- do not consume so much ALCOHOLwhen out
with a group or on a date that it impairs one’s
ability to take action to stop unwanted sexual
advances - do not accept or consume “party drugs”
See also DOMESTIC VIOLENCE; ELDER ABUSE; GAMMA
HYDROXYBUTYRATE(GHB).
sexual orientation A continuing or enduring
physical and emotional attraction and sexual
interest in another person. Most health experts
view sexual orientation as a continuum with
exclusive heterosexuality (attraction only to peo-
ple of the opposite sex) at one end and exclusive
homosexuality at the other end (attraction only to
people of the same sex). Along the continuum are
varying degrees of mixed attraction (heterosexual
and homosexual), often called bisexuality. Sexual
orientation is distinct from an individual’s sexual
identity and perceptions of SEXUALITY.
Most researchers believe sexual orientation
develops in early childhood as a complex interac-
tion of numerous psychologic, biologic, and
behavioral factors. However, some researchers
believe sexual orientation is purely biologic or
genetic, and others maintain that it is purely
behavioral. Within these attempts to understand
and explain sexual orientation, nearly all
researchers agree that whatever its origins, sexual
orientation is not a matter of choice. The basis for
this agreement is the recognition that sexual ori-
entation emerges before sexual exploration.
The American Psychological Association, Amer-
ican Psychiatric Association, American Counseling
Association, and other organizations of health-
care professionals affirm that sexual orientation,
no matter where it is along the continuum of pos-
sible expressions, is simply a dimension of individ-
ual experience and definition and adamantly
oppose efforts to change sexual orientation
(notably homosexuality) through therapy and
refute claims that therapy can accomplish such an
objective. Rather, mental health professionals hold
that the purpose of therapy related to sexual ori-
entation is to help an individual who is uncom-
fortable with his or her sexual orientation reach a
level of understanding and acceptance about it,
which may include choices around how to accom-
modate sexual orientation issues and whether to
engage in intimate relationships.
See also INTERPERSONAL RELATIONSHIPS; SEXUAL
HEALTH.sexuality A person’s overall attitudes, percep-
tions, and expressions of sexual identity, SEXUAL
ORIENTATION, and sexual behavior, intimate rela-
tionships (whether or not those relationships
include sexual activity). The organs of reproduc-
tion provide the physical basis for gender and sex-
uality. Other factors, from genetics to
biochemistry, add further layers of complexity so
that sexuality becomes a fundamental element of
human existence along the entire continuum of
life. Sexuality plays a significant role in self-
esteem and self-confidence, shaping how people
perceive themselves, and how they present them-
selves to others.
Numerous health circumstances affect sexual-
ity, from physical development and aging to injury
and illness. Changes in the body’s physical appear-
ance shift awareness of sexuality at key life pas-
sages such as PUBERTY, PREGNANCY, and MENOPAUSE.
Health conditions that affect physical function
may affect an individual’s interest in or ability to
participate in SEXUAL INTERCOURSEand other sexual
activity. Among such health conditions are
OBESITY, DIABETES, CARDIOVASCULAR DISEASE (CVD),
neurologic disorders, STROKE, HEART ATTACK, and
CHROMOSOMAL DISORDERSsuch as TURNER SYNDROME
and KLINEFELTER SYNDROME. Because the base of
sexuality is inherently linked to the organs of
reproduction, conditions (and their treatments)
that affect those organs are often especially chal-
lenging to sexuality. Treatments that result in
physical alterations of the body, such as AMPUTA-
TIONand MASTECTOMY, often affect the person’s per-
ceptions about his or her physical attractiveness
and sexual desire.
See also AGING, REPRODUCTIVE AND SEXUAL
CHANGES THAT OCCUR WITH; ERECTILE DYSFUNCTION;
INTERPERSONAL RELATIONSHIPS; LIBIDO; SEXUAL DYS-
FUNCTION; SEXUAL HEALTH.spiritual beliefs and health care The influences
of an individual’s faith on health-care decisions
and outcomes. Spirituality is the sense of how one
fits within and relates to the scheme of existence,252 Human Relations