to be deeply sedated under general anesthesia ether, mild sedation and pain reducing gas, large amounts needed for full pain relief but that much might be harmful Dr. James Young Simpson professor of midwifery used chloroform for birth by putting a few drops on a hankerchief and putting on mouth and nose and then sedation was quick and deep with no side effects hankerchief delivery was no precise and overdose easy to happen and can cause liver damage twilight sleep by Dr. Birtha Van Hoosen combination of two injectable drugs: morphine and scopolamine These two drugs combined have the advantage of pain relief (morphine) and amnesia (scopolamine) woman awoke without any memories of labor or delivery if the morphine administered was kept to a minimum, the mother was capable of hearing, speaking, and participating emotionally in the birthing process, although, owing to the effects of the scopolamine, she would have no memory of it. the mother's memories of childbirth, if any, were vague, many women at the time saw twilight sleep as the most natural method of childbirth available. Because in twilight sleep the pelvic and uterine muscles are not paralyzed, as they are with ether and chloroform, the woman was able to assist in the birthing process and help push the baby out.

gay people and suicide

gay people have higher rates then straight people

straight

heterosexual refer to individuals who are primarily attracted in all those ways to members of the opposite sex.

PAIN MEDICATION DURING LABOR AND DELIVERY

lamaze: Here was a way for women to give birth not only fully conscious but also, if they chose, with no drugs at all, using special breathing exercises, visualization, massage, focused attention, and relaxation training, along with the help of a "coach" (husband or partner, friend, relative) to ease pain and increase the mother's comfort during labor and delivery The most common pain medications in use today are sedatives, such as antianxiety medica- tions; local anesthesia, numbing agents used in specific areas of the birth canal; regional anesthesia, the numbing of the entire birth canal and pelvic area; and the epidural, cur- rently the most popular method in the United States. An epidural involves the insertion of a small tube, called a canula, near the base of the woman's spine into the fluid that surrounds the spinal cord. This is typically done prior to the beginning of hard labor. With the canula in place, pain-relieving anesthetic can be administered easily as needed during labor and delivery. The administering of the anesthesia may be controlled by the mother herself, as she experiences various levels of pain (within medically safe parameters). Research has found that when the mother is given control over the amount and frequency of the epidural pain medica- tion, she will, on average, use less than when it is administered by the delivery room medical staff

breastfeeding

one common fertility myth is that a woman cannot become preg- nant while she is breastfeeding (lactating). Although the chances of pregnancy during lactation may be reduced, it is far from a reliable method of contraception. dont have sex until 6 weeks after giving birth or until girl is comfortable

How ovum sperm meet

the ovum is in the fallopian tube and the sperm cellshave recently been ejaculated into the vagina. The ovum is gentlywhisked along the tube by cilia, tiny hair-like structures that createa current in the intrafallopian fluid. The ovum can be fertilized during the first 12 to 18 hours after entry into the tube the best chance for conception occurs when sperm cells are already high up in the fallopian tube when the ovum arrives sperm cells survive in the female reproductive tract for about two to five days, so the average couple is fertile for approximately six to seven days each month. In other words, if ejaculation occurs in the vagina from four days before to approximately one day after the moment of ovulation, live sperm cells may have an opportunity to encounter the ovum in the fallopian tube. the odds of conception are only about one in five from a single act of intercourse and only one in three when a couple is trying to become pregnant and the timing of intercourse is right. only about a hundred to a thousand of all those hundreds of millions of sperm manage to make it all the way to the upper portion of the fallopian tubes where fertilization occurs. On their way there, the sperm cells have undergone physi- cal and chemical changes that make them capable of penetrating the outer membranes of the ovum by releasing a mix of chemicals that literally dissolves the ovum's layers of membranes These survivor sperm then surround the ovum in a sort of competition to be the first to penetrate and fuse their chromosomes with those of the ovum after the first sperm successfully penetrates the ovum's outer membrane, biochemical changes triggered in the ovum create a barrier that effectively blocks any other sperm cells from entering because only one sperm cell's DNA can enter and fuse with the DNA contained in the ovum. Upon successful fertilization, the DNA of the man's sperm and the woman's ovum join together, and a new organism, combining the genetic material of both, is created. Within hours, this organism, now called a zygote divides into two cells, then four, and eight, and so on, as it continues its week-long journey along the remainder of the fallopian tube to the uterus Immediately upon fertilization, a hormone called human chorionic gonadotropin (hCG) begins to increase in the woman's body. Within about two weeks after conception, this hormone has reached high enough levels that conception can usually be determined using a standard home pregnancy test that measures the level of the hormone in the woman's urine. Because the level of hCG continues to increase day by day, the test becomes more reliable each day following the initial two weeks. However, the woman is not pregnant, yet. Although conception may have occurred, pregnancy is not established until about a week after conception when the zygote divides into many cells (called a blastocyst) and implants into the lining of the uteruine wall Therefore, what we call a pregnancy test is often, in reality, a conception test. If a woman has a positive test result, she should assume that she has conceived and may be, or become, pregnant until proven otherwise Figure 9.7 Sperm Cells on the Surface of the Ovum Only one sperm cell will be allowed to penetrate the ovum's membrane. Many people confuse conception and preg- nancy, although they are distinct, separate events. As discussed previously, conception occurs when a sperm cell penetrates an ovum and the genetic material from each par- ent merges. Then, if all proceeds normally and successfully, pregnancy begins when the fertilized ovum implants into the wall of the uterus.

Biology and Gender Development

the presence or absence of specific male and female hormones produced during pregnancy, depending on the chromosomal sex of the fetus (XX or XY), triggers the development of either male or female genitals and internal sex organs Some evidence suggests that hormones may also play a role in the development of a person's sexual orientation But do sex hormones also influence the characteristics in humans that are usually associated with gender? The answer appears to be that they do, but hormonal effects are difficult to study systematically in humans. In addition to the hormone disorders discussed in the preceding section, a condition known as congenital adrenal hyperplasia, or CAH, causes the adrenal glands of affected indi- viduals to produce large amounts of male hormones beginning before birth and continu- ing throughout their lives Boys may have some health issues due to CAH but typically develop relatively normally. In girls, however, CAH usually produces ambiguous external genitalia, and the imbalance of male hormones must be controlled with hormone treatments Researchers studying the gender effects of CAH on children have found that boys with the condition appear to develop the usual patterns of sex-typed behaviors, same as their peers. CAH girls, however, have been found to engage in many sex- atypical behaviors. These girls tend to prefer toys that are typically associated with boys (trucks, fire trucks, toy guns, etc.), seek out boys as playmates rather than girls, engage in more rough-and-tumble play activities than non-CAH girls, and reject tra- ditional female childhood pretend roles of wife and mother. support to the idea that hormones play a significant role in the development of gender-typed behavior. Other evidence of this comes from sys- tematic observations of early childhood development of normal children. A well-established pattern of behavior in most children is a preference for friends, playmates, and activity-preferences of their own sex But does this observation imply that the prefer- ence for same-sex playmates is biologically based? Not necessarily. You could easily argue that by age three or four, children have already been exposed to many poten- tially powerful environmental behavioral influences from parents, siblings, peers, and the media, which could have molded their play and peer tendencies completely sepa- rately from hormonal or genetic effects. However, several other factors lend strength to the hormonal argument for this gender-based behavior. The degree of the preference for same-sex friends is very strong. Anyone who has ever observed young children over time has seen that girls and boys seem automatically to form totally separate groups in play settings and rarely allow a child of the opposite sex to participate in the group's activities. You can see one obvious example of this gender segregation at children's birthday parties: The guests, with very few exceptions, are all girls or all boys, and the mere suggestion that the child invite even one guest of the oppo- site sex is soundly rejected.