Archive for ◊ September, 2010

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Situations arise right throughout life that we react to instantaneously and sometimes think later … ‘Why did I say that?’ Most of these reflex reactions have their origins in our own childhoods and show just how much the attitudes from our early training can stick.

One of the common dilemmas for parents comes up when they see their children handling their genitals and it can be hard to know how best to deal with it. Sure, some children are never seen doing this. On the other hand there’s the exceptional case where it seems to be an obsession, but for the most part self-exploration can be seen as a normal activity, even for babies. As they explore their bodies they discover that touching their genital area feels good. Unfortunately some parents don’t know how to handle the situation. I suppose calling it a ‘situation’ at all is probably blowing it out of proportion in the first place. Because of their own upbringing, their own fears and embarrassment, they may even see it as a punishable offence. Less than a century ago, parents sent their children to bed in metal mittens or strapped into straitjackets. They tied their legs together or wrapped them from the waist down in cold, wet sheets. Little boys’ penises were placed in spike-lined metal tubes to discourage erections and heavy punishments meted out for touching the goods. For decades children were threatened with, ‘Don’t touch, you’ll go blind or mad!’

No wonder we are left with a few hangups!

Spare a thought for all those poor young lads of previous generations who were told they needed glasses and blamed themselves because they believed the warnings. Now let’s think about the effects of punishing a child for the offence of touching their own genital area.

Melissa is thirty-five, and has two children. Although she felt loved and was close to her parents, she never felt comfortable talking to them about anything to do with sex.

One afternoon when her son James was about three, she found him lying face down on the floor with his hands underneath his groin. At first she thought he had fallen asleep, but he was rocking rhythmically back and forth and was quite hot and sweaty. It was then that she realized what he was doing.

Although looking back now she can’t explain her reaction, she felt immediately embarrassed and angry. Melissa picked him up off the floor, smacked his hand and said, a little too loudly, that only dirty boys did that sort of thing and that if anyone saw him doing it at kindy he wouldn’t be allowed to go back, and he wouldn’t see his friends anymore. Well, there were the predictable tears. How did it all look from James’ point of view? There he was, minding his own business and feeling pretty relaxed when suddenly he is wrenched up to his feet and Mummy is shouting at him that he’s done something very wrong, very naughty; but he can’t understand why. This doesn’t happen when he does anything else that feels nice. If this situation is repeated a few times, he learns, ‘This feeling makes Mum yell and hurt me so I won’t do it anymore. Well, not while she’s around anyway.’ Even though he may continue, he becomes anxious and furtive, and quite likely guilty about it.

Punishing boys for masturbation is rarely successful. The penis is right there, they have to hold it many times a day when they go to the toilet, it rises to greet the dawn, and it feels good when they touch or rub it. There’s no escaping its prominence in the life of any male. There’s an old joke that goes along the lines of  ‘ninety percent of men have masturbated and the other ten percent lie.’ Punishment doesn’t make the penis any less sensitive or any less interesting. What punishment achieves is furtiveness. ‘Let’s get this over with before I get sprung.’ Experts have linked this early ‘aversion therapy’ with later premature ejaculation and excessive sexual inhibitions.

With girls, you will most likely succeed in stopping them from touching their genitals. Hidden away from view and easy reach, a girl who is punished for touching her genitals is quite likely to stop. But what sort of triumph is this? Is it a Pyrrhic victory? Research has shown that women who never masturbated prior to having a sexual relationship have more difficulty with sexual responsiveness and orgasm with a partner.

If a child learns to link sexual pleasure with punishment, it leads to a logical thought progression. Thinking of a feeling of sexual pleasure as ‘wrong’ leads to a reaction of guilt whenever that sensation arises. That guilt shows itself as anxiety in sexual situations.

Let’s just think for a moment what would happen if we were just to ignore the whole thing. By the time they get to school age many children will masturbate quite regularly, but by this stage they have usually learnt through observation of other people that it is a private and personal matter, and will wait until they are on their own. Again, this is considered to be a normal part of a child’s development.

However, some children will need to have it spelt out with a distraction or a gentle reminder from time to time, if they continue to masturbate in public. By avoiding a big confrontation, they will escape that sense of anxiety or guilt that so many people have focused on their sexual organs, psychologically separating those parts from the rest of the body.

Sex therapists not only approve of masturbation as a normal activity, but use it as a form of therapy for sexual problems like premature ejaculation in men and failure to orgasm and sexual disinterest or inhibition in women.

On an even more serious level, if a child is trained to ignore their sexual organs, they don’t become familiar with what is normal for them. As adults, they will take longer to report sexual health problems and delay treatment.

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One of the first sexual decisions for boys is made for them at birth by their parents. Although it’s much less common these days, most parents still go through the motions of deciding whether to modify their sons’ sexual apparatus by circumcision. Boys are born with a hood of skin called the foreskin, covering the glans (knob) of the penis. Circumcision is a surgical procedure where this foreskin is cut off. Although there is no accepted medical reason to do it, parents have all sorts of motives for deciding to have this done. For followers of the Jewish faith, it is a non-negotiable issue. They see it as a physical mark of dedication to the service of God, and as such it is considered a religious rite rather than a medical procedure. As a family doctor I am occasionally asked for my opinion. Now aside from religious reasons, I tell parents ‘If it’s not broken, it doesn’t need fixing.’ In addition, the foreskin is loaded with sexual sensory nerve endings, so it is impossible to tell what difference that could make to his sex life.

Because the groundswell of medical opinion is now firmly against routine circumcision, some parents like to explain to me why they decided to go ahead with the operation; not that I think anyone needs to justify it after the fact. Some want their sons to look like their fathers, to have a set of matched penises in the family. Unfortunately, it’s going to be a long time before that little thing is going to look the slightest bit like Dad’s, and by then it’s not likely to be an issue. Some parents are worried that if the father is circumcized, he won’t know how to look after his boy’s foreskin, or teach him later how to maintain it himself. Certainly an uncircumcized penis does need a little more attention than a circumcized one, but it’s simple enough. In small boys, the foreskin is actually attached to the glans beneath. It can be tempting to pull the foreskin back before it’s ready, but this is not necessary. As a general rule of thumb, a foreskin is ready to be pulled back when a boy discovers he can do it himself. This usually happens by the time he is three or four years old. After that, he just needs to be taught to pull it right back and clean under it every day, just as you would teach him to wash behind his ears or brush his teeth. Of course there will be some foreskins that need to be removed at some stage because they are too tight or have become infected, but if we accepted that logic as a reason for routine circumcision, we would also take out everyone’s appendix and gall bladder at birth just in case something goes wrong there too.

You may have heard that recent evidence has suggested that the incidence of cancer of the penis, AIDS and urinary tract infection in males is slightly higher in the uncircumcized group. Taking a closer look, these findings are open to question, and the current opinion is that the results don’t justify recommending the operation.

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