8: Reproductive Health - Part 1

Transcription

1 8: Reprductive Health - Part 1 Purpse: T identify the majr structures and functins f the male and female reprductive systems in preparatin fr later understanding and discussin f STDs, HIV, and teen pregnancy with peers. Stages f Change Prcess: Getting infrmatin Learning Objectives: By the end f this sessin, Native STAND members will be able t: 1. Identify the majr structures and functins f parts f the male and female reprductive systems. 2. Explain the physical changes that ccur during puberty. 3. Cite the phases f a wman s menstrual cycle. 4. Describe recmmended male and female hygiene practices. Supplies/Materials: Chart paper, markers, masking tape Resurces/Handuts: RM PM HO Wrds f Wisdm What D Ya Knw? Quiz Male & Female Reprductive Systems Big Changes: Stages f Adlescent Develpment The Menstrual Cycle When a Wman Has Her Mn Duching FAQs I Didn t Knw That! - Male Reprductive Health Issues Answers t What D Ya Knw? Quiz Preparatin: Yu will need a secnd rm and THINKING AHEAD: Grade quizzes fr Sessin 9 Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1 1

2 1. Welcme/Overview 3-5 minutes, large grup lecture, adult r teen c-facilitatr Review Sessin 7: Healthy Relatinships - Part 1. Answer any questins in the Questin Bx. Read tday s WOW. There are many paths t a meaningful sense f the natural wrld. Blackft Intrduce tday s sessin In this sessin and the next, we will be lking at reprductive health issues. Fr sme this will be a review, fr thers it will be a learning pprtunity. Remind them that n ne has all the answers and it s never wrng t ask if they have a questin abut smething, there s prbably smene else in the rm that has the same questin. If they are t embarrassed t ask it, they can always put a questin in the Questin Bx. We ll have fun as always but it s imprtant t be respectful and nt make crude r crass cmments as we g thrugh the sessin. T ensure that students can maximize the learning pprtunities in tday s sessin, we will d this sessin separately fr the bys and the girls. The exact same infrmatin will be cvered, but we will d them separately t make sure everyne is cmfrtable and can get their questins answered withut embarrassmen. Break the students int tw grups by sex. Nte: If there are transgendered students in the grup, encurage them t g with the grup that they wuld be mst cmfrtable with. 2. What D Ya Knw? Quiz minutes, individual wrk, adult facilitatr Refer students t What D Ya Knw in the PM. Ask them t put their names n the papers s that yu can return them t the right persn next sessin. Give them a fixed amunt f time t cmplete the quiz (e.g. 5-7 minutes) and tell them t answer as many questins as they can in that time. Cllect quizzes they will be used again in Sessin 9. What D Ya Knw?? 1. Ovaries prduce eggs. T F 2. Men and wmen bth have urethras. T F 3. Babies grw in a wman s vagina. T F 4. Wmen shuld begin t get Pap Smears three years after they becme sexually active r at 21 years f age. T F 5. A Pap Smear checks fr STDs. T F 6. Duching is a recmmended way t maintain hygiene. T F 7. Sme untreated STDs can scar the fallpian tubes and cause infertility. T F 8. The average age wmen begin t menstruate is 16. T F 9. Cervical cancer is assciated with an STD. T F 10. Sme birth defects and disabilities can be prevented. T F 11. Overweight and bese wmen are at increased risk fr pr reprductive health and pregnancy cmplicatins. T F 12. Wmen wh smke are at an increased risk fr reprductive health prblems. T F 13. Sex during pregnancy isn t safe. T F 14. Drug and alchl use can increase yur chances f getting an STD r pregnant. T F 15. Wmen wh are pregnant shuld nt drink alchl. T F 16. Oil-based lubricants shuld be used with cndms. T F 17. Peple wh dn t want t get pregnant shuld use prtectin against pregnancy and STDs every time they have sex. T F 18. Girls get sexual urges that are just as strng as thse that bys get. T F 19. The average size f an erect penis is between 7 and 10 inches. T F 20. A penis reaches its full size at arund age 16. T F 2 Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1

3 What D Ya Knw?? 1. Ovaries prduce eggs. 2. Men and wmen bth have urethras. 3. Babies grw in a wman s vagina. 4. Wmen shuld begin t get Pap Smears three years after they becme sexually active r at 21 years f age. 5. A Pap Smear checks fr STDs. 6. Duching is a recmmended way t maintain hygiene. 7. Sme untreated STDs can scar the fallpian tubes and cause infertility. 8. The average age wmen begin t menstruate is Cervical cancer is assciated with an STD. 10. Sme birth defects and disabilities can be prevented. 11. Overweight and bese wmen are at increased risk fr pr reprductive health and pregnancy cmplicatins. 12. Wmen wh smke are at an increased risk fr reprductive health prblems. 13. Sex during pregnancy isn t safe. 14. Drug and alchl use can increase yur chances f getting an STD r pregnant. 15. Wmen wh are pregnant shuld nt drink alchl. 16. Oil-based lubricants shuld be used with cndms. 17. Peple wh dn t want t get pregnant shuld use prtectin against pregnancy and STDs every time they have sex. 18. Girls get sexual urges that are just as strng as thse that bys get. 19. The average size f an erect penis is between 7 and 10 inches. 20. A penis reaches its full size at arund age 16. Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1 3

4 3. Whatchamacallit minutes, large grup, adult r teen c-facilitatr Intrduce activity by acknwledging that even thugh everybdy has genitals, peple ften feel embarrassed r giggly talking abut them. Ask the students t call ut sme cmmnly used ( street r slang ) names they may have heard fr genital structures, including the penis, vagina, breasts, and testicles. (If the students are reluctant t say cmmnly used names alud, yu may need t start the list yurself.) As the students thrw ut terms, repeat them alud t acknwledge their existence. Once the students start running ut f terms, ask them t call ut cmmnly used names fr ther bdy parts, like the elbw, ft, r ear. Ask the students why they think there are s many cmmnly used names fr bdy parts related t sex, but nne fr nnsexual bdy parts. Pint ut that sex and reprductin are emtinally charged and ften held secret in ur sciety, and these are sme reasns why there are s many cmmnly used, r slang, names. Let the students knw that in Native STAND we will use the prper names fr bdy parts s that everyne understands what we are talking abut. 4. Learning the Parts 2, minutes, large grup discussin, adult facilitatr Refer students t the handuts f the Male and Female Reprductive Systems in the PM. Ask the students t fllw alng as yu describe the different parts f the systems and their functins. On the diagram f the male external genitals: Describe these cmpnents: Shaft allws fr sexual stimulatin and sex Scrtum cntains testicles Freskin cvers the glans f the penis (if nt circumcised) Glans head f the penis Opening f urethra urine and semen leave the bdy thrugh this pening Pint ut that sme males are circumcised and sme are uncircumcised. Circumcisin is remval f the freskin, and it is usually perfrmed shrtly after birth. Let the students knw that males can be healthy and nrmal, whether r nt they are circumcised. Mentin als that mst males have ne testicle that hangs lwer than the ther. Freskin Male External Genitals Shaft Scrtum Glans Opening f Urethra 1 Adapted frm Big Decisins curriculum, available at: 2 Adapted frm Guide t Implementing TAP (Teens fr AIDS Preventin): A Peer Educatin Prgram t Prevent HIV/STD Infectin. Washingtn, DC: Advcates fr Yuth, Adapted frm Big Decisin curriculum, available at: 4 Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1

5 On the diagram f the male internal reprductive system: Describe these cmpnents: Male Internal Reprductive System Bladder hlds urine Urethra urine and semen leave bdy Bladder thrugh this pathway Seminal Vesicles makes fluid fr semen Seminal Vesicle Urethra Prstate Gland makes fluid fr semen Prstate Gland Vas Deferens pathway fr sperm Vas Deferens Epididymis sperm mature and travel Epididymis thrugh this rgan Testicle Testicles prduce sperm and male hrmnes Trace the path that sperm take frm the testes, thrugh the epididymis and vas deferens, ver and behind the bladder, thrugh the prstate gland, int the urethra, thrugh the penis and ut the tip f the penis with ejaculatin. On the diagram f the female external genitals: Describe these cmpnents: Female External Genitals Clitris sensitive bump that allws fr sexual stimulatin Labia Minra small lips, prtect vaginal Labia Majra area Clitris Opening f Urethra Labia Majra large lips, prtect vaginal Labia Minra Vaginal Opening area Opening f urethra urine leaves bdy Anus thrugh this pening Opening f vagina allws fr birth, menstrual flw, and sex Anus feces leaves bdy thrugh this pening Pint ut the pening f the vagina, and let the class knw that sme females have a hymen, i.e., tissue arund the pening. This is the tissue that is smetimes called a cherry. Fr many females, this tissue is stretched r brken when they first have vaginal sex, and they can have sme bleeding r pain. Sme females have very little hymeneal tissue, and have n bleeding r pain when they first have vaginal sex. On the diagram f the female internal reprductive system: Describe these cmpnents: Fallpian Tube pathway fr egg, where Female Internal Reprductive System fertilizatin ccurs Vagina allws fr birth, menstrual flw, sex Fallpian Tube Ovary Uterus fetus grws inside Uterus Ovary prduce eggs and female hrmnes Cervix pening t uterus, dilates in labr, Cervix Vagina where a Pap Smear is dne Trace the path that the egg takes frm the vary, thrugh the Fallpian tube, int the uterus. Then, if it has nt been fertilized (in the tube), the egg ges with the menstrual bld flw thrugh the cervix, and thrugh the vagina t the utside f the bdy. If the egg is fertilized, this happens shrtly Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1 5

6 after vulatin (when the egg is released frm the vary). Fertilizatin f the egg by the sperm ccurs in the Fallpian tube. The fertilized egg takes abut a week t travel t the uterus, and then it implants in the uterine lining t begin a pregnancy. If fertilizatin and implantatin are successful, the female will usually nt have menstrual bleeding. This missed r late menstrual perid is ne f the symptms f early pregnancy. Lead a discussin: D yu think males generally feel mre cmfrtable than females abut their genitals? If s, why d yu think this is? (Pssible answer might include): Males can see their genitals and are taught t tuch and handle their penis t urinate. Females cannt easily see their genitals and are ften discuraged frm tuching them. Why is it imprtant t feel cmfrtable tuching yur wn genitals? (Pssible answer might include): Genitals are surces f ertic pleasure and masturbatin is a risk-free way f expressing and experiencing ne s sexuality. Males need t tuch their testicles t feel fr lumps that might be a sign f testicular cancer Wmen wh use tampns must tuch their genitals. Fr bth sexes, sme methds f cntraceptin require tuching the genitals. It s always imprtant fr teens t knw hw their bdies functin and hw they can stay healthy Why is it imprtant fr teens t understand exactly hw and when cnceptin ccurs? (Pssible answer might include): Knwing exactly hw and when cnceptin ccurs is necessary s that teens knw hw t prevent pregnancy, by abstaining frm vaginal intercurse r by using effective cntraceptin. 5. Big Changes: Stages f Adlescent Develpment minutes, large grup discussin, adult facilitatr Ask fr a vlunteer t define the term puberty. (The respnse may be: When bys and girls experience physical changes as they mve frm childhd int adulthd.) Ask the grup what specific physical changes ccur during puberty. Write the answers n chart paper. (Answers may include: acne/breakuts, breasts grw, testicles and penis grw, bdy hair starts t grw, bys vices change, yu start t sweat mre, bdy dr starts, girls start their menstrual perids, sexual urges may begin, girls hips grw and their waists frm.) Direct students t Big Changes: Stages in Adlescent Develpment 4 in the PM. Read thrugh the table n the next page and ask them t fllw alng. Emphasize that everyne experiences these changes differently and there is n right r wrng way t develp int an adult. Big Changes: Stages f Adlescent Develpment 1 Stage Bys Girls 1 N sexual develpment N sexual develpment 2 Testicles enlarge arund age 9 Bdy dr begins Penis begins grwing Pubic hair starts grwing arund age 12 Wet dreams ( ncturnal emissins ) begin Vice deepens begins arund age 13 Penis and testicles cntinue t grw Penis and scrtum deepen in clr Pubic hair becmes curlier and carser Grwth spurt begins arund age 14 Breast develpment begins Penis reaches full size arund age Pubic hair extends t inner thighs arund age 16 Height spurt tapers ff Fully mature male 1 Adapted frm Puberty Infrmatin fr Parents and Kids, Breasts begin grwing may start as early as 8 yrs ld Bdy dr begins Pubic hair starts t grw arund age 9-10 Grwth spurt begins between ages 9-14, av. age 12 Breasts keep grwing Pubic hair darkens Vaginal discharge begins Menstruatin begins usually 2 years after puberty starts can be as early as 9 r as late as 15 average age is 12.5 Pubic hair extends t inner thighs arund age 14 Height spurt tapers ff Breasts are fully develped between yrs ld Fully mature female 4 Adapted frm Puberty Infrmatin fr Parents and Kids, 6 Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1

7 Big Changes: Stages f Adlescent Develpment 1 Stage Bys Girls 1 N sexual develpment 2 Testicles enlarge arund age 9 Bdy dr begins Penis begins grwing Pubic hair starts grwing arund age 12 Wet dreams ( ncturnal emissins ) begin Vice deepens beginning arund age 13 Penis and testicles cntinue t grw Penis and scrtum deepen in clr Pubic hair becmes curlier and carser Grwth spurt begins arund age 14 Breast develpment begins Penis reaches full size arund age Pubic hair extends t inner thighs arund age 16 Height spurt tapers ff Fully mature male N sexual develpment Breasts begin grwing, may start as early as 8 yrs ld Bdy dr begins Pubic hair starts t grw arund age 9-10 Grwth spurt begins between ages 9-14, average age 12 Breasts keep grwing Pubic hair darkens Vaginal discharge begins Menstruatin begins usually 2 years after puberty starts can be as early as 9 r as late as 15 average age is 12.5 Pubic hair extends t inner thighs arund age 14 Height spurt tapers ff Breasts are fully develped between yrs ld Fully mature female 1 Adapted frm Puberty Infrmatin fr Parents and Kids, Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1 7

8 6. It s That Time f the Mnth... Again! minutes, large grup discussin, adult facilitatr Explain that a wman s menstrual cycle is a very basic human physical prcess, and that withut it nne f us wuld be here. A wman s mnthly cycle is what allws her t becme pregnant (r nt). Ask: Why is it imprtant fr a wman t understand her menstrual cycle? S she can knw when her mst fertile times f the mnth are t avid r attempt a pregnancy S she can knw whether her cycles are regular r nt Is it imprtant fr men t understand hw a wman s menstrual cycle wrks? Why r why nt? Yes, because men are als respnsible fr aviding an unplanned pregnancy Why is it imprtant fr a wman t keep track f when her perids start? S she can knw when her cycle began and estimate her mst fertile days s she can be extra careful t avid pregnancy during that time. Refer students t The Menstrual Cycle 5 in the PM. Have them fllw alng as yu describe the menstrual cycle: Mst wmen have a menstrual cycle that last an average f 28 days. The first day f her cycle is the day her perid begins. The bld that cmes ut is actually the lining f her uterus. A wman s uterus builds up the lining anticipating a fertilized egg. Since n fertilized egg happened, the bdy sheds the lining. Half-way thrugh her cycle, hrmnal changes cause her vary t release an egg. An unfertilized egg nly lives up t 24 hurs after it is released frm the vary. (Hwever, sperm cells can live as lng as five days in the female reprductive tract. S if sperm are present as the egg travels frm the vary thrugh the fallpian tube, fertilizatin can ccur.) In the meantime, hrmnal changes cause the uterine lining t begin t build up again. If the egg is fertilized, hrmne levels cntinue t rise and the uterine lining becmes even thicker. The fertilized egg may becme implanted in the uterine. If s, the uterine lining des nt shed, and the pregnant wman's menstrual perid des nt begin. She is pregnant. If fertilizatin des nt ccur, hrmne levels fall, the uterine lining sheds, and menstrual bleeding begins again. Ask: What happens the first day f a wman s menstrual cycle? Arund hw many days after her perid des a wman s fertile perid begin? (Remind students that every wman is different and these are just apprximatins.) Arund hw many days des a wman s fertile time last? 5 Surce: Family Health Internatinal, 8 Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1

9 Once a wman s fertile perid has passed, is it safe t have sex withut prtectin? Why r why nt? 7. When a Wman Has Her Mn 5-7 minutes, large grup discussin, adult facilitatr Intrduce tpic by stating that in many cultures there are strng beliefs, custms, and practices abut menstruating wmen. In sme cultures, menstruating wmen are seen as having a lt f pwer, in thers they may be seen as unclean. Because f these beliefs, in sme cultures, wmen live in separate quarters while they menstruate, they may nt be able t interact with ther peple, r they may nt be able t prepare fd. Refer students t When a Wman Has Her Mn in the PM. Read the passage t the students r have them read it silently t themselves. When a Wman Has Her Mn Peple will say that a wman wh is having her mn shuld stay away frm the ceremnies because she culd ruin them, but they dn t understand r knw why this is. It is because a wman is the nly ne wh can bring a child int this wrld. It is the mst sacred and pwerful f all mysteries. Certainly the man must be there t plant the seed, but his part is simple and relatively unimprtant. When a wman is having her time, her bld is flwing, and this bld is full f mysterius pwers that are related t childbearing. At this time she is particularly pwerful. T bring a child int this wrld is the mst pwerful thing in creatin. A man s pwer is nthing cmpared t this, and he can d nthing cmpared t it. We respect that pwer. If a wman shuld cme int cntact with the things that a man prays with (pipe, rattles, medicine bjects) during this time it will drain all the male pwers away frm them. Yu see, a wman s pwer and a man s are ppsites nt in a bad way, but in a gd way. Because f the pwer a wman has during this time it is best that, ut f respect fr her men and fr their medicine things, she stay away frm them. In the past they wuld build a little ldge fr her, and their ther female relatives wuld serve n her needs. She wuld get a rest frm all f her chres. It was nt a negative thing like peple think nw. S yu see, we did this ut f respect fr this great mystery, ut f respect fr the special pwers f wmen. Jseph Rckby Yanktn/Sicangu Dakta Surce: Fitzgerald J & Fitzgerald MO. (eds) The Spirit f Indian Wmen. Wrld Wisdm, Inc., 2005 When a Wmen Has Her Mn Peple will say that a wman wh is having her mn shuld stay away frm the ceremnies because she culd ruin them, but they dn t understand r knw why this is. It is because a wman is the nly ne wh can bring a child int this wrld. It is the mst sacred and pwerful f all mysteries. Certainly the man must be there t plant the seed, but his part is simple and relatively unimprtant. When a wman is having her time, her bld is flwing, and this bld is full f mysterius pwers that are related t childbearing. At this time she is particularly pwerful. T bring a child int this wrld is the mst pwerful thing in creatin. A man s pwer is nthing cmpared t this, and he can d nthing cmpared t it. We respect that pwer. If a wman shuld cme int cntact with the things that a man prays with (pipe, rattles, medicine bjects) during this time it will drain all the male pwers away frm them. Yu see, a wman s pwer and a man s are ppsites nt in a bad way, but in a gd way. Because f the pwer a wman has during this time it is best that, ut f respect fr her men and fr their medicine things, she stay away frm them. In the past they wuld build a little ldge fr her, and their ther female relatives wuld serve her needs. She wuld get a rest frm all f her chres. It was nt a negative thing like peple think nw. S yu see, we did this ut f respect fr this great mystery, ut f respect fr the special pwers f wmen. Ask: What are yur cmmunity s beliefs abut menstruating wmen? Are there particular stries yur tribe tells abut them? Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1 9

10 8. The Truth Abut Feminine Hygiene 5-7 minutes, large grup discussin, adult facilitatr Explain that many peple especially teens whse bdies are changing s quickly wrry abut sweat and smells cming frm their underarms. Girls and wmen smetimes wrry abut vaginal drs. Shwering and bathing n a regular basis, using mild sap and warm water, shuld be effective in keeping underarms and genital areas clean as well. Dedrants are a gd idea fr underarm areas fr males and females. Many prducts like duches, feminine sprays, dedrants, r wipes are marketed t suppsedly keep a wman's vaginal area smelling fresh and clean. Duching (the name cmes frm the French wrd "t wash") refers t washing ut the vagina, usually with a prepackaged mix f fluids. Unless a dctr tells yu t, yu never need t duche. Duching can Duching FAQs Q: What is duching? A: The wrd duche means t sak r wash in French. Duching is washing r cleaning ut the vagina with water r ther mixtures f fluids. Usually duches are pre-packaged mixes f water and vinegar, baking sda, r idine. Wmen can buy these prducts at drug and grcery stres. The mixtures usually cme in a bttle and can be squirted int the vagina thrugh a tube r nzzle. Q: Why d wmen duche? A: Wmen duche because they mistakenly believe it gives many benefits. In reality, duching may d mre harm than gd. Cmmn reasns wmen give fr using duches include: T clean the vagina T rinse away bld after mnthly menstruatin T get rid f drs frm the vagina T avid STDs T prevent pregnancy Q: Hw cmmn is duching? A: Duching is cmmn amng wmen in the U.S. It is estimated that 20-40% f American wmen aged 15 t 44 duche regularly. Abut half these wmen duche every week. Q: Is duching safe? A: Mst dctrs and the American Cllege f Obstetricians and Gyneclgists (ACOG) suggest that wmen d nt duche. All healthy vaginas cntain sme bacteria and ther rganisms called the vaginal flra. The nrmal acidity f the vagina keeps the amunt f bacteria dwn. But duching can change this delicate balance. This may make a wman mre prne t vaginal infectins. Plus, duching can spread existing vaginal infectins up int the uterus, fallpian tubes, and varies. Q: What are the dangers linked t duching? A: Research shws that wmen wh duche regularly have mre health prblems than wmen wh d nt. Health prblems linked t duching include: Vaginal irritatin Vaginal infectins (called bacterial vaginsis r BV) STDs Pelvic inflammatry disease (PID) PID is an infectin f a wman s uterus, fallpian tubes and/r varies. It is caused by bacteria that travel frm a wman s vagina and cervix up int her reprductive rgans. If left untreated, PID can cause fertility prblems (difficulties getting pregnant). PID als increases a wman s chances f an ectpic pregnancy (a pregnancy that ccurs in the fallpian tube instead f the uterus). cause allergic reactins, irritatin, and even infectins in the vagina. Feminine sprays and dedrants aren't a gd idea either. They are ften heavily perfumed and like duching can lead t allergic reactins, irritatin, and infectins. The vagina has its wn natural cleaning system that flushes ut bacteria, s yu dn't need t add any chemicals t help it. Fr mre infrmatin, refer students t Duching FAQs in the PM. 9. I Didn t Knw That! Male Reprductive Issues minutes, individual, large grup, adult facilitatr Refer students t I Didn t Knw That! - Male Reprductive Health Issues the PM. Ask them t read the handut individually. Ask vlunteers t share ne piece f infrmatin that they did nt knw befre reading the handut. 10. Clsing 3-5 minutes, large grup lecture, adult c-facilitatr Answer any questins. Preview next sessin: Reprductive Health Part 2 Direct the students attentin t the WOW. Ask a vlunteer t read the wrds and t share with the grup what thse wrds mean t him r her and hw they relate t tday s sessin and activities. Adjurn. I Didn t Knw That! : Male Reprductive Health Issues Des size really matter? Many bys wrry abut the size and shape f their penis. Is it t small? T big? T thin? Des it hang straight? Or des it curve slightly t ne side? Yet penises cme in all shapes and sizes and all are very different. The average length f a penis when it is flaccid (nt erect) is arund 3 t 4 inches whereas when it is hard it is arund 5 t 7 inches. Hwever, yur penis size can depend n many things like the weather, yur bdy shape, pubic hair and even ethnicity. Yur penis als desn t stp grwing until yu reach the ages f 18 t 21, s dn t fret yet if yu feel yurs is t small. What is a penis? The penis is made up f a shaft, the glans (head/helmet) and the prepuce (freskin). Yu pee thrugh the urethra, which is a tube that passes thrugh the penis and carries bth urine frm the bladder and semen frm the testicles. If yu have been circumcised then yu wn t have a freskin. This is surgically remved at a yung age fr cultural and religius reasns. Freskin When a by is brn he has an uncircumcised penis. This means his penis has a freskin that cvers the head (glans) f the penis. In the U.S., many parents chse t have the freskin remved within a few f days f the baby s birth, which is called circumcisin. Other parents leave the freskin intact. Whether r nt a child is circumcised is a matter f the parents persnal preference and beliefs, and smetimes is because f religius r cultural practices. If a man is uncircumcised, the freskin shuld be gently pulled back t expse the tip f the penis, which shuld then be washed with mild sap and water. Washing the penis daily this way is imprtant because during puberty and beynd, dead skin cells and an il-like substance called sebum can accumulate under the freskin frming a substance called smegma. Smegma can build up and cause infectins r harden if nt washed away n a regular basis. A man with a circumcised penis shuld als wash his penis with mild sap and water daily. Erectins Mst bys start t experience erectins when they reach puberty. They happen when yu get sexually arused and extra bld flws t the penis. This causes the penis t swell and grw large and hard. Smetimes erectins are referred t as a hard-n r a bner, althugh there aren t actually any bnes in the penis! 10 Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1

11 NOTES Native STAND Facilitatr s Manual - Sessin 8: Reprductive Health - Part 1 11

12