The Sexual Life of the Child

by Albert Moll

The problem of the significance of sexual phenomena in the child is naturally one of great importance. We have here, in fact, two problems to consider: first, whether the appearance of sexual phenomena in childhood indicates a morbid or in other ways abnormal state; and, secondly, what are the consequences of the occurrence of sexual phenomena in the child. An example will help to illustrate the need for drawing this distinction. Certain malformations of the external ear are indications of the existence of a morbid degenerative condition; but from the malformation itself there is nothing to fear. Similarly with the sexual life of the child, it may happen that a manifestation indicates the existence of morbidity, although the manifestation does not by itself entail upon the child any serious consequences. On the other hand, sexual phenomena in the child deserve in some cases the most attentive study, owing to the dangers likely to result from their occurrence.

With regard to the first question, whether sexual manifestations in the child indicate per se the existence of a morbid state, it is not necessary to say much here, since the subject has been fully discussed in the section on Etiology (see page 148). In any case, we must avoid exaggerating the importance of sexual feelings in the child. Ribbing[87] contends that we must regard it as abnormal when a boy of thirteen or fourteen is obsessed (hanté) by erotic ideas. This is true enough if there is real obsession by such ideas, but it is not true if there is no more than an occasional uprising of sexual feelings. On page 118 of this work, I explained that an over-development of the sexual life in the child was an indication of the existence of a congenital morbid predisposition.

Passing to the second question, as to the consequences of the occurrence of sexual phenomena in the child, these consequences may be very various in nature. They arise more especially in the hygienic, social, ethical, educational, forensic, and intellectual domains.

First of all, then, let us consider the dangers to health.

The earlier the sexual impulse awakens, the earlier also arises the danger of sexual practices, and more particularly of masturbation. Common sensations in the genital organs, the feelings associated therewith, the impulse to allay the unsatisfied libido—all these may lead the boy to handle and rub his penis. The girl is affected by similar stimuli. In these cases, the first act of masturbation does not depend upon the desire to enjoy a voluptuous sensation, but results from the impulse to allay vague feelings of uneasiness. Only subsequently, when the child has learned by experience that mechanical stimulation of the genital organs induces voluptuous sensations, or when he has been taught this fact by a seducer, does the desire to produce voluptuous sensations become the mainspring driving to masturbation. The danger, of course, increases, in proportion as the child comes fully to understand that in this way it can produce agreeable sensations, all the more because the child is either unaware of the injurious consequences of the practice, or, if it has been informed of these consequences, the knowledge cannot weigh in the balance against the easily induced enjoyment. But, let me say here at the outset, the dangers of masturbation have been greatly exaggerated. Chiefly since the publication, at the end of the eighteenth century, of Tissot's book on masturbation, but to some extent also even earlier, it has been usual to refer to masturbation the occurrence of innumerable diseases, including mental disorders and locomotor ataxia. I do not propose to reproduce the account given by Tissott, and after him by Hufeland, and also by the innumerable quacks and swindlers who trade in the "cure" of "secret diseases"—these latter, preying upon the fears of humanity, declare that every possible affliction in both sexes may result from masturbation, and recommend innumerable miraculous remedies for these often imaginary ills. Disorders and displacements of the uterus, ulcers and cancer, gastralgia and gastric spasms, jaundice, pains in the nose, are supposed in women to result from masturbation, as well as fluor albus, nymphomania, &c. There is hardly a single organ of the body of which disease and destruction have not by many been referred to masturbation. In reality all this is false. It is more than doubtful whether, as far as adults are concerned, occasional masturbation is necessarily more harmful than normal sexual intercourse. According to my own observations, the principal question is whether, in masturbation, the bodily and mental stimuli employed to obtain sexual gratification involve an especial shock to the nervous system—a greater shock than results from normal sexual intercourse. More powerful shock may, indeed, arise from the fact that the masturbatory act is apt to be repeated with excessive frequency; and we have to admit that the chief danger of masturbation lies in the fact that there is so grave a risk of sexual excess. Owing, too, to the frequency of repetition, a need will very readily arise for an increase in the stimulation, and this may apply alike to the bodily stimuli and to the mental; and the stronger the stimuli have to be, the more powerful also will be the general effect on the nervous system. Thus the danger of shock to the nervous system from masturbation will be seen to depend, first, upon the frequency with which the act is repeated, and, secondly, upon the increasing intensity of the stimulation. To this extent, therefore, masturbation may be more dangerous than normal sexual intercourse; for this latter also, unless it is to exert an unfavourable influence on the health, must not involve mental and bodily stimulation of too powerful a kind. The good effects of sexual intercourse depend upon its adequacy to the feelings, upon the absence of any exhausting imaginative activity, and upon the absence also of artificial bodily stimulation. But artificial stimuli and exhausting imaginative activity are often associated with coitus also, in cases in which the stimulus evoked by the personality of the sexual partner is inadequate. Again, the powerful efforts which must as a rule be made by persons who desire to repeat the act of intercourse several times within a brief period, will have a similar effect upon the system to the powerful imaginative activity in cases of masturbation. The resemblances, on the one hand, and the differences, on the other, between masturbation and normal sexual intercourse, will be apparent to those who carefully consider the facts just stated; and it will also become apparent in what circumstances masturbation must be regarded as injurious. This is all I have to say concerning masturbation in adults.

The idea that masturbation is, generally speaking, dangerous, is by many restricted to the practice during childhood and youth, the belief in its danger at this stage of life being based upon the view that the organs are at this time insufficiently developed. But even this contention cannot be regarded as fully established. I will, in the first place, consider those cases only in which masturbation is practised after the formation of semen has begun, but when the processes by which bodily maturity is attained are not yet fully completed. To the theoretical assumption that masturbation is especially hurtful in cases in which the organs are not yet adequately developed, we may oppose the consideration that the completer development of organs is favoured by exercise. We cannot further discuss such theoretical speculations, which lack the firm foundation of experience. On the whole, I agree with the estimate of the consequences of masturbation expressed by Aschaffenburg,[88] a man to whom we are indebted for the refutation of many extravagant views. Experience teaches that almost all men, healthy and unhealthy, moral and immoral, have masturbated for some years, once or several times a week, towards the end of the second and during the beginning of the third period of childhood. In view of this experience, what right have we to maintain seriously that masturbation is, generally speaking, dangerous to health. It is, of course, possible to contend that these persons would have developed better if they had not masturbated. But there is equal ground for asserting the opposite. We possess no evidence whatever to show that those young persons who never masturbate are in after life stronger and healthier than the others. I know some persons who have never masturbated. In the case of some of these, it was because the impulse to masturbate was lacking; others, notwithstanding the existence of a strong impulse, refrained from masturbation under the influence of religious or ethical motives. In both of these groups, I have seen persons exhibiting the very morbid symptoms which Tissot and his followers referred to masturbation; and I was quite unable to convince myself that abstinence from masturbation secured any notable advantage. Whilst I do not assert that the morbid phenomena which I observed in these individuals arose in consequence of their refraining from masturbation, I consider that there is no justification for the converse assumption in the case of those who did masturbate. I believe that many of those patients who never masturbated were the subjects of congenital morbid predisposition, and that, as a direct consequence of this fact in many of them, the sexual impulse was of minimum intensity or developed exceptionally late; I consider, therefore, that the morbid manifestations in the domain of the nervous system were dependent, not upon the fact that they did not masturbate, but principally upon the congenital morbid predisposition.

Whilst I thus reject the view that masturbation in children is generally dangerous, this must not be regarded as implying that I consider the practice altogether indifferent as far as its influence upon health is concerned. In the child, as in the adult, there is danger in the fact that the act is so easy that it is likely to be repeated very frequently, and thus to become habitual. In addition, the masturbator is apt to require strong physical and mental stimuli, and this increase of the stimulus may become dangerous. A special danger of persistent masturbation is to be found in the possibility that impotence may result. The masturbator, being accustomed to stimulate his genital organs by manipulations, and by various methods increasing in intensity of stimulus, will often find subsequently that the normal stimuli, acting in part in the form of the sensory processes in the genital organs, and in part in the form of the normal psychical influences proceeding from without, are no longer competent to induce the normal sexual reactions (erection and ejaculation). This affects chiefly members of the male sex, but in some instances the same is true also of women. It is true that in women the sexual act is rather of a passive character, erection not being in them essential as it is in the male; but in the case of women also, long-continued masturbation, whether practised in childhood or subsequently, may bring about so intimate a dependence of sexual desire, ejaculation, and gratification, upon the artificial stimuli, that the occurrence of these phenomena in normal coitus may be hindered or completely inhibited.

Some writers contend that sexual perversions, homosexuality, for example, may be induced by masturbation, but I myself doubt this. For such a development to be possible, it is necessary that very special influences should be in operation, more particularly a congenital predisposition, or the cultivation of the perversion by perverse imaginative processes—this latter, indeed, occurring very readily in masturbators. But masturbation to excess is far more likely to induce general neurasthenia than to give rise to sexual perversions. When I speak of excessive masturbation, however, it must be admitted that the term is a relative one. What is harmful excess in one person is not necessarily excess in another. This is true of children as well as of adults. I have seen children who, owing to premature awakening of the sexual life, have begun to masturbate at a very early age, without any serious effect upon health. Having seen such children again in adult life, after the lapse of more than fifteen years, I consider that I have had opportunities for forming a sound judgment upon this point. We have to take into account the fact that when a youthful masturbator subsequently exhibits nervous manifestations, these often result from the anxiety he has experienced on being informed of the serious consequences of masturbation. Not masturbation itself, but fear of the effects of the practice, is here responsible for the resulting injury to health. Experience teaches that a certain sort of popular literature has an especially unfavourable influence in this respect. Moreover, in many cases, self-reproach on moral grounds, it may be in childhood, but more often later in life, must in such persons be regarded as the cause of the appearance of nervous and mental symptoms. The dread of having committed a deadly sin, or an extremely immoral act, explains a part of the results which are commonly referred directly to masturbation. The dangers of masturbation must not be underestimated, but exaggeration must equally be avoided. I do not believe that in children masturbation is, generally speaking, more dangerous than it is in adults; but I consider that masturbation resulting from a spontaneous impulse is less harmful, than when artificial bodily and mental stimuli are freely employed. And though the dangers are slightest when masturbation is not continued for a long period, still, in this connexion, a period of a few years cannot be regarded as so very long; at any rate, practical experience shows us that we must avoid over-estimating the importance of masturbation even if continued for several years.

A particular description must now be given of masturbation as practised in boys before the formation of semen has begun—that is, before the fourteenth or fifteenth year of life. Féré[89] regards orgasm without ejaculation as very dangerous, and compares its effects with the phenomena of fatigue. The nervous discharge occurring in the orgasm may certainly explain the depressed state of many masturbators, also their tired appearance, dilated pupils, and languid movements. We note also mental disturbances as well as physical, especially diminished powers of attention and memory, and somnolence up to the point of narcolepsy. According to Féré, the physical and the mental symptoms alike can be detected by precise investigations. In children suspected of masturbation, dynamometric observations disclosed a notable diminution, to the extent even of one-half, when the children were not kept under constant observation and when other signs of masturbation existed; and in these cases experimental observation also showed a diminution of the power of attention. The test applied was to erase some particular letter of the alphabet from one page of a book. When such a test is employed, the practice of masturbation is said to have an unfavourable effect, and to cause mistakes. I do not think that these so-called precise investigations are of much value, for suggestion on the part of the experimenter, who is sometimes prejudiced, may play a great part in producing the results. Even when transient phenomena of fatigue appear, and are demonstrable by experiment, it does not follow that any permanent injury has been done, and just as little do otherwise transient manifestations of fatigue necessarily indicate anything pathological, or foreshadow the onset of any progressive morbid state.

The clinical material offered in support of the idea that masturbation is especially dangerous in children too young to have an ejaculation should, moreover, be carefully and critically examined. I myself formerly accepted the view of most authoritative writers as to the grave danger of masturbation in these circumstances. But we can no longer do this unconditionally. The gradual change in my own views arose as follows. From the commencement of my medical practice I was frequently consulted about masturbation in children. Many of these cases date from ten, fifteen, and even twenty years back. I have recently instituted inquiries as to the present condition of my former patients. In so far as information was obtainable, I have been astonished to learn how well boys, who from the age of eight, nine, or ten had masturbated for several years, had developed as youths and as full-grown men. I have had similar experiences in the case of girls. Among my patients, I have had girls who masturbated at the age of five or six years; and ten to twenty years later, when some of them have married, I have gathered information regarding their subsequent development, either from the patients themselves or from their associates. Here also it was very remarkable to learn how rarely unfavourable consequences have occurred from the practice of masturbation in early childhood, notwithstanding the dangers commonly supposed to attend thereon. Especially rare have ill consequences been in those cases in which masturbation was not pushed to the point of inducing orgasm, but in which the children have masturbated simply in order to procure agreeable local stimulation. But in some instances also, in which orgasm without ejaculation had been observed, no bad results have occurred. Such results are, however, much more likely to follow in cases in which there has been prolonged sexual excitement preparatory to the orgasm, whilst this latter has been artificially deferred as long as possible. Where this has been habitual, I have, in some of the patients, seen serious consequences, and especially neurasthenic symptoms, result from masturbation. But the persons thus affected were in many cases the subjects of such severe hereditary taint, that it was impossible to decide to what extent their troubles were due to congenital predisposition, and to what extent they were referable to masturbation or to other noxious influences. It is, moreover, probable that when the nervous system is less resistent in consequence of congenital predisposition, the bad effects of masturbation will more readily appear than in those whose inheritance is a sound one.