I need not describe the dangers to health resulting from masturbation and sexual excesses, for these have previously been considered in detail; but it is necessary to allude to the exaggerated statements which are sometimes encountered regarding the dangers of masturbation, especially in popular works on the subject, so that the physician may be on his guard about this matter. A child who during and after the act of masturbation has a keen sense of wrong-doing, and consequently suffers much from self-reproach, may, if the fear is superadded of having done serious permanent injury to health, be affected with grave hypochondriacal manifestations. Many instances of this have come under my notice, in young men and young women of sixteen or thereabouts. Even when the practice of masturbation has long been discontinued, and the patient is quite grown up, such symptoms may arise, owing to the persistence of the fear of disastrous results, and the auto-suggestive influence of this fear. Nowhere is more tact required by the physician than in his dealings with those who masturbate or have masturbated. There is even a real danger that a moral lecture may cause a shock to the system; in the case of some young men it may sometimes be better to acquiesce in masturbation, rather than to alarm them by talking about the disastrous consequences of the indulgence. I refer to those unfortunate creatures who suffer from severe hyperæsthesia of the sexual impulse, and who for social reasons are not in a position to satisfy the impulse in any other way than by masturbation, or who refrain from illicit intercourse in the well-grounded fear of venereal infection. The physician who has seen a number of such cases, who has learned how they continually relapse into the practice of masturbation, notwithstanding all their good resolutions and their conviction that masturbation is at once dangerous and immoral, will be likely to feel that it is better, not indeed to recommend masturbation, but from time to time tacitly to permit it. To do in these cases what it is well to do in certain others, namely, to describe the bad effects of masturbation, may give rise to grave conditions of depression, and even to suicide. Certainly, in such cases, we must carefully avoid alarming the patients too seriously about the consequences of masturbation.
In undertaking the sexual enlightenment of the child, those phenomena of the sexual life should not be forgotten which are shown by experience to arouse in the ripening child, now curiosity, and now anxiety—and the chief among these are involuntary sexual orgasm and menstruation. Imagine the state of mind of the girl who has never heard a word about menstruation, and awakens one morning with blood flowing from the genital organs; or that of the boy, who has his first nocturnal seminal emission, without having received any information as to its significance. Similar considerations apply to some of the other signs of puberty; and especially to the growth of the pubic hair, which has made many a child extremely anxious. Although, by the time this age is reached, a child has commonly been sufficiently informed about these things by his playfellows, we meet with instances in which nothing of the kind has occurred.
Hitherto I have been considering the hygienic grounds for effecting sexual enlightenment; but there are also important ethical reasons for such enlightenment. It is not possible in our life to speak the truth always and unconditionally; but this fact does not give us the right to lie to children without good cause. Especially dangerous is it to relate to children fables about the stork or the cabbage-garden, at a time when they have long been enlightened about sex from other sources. I recall the case of a girl seven years of age, whose mother was still in the habit of telling her that babies were brought by the storks; but this child was accustomed to join with other girls and boys in playing at "father, mother, and midwife," wherein they displayed a comparatively exact knowledge of the processes of reproduction and birth. We are not surprised when a woman tells us that as a child her confidence in her mother was seriously shaken from the moment when she was enlightened by others concerning the sexual life, and she recognised that what her mother had told her about the matter was quite untrue. I do not mean to imply that stories of the stork and cabbage-garden variety are to be altogether excluded. It would be as reasonable to prohibit all kinds of fairy tales. Some tell us that we should tell children fairy stories only so long as they regard the whole of life as a fairy tale. But in view of the vivid imagination of childhood, no such sharp distinction is practicable. Let the reader recall his own childhood. Does the child regard the fairy tale as a lie, even after he has began to doubt if the world of fairy stories has any actual existence? Certainly not. Similarly with regard to the stork fable. I consider that the complete suppression of this fable, unless we replace it with some like poetical fancy, can do nothing but harm to the child's nature. All that we must ask is that such a story shall not for too long be put before the child as fact. When the child's development has gone far enough, it will be well to dispense with the stork story. This is suggested by considerations both of prudence and of morals, and the like considerations urge us to describe to the child, tactfully and at the proper time, the true nature of the reproductive processes.
Such a course is desirable, if merely for the reason that when a child is sexually enlightened by other children, this is usually effected in so coarse a manner as very readily to undermine the bases of respect for the sexual life of humanity. A child who has been instructed regarding this grave and important matter by his parents and in a proper manner, is in a position to reject offers of a coarse method of enlightenment; but by the customary—too long customary—plan, as far as children are concerned, of altogether ignoring the sexual life, children are deprived of the power of repelling obscene methods of enlightenment.
The legal dangers to which reference was made on p. [201] et seq. are additional reasons for undertaking the sexual enlightenment of the child. I pointed out that, in certain circumstances, a boy of thirteen who undertook sexual practices with a girl of twelve was committing a punishable offence. But sexual enlightenment is desirable, not merely for those of this age, but also for those who are somewhat older. A large number of people are completely ignorant of our penal code in these relationships. I recall the case of a sexually perverse young man of twenty who on a number of occasions performed the following acts with boys of about thirteen years of age. He would go to a public bath, induce a boy of thirteen or so to enter his dressing cubicle, and, as if in joke, tie the boy's hands together. In reality, as he did this, he experienced sexual excitement to the point of ejaculation. This latter occurred especially when he touched the boy's body—not his genital organs. He had absolutely no idea that such acts were punishable with imprisonment, in accordance with the third paragraph of Section 176 of the Criminal Code; and it gave him a terrible shock when I explained to him that he had rendered himself liable to imprisonment. Some persons even believe that they may handle children's genital organs, for the purpose of exciting themselves sexually, without rendering themselves liable to punishment. It is obvious that on these grounds also enlightenment on sexual matters may be extremely desirable.
Finally, there are certain social and economic reasons for sexual enlightenment. These reasons are closely connected with those bearing upon health, but they may in part be separated from the latter. No one will deny that illegitimate sexual intercourse may entail grave social consequences. For women these dangers are much greater than they are for men; but for men, even, they are by no means inconsiderable. As far as women are concerned, the danger of extra-marital impregnation occupies the first place. The importance of this of course varies greatly in various regions and in different social strata. In the servant-class in the country, for instance, pre-marital sexual intercourse, and even pre-marital motherhood, is far from having the seriousness which attaches to these things among the old peasant families firmly rooted to the soil. Among the servant-class in towns, the matter has a more serious aspect than among the same class in the country. On the other hand, in many artistic circles in the Metropolis, pre-marital intercourse, even on the part of women, is regarded far more indifferently than in other strata of society. None the less, for a girl of the upper ranks, extra-marital pregnancy is for the most part tantamount to social annihilation. Even here exceptions occur, and we shall find good families of the aristocracy and the upper bourgeoisie in which a woman who has given birth to an illegitimate child, or even one who is manifestly a cocotte, will be socially recognised, provided she has attained some great position, such as that of a great artist, for instance. In such cases we may even find that women who on other occasions are unable adequately to express their hatred and contempt for prostitutes and similar unfortunate beings, will yet be proud of their friendship with such a woman, and will boast of it in public. But such opportunities of social recovery are open to very few; most women of the upper classes sink rapidly and far in the social scale as soon as it is publicly known that they have experience of illegitimate intercourse. For this reason, such consequences must be taken into the reckoning. The objection need not be raised that the sexual enlightenment would not safeguard a girl, since, when she gives herself to a man, a girl knows well enough that children are the result of sexual intercourse. The objection is unsound, if we only have a right understanding of what we mean by sexual enlightenment, and if at the same time we do not neglect the general sexual education. Enlightenment should not be limited to merely making the person concerned aware of the consequences of sexual acts; it should, as it were, become ingrained in the flesh and blood, so as to influence the actions, even unconsciously. A girl brought up in this way will defend herself instinctively against the wiles of a seducer. But only by such an education, by one which is not confined to the mere imparting of information, can we produce in the girl greater powers of self-protection and a more enduring self-consciousness, and so save her from the far too common fate of behaving like a stupid unripe creature, and believing all the asseverations of the first man who makes love to her—asseverations which the man himself, in the moment of passion, very probably believes. Let me, then, repeat that all that appertains to the sexual enlightenment must became part of the flesh and blood of the subject; only from this can we expect good results, whereas a sexual education which consists merely in the acquirement of information, is altogether valueless. But by a true sexual enlightenment, in the sense above defined, it is probable that many a girl may be safeguarded from prostitution; and many a child, boys as well as girls, may be better protected against the attempts of pædophiles. And these considerations apply, not merely to childhood, but also to subsequent life—especially as regards girls. How many girls enter upon marriage quite ignorant and altogether inexperienced. They commit themselves to the keeping of a man of whom they know hardly anything at all. The parents are often satisfied with the most meagre information. It is considered improper to ask for detailed information regarding the husband's past life, and hence it often happens that a girl is delivered up to an unscrupulous man suffering from venereal infection, simply because she has never been adequately informed regarding the serious step she is undertaking, regarding the completely new mode of life upon which she is so suddenly entering. We thus see that there are ample grounds for explaining to a girl in good time precisely what she will undertake in entering the married state.
A question of importance is at what age the sexual enlightenment can most wisely be effected. Some advise that enlightenment should begin with our answers to the first questions the child propounds upon the subject; others contend that it is better to wait till it is somewhat older than this. There is truth in both these views; but the matter and manner of our communications must be appropriate to the age of the child with which we are dealing. When a young man is being sent to the university, it is wise to instruct him concerning the dangers of venereal infection; but to inform him that human beings come into the world as the result of an act of sexual intercourse would be altogether superfluous. Conversely, if a child asks its parents where its little brother has come from, we do not need to say anything about syphilis and gonorrhoea; but none the less we can give such a child an account suitable for one of its age of the way in which human beings come into the world. Speaking generally, it may be said that the biology and physiology of reproduction—that is to say, the objective processes—may be described at a comparatively early age; but that cautions regarding masturbation should not, in average cases, be given before the age of thirteen or fourteen; and that instruction about the risks of venereal infection should be deferred until even later than this. In the case of boys, in so far as enlightenment in the school is concerned, information about venereal infection may, for practical reasons, best be given about the time the boys are preparing to leave for a higher school. In the case of girls, for whom a caution against risks of impregnation and against prostitution are especially in question, we have also, as far as sexual enlightenment in the school is under consideration, to recommend the time when they are about to leave school. But if we prefer that sexual enlightenment, or at any rate a part of such enlightenment, should be effected at home rather than in the school (a course which I regard as essentially preferable), it will be impossible to lay down a fixed rule as to the age at which this should take place. To a lively girl of twelve or thirteen years, a great deal can be said far better by the mother, than can be said to a girl considerably older, say at fifteen, by the school physician, schoolmaster, or schoolmistress. Speaking generally, in the case of girls, the enlightenment may well begin at a somewhat earlier age than in the case of boys—at any rate as regards the subjective processes of the sexual life.
On the whole, it may be regarded as definitely established that the child may well receive information about the objective processes at a very early age, and this long before the time commonly regarded as marking the commencement of puberty. But as regards the subjective processes, it is better that there should be some delay. It may, indeed, be asked whether it would not be preferable that in the case also of the subjective processes, the child should be instructed before they actually make their appearance in the child's own consciousness, to render possible the adoption on the child's part of a more objective attitude towards these phenomena. But in reality such a course offers no advantages. The child is quite unable to understand the dangers of the sexual life, as long as it has no actual experience of sexual feelings. For this reason, it is better to accept the view of those who contend that, as far as the subjective processes of the sexual life are concerned, we should wait till near the end of the second period of childhood before beginning the enlightenment. But we must not forget what has previously been pointed out, that the puberal development may begin at a time when nothing of the sort is apparent to the eye of the observer; and we must also bear in mind that the first seminal emission and the first menstruation are by no means so important, as marks of the puberal development, as is commonly believed. For the fulfilment of the aims of the sexual enlightenment, however, it does not so much matter when the first physical manifestations of the puberal development make their appearance, but when the first sexual feelings and sentiments, which must be distinguished from the unconscious and purely physical symptoms, are experienced. The important matter is, not whether follicles have already matured in the ovary, but what influence such a process has exercised upon the mental life of the child. For this reason, in our study of the individual case, we must have some knowledge of the psyche of the child with which we are concerned.
A matter also within the scope of our subject is the question by whom the sexual enlightenment may best be effected. This question is connected with the questions for what reason and at what age enlightenment should take place. As regards these points, it lies between the school and the home. Some writers contend that so far as possible every thing, others, that, at any rate, a great deal, should be imparted at school. The latter view is also my own.
In so far as the enlightenment has to do with purely biological processes, and especially in so far as it relates to processes in the vegetable and lower animal world, it can be effected in the school, and in the first years of the second period of childhood; but of course the giving of such instruction at school does not prevent a father who goes out walking with his son, or a mother with her daughter, from seizing opportunities of giving information about the sexual processes of plant-life. At school, education regarding such biological processes will form a part of the lessons in botany and zoology; or will be imparted in the class on general biology, if such a class exists. Instruction in hygiene, such as is often advised, has little to do with the matters we are now considering; and at any rate could merely involve an elementary account of such processes. The school may even be the best place for sexual enlightenment regarding the sexual life of human beings, at least in the case of the older pupils. There is no adequate reason for objecting to boys about to leave school being warned by a schoolmaster or a physician about the dangers of venereal disease; and at the same time a plea may be put forward against the view that it is incumbent upon every young man to prove his strength by the maximum indulgence in sexual intercourse.