Chapter 10

All adults should take a sane and scientific view of the sex problems that are likely to come even to normal children. We must remember that they are born with sexual mechanisms that may easily and automatically lead into harmful habits unless parents and teachers guide hygienically and mentally along the lines that are known to offer safety.

[Sidenote: Masturbation.]

Concerning habitual manipulation of the sexual organs of either sex, known in medical literature as masturbation or self-abuse (often erroneously called "onanism"), there are certain facts that are important for the guidance of all parents and teachers. I discuss it in this connection since the problem often arises in the later years of the pre-adolescent period.

[Sidenote: Does not indicate degeneracy.]

It is absurd to suppose that the tendency towards the habit means degeneracy or innate viciousness of children. Young horses, dogs, monkeys, and other animals sometimes form a similar habit, the stimulus being some irritation of the sexual organs. Hence, it is not at all unnatural when children attempt to relieve their irritated organs by friction, and then it is inevitable that the sensitive nerve endings will give sensations that are more or less pleasurable and satisfying, depending upon the sex, age, and emotional peculiarity of the individual child. This fact suggests to parents and teachers the methods of prophylaxis; namely, avoid (1) irritation of sexual organs and (2) opportunity for manipulation.

[Sidenote: Irritation.]

[Sidenote: Circumcision.]

With regard to irritation, the first sign of such disturbance may appear in babyhood. In the case of boys, whose structure renders them vastly more liable than girls to external irritation, the family physician should make sure during infancy whether circumcision or a stretching of the prepuce (foreskin) may be desirable. According to Dr. Emmet Holt, the eminent pediatrician, about one male baby in four or five is born with an elongated or tight prepuce that needs surgical attention. A corresponding abnormality of the clitoris is sometimes found in baby girls. Some radical surgeons advocate universal circumcision of boys because they believe that it reduces local irritation, favors cleanliness, tends to prevent masturbation, and reduces susceptibility to the venereal diseases. There is certainly some truth in these claims; but some conservative surgeons point out that for the great majority of boys all these advantages may be obtained by reasonable attention to hygienic habits, that orthodox Jewish and other circumcised boys are by no means free from harmful habits, that some boys are more irritable after circumcision, that preputial stretching is often a good substitute for circumcision, and that the taunts of other boys often make circumcised boys too conscious of their own mutilation. A scientific doctor who has no special financial interest in the increase of surgical operations and who carefully reviews both the radical and conservative literature relating to circumcision, will not hasten to submit boys to this operation until it is certain that their sexual organs happen to have congenital deformity that only radical surgical treatment can correct.

[Sidenote: Hygienic rules.]

In addition to making sure that uncleanliness or structural abnormality are not responsible for irritation of sex organs, there are some special hygienic rules useful for parents and teachers who have charge of children. Most important is avoidance of habit formation. Clothing should be well adjusted to avoid pressure and friction of the sexual organs, and so constructed (especially night clothing) that it is not convenient for the hands to reach the organs. Normal boys require pockets, but they should open at the waist-band and not at the side of the hips. The reason for these suggestions is evident. When we recall that little children naturally tend to explore themselves, such as by putting fingers into the mouth, feeling their toes, inserting foreign objects into nose and ears, and when we also recall how quickly a child may learn the habit of sucking its thumb, we must realize the importance of guarding the child from extending such activities to its sexual organs, which, because they possess the most sensitive nerve endings in the body, are most liable to lead to habitual manipulation. In the light of such facts, it is nonsense to assume, as so many good mothers have done, that only innately vicious children learn masturbation. The truth is that in the case of most children under twelve this habit has an origin no more vicious than such habits as thumb-sucking; and in all cases of habits, parents and others responsible for the children should be given the blame.

[Sidenote: Other suggestions for parents.]

The following suggestions in addition to those above are likely to help parents do much towards avoiding or solving the early sex problems of their children. These facts apply also to later years.

Have children sleep on a hard mattress. The old-time feather bed was dangerous. There should be light-weight covers, and the room cool. Children should sleep on either side, _rarely_ in the unnatural back position. Aim to have regular sleeping hours; but do not send children to bed unsupervised when they are excited and not tired enough for immediate sleep. Have them arise as soon as wide awake in the morning. Never punish children by sending them to bed.

[Sidenote: Dangers of privacy.]

Do not leave children to their own devices; they may naturally fall into dangerous play. Privacy is often demanded by the moods of adults, but it is dangerous for children. A certain camp for boys has the commendable rule that the boys have no privacy during the entire summer. Many educators and physicians condemn private bedrooms or cubicles in schools for boys.

[Sidenote: Athletics.]

A strenuous life of physical and mental activity is the best solution of personal control of sexual instincts. Reasonable athletics and study make an ideal combination for both boys and girls. And yet we must not trust absolutely to athletics or other physical work, for there are certainly many individuals whose sexual desires are not controlled by muscular exercise. Much of the formal athletic training may have no more influence on sexual control than dogmatic creeds.

[Sidenote: Drugs.]

Strong condiments and alcoholic drinks are known to be sexual excitants for many people, and for this and other hygienic reasons should be forbidden to children. There is a widespread, but still undemonstrated opinion that tea, coffee, tobacco, and strong condiments have an exciting effect. However, there is plenty of scientific authority, based on other hygienic grounds, for avoiding these at least during the years of growth.

[Sidenote: Constipation.]

Constipation is likely to cause sexual irritation, and hence this is an additional reason for submitting children to competent doctors for treatment of this disturbance which so seriously affects general health, especially by auto-intoxication.

[Sidenote: Bathing.]

Cool bathing in the morning, especially of the sexual organs, is hygienic, except for girls during the monthly periods (including two days before the expected menstrual onset). For various reasons, bathing in very warm water should be very limited, and then only for cleansing.

[Sidenote: Form of instruction.]

In hygienic instructions to children, avoid giving them any ideas concerning the supposed prevalence of the habit of masturbation. There is a dangerous tendency to follow the crowd. Also, the habit should never be described to children except as "unnecessary handling of the sex organs." It is dangerous to suggest to children, as certain books do, that there is any pleasurable sensation resulting from manual manipulation of the organs, for the force of suggestion or curiosity has led some children to experiment with themselves until they formed the habit.

[Sidenote: Symptoms.]

There are no absolutely certain signs or symptoms, and those suggested by certain authors, especially by quack doctors, make young people and even parents and teachers judge some individuals in an unfortunate way. Especially should parents and teachers remember that there is absolutely no scientific basis for supposing that great diffidence, indigestion, pimples on the face, boys' lack of interest in girls, and numerous other popular "signs," are indications of the masturbation habit. Like the symptoms in patent-medicine advertising, the above "signs" are so general that they are sure to fit some cases.

[Sidenote: Insanity.]

Do not tell children the ancient falsehood that insanity will surely result from handling the sexual organs. It is true that masturbation is a common habit of certain types of insane people and of some neurotics; but it is probable that the habit is more often one of several factors rather than the direct cause of the nervous breakdown. However, it is scientific to say that the habit may weaken the nervous system and indirectly affect general health, especially in pre-adolescent and early adolescent years. Probably the greatest nervous damage comes because there is often greater excess than is possible in natural sexual relations; the strain of all sexual excess is more in loss of nervous energy than of secretions. The safest advice one can give children is that the doctors agree that unnecessary touching of sexual organs has interfered with the health of many children and that those who avoid this are most likely to grow up strong in body and mind. This is the truth and practically the whole of the known truth that might have influence with young people.

[Sidenote: Mental habit.]

Mental masturbation or "day dreaming" concerning sexual functions is probably more harmful than mechanical manipulation. It is believed to be more common in young women than in men. However, there is little reliable evidence as to the prevalence of the habit. As an educational problem, there is nothing to be done beyond informing all adolescent young people that allowing their minds to dwell on sexual affairs may interfere with nervous health, scholarship, and future efficiency in life. Hard mental and physical work and strenuous play as a daily routine will avoid or solve most such difficulties of young people.

[Sidenote: Not hopeless.]

In all dealing with this problem of young people, we must beware of overemphasis or exaggeration. Parents and teachers should do all possible to prevent and cure the habit; but there is still hope for most young people who, in spite of warning, occasionally lapse into their old habits. Both men and women of this type have led their classes through college and won success afterwards. Probably they would have done still better if entirely free from the habit. On the other hand, men and women of neurotic inheritance combined with the habit have suffered nervous collapse during college years; and it is scientific to assume that the additional nervous strain produced by masturbation was a contributing factor. Evidently, we dare make no definite prophecy as to what will happen to one who in early life forms the habit of masturbation. There is no excuse for excessive alarm in any ordinary case; but, as we have seen, there are good reasons why parents and teachers should calmly and yet firmly help young people avoid unnatural sexual activity.

To those who must consider the problem of masturbation in boarding schools, I recommend Hime's "Schoolboys' Special Immorality."

FOOTNOTES:

[13] See books on nature-study, _e.g._, Holtz's "Nature-Study," Hodge's "Nature-Study and Life," Comstock's "Handbook of Nature-Study." Morley's "Renewal of Life," March's "Towards Racial Health," and Hall's "The Doctor's Daughter" suggest the main lines of the nature-study approach to sex-education.

VII

SEX-INSTRUCTION FOR EARLY ADOLESCENT YEARS

§ 27. _The Biological Foundations_

In discussing instruction for the pre-adolescent years I have stressed biological nature-study as important for the purpose of giving general knowledge of how new living things come into the world. This will develop a good attitude concerning the origin of the individual human life. In this lecture I wish to direct attention to the scientific facts which are foundations for the sexual knowledge that is important for other phases of sex-instruction during early or late adolescence.

[Sidenote: Biological foundations.]

I believe that the best introduction to advanced sex-instruction is through biological ideas which may be presented in popular lectures and books; but, of course, will be best taught in courses of biological science. My own view as to the selection of materials for such biological studies is expressed in the sections on reproduction connected with the account of each animal or plant type in the "Applied Biology" and in the last chapter of the "Introduction to Biology."[14] In these books the study of life-histories of plants and animals leads up through vertebrates to mammals, and there are a few remarks suggesting that human development is like the mammals.[15] At this point these books should be supplemented by a brief survey of the essential structure, physiology, and embryology of human reproduction.

[Sidenote: Mixed classes.]

Biological studies of human reproduction should not be coeducational in high schools or the early years of college. Mature college students who have passed through extensive biological studies, may, without apparent embarrassment, study human embryology in mixed classes; but after experience with many such groups I have begun to think that separate classes are desirable if the course is made to include all the important facts that college graduates should know concerning human reproduction. At any rate, there should be special lessons or reading dealing with detailed information that directly concerns one sex only.

[Sidenote: Impersonal approach of biology.]

I certainly do not believe in completely revamping biological science for the purposes of sex-education. It is better not to "spoil" a course by overemphasis on sex, for much of the value of biology as a basis for sex-education is the fact that sex appears gradually and naturally and far away from human relations. This impersonal approach will be lost if the course in biology seems to revolve around sex-education, for that will make sex too prominent.

It is still debatable as to how much should be taught in high schools or in public lectures concerning the biological facts of human reproduction. I think that I can make my own views clearer if I discuss this first for boys, then for girls.

§ 28. _Scientific Facts for Boys_

First, it is generally agreed that boys of high-school age may profit by learning their own sexual structure by means of diagrams such as the one in Hall's "Sexual Hygiene." There is no harm, and also no gain, in minute description, especially histological.

[Sidenote: Scientific names.]

The chief technical names of the parts of the male organs--testicle (spermary or testes), sperm duct (vas deferens), scrotum, prostate, seminal vesicles, penis, glans, prepuce (foreskin), urethra--should be taught; and the scientific dignity of these words as substitutes for vulgar words should be emphasized. In dealing with boys and young men I have noticed that these and other scientific words have a great influence on their attitude. The scientific names of the sex organs should be made part of popular vocabulary for the reason that there are no established common names corresponding to lungs, liver, stomach, arm, leg, brain, and so on for all prominent organs except the sexual. These have been left without authoritative names except in scientific language, and as a result dozens of ordinary words have been vulgarly applied and unprintable ones invented by uneducated people. Such usage of vulgar terminology is widespread, especially among men and boys. An editor of schoolbooks recently called my attention to the necessity of changing some ordinary words in certain books because in some localities the boys applied the words to sexual organs. Even the little words "nuts," "stones," "balls" accompanied by the adjective "two" mean testicles in the widespread vulgar language; and a physician told me that a college graduate used one of these words the other day when seeking medical advice concerning her baby. Here is an intolerable situation that must be improved by establishing in popular usage the dignified scientific words for the chief sexual organs. We must begin to do so by teaching the words frankly to boys of adolescent years, and by persuading parents to teach their children correctly.

[Sidenote: Sex-physiology.]

Having learned the structure and names of their sexual organs, boys may easily understand the function of each part if explained in simple language. Ten or twenty minutes ought to be enough time for stating the important facts. One printed page could state them clearly. Here is the time for personal hygienic advice, especially such topics as: rules for self-control; harmful habits (see discussion of masturbation in § 26); sexual activity not necessary for health; occasional nocturnal emissions not pathological.[16]

[Sidenote: Female organs.]

I believe it is well for boys of adolescent years to know a few leading facts regarding female structure and function, but such knowledge is best learned from oral description by a well-balanced teacher. Diagrams and (in some schools) a demonstrated dissection of a cat or other animal will be helpful. The meaning of the ovaries as sources of the egg-cells and of the uterus as the place for development of the fertilized egg-cell should be explained in a serious way that will help boys get some fundamental ideas as to what motherhood means Boys, moreover, should be informed concerning the existence of the periodic disturbance in the other sex, for unless they know they are sure at times to misunderstand their sisters and other girls. Professor W.S. Hall has stated the essential information in "Chums" (for boys twelve to sixteen), but his comparison of periodicity in the two sexes is not strictly accurate, for there are not in men any sexual cycles that are strictly comparable with the menstrual cycles of women.

[Sidenote: No pictures.]

It is probably best, as urged by several writers, that the life-like illustrations, some of them photographic, in books of human anatomy be kept away from boys of early adolescent age. Diagrams can be made to explain all that is necessary, and without the danger of stimulation that might come from the illustrated medical books.

[Sidenote: Embryology.]

The embryological facts of human biology are very impressive to boys and young men who know little of science. I believe that no other line of scientific facts is so likely to claim a serious and respectful attitude. The ideal way for giving a popular glimpse at human development is with a small series of lantern slides or photographs from embryological works. Unfortunately, there is no available popular treatment of the main facts of human development, but teachers trained in biology can easily glean the facts for the preparation of a short lecture.

[Sidenote: Social diseases.]

Since the venereal diseases are due to micro-organisms, I believe that they should be introduced in connection with the study of bacteria and other germs, either in school courses or in popular lectures. Such instruction should be very brief.

§ 29. _Scientific Facts for Girls_

[Sidenote: Girls more innocent.]

I discussed first the problem of selecting scientific facts for boys because there is little dispute as to the advisability of giving them as much scientific information as may possibly replace the vulgar knowledge that the average boy is likely to possess. I know that there are a few men and many women who will disagree with this because they believe in the absolute ignorance of their boys; but I doubt whether one healthy adolescent boy in a hundred belongs in the "innocent" class. So we need not worry much concerning any supposed danger of treating facts too frankly, provided that they are given a dignified, scientific setting. In the case of numerous adolescent girls there is certainly dense ignorance, and so there must be more difficulty in getting approval of parents and teachers concerning facts proposed for girls. Often when talking with groups of parents I have heard them say that they would like to have their boys learn the scientific truth regarding certain facts, but they feel that it would be too startling and unnecessary for their daughters. Such is the widespread feeling which must be seriously considered in all planning of advanced sex-instruction for girls. No doubt there will be much honest disagreement with the suggestions here offered.

The biological introduction based on plants and animals should be the same as for boys (§ 27).

[Sidenote: Structure and names.]

An adolescent girl of fourteen to sixteen should know the general plan of her own sexual structure. She should know the scientific names of her organs, not because there are many vulgar names as in the case of boys, but because dignified names help attitude. Ovaries, uterus (womb), vagina, Fallopian tubes, and vulva will be sufficient. Detailed description of the external organs (vulva) might arouse curiosity that leads to exploration and irritation, and hence many women physicians think that a girl under sixteen or possibly eighteen needs only the name vulva for the external parts surrounding the entrance to the vagina.

[Sidenote: An ancient belief.]

Some books for girls perpetuate the ancient but absurd emphasis on the virginal significance of the hymen; and a recent book from a prominent publisher goes so far as to try to frighten girls into remaining chaste by stating that a physician could discover if they have been unchaste. This is far from being always true, for the structure may be congenitally absent, may sometimes remain after sexual union, or may be accidentally destroyed in childhood; and reliable physicians have stated that proving unchastity by the hymen is by no means easy. Hence, the less said about the ancient belief, the better for young women. The truth is that the hymen is a worse-than-useless relic of embryological development, and it is neither an indicator nor a dictator of morality.

[Sidenote: Physiology of women.]

With regard to the physiology of the female organs, the following topics should be considered: The meaning of puberty as the beginning of a long fertile period of about thirty years; the nature of menstruation as a periodical process preparing the lining of the uterus for reception and attachment of an embryo if a sperm-cell meets a liberated egg-cell near an ovary, and not as a season of illness invented by the powers of darkness; the possibility of fertilization following sexual relations at any time during the fertile life of a woman; the essential facts of sexual relation as a method of depositing sperm-cells so that they can swim on the way to meet an egg-cell; and the nature of the close blood relationship of mother and embryo. These are physiological topics which many parents would like to have taught to their daughters of fourteen to eighteen by some careful woman or by some good book.

[Sidenote: Social ills.]

With regard to the social diseases and the social evil, I have long sympathized with the conservatives who hold that extremely limited knowledge is sufficient for the average girl under eighteen or twenty. No doubt that many working girls in cities need more protective knowledge than do school girls of the same age. Hall's "Life Problems" seems to me to give the important facts.

[Sidenote: Habits.]