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Carlos Hilado Memorial State College

Alijis Campus | Binalbagan Campus | Fortune Towne Campus | Talisay Campus

To be a leading GREEN institution of higher learning in the global


community by 2030
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building)
leizl.tortogo@chmsc.edu.ph (63-34) 712-0420 local 116

Gender and Development and Green Culture (GAD GRC)

Module 5: Reproductive Health, Issues and


Concerns

Chapter 5: Lesson Objectives


At the end of this lesson, you will be able to:
1. Recognize the general importance of maintaining reproductive and sexual health,
free from risks and complications
2. Explain the risks, danger and complications of premarital sex, teenage pregnancy,
abortion and sex change surgery
3. Discuss the relevance of same sex marriage legalization to global community and
the importance of responsible parenthood to the lives of Filipino families.

I. Introduction

The chapter presents several issues and concerns of reproductive health. The module
covers topics on mate selection, sexual and non-sexual risk behaviors, premarital sex, teenage
pregnancy, abortion, responsible planned- parenthood, same sex marriage and sex change.
Learning activities of the module include writing your analyses on cases of teenage pregnancy,
unsafe abortion, and discrimination against workers with HIV. As Gender and Development
(GAD) is mainstreamed in instruction, research and extension in all programs and activities of
CHMSC, the lesson encourages students‟ support in HIV/AIDS awareness campaign to further
educate the youth, stop the stigma, and promote prevention and risks among Filipinos. This
chapter covers 9 hours per week.

II. Lesson/Unit/Study Guide/ Notes

Mate Selection
- is the process of choosing a partner with whom to
form a long‐term relationship or a marriage bond. Personal preference is a key component in
the
selection process through structural influences. Sociological literature studies have emphasized
life course factors and variations by gender, race, class, culture, and specific personal traits are
among the explanations for mate choice selection.

Mate Selection Theories


Social Homogamy
People are attracted to those from similar backgrounds
Areas of similarity: Age, race, ethnic background, socioeconomic status, political views,
religion, similar appearance status, proximity (live nearby).
Similarities ensure that couples will manage their shared resources more efficiently and with
less conflict
Best explained in “arranged marriages” when parents seek out a partner who is similar to their
son/daughter

Ideal Mate Theory


Attraction is based on an individual‟s unconscious image of the ideal partner. This is
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based on their perceptions of the meaning of certain physical characteristics and


social status
● People assess their resources (attractiveness, wealth, personality, and social
status) and look for a mate who will be attracted to these resources and/or traits
● Most will find a mate in society because individuals are attracted to different people
● Supports the idea of “love at first sight,” since everyone has an unconscious ideal
with which they compare a person to find him/her attractive. This helps them make
the immediate comparison or judgement of a person as loveable or unlovable.
1.3Developmental Perspective
● Individuals are unable to relate to someone
else without first understanding who they are
and what their roles in life are. They must
understand what they have to offer to another
person and what they want or need in return. If
they don‟t have a sense of who they are (their
identity) prior to forming romantic
relationships, the relationship defines their
identity.
1.4Evolutionary Psychology
● In prehistoric times, mate selection was based on reproduction and the ability to
procreate future generations
● Women preferred men who would be good fathers and providers for their
children. They sought out men who were healthy, intelligent, well-educated, hard-
working, and ambitious
● Men preferred women who could bear healthy babies, feed their kids, and were
intelligent and well-tempered to raise them. They sought out women who were
attractive, young, healthy, had wider hips than their waist (a sign of fertility).
1.5Social Exchange Theory
● Individuals will analyze their assets and deficits (flaws). They will look for a
partner who balances their assets and deficits.
● They will seek to get ahead or to move up through successful mate selection.
Best explained in marriages of older, wealthier men/women with young, attractive
men/women.
1.6Murste in‟s Filter Theory
● Explained the relationship among dating, social homogamy, and social exchange as
a multi-step process. Theory uses the analogy of „sifting‟ to suggest that individuals
pass their dates through a series of „filters‟ to screen out unacceptable marriage
partners.

2. Sexual and Non-sexual Risk Behaviors

2.1Sexual Risk Behaviors


Many young people engage in sexual risk behaviors and experiences that can result in
unintended health outcomes. CDC data show that lesbian, gay, and bisexual high school
students are at substantial risk for serious health outcomes as compared to their peers.
Sexual risk behaviors place youth at risk for HIV infection, other STDs, and unintended
pregnancy:
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Previous studies have identified these


behavior combinations with sexual
activity: substance use or drug use,
suicide behavior or suicide attempts,
violence, smoking, binge drinking, and
gambling. Some problem behaviors
relevant for younger adolescents, e.g.
early „ drinking, may also predict later
sexual risks. Early drinking may shape
subsequent functioning through

2.2 Non-sexual Risk


Behaviors
multiple pathways, for example, by affecting judgment,
school performance, peer selection, and exposure to
environments that reward risk taking.

It has been suggested that the relationship between


problem behaviors may differ across ethnic groups and
it is possible that the “syndrome” of problem behaviors
may have different patterns for various ethnic groups
from diverse socioeconomic, historical, and cultural
backgrounds. As the AIDS epidemic continues to
spread across Asia, increases in premarital sexual
behaviors are issues of growing concern. Until recently, however, little evidence has been
available on the relationship between sexual behaviors and non-sexual risk behaviors among
adolescents in Asian countries.

3. Pre-marital Sex, Teenage Pregnancy and Abortion

3.1 Pre-marital Sex


Premarital sex or penetrative sex before marriage and its
consequences on adolescent‟s health has generated a lot
of concerns among policy makers, researchers and even
religious leaders.

Teenagers who feel incomplete, inadequate and unappreciated are more likely to seek
comfort in a sexual relationship. But those with a life rich in relationships, family
traditions, activities, interests and most of all consistent love and affirmation are less likely
to embark on a desperate search for fulfillment that could lead to unwise sexual decisions.
Those who have a healthy, productive faith in God are more likely to have deeply rooted
reasons to respect and preserve the gift of sex and to respect rather than exploit others. The
following are the specific risk factors for teen sex:
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Alcohol and drug use - Aside from reflecting problem attitudes (rebellion, poor
self-concept, invulnerability) that make sex more likely, intoxication also clouds
judgment and weakens resistance to sexual overtures.

Physical or sexual abuse. These acts against


children and adolescents violate their bodies,
minds and hearts. Sexual abuse creates a grossly
distorted view of sexual behavior, destroys
boundaries, and drives a deep sense of
worthlessness into the emotions. Whether the
abuse occurred in the distant or recent past,
adolescents with this history need ongoing support, counseling and prayer to help
them develop healthy attitudes about sex and about themselves.

Risk for STDs (Sexually Transmitted Diseases) – A study has revealed that time
spent single after sexual debut was significantly associated with HIV and other
STIs. The study found higher odds of HIV-1, HSV-2 and other STIs among women
with longer duration of premarital sex. Moreover, women with longer duration of
premarital sex were more likely to report multiple sexual partners (Finkelman, 2013).
The number of new cases in the Philippines of HIV, which causes AIDS, jumped
from only four a day in 2010 to 31 a day as of November 2017. From just 117 cases
a decade ago, the total number of HIV cases as of November 2017 is 49,733, an
overwhelming majority of which – 41,369, or 83 percent – were reported in the past
five years alone. Most new infections, up to 83 percent according to the Philippine
government, occur among men or transgender women who have sex with men. The
increase prompted the government to declare a “national emergency” in August
2017. The epidemic is fueled by an environment hostile to policies and programs
proven to help prevent HIV transmission. Government policies create obstacles to
access to condoms and HIV testing and limit educational efforts on HIV
prevention.

3.2 Teenage Pregnancy


Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in females under
the age of 20. A female can become pregnant from sexual intercourse after she has begun to
ovulate, which can be before her first menstrual period (menarche) but usually occurs after
the onset of her periods.
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Effects of Teenage Pregnancy
Teenage pregnancy is a serious issue that may seriously impact the future of a young
woman. Any teen pregnancy will be a challenge as teens typically lack skills needed to
handle a pregnancy and motherhood.
● Medical complications often occur in pregnant teenagers, according to the
American Academy of Child and Adolescent Psychiatry such as anemia, eclampsia,
increased maternal mortality, low birth weight and difficulty in child labor as a
result of cephalopelvic disproportion.
● Depression may arise when a teenager is pregnant. The teen may fall into a
depression while trying to handle the emotions a pregnancy creates and all of
the possibly negative feedback about the pregnancy from friends and family the
fluctuating hormones that a pregnancy creates may also prompt depression
● Smoking and drug use may be problematic during a teen pregnancy. An adolescent
pregnant may not have the willpower to stop using substances that can harm the
developing baby.
● Neglect of the baby - Once the baby is born, teenagers may not be willing or able to
give it the undivided attention it needs. A teenage mother may not be an adequate
mother because she is overwhelmed by the constant needs of the baby. She may
easily be annoyed at the lack of freedom to interact with her peer group due to the
baby.
● Delayed Education – education may be put on hold when a teen becomes pregnant.
Some pregnant teens may decide to leave high school. Others who were planning to
attend college in the future may put off that experience after becoming pregnant.
They may decide to focus on the baby or getting married rather than pursuing
further education.
● Financial difficulty may arise during a teen pregnancy or after the baby is
born. Teens who do not have full-time employment may struggle to cover the
basic expenses of life upon having a baby.
● Emotional crisis - A pregnant teenager may suffer from an emotional crisis when she
does not want the baby. This crisis may lead to rash behavior such as attempting to
self-abort the baby or a suicide attempt.

3.3 Abortion

Teenage abortion is a controversial subject


and a pregnant teen considering abortion often finds herself in a difficult situation where
either of her decisions --- abortion or
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choosing to give birth, will leave an everlasting impact on her life. While an abortion may
seem to be the only way out for pregnant teenagers who do not have financial and family
support, the fact remains that an abortion can leave them emotionally unstable for a long
time, sometimes for life.
Abortions are safe if they are done with
a method recommended by World Health
Organization (WHO) that is appropriate to
the pregnancy duration and if the person
providing or supporting the abortion is
trained. Such abortions can be done using
tablets (medical abortion) or a simple
outpatient procedure. However, unsafe abortion occurs when a pregnancy is terminated
either by persons lacking the necessary skills or in an environment that does not conform
to minimal medical standards or both. Women, including adolescents, with unwanted
pregnancies, often resort to unsafe abortion when they cannot access safe abortion.

Complications of unsafe abortion include hemorrhage, sepsis, peritonitis, and


trauma to the cervix, vagina, uterus, and abdominal organs. Moreover, one in four
women who undergo an unsafe abortion is likely to develop temporary or lifelong
disability requiring medical care. The risk of abortion related -death surges when the rate
of unsafe abortion increases.
4. Responsible Planned Parenthood
- as defined in the Directional Plan of
Department of Health (DOH), “is the will
and ability of parents to respond to the
needs and aspirations of the family and
children.” It is a shared responsibility of
the husband and the wife to determine and
achieve the desired number, spacing, and
timing of their children according to their
own family life aspirations, taking into
account psychological preparedness, health
status, socio-cultural, and economic
concerns.
4.1 Concepts of Responsible Parenthood
Church Teaching on Responsible Parenthood
-the church teaches the necessity of
responsible parenthood for married couples.
Parents in the exercise of responsible parent
-hood, need to plan their families. Relying
on God‟s providence they will use their God-given minds to plan and decide on the number
of children they will beget. Humans should bring into the world generously the children
whom they can raise up as good human beings, but they should seek to bring into the
world only those that they can raise up as good human beings‟ (CBCP Guidelines). In
making decisions, parents must consider their own good and the good of their children
already born or yet to come, as well as the good of the family, of society and of the church,
and their responsibility to God.
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State Perspective on Responsible Parenthood
Having the desired number of children and when you want to have them by using safe and
effective modern methods (DOH). Proper birth spacing is having children 3 to 5 years apart,
which is best for the health of the mother, her child and the family.

4.2 Family Planning


As defined by POPCOM, is a program that enables
parents to deliberately and responsibly decide the
number and spacing of their children, by avoiding for
the time being, or even for an indefinite period, a birth.
It is not a prognosis imposed on the parents but an
expression of responsible parenting based on informed
choices and decisions of couples to achieve their
desired family size based on their social and economic
capacity.

Natural Family Planning


The natural family planning methods do not include any chemical or foreign body
introduction into the human body. Most people who are very conscious of their religious
beliefs are more inclined to use the natural way of birth control. Some want to use natural
methods because it is more cost effective.

Abstinence
- This natural method involves abstaining from sexual intercourse and is the most
effective natural birth control method with ideally 0% fail rate. It is also the most effective
way to avoid STIs. However, most people find it difficult to comply with abstinence, so
only a few of them use this method.

Calendar Method
- Also called as the rhythm method, this natural
method of family planning involves refraining from
coitus during the days that the woman is fertile.
According to the menstrual cycle, 3 or 4 days before
and 3 or 4 days after ovulation, the woman is likely
to conceive. The process in calculating for the
woman‟s safe days is achieved when the woman
records her menstrual cycle for six months. It has an
ideal fail rate of 5%, but when used it has a typical
fail rate
of 25%
Basal Body Temperature
- The basal body temperature is the woman‟s temperature at rest. BBT falls at 0.5⁰F
before the day of ovulation and during ovulation, it rises to a full degree because of
progesterone and maintains its level throughout the menstrual cycle, and this is the basis for
the method. The woman must take her temperature early every morning before any
activity, and if she notices that there is a slight decrease and then an increase in her
temperature, this is a sign that she has ovulated. The woman must abstain from coitus for
the next 3 days.
The BBT method has an ideal fail rate of 9% and has a typical use fail rate of 25%.

Cervical Mucus Method


- The basis of this method is the changes in the cervical mucus during ovulation. To
check if the woman is ovulating, the cervical mucus must be copious, thin, and watery.
The
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cervical mucus must exhibit the property of spinnbarkeit, wherein it can be stretched up
until at least 1 inch and feels slippery. The fertile days of a woman according to this method
is as long as the cervical mucus is copious and watery and a day after it. Therefore, she
must avoid coitus during these days. When used typically, it has a fail rate of 25%.

Ovulation Detection
- The ovulation detection method is an over-the-counter kit that can predict ovulation
through the surge of luteinizing hormone that happens 12 to 24 hours before ovulation.
The kit requires the urine specimen of the woman to detect the LH. The kit is 98% to 99%
accurate and is fast becoming the method of
choice by women.

Lactation Amenorrhea Method


- Through exclusive breastfeeding of the
infant, the woman is able to suppress
ovulation through the method of lactation
amenorrhea method. However, if the infant
is not exclusively breastfed, this method
would not be an effective birth control
method. It is also best to advise the woman
that after 3 months of exclusive
breastfeeding, she must make plans of
choosing another method of contraception.

Coitus Interruptus
- This is one of the oldest methods of contraception. The couple still proceeds with the
coitus, but the man withdraws the moment he ejaculates to emit the spermatozoa outside
of the vagina. The disadvantage of this method is the pre-ejaculation fluid that contains a
few spermatozoa that may cause fertilization. Coitus interruptus is only 75% effective
because of this.
Hormonal Contraception
These hormonal contraceptives are effective through manipulation of the hormones that
directly affect the normal menstrual cycle so that ovulation would not occur.

Oral contraceptives
- Also known as the pill, oral contraceptives contain synthetic estrogen and progesterone.
Estrogen suppresses the FSH and LH to suppress ovulation, while progesterone decreases
the

permeability of the cervical mucus to limit the


sperm‟s access to the ova. To use the pill, it is
recommended that the woman takes the first pill on
the first Sunday after the beginning of a menstrual
flow, or the woman may choose to start the pill as
soon as it is prescribed. Advise the woman that the
first 7 days of taking the pill would still not have an
effect, so the couple must use another contraceptive method on the initial 7 days. If the
woman has skipped one day of taking the pill, she must take it the moment she remembers
it, than still follow the regular use of the contraceptive. If the woman has missed taking the
pill for more than one day, she and her partner must consider an alternative contraception
to avoid ovulation. Side effects for OCs are nausea, weight gain, headache, breast
tenderness, breakthrough bleeding, vaginal infections, mild hypertension, and depression.
Contraindications to OCs are breastfeeding, age of 35 years and above, cardiovascular
diseases, hypertension, smoking, diabetes, and cirrhosis.

Transdermal Patch
- The transdermal patch has a combination of both estrogen and progesterone in a form of a
patch. For three weeks, the woman should apply one patch every week on the following
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areas: upper outer arm, upper torso, abdomen, or buttocks. At the fourth week, no patch is
applied because the menstrual flow would then occur. The area where the patch is applied
should be clean, dry, free from any applications. And without any redness or irritation.
Patches can be worn while bathing or swimming,
but when the woman notices that the patch is loose,
she should immediately replace the patch. If the
patch has been loose for less than 24 hours, the
woman need not use an alternative form of
contraceptive, but if she is not sure of how long the
patch has been loose, she should replace it and start
with a new week cycle and also use an additional
contraceptive method.

Vaginal Ring
- The vaginal ring releases a combination of estrogen and progesterone and surrounds the
cervix. This silicon ring is inserted vaginally and remains there for 3 weeks, then removed
on the fourth week as menstrual flow would occur. The woman becomes fertile as soon as
the ring is removed. The vaginal ring has the same effectivity rate as the oral
contraceptives. The subdermal implants are two rod-like implants embedded under the skin
of the woman during her menses or on the 7 th day of her menstruation to make sure that she
is not pregnant. It contains etonogestrel, desogestrel, and progestin. It is effective for 3 to 5
years. Subdermal implants have a fail rate of 1%.

Hormonal injection
- A hormonal injection consists of
medroxyprogesterone, a progesterone, and given
once every 12 weeks intramuscularly. The injection
inhibits ovulation and causes changes in the
endometrium and the cervical mucus. After
administration the site should not be massaged so it
could absorb slowly. It has an effectiveness of almost 100%, making it one of the most
popular choices for birth control. Advise the woman to ingest an adequate amount of
calcium in her diet as there is a risk for decreased of bone mineral density and to engage
in weight-bearing exercises.

Intrauterine Device (IUD)


- An IUD is a small, T-shaped object that is inserted into
the uterus via the vagina. It prevents fertilization by
creating a local sterile inflammatory condition to prevent
implantation.
The IUD is fitted only by the physician and inserted after
the woman‟s menstrual flow to be sure that she is not pregnant. The device contains
progesterone and is effective for 5 to 7 years. A woman with IUD is advised to check the
flow of her menstruation every month and the IUD string, and also to have a pelvic
examination yearly.

Chemical Barriers
- Chemical barriers such as spermicides, vaginal gels and creams, and glycerin films are
also used to cause the death of sperms before they can enter the cervix and also lower the
pH level of the vagina so it will not become conducive for the sperm. These chemical
barriers cannot prevent sexually transmitted infections; however, they can be bought without
any prescription. The ideal fail rate of chemical barriers is 80%.
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Diaphragm
- A diaphragm works by inhibiting the entrance of the sperm into the vagina. It is a
circular, rubber disk that fits the cervix and should be placed before coitus. If a spermicide
is combined with the use of a diaphragm, there is a failure rate of 6% ideally and 16%
typically. The diaphragm should be fitted only by the physician, and should remain in
place for 6 hours after coitus. It can be left in place for not more than 24 hours to avoid
inflammation or irritation. The cervical cap is another barrier method that is made of soft
rubber and fitted on the rim of the cervix. It is shaped like a thimble with a thin rim, and
could stay in place for not more than 48 hours.

Male Condoms
- The male condom is a latex or synthetic rubber sheath
that is placed on the erect penis before vaginal
penetration to trap the sperm during ejaculation. It can
prevent STIs and can be bought over-the-counter. Male
condoms have an ideal fail rate of 2% and a typical fail
rate of 15% due to a break in the sheath‟s integrity or spilling. After sexual intercourse,
the condom is removed to be disposed.

Female Condoms
- These are also latex rubber sheaths that are specially designed
for females and pre-lubricated with spermicide. It has an inner ring
that covers the cervix and an outer, open ring that is placed against
the vaginal opening. These are disposable and require no
prescription.
The fail rate of female condoms is 12% to 22%.

Surgical Methods of Family Planning


One of the most effective birth control methods is the surgical method. The two kinds
of surgical methods are used by either the male or the female, and would ensure that
conception is inhibited after the surgery for as long as the client lives.

Vasectomoy
- Males undergo vasectomy, which is executed through a small incision made on each
side of the scrotum. The vas deferens is then tied, cauterized, cut, or plugged to block
the passage of the sperm. This procedure is done with local anesthesia, so advise the
patient that mild local pain can be felt after the procedure. There is a 99.5% accuracy
rate for vasectomy and has a few
complications.

Tubal Ligation
- In women, tubal ligation is performed by
occluding the fallopian tubes through cutting,
cauterizing, or blocking to inhibit the passage
of the both the sperm and the ova. After
menstruation and before ovulation, the procedure is done through a small incision under
the woman‟s umbilicus. The woman may return to her sexual activities after 2 to 3 days of
the operation. The effectiveness of this method is at 99.5%.

5. Same Sex Marriage


- the practice of marriage between two men or between two women. Although same-sex
marriage has been regulated through law, religion, and custom in most countries of the
world, the legal and social responses have ranged from celebration on the one hand to
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criminalization on the other.
The acceptance of same-sex partnerships
was particularly apparent in northern
Europe and in countries with cultural ties
to that region. In 1989 Denmark became
the first country to establish registered
partnerships, an attenuated version of
marriage for same- sex couples. Soon
thereafter similar laws, generally
using specific vocabulary (e.g., civil union, civil
partnership, domestic partnership, registered partnership) to differentiate same-sex unions
from heterosexual marriages, went into effect in Norway (1993), Sweden (1995), Iceland
(1996), the Netherlands (1998), and elsewhere in Europe, including the United Kingdom
(2005) and Ireland (2011).
Societies have resolved the intertwined issues of
sexuality, reproduction, and marriage in myriad ways.
Their responses regarding the morality, desirability,
and administrative perquisites of same-sex partnerships
have been equally diverse. Notably, however, by the beginning of the 21st century most
countries opted for one of only three legal resolutions to these intersecting problems: to
ignore same-sex partnerships, to criminalize them, or to grant them a status similar or
equal to that of heterosexual marriage. Many countries have yet to reach a consensus on
these issues.
Traditionally, many societies chose to ignore the issue of
same-sex marriage by treating same-sex intimacy as a
subject unsuitable for discussion. Many of these
jurisdictions, as well as those that actively criminalize same-
sex unions, contended that homosexuality and lesbianism
are
mental disorders and built their public policies on this premise. In treating same-sex desire
as a psychiatric illness, these cultures moved same-sex intimacy and marriage from the
realm of civil regulations (the domain of contract law) to that of public safety (the domain of
criminal law). In such societies, the possibility of arrest or institutionalization further
reinforced taboos on same-sex intimacy and discussions thereof, typically driving such
activities underground.
6. Sex Change
- also known as Gender or Sex
Reassignment
and Gender Affirming surgery.
Adults who are suffering from gender dysphoria may opt for a sex change operation which
permanently alters one‟s sex to their desired gender identity. This surgical procedure

enables a trans person to alter their physical appearance and the existing sexual
characteristic into the one of their identified gender.
This procedure has become popular, so much so that
many of the public and commercial health insurance
plans in countries abroad provide defined benefits
covering such surgeries. The reassignment primarily
includes Genital Reconstruction Surgery (MTF and
FTM), Chest Reconstruction (FTM), Breast
Augmentation (MTF) and Hysterectomy (FTM). Here
MTF means Male to Female and FTM means
Female to Male.
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Pros:
Pros and cons of Sex Change
Surgery:
✔ A patient who undergoes a sex reassignment procedure is able to enjoy her
sexual life in the future as s/he does not have to deal with the mental stress of
being in the wrong body.
✔ Finding the right doctor and getting the desired treatment can lead to
psychological happiness for the patient.
✔ After the gender reassignment surgery, the patients are usually found to be less
gender dysphoric. There have less anxiety levels, depression levels than
before.
Cons:
o The patient who has undergone the surgery from male to female or vice versa,
will be unable to reproduce.
o The patient will not only have to face physical changes but also
psychological changes which may be hard to deal with.
o Postoperative complications can include hematoma. Small hematoma can be
cured through puncture and the larger one needs the patient to undergo surgical
treatment.
References:
Book:
Aguilar,et.al. (2006).Teaching Gender, Sexuality and Reproductive Health (Modules for Integration in the
Social Sciences, Humanities and the National Service Training Program

Amper, Zona S. et.al., Teaching Gender, Sexuality and Reproductive Health. Academe Component of the
Visayas Reproductive Health Initiative. 2006.)

Finkelman, Matthew D. and Ghebremichael, Musie S. (2013) The Effect of Premarital Sex on Sexually
Transmitted Infections (STIs) and High Risk Behaviors in Women. US National Library of Medicine
National Institute of Health. HHS Access Author Manuscript Peer Review and Accepted for Publication.

Electronic resources:

https://www.doh.gov.ph/faqs/What-is-meant-by-Responsible-Parenthood
https://schoolworkhelper.net/understanding-the-theories-of-attraction-and-mate-
selection/
Sex, Love or Infatuation, How Can I Really Know?, Ray E. Short, Kadena Books, 1991, pp . 186-
187. http://www.heraldopenaccess.us/openaccess/premarital-sex-safer-sex-and-factors-influencing-
premarital-sex-practices-among-senior-secondary-school-students-in-ebonyi-local-government-
area- of-ebonyi-state-nigeria
https://www.who.int/health-topics/abortion#tab=tab_1
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3634578/
https://nurseslabs.com/family-planning-methods/#natural_family_planning
https://www.freedomofresearch.org/abortion-in-the-philippines-a-true-story/
https://www.hrw.org/news/2018/02/09/philippines-discrimination-against-workers-
hiv

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