Sexuality Concepts
for Social Workers
Brent Satterly
Widener University
Contents
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Chapter 1
Circles of Sexuality and Social Work
The Circle of Reproduction and Sexual Health: The Blue Light Special
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11
13
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19
18
Case Questions
19
Closing Thoughts
20
References20
Credits21
Chapter 2
ValuesLearning and Thinking About Sexuality
23
Introduction23
Values Related to Sensuality: Body Image
27
Practice Implications
30
Processing Questions
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32
35
Processing Questions
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Practice Implications
37
Processing Questions
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Closing Thoughts
48
References49
QR Web-Links
53
Credits53
Chapter 3
The Intersection of Cultures, Sexuality,
and Social Work Practice
Quick Review
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Foundations56
Cultures and Cultures
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58
Sexological Worldview
60
61
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Case Example
63
Questions to Consider
64
64
References66
Special Topic: Intersectionality of Being Queer, Latino, Young, and HIV-Positive
General Tips for Students Working with Queer, Latin@, and/or HIV-Positive Clients
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Credits72
Chapter 4
Special Topics Related to Sexual Health and
Reproduction: Hormonal Influences on Behavior,
Infertility, and Adoptee Rights
Premenstrual Syndrome (PMS)
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Discussion Questions
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References81
Special Topic: Infertility
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Discussion Questions
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Discussion Questions
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Sensate Focus
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Clinical Decision-Making
94
Factors to Consider
95
Discussion96
General Tips for Students Working with Clients Experiencing Infertility
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Infertility: References
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101
Adoptee Rights
103
Mothers Rights
104
Fathers Rights
105
107
Final Thoughts
Adoption Policy and Activism Organizations
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References109
QR Web Links
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Credits111
Chapter 5
RelationshipsLove, Attachment, and Intimacy
Passionate vs. Compassionate Love
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A Focus on Intimacy
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Fear of Intimacy
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References129
QR Web-Links
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Credits133
Chapter 6
Sexual Orientation
135
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Sexual Orientation
136
Oppression137
Homophobia137
Heterosexism
137
Bi-negativity137
Orientation-Behavior-Identity138
The Kinsey Scale
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Practice Implications
146
Oppression in Practice
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Bisexual Clients
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Processing Questions
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References157
QR Web-Links
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Credits
163
Chapter 7
Gender and Gender Identity
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Practice Implications
180
Transgender Clients
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Case Example
183
Practice Questions
184
References184
QR Web-Links
188
Credits
188
Chapter 8
Sexuality and the Lifespan
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The Effects of Media Portrayals of Ideal Body Type on Older Adult Body Satisfaction
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Institutional Role
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Credits
210
Chapter 9
Special Topic: Sex Work and Social Work Practice
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References222
QR Web-Links
223
Credits
223
Chapter 10A
SexualizationYouth225
Introduction225
Healthy Forms of Early Sexual Expression
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Stigmatization
251
Powerlessness
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Processing Questions
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QR Web-Links
255
Credits255
Chapter 10B
SexualizationAdulthood257
Intimate Relationship Violence
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Micro/Mezzo Interventions
263
Macro Interventions
264
Practice Implications
Date Rape and Sexual Assault Prevention
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Policy Implications
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Conclusion272
References272
QR Web-Links
279
Credits
279
Chapter 11
Special Topics: Illness, Disability, and Sexuality
Sexual Health Education Needs of Cancer Patients
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References284
Special Topic: An Overview of Sexuality and Disability
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Caregiver-Assisted Sexuality
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Books293
Movies294
Websites
295
295
References295
QR Web-Links
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298
Executive Functioning
299
300
Conclusion302
Suggestions for Students and Implications for Practice
303
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Helpful Referrals
303
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Quick Tips for Working with Individuals with Brain Injury about their Sexuality
304
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References306
QR Web-Links
307
Credits307
Chapter 12
Being a Sexually Healthy Adult and Sex Positive
Social Worker
309
309
310
313
313
References314
Dr. Ingersolls Rant: On People Who Express to Me Their Disbelief in the Existence of
True Love and What I Think Being Sex Positive Is All About
315
QR Web-Links
318
Credits318
Biography
Dr. Travis Sky Ingersoll, Ph.D., MSW, M.Ed., is a social work professor, sexuality educator, and researcher based outside of Philadelphia, Pennsylvania, USA. His research publications include crosscultural studies regarding the fear of intimacy, the psychological well-being of older adults, gender
roles, suicidal ideation, and implementing clinical interventions for residents of elderly communities.
Current research projects and interests include the role of male involvement in domestic violence
agencies, sexual communication, and collaborative cross-cultural projects focusing on a wide range
of topics related to human sexuality. As a sexuality educator, Dr. Ingersoll has provided semesterlong classes, guest-lectured, and facilitated interactive workshops in person and via distance-learning
technologies both domestically and internationally. Presentation topics have included: Sexuality
Concepts for Social Workers, Cross-Cultural Sexuality, Sexual Health, Sex Throughout the Lifespan,
Sexually Transmitted Infections, Sexual Orientation, Intimate Relationship Violence, Medias Role
in the Promotion of Sexual Violence Among Men, Trans-Realities and the Gender Spectrum, How
to Utilize the Fear of Intimacy and Fear of Intimacy with Helping Professionals Scales in Clinical
Settings, Clinical Social Work Skills, and Producing Sexuality Scholarship in a Multitasking World.
In addition to teaching and research, Dr. Ingersoll has developed anti-homophobia curriculum and
sexuality policies for retirement communities and assisted-living facilities.
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Acknowledgements
First and foremost, I want to acknowledge and thank my wife, partner, and best friend Melinda
Massaro Ingersoll. We met at the beginning of our undergraduate education and have stuck together through all the ups, downs, spirals, and brick walls that life has thrown at us. In the middle
of May, 2014, I almost lost my life to a tumor growing on top of my brain stem. Mindy was my
guardian, asking the right questions, making the right calls, and getting me exactly what I needed
to have the best chance at surviving. Without her spirited loyalty and love, it would be very unlikely
that these words would ever be read. Thank you sweets! Im forever in your debt!
Thank you Mom Ingersoll! Thank you brother! Love you! To the rest of my friends, I wouldnt
be the person Ive grown into without your care, love, and encouragement. Thank you Brent
Satterly, Don Dyson, Bill Stayton, Paula Silver, Jon Poulin, Jon Chatfield, Curry (and the Malott
family), David and Cherly Vermillya, Jill Norvilitis, Jia Shua, Shan Xu, Melanie Swain, Heather
Witt, Candy Brink, Courtney Weaver, Timaree Schmitt, Jill Brinker, Dr. Heiman, Dr. MacLean,
and everyone who has ever taught me anything, extended a helping hand, given me support, and
believed in me. You all know who you are! You are awesome! Youll always remain a part of me .
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Acknowledgements
I would like to thank my husband and partner in life, love, and scholarship, Dr. Don Dyson. Your
caring, brilliance, patience, and sheer joy in the discovery of knowledge are inspiring. Thank you
for reminding me of the important things. I Tuesday.
Thank you to my co-author, Dr. Travis Ingersoll, whose sheer enthusiasm about writing is
infectious! Thank you, Dad. Your ability to tell a tale of wisdom and love continues to inspire
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me. Thank you, Mom. Your love and pride are so easy to feel! And thank you to so many more
of my colleagues, family, friends, and mentors: Paula Silver, John Poulin, Bill Stayton, Konnie
McCaffree, Ryda Rose, eryc Mallinger-Noonan, Scott Mallinger, Amelia Hamarman, Samantha
Sherman, Justin Sitron, and Bob Keenan. And to my students you continue to teach and inspire
me everyday.
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In a study on the provision of training in human sexuality in medical schools across the
USA, Wittenberg and Gerber (2009) discovered that despite medical students valuing sexual
health as part of the curriculum, they did not feel adequately prepared to tackle the subject
with their patients because the time allotted for sexual health education was limited (Wylie
& Weerakoo, 2011).
Historically, social work education has included minimal attention to three essential foci: (1)
disability; (2) sexuality; and (3) the intersection of disability and sexuality (Ballan, 2008). As
noted by Glasgow (1981), the intersection of sexuality and disability has received almost no
attention in social work education. There has been insufficient change in the 25 years that
followed this initial observation (Ballan, 2008).
Low numbers of professional preparation programs incorporate content on human sexuality or sexual diversity within social work curricula (Diaz & Kelly, 1991).
Although social workers are educated to address a continuum of sensitive topics, discussions
regarding sexuality and sexual behaviors are all but absent in the literature and in practice
(Stawgate-Kanefsky, 2000), rendering social workers inadequately prepared to address sexual
issues in their many professional roles (Speziale, 1997).
Clients expect social workers to understand issues of intimacy and sexuality and to provide
guidance in these areas (Boyle, 1993).
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There is a great need for social workers to obtain knowledge and develop skills to help persons with and without disabilities in the area of sexuality education and counseling (Boyle,
1993; Mary, 2007).
Rogers, McRee, and Arntz (2009) conducted a study examining factors among university
students that may be associated with homophobic attitudes and whether homophobia
may be reduced by educational interventions. Their results suggest that the knowledgebased curriculum of sexuality courses may play an important role in affecting broader
attitudes about sexuality among college students, including attitudes about homosexuality. Students who took human sexuality courses were found to be more tolerant of homosexuality and were less likely to subscribe to homophobic statements or sentiments.
The results from a study of 41 schools of nursing in the UK indicated that the provision
of training in human sexuality in nursing curricula is inadequate to meet the current varied
needs of patients. On average, a mere 6.8 hours out of a potential 2,300 hours of theoretical
learning is dedicated to teaching human sexuality in schools of health in the UK. The overall
provision of training in human sexuality in the nursing curricula does not seem to have
significantly improved, regardless of pleas from such esteemed bodies as the World Health
Organization and others (Astbury-Ward, 2011)
Referring to a study of Australian schools of social work, it was found that whereas most
social work courses allocate curriculum space for examination of gender and life-cycle stages,
such is not the case for sexuality (Roberts, 1986).
In a 2015 exploratory study, McKay (2015) surveyed faculty teaching in Masters of Social
Work (MSW) programs regarding current sexuality-related curricula, their attitudes toward
the inclusion of sexuality education, and their perception of the supports and barriers to
incorporating sexuality-related content into MSW curricula. The sample for this quantitative
study included 596 social work faculty participants through an online survey. Findings revealed that a majority of faculty (82%) agreed that sexuality education is important for MSW
curriculum. Only 1.3% of faculty reported that there was a current required human sexuality
course within their MSW program. Faculty also rated the importance of 23 sexuality-related
topics and whether they teach the topic. In each case, the rating of a sexuality-related topic
as important did not necessarily correspond to that topic actually being taught.
References
Astbury-Ward, E. (2011). A questionnaire survey of the provision of training in human sexuality in schools
of nursing in the UK. Sexual and Relationship Therapy, 26(3), 254270.
Ballan, M. S. (2008). Disability and sexuality within social work education in the USA and Canada: The social
model of disability as a lens for practice. Social Work Education, 27(2), 194202.
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Boyle, P. S. (1993). Training in sexuality and disability: Preparing social workers to provide services to individuals with disabilities. Journal of Social Work and Human Sexuality, 8(2), 4562.
Diaz, Y., & Kelly, J. (1991). AIDS-related training in US schools of social work. Social Work, 36(1), 3842.
Glasgow, M. (1981). Human sexuality education for clinical social workers. Social Casework, 62(8), 480485.
Mary, N. L. (2007). An approach to learning about social work with people with disabilities. Journal of Social
Work in Disability & Rehabilitation, 6(1/2). 122.
McKay, K. (2015). Sexuality Education within Masters of Social Work Programs (Unpublished doctoral dissertation). Widener University, Chester, PA.
Roberts, R. (1986). Results of a survey of Australian schools of social work on the teaching of human
sexuality in their undergraduate programmes. Australian Social Work, 39(3), 2428.
Rogers, A., McRee, N., & Arntz, D. L. (2009). Using a college human sexuality course to combat homophobia. Sex Education, 9(3), 211225.
Speziale, B. (1997). Introducing sexual diversity into social work education: A humanistic group approach.
Journal of Teaching in Social Work, 15(1/2), 5161.
Strawgate-Kanefsky, L. (2000). A national survey of clinical social workers knowledge, attitudes, and practice regarding
sexuality. New York, NY: New York University.
Wittenberg, A., & Gerber, J. (2009). Recommendations for improving sexual health curricula in medical
schools: Results from a two-arm study collecting data from patients and medical students. Journal of
Sexual Medicine, 6(2), 362368.
Wylie, K., & Weerakoo, P. (2011). International perspective on teaching human sexuality. Academic
Psychiatry, 34, 397402.
Why Sexuality Education Training is Necessary for Social Work and Other
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QR CODES
If you look around carefully, youll begin to notice how QR (quick response) codes are popping
up over the place. They show up on billboards; on storefront signs; in magazines, newspapers,
and print ads; and even in the form of ceramic tiles on gravestones. QR codes look and work
similar to bar codes, but instead of rectangular stacks of lines of various widths theyre square
boxes of pixilation. QR codes are able to hold a lot more information than bar codes, and they
can be used to save messages; provide answers to questions; or link a reader to a document,
website, or video clip. If you have a smartphone or a tablet computer, you can easily scan a
QR code.
QR codes are placed throughout this textbook. As you read through the text, make sure to scan
the QR codes that have been purposely placed to show you additional information regarding the
topic you are reading about. Some codes bring you to PDFs of relevant research and publications,
some bring you to videos and clips related to the topic, and others link you to websites full of
useful resources. If you dont have the ability to scan any of the QR codes found throughout this
book, the websites linked to the codes will be available at the end of every chapter.
Step 1
Search for QR code reader in an App store of your choice. Most are named something like QR
Reader or QR Scanner. When you find a QR Reader App you like (most are free), download
and install it. There are paid versions, but the free ones work just as well.
Step 2
Open the QR reader app on your smartphone or tablet and choose scan QR code or scan from
camera from the main menu. When your device is ready to scan, a framed window will appear.
Sometimes the viewer window will have a red line to help you center on the QR code youre trying
to scan.
Step 3
Once the center of the QR code is in the middle of the square on your screen (and when you can
keep still), the app should automatically take a picture of the code when it has finished scanning it.
The screen will then display the information contained in the QR code.
Step 4
If the QR code brings you to a web link, click on it to be brought to a website. However, many QR
codes will automatically bring you to a website, video clip, or document. The QR code could also
have photos or a message embedded in it. Now youre ready to scan QR codes. Enjoy!
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