AWARENESS:: Sex education for the next generation ::

Dr. Khalid Sohail

Many are told by their parents, teachers or religious leaders that sex is something sinful, dirty and should not be enjoyed unduly, even in marriage it should be indulged in only for reproductive purposes

As a practicing psychotherapist for more than twenty years, I have had an opportunity to meet and help many Eastern and Western men, women and couples who had emotional and sexual problems because of their conservative religious and cultural upbringing. In the last few years, I have shared some of my observations and professional experiences in two books: The Art of Loving in Your Green Zone and Love, Sex and Marriage. In this essay I will discuss some of the problems I witnessed while working with those people and offer suggestions for such people to decrease their suffering and improve their quality of life.

I have met many men and women from traditional and religious families who associated sex with sin. Because of their concept of sin they either remained celibate and felt embarrassed because of their sexual fantasies, or felt guilty about their sexual encounters. They were told by their parents, teachers or religious leaders that sex was something bad and even in marriage was allowed for reproductive purposes. They did not feel they should enjoy it even with their spouse if they were not going to have children. One man told me that he had not had sex with his wife for ten years, because she had told him she did not want to have any more children. I suggest to such men and women that rather than associating copulation with sin that they should associate it with affection and love and learn to enjoy it rather than feel guilty about it.

Many individuals of both sexes did not feel comfortable with their bodies. For them masturbation was a sin. Some called it self-abuse. As they got better they realised that their emotional and sexual problems were related to their inhibitions. Gradually they changed their attitudes and started finding relief without having sinful associations or the unhealthy and bad effects that frustration has on people’s personalities.

One of the common factors causing emotional and sexual problems was lack of sex education. I met some couples who had been married for years but whose marriage had not been consummated because they had never been taught about sexuality or healthy intimate relationships. I think it is important that all teenagers receive sex education at home and in schools so that they can make rational and responsible choices about their private lives. When my own nephew and nieces ask me such questions I educate them with the following information:

The human embryo comes into being through the union of a human sperm and ovum. Each of them has 23 pairs of chromosomes, out of which 22 are autosomes and the last one is the pair of sex chromosomes. The mother’s pair is XX chromosomes and father’s pair is XY chromosomes. If the fetus inherits an X from father then we have a XX chromosome baby girl and if the fetus inherits a Y from father then we have an XY chromosome baby boy. That is why holding mothers responsible for the baby’s gender is neither morally nor scientifically right.

When we study human embryology and focus on the week-to-week development of the human fetus, we discover that all fetuses start out as female fetuses. If the fetus has a Y chromosome, after a few weeks of development male hormones kick in and the fetus is gradually transformed into a male. When the fetus has XX chromosomes then the baby develops into a girl.

If there are problems in the normal development then we have children whose sexual organs are not fully developed and they are called hermaphrodites. In Pakistan they are called hijras and unfortunately they are socially ostracised and become victims of prejudice and ridicule, although they too are just another product of nature.

A number of psychologists believe that by the time children reach the age of four they have developed an identity of being a boy or a girl and that identity does not necessarily depend upon the genetic and anatomical sex. It is still a mystery. Most children who have XX chromosomes and have female sexual organs develop a feminine Identity and most children who have XY chromosomes and male sexual organs develop a masculine Identity, but there are exceptions. Those exceptions are called transsexuals. Male transsexuals for some reason develop feminine identities though they have XY chromosomes and are men. Consequently they feel they are females trapped in male bodies. Conversely female transsexuals develop male identities and believe they are females trapped in male bodies. This is just one of those biological quirks of nature and not something that the patient should be ostracised for. Many transsexuals remain quiet about their problem, while some seek psychiatric help and request a sex change operation.

Most males who have male sexual organs and a male gender identity are attracted to females, while most females with female sexual organs and female gender identity are attracted to males. They are called heterosexuals. On the other hand those males and females who are attracted to members of the same sex are called inverts, or homosexuals and lesbians. Again this is in most cases a quirk of nature depending on how the person’s gender identity developed and he or she should not be ostracised or censured unduly.

Most adult females and males after finding a partner are able to enjoy their marital relationship, while there are some who have difficulties in their sexual performance and suffer from frigidity in females and impotence in males. Most women who are frigid and most men who are impotent have unresolved emotional and sexual conflicts. These may be because of ill-health, some traumatic childhood experience, personality quirk or, which in our country is most prevalent, inhibitions. Often inhibitions can be caused by an overly puritanical or suppressive upbringing. Such people need emotional help to resolve their conflicts so that they can have a healthy and enjoyable private life.

I met many men and women who grew up in segregated families and communities who did not learn to socialise with the opposite sex and when they were married they had great difficulties communicating emotionally or with intimacy with their spouses. In some families they did not even allow privacy for intimacy, which made their shyness even worse.

I also met many young men and women who were not told by their parents about the changes in their bodies when they reached puberty. Some boys were shocked when they started having wet dreams and some girls were terrified when they started having menses. They were scared they were going to die because of the mysterious bleeding.

Some people who had sexual difficulties were more inhibited by fear than guilt. They were nervous about the negative reactions of their families and communities. They were scared they would be persecuted and penalized, put in jail or even executed or stoned to death. Some had fallen in love with people from other cultures and religions and had kept it a secret. They felt their private sexual life had become a social, cultural and religious issue and they did not know how to cope with it. As they grew emotionally stronger and more confident they were able to accept their truth without fear and guilt and share it publicly and deal with the consequences. Gradually they learnt to make rational choices and take responsibility for their actions and life choices.

While I worked in the obstetric department in a women’s hospital in Peshawar Pakistan I was shocked to find out that many men and women had no understanding of human physiology and did not know that ovulation took place 14 days before menstruation and that the human sperm and ovum live for only 24—48 hours and if they did not make love during those 48—96 hours they would not get pregnant. I met many infertile women who went to holy shrines to pray for children rather than obtaining medical help for their problems.

As more and more people are learning about the biology and psychology of human physical relationships and developing healthy attitudes towards these relationships, they are associating sex with love and affection rather than with sin and guilt and are open to obtaining professional help when they suffer from emotional and problems of compatibility in their intimate lives. I hope we see a day when teenagers and young adults receive sex education based on science, medicine and human psychology rather than cultural and religious superstitions, so that they make rational and responsible choices in life. I hope we see a day when people in love are not afraid of moralistic laws and punitive traditions and feel free to grow in loving relationships. I believe growing together is better than growing alone. Unfortunately we still have a long way to go.

Dr Khalid Sohail is a psychiatrist at Creative Psychotherapy Clinic, Ontario, Canada