Sexuality Topics

Relationships

• How did you react to the example? Why do you think you reacted that way?
• If this was your client, what would be the most important discussion points?
• What  additional information do you need to respond to the case example?

Relationships

Relationships are associations or interactions between individuals. Interpersonal relationships can be close such as those between family members, friends or lovers, or more distant such as those between acquaintances or professional contacts. People form relationships to meet needs, and for a relationship to be healthy, it needs to meet the needs of both participants without causing harm to either.

Healthy Relationships

Regardless of the type of relationship (family, friend, professional, intimate) a relationship must reflect some basic qualities to be healthy:

• Personal boundary definition – both individuals in the relationship recognize and respect the physical, spatial, touch and emotional boundaries of each other.
• Clear role definition – each individual recognizes the nature of the relationship and acts in the role appropriate to that relationship.
• Appropriate power distribution – power and responsibility is shared in a way consistent with the nature of the relationship.
• Healthy communication – both individuals feel comfortable and able to express themselves in an assertive manner (as opposed to passive, aggressive or passive-aggressive) and are able to listen to the other.
• Trust, honesty – there is a basic trust that the other will meet the expectations both individuals agreed upon and that they will be truthful about their thoughts, behaviours and values.
• Safety – the well being of both partners is not put at risk by the words, actions or behaviours of the other individual.
• Respect – both individuals respect the worth and dignity of the other as a person of equal value.
• Acceptance and caring – there is caring for the other individual with differences being accepted and celebrated.
• Meeting of both individual’s  needs within relationship – the relationship enhances both individual’s well being and each takes responsibility.

To learn more about healthy relationships, see:
Healthy Relationships Information Sheet (PDF)

For more information on maintaining healthy relationships, see:
http://ywcagirlspace.ca/articles.php?subject=3

Unhealthy Relationships

Unhealthy relationships have the potential to harm one or both participants in the relationship and the relationship itself.  If a relationship does not reflect the qualities of a healthy relationship it may be unhealthy.  Other signs of an unhealthy relationship are:

• Threats, bribes, manipulation and/or coercion
• Self depreciation, constant apologizing
• Going against own values, boundaries, limits
• Obsessing over or about the other person
• Complete dependence on the other person
• Loss of autonomy
• Constant feelings of unease or stress
• Lack of negotiation
• Person cares for the other more than self
• Expectations of each other are unrealistic

Unhealthy relationships cause, or have the potential to cause, harm to either or both people in the relationship. Unhealthy relationships can lead to abusive relationships.

To learn more about healthy and unhealthy relationships, see:
http://www.sexualhealthcentresaskatoon.ca/par/relate.htm
http://sexualityandu.ca/sexual-health/how-do-i-know-i-am-ready-for-sex/healthy-relationships

Abusive Relationships

Abuse in a relationship happens when harm is inflicted.  All abusive relationships are unhealthy, but not all unhealthy relationships are abusive.  People of any sexual orientation, gender identity, biological sex, religion, race, socio-economic status, age or profession can be affected by abusive relationships and can be the perpetrator or victim of the abuse.  Abuse can occur in any type of relationship, but is often more serious in emotionally intimate relationships.

This harm may be:

• Emotional or psychological – threats, excessive criticism, humiliation, shouting, swearing, put downs, racist or sexist remarks, harassment or stalking, harm to pets.
• Physical – hitting, punching, biting, shoving, locking-up/confining, interfering with eating or sleeping, restricting mobility.
• Sexual – forcing sexual acts, committing or threatening sexual assault, other forms of abuse in retaliation for not engaging in sexual acts.
• Financial – controlling finances, interfering with ability to a make living, stealing, creating debt, destruction of property.
• Social – restrict access to activities, resources, friends, family or other supports.
• Spiritual – restricting religious practice, using religious practice to exploit or attacking spiritual belief.
• Neglect – if the relationship is one of dependence, the basic physical, emotional, and developmental needs of the dependent are not met by caregiver.

To learn more about types of abusive relationships, see:
http://www.sexualityandu.ca/health-care-professionals/types-of-abuse

Emotionally intimate, dating, domestic or family relationships that are abusive tend to follow the abuse cycle that looks something like:

As the cycle repeats, the intensity and harm caused by each incident becomes increasingly serious.

Sometimes we suspect that a client, friend, family member, colleague or someone else we know might be in an abusive relationship.  Some signs of abuse in others include:

• Personality changes such as becoming withdrawn, depressed, angry, fearful, over-cheerful.
• Behavior changes such as stopping going to regular activities, excessive apologizing, neglecting hygiene, making excuses for others.
• Physical marks or injuries, attempts at disguising injuries or implausible excuses for injuries.
• Disclosure of abuse or subtle hints at abuse.

To learn more about recognizing abuse in others, see:
http://connectnetwork.ca/does-someone-you-know-need-connect/

Practice note: It can be difficult for practitioners to accept that it may be safer for an individual to stay in an unhealthy relationship than to ask for help or leave. Some youth stay in unhealthy relationships out of fear, the need to have somewhere to stay or loneliness. Building relationships with youth provides them with a support when they are ready to choose to ask for help.

Choosing to be a support and not be a bystander can be the difference between an individual moving forward into a healthy life or staying in an abusive situation. It can be the difference between life and death. It often takes many attempts at intervention before victims or abusers are willing to acknowledge the situation and get help. The more people who do not address the concern, the longer it can take for both parties in the abusive relationship to recognize it as such.

If you are supporting someone experiencing abuse or are concerned about a relationship that is becoming abusive, see:
http://connectnetwork.ca/

It can be difficult to know how to raise a concern about abuse and how to be a support for someone involved in an abusive relationship.  Some ways of bringing up a concern of abuse with someone you know are:

• Simply asking if violence or abuse is part of their life – they may say yes or no, but the more times an individual is asked, the more opportunities that individual has to disclose when ready.
• Objectively noting your observations and saying that these are sometimes indicators of abuse.
• Handing out a card for an abuse support agency such as CONNECT and stating that it is a resource card you give to all clients.

Once someone has disclosed that they are involved in an abusive relationship, they can either choose to leave the relationship or stay in the relationship.  In either case, both victims and perpetrators can be supported in creating a safety plan and learning about the support services in their community.

If you are supporting someone experiencing abuse who is staying in the relationship, see:

http://help.endviolence.ca/staying-in-abusive-situations

If you are supporting someone experiencing abuse who is leaving the relationship, see:
http://help.endviolence.ca/leaving-abusive-situations

If you are supporting someone who perpetrates abuse, see:
http://community.ywcaofcalgary.com/Page.aspx?pid=339

Sexual Relationships

Many, but not all, sexual relationships happen in the context of an emotionally intimate relationship.  When this is the case, there tends to be progression of the relationship as both partners get to know the other person’s interests, values, beliefs and personalities through verbal and non-verbal communication.  This process can allow a couple to develop a thorough understanding and sincere affection for each other.  This type of relationship builds intimacy on different levels, often culminating in physical intimacy.

To learn more about relationship progression, see:
Teachingsexualhealth.ca relationship lesson plan (PDF)

Regardless of whether a sexual relationship is within the context of an emotional relationship or a sex-only relationship such as a “hook-up”, many of the basic components of a healthy relationship are needed to ensure the safety of both individuals and the overall health of the sexual relationship.

For a sexual relationship to be healthy, it needs to have:

• Legal consent of both partners.
• A clear understanding of the boundaries of the relationship from both partners.
• Communication before sexual intimacy about sexual history, sexual limits, sexual desires, likes, dislikes, STI protection and, if necessary, pregnancy protection.
• Access and use of STI protection and, if necessary,  pregnancy protection.
• Communication throughout sexual acts regarding limits, likes, dislikes.
• Safety and trust both emotionally and physically.
• Respect of limits and boundaries, including a “no” given at any time.
• Neither partner dependent on substances to engage in the sexual activity.
• Power equality between partners.

To learn more about “hook ups,” see:
http://sexualityandu.ca/uploads/files/CTR_FriendswithBenefits.pdf

For more information on how to talk to a sexual partner, see:
http://www.cfsh.ca/Your_Sexual_Health/How_to_Talk_about_Sex/With-Sexual-Partners

HOW TO TALK TO PARTNERS ABOUT CONDOM USE

For many people, discussing, accessing and using condoms are part of any sexual relationship. However, many individuals struggle with knowing and using the skills to have this conversation with partners, especially with partners reluctant to use a condom. Some people are embarrassed to initiate a sexual conversation, intimidated by partners, feel they need to comply in order to “keep” a partner (or the peace), or simply believe the excuse a partner gives.

Some clients may need support in recognizing that:

• Have sex…or not
• Set personal boundaries and limits
• Make sexual decisions sober
• Talk to a partner about limits and safety
• Protect each other with a condom and safer sex practices

There are some strategies that are useful when negotiating condom use or supporting others to negotiate condom use. Youth can:

• Set personal values and boundaries regarding condom use.
• Have a discussion about condom use before intimate activity begins…ideally long before it begins as one of the steps in getting to know each other and setting personal boundaries and limits.
• Be willing to initiate that conversation.
• Carry condoms to avoid the excuse “I don’t have a condom so we can’t use one”.
• Make sexual decisions when sober so that it is easier to consider and communicate values and limits.
• Bring out a condom and say “let’s use this” if sexual contact is imminent, and there has been no discussion about condoms.
• Be willing to walk away from the activity if a condom will not be used.
• Have comebacks or suggestions ready for the most common reasons why partners resist using condoms such as: 

I don’t have a condom: Don’t worry, I do

It takes away from the spontaneity: We can use the condom as part of foreplay

Condoms get in between us: If we don’t use a condom, there will be a great deal of space between us

It decreases my sensitivity: That means we can play longer

My penis is too big for condoms: This condom fits over my fist and down my arm…!

(adapted from: http://www.sexualityandu.ca/teens/sti-3.aspx)

For some youth, using latex condoms may negatively impact their sexual experience. For those individuals, there are alternatives that people can introduce during condom negotiation so that condoms can still be used.

For those allergic or sensitive to latex:

• Use a non-latex condom that is still tested to lower the risk of STI or HIV infection (lambskin or animal membrane condoms do not provide protection against STI or HIV transmission or lower protection against pregnancy)
• Use a female condom

For those who feel the condom is too small:

• Try different brands of condoms (this can be used if the whole condom or just the ring feels too tight)
• Use a non-latex condom (these retain body heat better than latex and may feel less restrictive)
• Use a female condom

Note: a loose fitting condom can result in a less secure fit and provide the potential for pregnancy and/or STI transmission.

For those who find that condoms decrease sensitivity:

• Recognize this may prolong sexual activity in a positive way
• Use a small drop of water or silicone based lubricant in the tip of the condom before applying it
• Try an ultra thin style of condom

• Care enough to use condoms
• No glove, no love
• You need the right equipment to play the game
• Protection for the erection
• Condoms don’t interrupt sex, they’re a part of it
• Don’t worry…be happy…use a condom

(adapted from the Sexual Health Access Alberta condom carrier insert)

For more information on how to talk to sexual partners about sex, see:
http://www.cfsh.ca/Your_Sexual_Health/How_to_Talk_about_Sex/With-Sexual-Partners
http://sexualityandu.ca/sexual-health/how-do-i-know-i-am-ready-for-sex/talking-to-your-partner-about-sex

Sex and the Law

Sexual assault is when an individual is kissed, sexually touched or forced to have intercourse without his/her consent.  This can occur between opposite sex individuals or same sex individuals and both males and females can be victims or perpetrators.  Sexual assaults can be committed by strangers, acquaintances, friends, dates, caregivers or spouses.

To know that a person has given consent, both partners need to voluntarily and verbally agree to the sexual activity prior to that activity happening.

Consent has NOT been obtained if:

• The sexual relationship violates age of consent laws.
• Consent was given by someone other than the person involved.
• A person is incapacitated by drugs or alcohol.
• Force or threats (explicit or implicit) are used.
• It is an incestuous relationship.
• Abuse of a position of authority, trust or power induces a person to engage in the act.
• A person expresses lack of agreement.*
• If during the act that a person has consented to, the person expresses a lack of agreement to continue.
• A person has not said yes.

* Lack of agreement can be in verbal or non-verbal form.  Verbal lack of agreement might be the words “no”, “uh, uh” or “stop”.  Non-verbal lack of agreement might be a shaken head, pushing away, lack of eye contact, limp body muscles, etc.

To learn more about sexual assault, see:
http://www.edmontonpolice.ca/CommunityPolicing/PersonalPropertyCrimes/SexualAssault/WhatisSexualAssault.aspx
http://aasas.ca/index.php/main/page/fact-2010-10-01-11-10-40
http://sexualityandu.ca/sexual-health/sex-and-the-law/sexual-assault

To learn more about what to do if someone tells you they have been sexually assaulted, see:
http://aasas.ca/index.php/main/page/faq-what-do-i-do-if-a-child-tells-me-about-being-sexually-abused-2010-11-02-08-11-04

In addition to consent as outlined above, there are laws in Canada regarding age of protection for minors in relation to sexual activity. This is called “age of consent”.

On May 1, 2008 the Tackling Violent Crime Act raised the legal age of sexual consent in Canada; it is the first time it has been raised since 1890.

When sexual activity involves exploitation such as prostitution, pornography or where there is a relationship of trust, authority or dependency, the age of consent is 18 years.

For other sexual activity ranging from sexual touching (such as kissing) to sexual intercourse, the age of consent was raised from 14 to 16.

There are “close-in-age exceptions” for example youth:

• 16-18 years old are able to consent EXCEPT when the partner is in position of authority (e.g., teacher, boss).
• 14-15 years old are able to consent IF close in age partner is not more than 5 years older (and partner is not in position of authority or exploitative relationship) OR they are in a married/preexisting common-law relationship.
• 12-13 years old are able to consent IF the partner is not more than 2 years older (and partner is not in position of authority or exploitative relationship).
• Children under 12 are unable to consent under any circumstance.

More information can be found on the Department of Justice, Frequently Asked Questions Website.

To learn more about age of consent, see:
http://sexualityandu.ca/uploads/files/CTR_AgeOfConsent.pdf

To learn more about sex and the law, see:
Sex and the Law in Canada (PDF)