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Sex education

Written on the date

Psychosexual development of adolescents. The development of human sexuality and the formation of sexual identity.

LAW on reproductive health, no. 138 of June 15, 2012, published in the Official Gazette no. 205-207 of September 28, 2012 Chapter II. Article 6. Sexual-reproductive health of adolescents 

(1) Adolescents have the right to information and access to reproductive health protection services adapted to their needs.

 (2) Adolescents have the right to sex education adapted to their age to ensure correct psychosexual development, prevention of sexually transmitted infections and HIV/AIDS infection, unwanted pregnancy and for the formation of responsible parenting skills. 

(3) Compulsory sexual education and preparation for family life are carried out in educational institutions and in other institutions where there are teenagers or young people, including those with special needs, according to specially developed programs, which are part of the compulsory curricula of educational institutions, taking into account age, sex and the particularities of psychosexual development. 

(4) The development of age-appropriate sex education programs for correct psychosexual development, the prevention of sexually transmitted infections and HIV/AIDS infection, unwanted pregnancy and the formation of responsible parenting skills is ensured by the Ministry of Education, in agreement with the Ministry of Health. 

(5) Medical services in the field of adolescent sexual-reproductive health are provided by youth-friendly health services and 6 to other services authorized in accordance with the normative acts of the Ministry of Health. 

(6) In the case of minors under the age of 16, voluntary consent to obtain reproductive health protection services is expressed by both the minor and his legal representative. In the case when it is impossible to obtain the consent of the minor's legal representative and when medical services are indicated to preserve his life and health, his voluntary consent is sufficient. In this situation, the decision is taken consultatively by the service providers, in the best interest of the minor, in accordance with the normative acts of the Ministry of Health. 

(7) In case of teenage pregnancy, they are guaranteed and assured the right to continue their studies during the pregnancy and after the termination of the pregnancy.

Sexual identity: 

• Learning gender roles and gender behavioral stereotypes 
• Awareness of belonging to a sex - gender identity 
• Clarifying the orientation of sexual attraction

Gender identity 

• Gender identity refers to the gender with which a person identifies. A person's gender identity can be male, female or pan-gender (ie neither exclusively female nor exclusively male, but a combination of these). 

• Gender identity is a different concept than biological sex and the two are not always the same. For example, in the case of trans people, the biological sex and gender identity are different (for example, the sex at birth may be male and the gender identity female or even a combination of female and male). 

However, most people are cisgender, meaning their gender identity is based on the sex they were assigned at birth. The basic gender identity is usually formed at the age of three, after 5-6 years this process usually ends.

Gender identity:

It is determined 
• prenatal 
• environmental factors in early childhood 

It is complemented by gender roles 

It is damaged by – chromosomal aberrations (S. Turner (X0), Klinefelter (XXY)) – other chromosomal aberrations (Hermaphroditism, congenital adrenal hyperplasia, androgen resistance syndrome, 5-Alpha-reductase deficient) – genital abnormalities – rituals related to sexuality.

Sexual orientation 

Sexual orientation is about: who we are attracted to and who we want you to have relationships with

Types of sexual orientation: 

- heterosexuals 
– homosexuals (gays and lesbians) 
– bisexuals 
- asexuals. 

Sexual orientation is about who we are romantically, emotionally and sexually attracted to and is different from gender identity.

Sexual development ≠ DPS Psychosexual development has 2 aspects:

1. THEORETICAL – training the ability to experience (thoughts, fantasies, emotions) the state of love and intimate friendship. 

2. PRACTICAL – experimenting with the loved one.

Stages of adolescent psychosexual development 

1. Platonic libido 

Adoration, platonic dreams and fantasies, falling in love, the desire for spiritual communication, the desire to please, the choice of attractive clothing, cosmetics, increases the importance of the mirror, signs of attention to the object of love.

Training the skills to make acquaintances, to attract attention, to communicate with the object of love.

2. Erotic libido 

The interest in erotica, reading romance novels, the need for caresses and bodily contacts, erotic fantasies. Walks as a couple, letters, meetings, courtship, touching and erotic games, masturbation. 

Erotic discussions with peers and preparation for the harmonious and natural transition to intimate contacts. The interest in erotica, reading romance novels, the need for caresses and bodily contacts, erotic fantasies. Walks as a couple, letters, meetings, courtship, touching and erotic games, masturbation.

Erotic discussions with peers, preparation for the harmonious and natural transition to intimate contacts.

Correspondence of pubertal and psychosexual development 

Key stages of pubertal development.

DPS stages

• 9-13 Formation of secondary sexual signs
• Platonic 12-15 (menstruation, ejaculation)
• Erotica 15-18 (Girls – stop growth, stabilization of menstrual cycle, Boys – expression of secondary sexual signs, continuation of growth)

Forms of sexual behavior in adolescents: 

o Masturbation 
o Petting 
o Transient homosexual behavior 
o Sexual relations 
o Sublimation

Types of psychosexual development (PSD)

Normal psychosexual development 
Accelerated psychosexual development (platonic libido at 7.5 years, sexual libido – at 12-14 years) 
Slowed psychosexual development (platonic libido – 14 years) 
Repressed psychosexual development (family problems, hypersocialization – sublimation)
Psychosexual development with repression of libido (denies sex, represses any thought about sexual relations - psychosomatic) 
Disharmonious psychosexual development (sexual activity anticipates psychosexual development)

"Sexual rights - human rights already recognized by national laws, international human rights documents and other consensus statements. They include the rights of all persons, free from coercion, discrimination and violence to: – the highest attainable standards of sexual health, including access to sexual and reproductive health services; – searching, obtaining and sharing information about sexuality; – sexual education; – respect for bodily integrity; – choosing the partner; – the decision to be or not to be sexually active; – consensual sexual relations; – consensual marriages; – the decision to have children or not and when to have them; and – the desire to have a satisfying, safe and enjoyable sex life.” (WHO, 2006)

Manifestations of the child 0-3 years

Curiosity about one's own body, including intimate areas
Curiosity about the body of adults
Interest in the activities in the bathroom: they look at the bodies of adults, examine the bodies of other children when they go to the toilet
He explores his body and discovers that touching the genitals gives a pleasant sensation, a completely normal fact

Manifestations of the child 3 – 6 years

They are concerned about the birth of babies and the phenomenon of magical thinking appears
Games in which children explore the intimate areas of others 
Questions related to sex
They are interested in the differences between men and women
They learn words with sexual connotations and use them to capture the reaction of adults

Manifestations of the child 6 – 12/14 years

The children begin to discuss among themselves about the conception and birth of children
Interest in the opposite sex and the differences between the sexes increases
Increases interest in the practical aspects of sexual intercourse
They begin to feel shame towards the opposite sex
The body begins to change: pubic hair appears, girls' breasts and hips develop, and boys' testicles and penis and their voice thickens
Menstruation occurs in girls and nocturnal ejaculations in boys, which is absolutely normal

Topics to address with teenagers: 

The differences that appear in the body between girls and boys
Aspects related to intimate hygiene and the reproductive system
Bodily hygiene and social and intimate relationships
Nocturnal pollution in boys is something normal and natural and not shameful (their body is preparing for when they become adults)
Menstruation in girls and additional hygiene measures
Composition of the female reproductive system (vagina, uterus and ovaries that produce eggs) and male (penis, prostate and testicles that produce sperm)
Sex means love, intimidation, trust, reciprocity, respect for yourself and your partner
Sexual health is as important as other aspects of body health

Sex education does not mean teaching children to have sex and does not force them to start their sex life, but shows them that they have a body that they must take care of

Questions related to pregnancy, contraception and abortion

Contraception: 

Short-acting hormonal methods (pill, mini-pill, patch, injections, vaginal ring) – depending on the method, it is administered daily, every 3 weeks or 3 months.

Barrier methods (condoms, diaphragm, vaginal cover, sponge) - must be used every time you have sexual contact.

Natural methods - do not use a certain type of contraception, but avoid sexual activity on the fertile days of the menstrual cycle (when it is very likely to get pregnant).

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