What it does mean, however, is that you have certain rights. If you have a question or problem during office hours, by all means, go ahead and call; you may not always get the doctor, but you’ll get somebody who can help.

And if you have a problem that you don’t think can wait until morning, call at night. Most doctors have 24-hour answering services; many doctors have partners who share “on-call” time—they split it up, each taking a certain number of nights, weekends and holidays a year. They do this because they expect to get some calls at night, because they know from years of training and experience that medical emergencies don’t always happen during office hours.

This won’t be the first phone call your doctor gets in the middle of the night, and it certainly won’t be the last. What would you rather do—wind up in the hospital as a result of a serious complication that should have been treated hours ago, or “bother your doctor?”

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Exercise is another crucial factor in helping to avert blood clots. Walking is good; it pumps blood back to the heart. Walk as soon as you’re allowed to after surgery. Your doctor probably will encourage you to do dorsiflexion exercises —pumping your feet up and down to exercise the calf muscles. Do them often, about 100 times an hour in between naps. Also, it’s a good idea not to sit upright in a firm chair (with your legs hanging down) for more than an hour at a time during the first four weeks. Try to sit with your legs elevated on a sofa, reclining chair, or comfortable chair with a footstool, as much as possible. This accomplishes two goals: One, because it raises your feet, it improves the blood flow from the veins in your legs. Two, it protects the area of surgery from bearing your full weight.

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The exceptions just mentioned consist of the percentage with premarital coitus very early in postpubertal life. By age twelve nearly 11 per cent, a relatively moderate proportion, had had coitus. By age fourteen some 14 per cent—the next smallest proportion on record-were thus experienced. Thereafter by any age the homosexual offenders vs. adults display the smallest percentages. As a dramatic example, by age twenty less than half had had coitus, in contrast to nearly three quarters of the control group and nine tenths of the prison group.

These offenders had, in general, fewer individuals than any other group having premarital coitus with companions within any five-year age-period. They are at the bottom of every rank-order, except between puberty and fifteen when they are second from the bottom. From age sixteen on, only one third to two fifths of these men had premarital coitus with companions in any age-period.

Of all the groups, the homosexual offenders vs. adults had the smallest proportions of men who had premarital coitus with prostitutes during any age-period after age fifteen; only between one fifth and one quarter were thus involved in age-periods 16-20 and 21-25, and thereafter the proportions decline to about 16 per cent. During this same period the equivalent figures for the control group were between two fifths and one half.

Similarly, fewer homosexual offenders vs. adults than any other group ever had premarital coitus with female prostitutes (37 per cent). The three homosexual groups and the control group occupy four of the last five positions in this rank-order. In the lifetime accumulative incidence table the percentage of individuals with experience by a given age, the homosexual offenders vs. adults invariably display the lowest figures. By age twenty-six, when even 62 per cent of the relatively restrained control group had had coitus with prostitutes, the figure for the homosexual offenders vs. adults is only 36 per cent.

As one would anticipate, the homosexual offenders vs. adults have the lowest frequencies of premarital coitus with companions in any age-period. The average (median) frequencies vary from 0.09 to 0.22 per week among those having such coitus.

Among those who had premarital coitus with prostitutes, the frequency was low; the average (median) individual displayed frequencies of from 0.08 to 0.12 (i.e., 4 to 6 times per year), which are ordinarily far less than those of the control group.

Confining attention to only those individuals with coital experience and calculating the median number of premarital partners, the homosexual offenders vs. adults are seen to have had the second fewest companions (five) and the fewest prostitutes (also five).

In keeping with the minimal frequencies, the proportion of total outlet derived from premarital coitus with companions is the smallest of any recorded. In several instances the percentages are half (or less) that of the nearest group, and never exceed 5 per cent. This is an impressively small figure when one recalls that most groups were deriving 25 per cent or more of their total orgasms in this way. Among these unmarried homosexual offenders vs. adults the difference between the number of orgasms obtained from coitus with companions and the number that occurred during sleep is often small; indeed, in age-period 21-25 each source contributed 4 per cent to the total.

It is no surprise to find that the proportion of total sexual outlet comprised by premarital coitus with prostitutes is smaller for the homosexual offenders vs. adults than for any other group, never exceeding 1 per cent.

Of the various deterrents to premarital coitus, only one was strongly influential with the homosexual offenders vs. adults: lack of interest. Seventy-seven per cent, over half again as much as the percentage of any group not convicted for a homosexual offense, reported that their premarital coitus had been seriously impeded by a lack of interest in having such coitus. Some 37 per cent (next to lowest in rank-order) claimed lack of opportunity as a major factor, and a somewhat small proportion listed moral considerations and fear of possible consequences. At this juncture we should point out that a substantial part of our sample of homosexual offenders vs. adults was drawn from homosexual cliques or, in one instance, from a formal homosexual organization. Consequently, the sample contains more individuals of exclusive or near exclusive homosexuality than would be true had we sampled only prison inmates.

The relative disinterest in coitus and the general homosexual orientation is again revealed in the evaluations made by the men of their initial coitus. Some 21 per cent, the largest proportion recorded, reported that they did not enjoy their first coitus, while 53 per cent, the second smallest proportion, stated that they enjoyed it strongly.

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Of all our groups the incest offenders vs. adults became embroiled with the law much more slowly than any. A mere 4 per cent had been convicted by age twenty, as against from 20 to 80 per cent of all other groups. A scant third had been convicted by age thirty, and a two-thirds level was not reached until forty-five—a level passed by virtually all others a decade or more earlier. This belated criminality is clearly evident in the average (median) age at first conviction for any crime: thirty-eight, the oldest recorded. The average age at the first conviction for incest with an adult daughter is still greater: forty-six.

The proportions of sex-offense convictions and nonsex-offense convictions are moderate and not unusual, but the number of men with solely sex-offense convictions is rather high: 56 per cent, a figure shared with the incest offenders vs. minors.

The incest offenders vs. adults were the least criminal of any group in that their per capita convictions were 2.4 and their sex-offense convictions were 1.2. Both figures are the smallest recorded for any of the groups.

Like other incest offenders, when these men committed a crime which was not a sex offense, it was most commonly a crime against order (36 per cent, a very high figure). Only rarely did they commit crimes against property, which again is typical of incest offenders.

When these men committed a sex offense other than one against an adult daughter it was against a younger daughter (except in the case of one male). Such absolute specialization is unique.

From the foregoing it is clear that these offenders are the least recidivistic of any: 44 per cent had only one conviction, the largest proportion on record and all the more impressive since it is for the oldest of all groups. Another 28 per cent, a large figure, had two convictions; few had more.

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Aside from their early involvement in crime, there are no outstandingly ominous signs in their presex-offense histories; indeed, their heterosexual adjustment is quantitatively well above average. There are occasional hints of underlying violence and sadism, but these are manifest in only a minority of individuals. In the sex offense itself, however, one can frequently see a basic pathology revealed by unnecessary violence, bizarre behavior, and self-delusion.

A minority of the aggressors vs. adults are not the amoral and anti social individuals often involved in criminal activities, but are seemingly rather ordinary citizens leading conventional or even restrained lives. Actually many are suffering from personality defects and stresses which ultimately erupt in a sex offense. A few aggressors vs. adults appear to be statistically normal individuals who simply misjudged the situation.

*120\161\2*

In keeping with the high incidence of petting experience, the aggressors vs. children engaged in petting with a moderately large number of girls, the average aggressor having petted with 26. However, nearly a third of these men had petted with five or fewer, and this is undoubtedly a manifestation of their ineptitude at getting along with girls, for despite their good adjustment during their childhood years, by the time they were sixteen to seventeen they had few female companions. At that age, one quarter of them, the third largest percentage, reported having none at all, and only a slightly larger number reported having had many. In short, the heterosexual aggressors vs. children had the next to the worst record insofar as female companionship at ages sixteen and seventeen is concerned.

We have in our sample too few aggressors vs. children who had experienced orgasm in petting to permit the calculation of meaningful average frequencies. Within any given age-period (e.g., ages sixteen to twenty), there were never as many as ten who had petted to orgasm— and we feel calculations based on less than ten individuals are risky. It is, however, worth noting that the frequencies of petting to orgasm reported by these few individuals were almost always very low. This is in keeping with the scarcity of petting partners and female companions remarked upon earlier.

We have seen that as a group the aggressors vs. children were relatively given to mouth-genital contact in their prepubertal play, and in postpubertal life they continued to have more mouth-genital activity than most other groups. This emphasis on mouth genital contact is characteristic of all aggressors. However, the aggressors vs. children display some unusually strong preferences as to the type of mouth-genital contact. Very few (8 per cent) placed their mouths on the genitalia (cunnilingus) of female companions before marriage, whereas in the other aggressor groups from one quarter to one third of their members did so; yet in terms of the premarital female partner’s placing the mouth on their genitalia (fellation), the aggressors vs. children had 28 per cent with such experience—the third largest percentage, exceeded only by the two other aggressor groups.

This same sharp distinction between cunnilingus and fellation is also seen in their relations with prostitutes: of those who had ever paid a woman for sex none had cunnilingus (whereas 5 per cent of the other aggressors did), though half (the fourth highest figure) were fellated by prostitutes. The other aggressors also rank high, first and second, in fellation.

Of the married males, the same number had experienced cunnilingus and fellation with their wives—26 per cent, a moderate to small proportion. The other aggressors show almost double that percentage.

All this suggests that here we are dealing with a group of people strongly interested in mouth-genital contact, but also deeply imbued with an attitude common at a lower social and economic level: that it is degrading to perform cunnilingus, but to be fellated is most desirable.

Similarly these aggressors were inhibited in another oral activity-biting or nibbling during sexual activity. Only 22 per cent had done so, this being the third smallest percentage for this behavior.

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he was on the average aged thirty-five. However, one sixth of them were over fifty and one quarter were over forty-five.

Approximately 31 per cent were married at the time of their offense, nearly an equal number were widowed or divorced, and 40 per cent had never married by that time. Later the proportion of bachelors shrinks, but at the time of offense it is large for a group of this age.

The offense against the child was in 40 per cent of the cases not the first sex offense; in fact in nearly 20 per cent the offense had been preceded by two others, not necessarily against children. These are higher figures than apply to other heterosexual offenders, but compared with the figures for a number of other types of sex offenders they are not remarkable.

As for the mental state prior to the time of the offense, it appears that the offenders vs. children had a high degree of psychiatric disturbance in comparison with other sex offenders: almost 10 per cent had been psychotic or severely neurotic. Only one other group exceeded this figure.

Since alcohol and drugs can impair judgment quite as effectively as a psychosis, they deserve attention here. Drugs may be summarily dismissed as an etiological factor—only one offender vs. children was a drug user at the time of his offense. Only a relatively small number, 13 per cent, had a history of any drug use, and nearly all of it was experimental—chiefly trying marijuana. Alcohol, however, was a factor in nearly 30 per cent of the offenses, and in most (three fourths) of these the man was drunk and not just moderately intoxicated. It is only in the other pedophilic offenses and offenses involving force that alcohol looms larger in importance. This importance of alcohol is not reflected in the general fife of the offender vs. children: their ranks contain only a moderate number of alcoholics and frequent drinkers, and the percentage of abstainers, 16 per cent, is the same as for the control group. Alcohol appears to have been a significant social factor in the lives of 37 per cent of these offenders, a proportion that is neither large nor small compared to that of other offenders, but definitely larger than that of the control group.

Despite the role of alcohol, about 70 per cent of the offenses against children were obviously premeditated. Some 6 per cent were committed by men who claimed to be rum compos mentis, and only 14 per cent were predominantly opportunistic in nature. Thus we see a recognized and clearly planned type of behavior outweighing unplanned impulsive behavior by a ratio of about 5 to 1. In some instances the first contact with the child was fortuitous, but the later contacts were sought.

The offenses typically occurred in residences: nearly a third took place in the offender’s home, 10 per cent in the child’s, and 5 per cent in a shared residence, for example, a rooming house. This “homebody” tendency is, however, even more marked in the heterosexual offenders vs. minors and adults. Next in importance as a place for the offense is the out-of-doors (almost one quarter of the instances), then theaters (a rather high figure, nearly 13 per cent), autos (7 per cent), and school grounds or buildings (only 3 per cent, but still the highest incidence reported for this location). The approach in the theaters usually is stereotyped: the man makes a visual census of females of acceptable age who are unaccompanied by adults, and changes his seat accordingly. A rebuff simply requires another move; it is not surprising that the offenders refer to their nomadic activity as “playing checkers.”

Three fifths of the young girls were known to the offenders and two fifths were strangers. This is a high proportion of “pickups” compared with those made by offenders vs. minors and adults, but low when compared with the aggressors. Among the girls known to the offenders, over two thirds were friends, about a fourth were casual acquaintances, and 5 per cent were related to them. Contrary to general opinion and to parental fears, it seems that the immature female is more vulnerable to adult friends and acquaintances than to mythical strangers lurking in concealment.

The girls ranged in age from three through eleven, the average (median) girl being eight, which made them younger by a year and a half than the boys approached by the homosexual offenders vs. children. Moreover, they were about a year younger than the girls involved in the aggressors vs. children cases.

In the great majority of cases the sexual behavior consisted of petting and fondling. In only 6 per cent of the cases was coitus attempted, and in less than half of these (2 per cent) was any intromission effected. These cases involved girls aged eight to eleven, i.e., the older girls within this pedophile category. It is interesting that the percentage of completed coitus was lower than in the incest or force cases involving girls of a similar age. Turning back to the majority of cases, we find that in a quarter of them the physical contact stopped short of genital stimulation, but in two thirds of the instances there was such stimulation of either the child or the male. In some cases this was through the clothing or underclothing. Mouth-genital contact occurred in about a sixth of the cases. It is clear that these offenses against children involve mainly the use of extensive petting techniques and only to a minor degree attempts to effect coitus.

The lack of coitus stems in part from the youthfulness and physical immaturity of the children and in part from one of the criteria defining the group—lack of force. Attempts at coitus are more apt to provoke resistance, which in turn often engenders the use of force.

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