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241 Cards in this Set

  • Front
  • Back
medical terminology, the developing human offspring from fertilization through birth
the prevention of conception altogether-sperm and egg are prevented from uniting
birth control
any means of preventing a birth from taking place-prevent a fertilized egg from implanting or removal of the fetus from the uterus
absence of genital contact that could lead to pregnancy
avoidance of all forms of sexual activity and, often, the religious commitment to not marry of to maintain a nonsexual lifestyle
oral contraceptives
a series of pills containing synthetic estrogen and/or progesterone that regulate egg production and the menstrual cycle-"the pill"
Abdominal pain (severe), Chest pain, Headaches (severe), Eye problems (blurred vision, spots, or change in shape of cornea), Severe leg pain
an injectable contraceptive injected four times a year under the skin
contraceptive patch
transdermal patch that releases synthetic estrogen and progestin to protect against pregnancy for one month
vaginal ring
a small flexible ring inserted high into the vagina once every 28 days, releases synthetic estrogen and progestin
no longer on the market
male condom
thin, soft, flexible sheath or latex rubber, polyurethane, or processed animal tissue that fits over the erect penis to prevent semen from being transmitted
nonoxyl-9 (N-9)
spermicide used on condoms, used as a back up to the condom, kills the sperm
female condom
disposable, soft, loose-fitting polyurethane sheath with a diaphragm-like ring at each end, designed to line the inner walls of the vagina to protect women against sperm
a rubber cup with a flexible rim that is placed deep inside the vagina, blocking the cervix, usually used with a spermicidal cream or jelly
number of times a woman has given birth
cervical cap
a small, soft, deep rubber barrier device that fits snugly over the cervix, held in place with a suction, prior to insertion it is filled one-third full with spermicidal cream or jelly
a round polyurethane shield measures about 2 inches in diameter and has a pouch that fits over the cycle, sponge is filled with N-9
a substance that is toxic to sperm
contraceptive foam
a chemical spermacide sold in aerosol containers
contraceptive film
a paper-thin tissue contains N-9 which dissolves into a sticky gel when inserted into the vagina, film place directly over the cervix at least 15 min. before intercourse
intrauterine device (IUD)
tiny plastic or copper device that is inserted into the uterus through the cervical os to prevent sperm from fertilizing the ova
a device or substance that causes an abortion
fertility awareness-based (FAB) methods
a family planning method that require substantial education, training and diligence. based on a woman's knowledge of her body's reproductive cycle (also known as the Natural Family Planning method)
calendar (rhythm) method
based on calculating the "safe" days, depends on the range of a woman's longest and shortest menstrual cycle, not practical for women with irregular cycles
basal body temperature (BMT) method
must record her temperature every morning upon waking for 6-12 months to gain an accurate idea of her temperature pattern, rise in temperature predicts when her cycle of ovulation will occur
ovulation method
determine their stage in the menstrual cycle by examining the mucus secretions of the cervix
symptothermal method
when two or more fertility indicators are used together
surgical intervention that makes the reproductive organs incapable of producing or delivering viable gametes (sperm and eggs), simpler safer and cheaper when performed on men
tubal ligations
"tying the tubes" either by laparoscopy or minilaparotomy, procedures are not reversible
most frequently used method, inflate woman's abdomen with gas to make the organs more visible, surgeon inserts a rodlike instrument with a viewing lens through a small incision and locates the fallopian tubes, the tubes are cauterized to seal them shut
minor surgical procedure that can be performed in a doctor's office under a local anesthetic, through an incision each vas deferens is lifted, cut, tied and often cauterized with electricity
Emergency Contraception (EC)
involves taking a large dose of the same hormones found in birth control pills (not an abortion pill, will not cause any damage if a pregnancy has already occured)
expulsion of the conceptus, can happen naturally or can be made to happen several ways
spontaneous abortions
also known as miscarriages, can happen for many reasons-woman suffered physical trauma, conceptus not properly developed, physical conditions within the uterus breakdown and end development
medical abortion
contains mifepristone and misoprostol. mifepristone prevents the cells of the uterine lining from getting the progesterone it needs to support a blastocyst, embryo cannot survive and is expelled from the uterus, can be taken up to 9 weeks into the pregnancy
the abortion pill, marketed as Mifeprex
Vacuum Aspiration (first trimester method)
performed under local anesthesia, first step=rinse vagina with antiseptic solution, second step=the cervix is dilated with a series of graduated rods, third step=a small tube attached to a vacuum is inserted through the cervix, fourth step=the conceptus, placenta and endometrial tissue is vacuumed out, can be performed up to 14 weeks' gestation, no evidence of childbearing problems
Dilation and Evacuation (second trimester method)
usually performed during the second trimester (weeks 13 to 20), local or general anesthesia is used, cervix is slowly dilated and the fetus is removed by alternating curettage and other procedures. somewhat riskier and often more traumatic than a first trimester abortion
a surgical method of abortion requires an incision in the woman's stomach, similar to a cesarean section, whereby the fetus is removed
the process by which the sperm's membrane becomes fragile enough to release enzymes from it's acrosome (the helmet like covering)
a fertilized zygote that has reached about 100 cells, after 4 to 5 days
when the blastocyst embeds itself in the soft, blood-rich uterine lining, takes about 1 week
blastocyst turns into this
an embryo is referred to as this after the eighth week of gestation
embryonic membranes
formed during the first 2 or 3 weeks of development, includes the amnion, amniotic fluid, yolk sac, and chorion
the amniotic sac, a membranous sac
amniotic fluid
fluid in the amniotic sac
yolk sac
producer of the embryo's first blood cells and the germ cells that will develop into gonads
the embryo's outermost membrane
a soft, downy hair that covers the fetus
nourishes the placenta by passing nutrients from the mother's bloodstream to the fetus, via the umbilical cord
umbilical cord
the tube through which the nutrients for the fetus travel
human chorionic gonadotropin (HCG)
a chemical secreted by the developing placenta, can be used as an indicator of pregnancy because it shows up in the urine
Hegar's sign
the softening of the uterus just above the cervix, can be felt during a vaginal examination to indicate pregnancy
substances that cause defects in developing embryos or fetuses
Fetal Alchol Syndrome (FAS)
a birth defect caused by chronic consumption of alcohol during pregnancy, symptons can include unusual facial features, small head and body size, congenital heart defects, defective joints, and intellectual and behavioral impairment
Fetal Alcohol Effect (FAE)
a birth defect caused by lower levels of alcohol consumption during pregnancy, symptoms include moderate intellectual and behavioral deficits that resemble FAS children but at a less severe level
ectopic pregnancy
also known as tubal pregnancy, occurs in about 1% of all pregnancies, fertilized egg grows outside the uterus, usually in the fallopian tube
growth of tissue outside the uterus
pregnancy-induced hypertension
previously referred to as toxemia or eclampsia, characterizd by high blood pressure and edema along with protein in the urine, occurs in less than 10% of all pregnancies
premature births
births that take place prior to 37 weeks of gestation
low-birth-weight infants
babies that weigh less than 2,500 grams, or 5.5 pounds at birth
delayed labor
pregnancies that go longer than 2 weeks after the expected delivery date
an examination that uses high-frequency sound waves to create a computer-generated picture of the internal structure of the fetus in the uterus
the picture result of the ultrasound
a test where amniotic fluid is withdrawn from the uterus using a long, thin needle, insertedd through the abdominal wall, the fluid is tested for birth defects, can cause a miscarriage
chorionic villus sampling (CVS)
a procedure that involves removal through the abdomen or the cervix of tiny pieces of membrane that encases the embryo, not as useful as amniocentesis but carries the same risk
Alpha-fetoprotein (AFP) screening
a test performed on the mother's blood at around 16-18 weeks of pregnancy, reveals defects of the spine, spinal cord, skull and brain
early pregnancy loss
the death of a fetus before 20 weeks
spontaneous loss of the fetus before it can survive on its own
sudden infant death syndrome (SIDS)
a perplexing phenomenon wherein an apparently healthy infant dies suddenly while sleeping, sleeping position may be one variable so AAP recommends placing infants on their backs for sleeping
the inability to conciece a child after a year of unprotected sex or the inability to carry a fetus to term
pelvic inflammatory disease (PID)
a infection of the fallopian tubes or uterus that is usually the result of an STI such as chlamydia
varicose vein above the testicle, impairs circulation to the testicle, causes an elevate scrotal temperature and intereferes with sperm development
artificial insemination(AI)
involves injecting the woman with sperm from her partner or a donor
assisted reproductive technology (ART)
surgical removal of the eggs from a woman's ovaries, combining them with sperm in the laboratory, and returning them to the woman's body or donating them to another woman
in vitro fertilization (IVF)
involves extracting a woman's eggs, fertilizing the eggs in the laboratory, and then transferring the resulting embryos into the woman's uterus through the cervix
gamete intrafallopian transfer (GIFT)
involves the use of a fiber-optic instrument to guide the transfer of unfertilized eggs and sperm (gametes) into the woman's fallopian tubes through small incisions in her abdomen
zygote intrafallopian transfer (ZIFT)
a woman's eggs are fertilized in the laboratory and then transferred to her fallopian tubes
is the reproduction of an individual from a single cell taken from a donor or parent
sex selection
marketed under the title "family balancing," allows couples to choose whether to have a boy or a girl
a hormone produced in the later months of pregnancy by the placenta, increases flexibility in the ligaments and joints of the pelvic area
Braxton-Hicks contractions
occasional uterine contractions in the last trimester that are strong but not painful, they exercise the uterus, preparing it for labor
the thinning of the cervix that begins with contractions
gradual opening of the cervix that begins with contractions
the first stage of labor, ends when the contractions become more intense and come quicker
the waxy substance covering a newborn baby
the expelling of the placenta, remaining section of the umbilical cord and the fetal membranes, completion of the third and final stage of labor
clinical name for the newborn
Apgar score
a score given an infant that rates the heart rate, respiration, skin color, reflexes and muscle tone, individually rated 0-2, infant needs a score of at least 8 to be healthy
a bloody discharge from the mother which continues for several weeks following the birth
a pain-killing drug continuously administered through a tiny catheter placed in the woman's lower back and numbs the body from the lower belly to the knees, child can receive the drug through the placenta which may reduce heart and respiration rates
an incision that enlarges the vaginal opening by cutting through the perineum toward the anus
Cesarean section or C-section
delivery of the baby through an incision in the mother's abdominal wall and uterus
Prepared childbirth
(natural childbirth) the practice of teaching both partners about childbirth and giving them physical exercises to ease muscle tension, women began rejecting anesthesia and taking a more active role in childbirth
sometimes as early as the second trimester, a yellowish liquid is secreted from the nipples, it's what nourishes the baby before the mother's milk comes in
postpartum period
three months following the birth, also known as the "fourth trimester", a time of physical and emotional adjustment
Family and Medical Leave Act (FMLA)
an act that assures eligible employees up to a total of 12 workweeks of unpaid leave for the birth and care of the newborn child
postpartum depression
occurs in 10-15% of new mothers and can have its onset any time in the first year postpartum, related to hormonal changes brought on by sleep deprivation, weaning, and the resumption of the mentrual cycle
postpartum psychosis
most serious and rarest postpartum mental illness, unlike the other disorders, postpartum psychosis is thought to be purely biologically based and related to hormonal changes, affected women tend to have difficulty sleeping, be prone to agitation and hyperactivity, and intermittently experience delusions, hallucinations, and paranoia
sexual health
a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity
eating disorders
compulsive overeating and compulsive overdieting and combinations thereof
anorexia nervosa
relentless pursuit of excessive thinness
characterized by episodes of uncontrolled, often secret, overeating, which the person then tries to counteract by purging--vomiting, fasting, excessive exercising or dieting, or using laxatives or diuretics
binge eating disorder
excessive overeating without any form of counteraction
anabolic steriods
a synthetic version of the hormone testosterone, used by body-builders and other athletes to enhance their strength and add bulk to their bodies
the phenomenon of activating behaviors that would normally be suppressed
substances that supposedly increase sexual desire or sexual function
the period of adjustment and gradual change before menopause, marked by the ovaries producing less and less estrogen and progesterone thus making ovulation irregular
natural menopause
the complete cessation of menstruation for at least one year, average age for this occurence is 51
hot flash
a period of intense warmth, flushing, and often perspiration, typically lasting for a minute or two, but ranging anywhere from 15 seconds to 1 hour in length
menopausal hormone therapy (MHT), aka hormone replacement therapy (HRT)
used to relieve the symptoms of menopause, involves the use of estrogen or a combo of estrogen with another hormone, progesterone or progestin in its synthetic form
benign prostatic hypertrophy (BPH)
an enlargement of the prostate gland, effects about half of men over 50 years of age
diabetes mellitus
chronic disease characterized by an excess of sugar in the blood and urine, due to a deficiency of insulin, a protein hormone
benign tumors
noncancerous, slow growing, and localized mass
malignant tumors
cancerous mass, does not remain localized, it invades nearby tissues and disrupts the normal functioning of vital organs
the process by which a disease spreads from one part of the body to another, unrelated
a clinical breast examination that screens the breast tissue for masses
fibrocystic disease
a common and generally harmless breast condition, not really a disease
a surgical procedure that involves the removal of only the breast lump and some normal tissue around it and is followed by several weeks of radiation treatment, also called breast conserving therapy
involves the removal of more of the breast tissue than with a lumpectomy and is usually followed by radiation therapy
cervical dysplasia also known as cervical intraepithelial neoplasia (CIN)
a condition of the cervical epithelium (covering membrane) that may lead to cancer if not treated
cervical cancer
an advanced and dangerous malignancy in the cervix
Pap Test, also known as a Pap Smear
a simple procedure that can not only detect cancer but also reveal changes in cells that make them precancerous, a pap test can warn against cancer even pefore it begins
a surgical removal of tissue for diagnosis
surgical removal of the uterus
the removal of one or more ovaries because of endometriosis, cysts, or tumors
prostate-specific antigen (PSA) test
a blood test used to help diagnose prostate cancer, although research shows that PSA misses some early prostate cancers
clitoridectomy, female circumcision, infibulation
types of female genital cutting
toxic shock syndrome (TSS)
an infection caused by the Staphylococcus aureus bacterium, tampons create an ideal culture medium for the overgrowth of this bacteria
one of the most common gynecological diseases, involves the growth of endometrial tissue outward into the organs surrounding the uterus
the inflammation of the prostate gland
sexual function dissatisfaction
another name for sexual dissatisfaction, a common outcome of a difficulty in sexual functioning
sexual dysfunctions (DSM-IV-TR)
disturbance in sexual desire and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty
Sexual Desire Disorders
Hypoactive sexual desire disorder and sexual aversion disorder
Sexual Arousal Disorders
Female sexual arousal disorder and male erectile disorder
Orgasmic Disorders
Female orgasmic disorder, male orgasmic disorder, and premature ejaculation
Sexual Pain Disorders
Dyspareunia and Vaginismus
Hypoactive Sexual Desire
the persistant or recurrent deficiency or lack of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty
Sexual Aversion Disorder
persistent and recurrent aversion to and avoidance of genital contact with a partner that causes marked distress
Female Sexual Arousal Disorder
persistent or recurring inability to attain or maintain the level of vaginal lubrication and swelling associated with sexual excitement, causing marked distress or interpersonal difficulty
Male Erectile Disorder or Erectile Dysfunction
persistent or recurring inability to attain or maintain an adequate erection until completion of sexual activity, causing marked distress or interpersonal difficulty
Persistant Sexual Arousal Syndrome (PSAS)
a sexual function problem not included in the DSM-IV-TR, sexual arousal that does not resolve in ordinary ways and continues for hours, days or even weeks
Female Orgasmic Disorder
persistent and recurrent absence of or delay in orgasm for women following normal sexual excitement
Male Orgasmic Disorder
persistent or recurrent delay in or absence of orgasm following a normal sexual excitement phase of Masters and Johnson's sexual response cycle that causes marked distress or interpersonal difficulty
Inhibited Ejaculation
when a man is unable to ejaculate no matter how long stimulation is maintained
Delayed Ejaculation
when the man is not able to ejaculate easily, it may take 40 minutes or more concentrated thrusting before ejaculation occurs
Premature Ejaculation
persistent and recurrent ejaculation with minimal sexual stimulation, before or shortly after penetration, that causes marked distress or interpersonal difficulty
persistent or recurrent genital pain, ranging from mild to severe, that is associated with intercourse and that causes marked distress or interpersonal difficulty
pain associated with sex that occurs during anal intercourse
persistent or recurrent involuntary spasm of the muscles of the outer third of the vagina that interferes with sexual intercourse and causes marked distress or interpersonal difficulties
Peyronie's Disease
a condition in which calcium deposits and tough fibrous tissue develop in the corpora cavernosa within the penis
prolonged, painful erection, ocurring when blood is unable to drain from the penis, lasting several hours to a few days
also known as P.C., the pelvic floor muscle surrounding the urethra and the vagina
when a person becomes a spectator of her or his own sexual performance
internalized homophobia
self-hatred because of one's homosexuality--a major source of conflict that can be traced to a conservative religous upbringing
sexual function enhancement
improving the quality of a sexual relationship, who may have normal sexual functioning and not need improvement
erotic aids/sex toys
products designed to enhance erotic responsiveness (eg: vibrators, dildos, clitoral stimulators, explicit videos, oils or lotions)
sex surrogates
part of Masters and Johnson's therapy team, whose role was to have sexual interactions with clients when no partner was available
sensate focus
focus on touch and the giving and recieving of pleasure
squeeze technique
(used to treat premature ejaculation) man is brought manually to a full erection, just before climax, he squeezes his penis with thumb and forefinger just below the corona, after 30 seconds of inactivity, the partner arouses him again and repeats the squeeze technique, the couple using this technique can continue 1-20 minutes before the man ejaculates
four progressive levels of sex therapy: Permission, Limited Information, Specific Suggestions, and Intense Therapy
number of new cases
total number of cases
ectoparasitic infestations
parasites that live on the outer skin surfaces
a bacterial infection characterized by unusual discharge, burning sensation with urination, unexplained vaginal bleeding between menstrual periods, pain and swelling of testicles
chlamydia-related inflammation of the epididymus, untreated can lead to infertility
gonorrhea ("The Clap")
a bacterial infection that thrives in warm moist environments: characterized by thick yellow or white vaginal discharge, itching or burning at the urethral opening, pain when urinating, severe lower abdominal pain
Urinary tract infections (NGU/NSU)
infections in the urethra characterized by a burning sensation when urinating, burning or itching around urethral opening, unusual discharge
genital ulcerative disease caused by a spirochete bacteria, Stage 1: Primary Syphilis, Stage 2: Secondary Syphilis, and Stage 3: Latency
a spiral-shaped bacterium
a round, painless sore (caused by syphilis)
Human papillomavirus (HPV)
genital infection, usually causes no symptoms, but some people experience genital warts, HPV can cause cervical cancer
genital warts
soft, moist, pink or flesh-colored swellings in the genital area, can be flat, single or multiple, small or large, and sometimes cauliflower shaped
herpes simplex virus (HSV)
type 1 and type 2, virus spreads from sores or outbreaks from the skin even when it does not appear to be broken or have a sore
a viral disease affecting the liver, most common types transmitted sexuality are A and B, C is primarily spread through contact with infected blood
often but not always sexually transmitted, three types are bacterial vaginosis, candidiasis, and trichomoniasis
bacterial vaginosis (BV)
bacterial infection caused by an overabundance of the bacteria Gardnerella vaginalis, a normal inhabitant of a healthy vagina
aka a "yeast infection", common fungal infection that occurs when there is an overgrowth of the fungus called Candida albicans
caused by a single-celled protozoan parasite, most common curable STI in young, sexually active women
a red, intensley itchy rash caused by the barely visible mite Sarcoptes scabiei
pubic lice
an infection of "crabs," move easily from one person to another, "crabs" can survive up t a day and lay eggs that hatch in about a week on clothing and bedding
bladder infection that affects mainly women, not transmitable, characterized by painful burning urination and a constant need to urinate
human immunodeficiency virus (HIV)
virus that causes AIDS
acquired immunodeficiency syndrome (AIDS)
HIV once the number of viral cells has reached a certain point
opportunistic infections (OIs)
a disease that takes advantage of a weakened immune system
Pneumocystis carinii pneumonia (PCP)
a type of pneumonia caused by a common organism that isn't usually harmful, an OI that kills AIDS patients
Kaposi's sarcoma
cancer of the blood vessels common in AIDS patients, causes red or purple blotches to appear under the skin
white blood cells, play major roles in defending the body against invading organisms
a type of white blood cell that engulfs a foreign particle and displays the invader's antigen
large molecules that are capable of stimulating the immune system and then reacting with the antibodies that are released to fight them
bind to antigens, inactivate them, and mark them for destruction by killer cells
a type of leukocyte, crucial to the immune system's functioning, types are B and T
B cells
T cells
helper T cells
programmed to "read" the antigens and then begin directing the immune system's response
killer T cells
purpose is to attack and obliterate the foreing body
a protein-coated package of genes that invades a cell and alters the way in which the cell reproduces itself
reverse transcriptase
an enzyme that allows the HIV virus to "write" its RNA into a cell's DNA
viruses with the ability to reverse the normal genetic writing process
the process by which a person developes antibodies
HIV negative if antibodies to HIV are not detected
the study of the incidence, process, distribution, and control of diseases
perinatal transmission
the passing of disease from mother to child in the womb
the statistical characteristics of populations
EIA (enzyme immunoassay)
standard test used to detect the presence of antibodies to HIV
Western blot
a confirmatory HIV test used after an EIA to make sure of a positive diagnosis
highly active antiretroviral therapy (HAART)
a regimen used to treat HIV which is made up of a combination of three or more medications
sexual harassment
two distinct types of behavior: (1)the abuse of power for sexual ends and (2) the creation of a hostile environment
hostile environment
an environment in which someone acts in sexual ways that interfere with a person's performance at school or in the workplace
an irrational or phobic fear of gay, lesbian, bisexual, and transgendered people
gay-bashing, queer-bashing
violence against people who are gay, lesbian, bisexual, or transgendered
sexual penetration against a person's will through the use or threat of force
sexual aggression
sexual activity, including petting, oral-genital sex, anal intercourse, and sexual intercourse, performed against a peron's will through the use of force, argument, pressure, alcohol or drugs, or authority
sexual coercion
broader term than "rape" and "sexual aggression," includes arguing, pleading, and cajoling as well as force and the threat of force
sexual assault
a term used by criminal justice system to describe forced sexual contact that does not necessarily include penile-vaginal intercourse, and so does not meet the legal definition of rape
date rape, acquaintance rape
sexual intercourse with a dating partner that occurs against the victim's will, with force or the threat of force
postrefusal sexual persistance
pursuit of sexual contact with a person after he or she has refused an initial advance
age of consent
the age at which a person is legally deemed capable of giving informed consent
statutory rape
consensual sex contact with a person younger than a state's age of consent
rape trauma syndrome
emotional changes undergone as a result of rape
posttraumatic stress disorder (PTSD)
a group of characteristic symptoms that follow an intensly distressing event outside a person's normal life experience
child sexual abuse
any sexual interaction (including fondling, sexual kissing, and oral sex, as well as vaginal or anal penetration) between an adult and a prepubescent child
extrafamilial abuse
sexual abuse by unrelated people
intrafamilial abuse
sexual abuse by biologically related people and step-relatives
nonpedophilic sexual abuse
an adult's sexual interaction with a child that is not sexually motivated (desire for power or affection)
sexual intercourse between people too closely related to legally marry (father-daughter, mother-son, brother sister)
sexual abuse trauma
four components: traumatic sexualization, betrayal, powerlessness, and stigmatization
sexually explicit material that can be evaluated positively
sexually explicit material that is generally evaluated negatively
implies a personal or societal judgment that something is offensive. Often, material depicting the use of violence and aggression or degrading and dehumanizing situations
sexually explicit material
material such as photographs, videos, films, magazines, and books whose primary themes, topics or depictions involve sexuality that may cause sexual arousal
femme porn
sexually explicit material catering to women and heterosexual couples (emotional intimacy, less male centered, avoids violence and more sensitive to women's erotic fantasies)
occurs when government, private groups, or individuals impose their moral or political values on others by suppressing words, ideas or images they deem offensive
the exchange of sexual behaviors such as intercourse, fellatio, anal intercourse, discipline and bondage, and obscene insults, for money and/or goods
peer delinquent subculture
an antisocial street subculture, is characterized by male and female prostitution, drug dealing, panhandling, theft, and violence
a man who has undergone breast augmentation
a word, gesture, or action that implies an offer of sex for sale
many definitions, any sexual behaviors between members of the other or the same sex that cannot result in procreation and sexual behaviors considered to be "homosexual acts"