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§ 5. Sex Problems and the Need of Special Knowledge

Arguments for sex-education.

In these lectures I shall discuss the great sex problems towards the solution of which knowledge conveyed by special education may help. These problems offer reasons or arguments in favor of sex-education, and I shall attempt to present them from this point of view. I shall at the same time point out in preliminary outline how organized instruction may apply more or less directly to the sex problems that seem to show the need of educational attack, but in later lectures the organization of instruction will be considered more specifically.

Propagandism needed.

In reviewing the literature that during the past decade has advocated sex-education, it has seemed to me that there is left little possibility of any decidedly new and important contribution to the arguments favoring such instruction, for the whole case has been splendidly presented by eminent writers in the fields of medicine, biology, sociology, and ethics. It now appears that the great majority of educators, scientists, and intelligent citizens in general have accepted the arguments for sex-instruction, so far as they have been informed concerning the meaning and need of the movement; and this leads me to the belief that in the future we need not new arguments but frequent restatements of the established facts which indicate the importance of widespread knowledge regarding the function that is inseparably connected with the perpetuation of life. In short, we now need a propagandism for extending the sex-education movement among the masses of people.

For those who have already accepted sex-education, a survey of the facts that created a demand for sex-instruction will give a clearer outlook on the movement. The rapid increase of interest in sex-education has been the result of widespread dissemination of convincing facts concerning some common disharmonies that grow out of the sexual problems of the human race. These facts which have led to sex-education should be kept in mind by all who wish to understand or to play a part in the instruction of young people.

It is quite unnecessary, and still more undesirable, to recite at length in these lectures the social, medical, and psycho-pathological facts concerning abnormal or perverted sexual processes. Fortunately, the educational ends may be gained by a general review that points out the bearings of the main lines of the sexual problems, the misunderstandings and mistakes that education may help prevent and correct.

Parents should know reasons for sex-instruction.

It is important that the general public, especially the parents, should understand the reasons which have induced numerous physicians, ministers, and educators to become active advocates of systematic sex-instruction for young people. Although the movement has made extensive progress in the ten years of propagandic work, is probably true that the majority of even intelligent parents are not yet convinced that their children need sex-instruction. This is due largely to the fact that the parents have not yet been shown the reasons why it is now, and always has been, unsafe to allow children to gain more or less sexual information from unreliable and vulgar sources. In fact, it is surprising to find many parents, especially mothers, who seem unable to grasp the idea that their "protected" children can possibly get impure information.

There are other parents who know that their children are almost sure to get vulgar information regarding sexual matters, and that some young people are likely to make sexual mistakes; but they calmly look upon such things as part of the established order of the world.

Still another type of parents who should know the reasons for sex-instruction are those who accept the traditional idea that their daughters must be kept "protected" and "innocent" while their sons are free to sow a large field of "wild oats," concerning which society in general, and such parents in particular, will care little as long as social diseases, bastardy suits, or chronic alcoholism do not result from the dissipations. These are the fathers and mothers who need the most enlightenment concerning the importance of such sex-instruction as will make clear the far-reaching consequences of "wild oat sowing." Perhaps most such parents are ignorant, but some are simply thoughtless. As an illustration of the latter, the editor of a well-known magazine was recently talking with a prominent author and made some reference to the immoral habits of young men. Their conversation was essentially as follows: The author remarked, "I assume that my boys will be boys and will have their fling before they settle down and marry." The editor quickly replied, "Yes, and I presume that you expect your boys to sow their wild oats with my daughters, and that in return you will expect my sons to dissipate with your daughters. At any rate, you have damnable designs on somebody's daughters." This put on the wild-oat proposition a light which was apparently new to the literary man, for he replied, "That is a phase of the young man's problem which never occurred to me. It does sound startling when stated in that personal way."

All these classes of parents who have not yet learned the facts which point to ignorance as the cause of the abundant sexual errors of young people and those who do not understand that sexual promiscuity or immorality is an error of gravest significance both to the individual and to society, should have set before them time and again some of the startling facts which in the first five years of the American sex-education movement were promulgated among physicians, ministers, and educators. All such ignorant or indifferent parents will not take an interest in the proposed sex-instruction unless they are convinced by frank and forcible statements regarding the great need of special safeguarding of young people.

Special associations needed.

Since there are so many people who still need the most elementary knowledge concerning the sexual problems that demand educational attack, it is important that there should be local associations which can manage lectures, publications, conferences, and other means of informing the public as to the gravity of the sexual problems of our times, and as to the part which sex-instruction may play in the attempt at finding a solution. Such work is now being done splendidly by the societies named in § 51. The magnitude of the problem of reaching the public is such that there is abundant work for numerous branches of such societies or for local groups willing to take a part in the needed work. As suggested elsewhere, the success of the movement for sex-instruction of children of school ages will depend largely upon the attitude and coöperation of parents; and hence it is important that parents should be led to understand the reasons or arguments for sex-instruction. In other words, they should know the problems that indicate the importance of enlightening the rising generation concerning the great facts of sex and life.

Books for parents.

Among the numerous publications that seem to me adapted for convincing parents that their children need instruction, I commonly mention the following: Lowry's "False Modesty" and "Teaching Sex Hygiene," Howard's "Start your Child Right," Wile's "Sex Education," Galloway's "Biology of Sex," March's "Towards Racial Health," Lyttleton's "Training of the Young in Laws of Sex," and pamphlets by Dr. Prince Morrow. See also pages 241–243.

Knowledge needed concerning eight sex problems.

There are eight important sex problems of our times that offer reasons or arguments for sex-instruction, because ignorance plays a large part in each problem. I shall state them briefly here and discuss each in succeeding lectures: (1) Many people, especially in youth, need hygienic knowledge concerning sexual processes as they affect personal health. (2) There is an alarming amount of the dangerous social diseases which are distributed chiefly by the sexual promiscuity or immorality of many men. (3) The uncontrolled sexual passions of men have led to enormous development of organized and commercialized prostitution. (4) There are living to-day tens of thousands of unmarried mothers and illegitimate children, the result of the common sexual irresponsibility of men and the ignorance of women. (5) There is need of more general following of a definite moral standard regarding sexual relationships. (6) There is a prevailing unwholesome attitude of mind concerning all sexual processes. (7) There is very general misunderstanding of sexual life as related to healthy and happy marriage. (8) There is need of eugenic responsibility for sexual actions that concern future generations.

Here are the eight sexual problems of our times. Any one of them has significance great enough to demand the attention of educators and social reformers. One and all they point to the need of better understanding regarding the sexual functions and their relation to life. I shall now turn to outline the main facts concerning each of these sexual problems so far as it seems likely that they will concern educators and social workers. For convenience I shall use the following brief headings: (1) Personal sex-hygiene, (2) social diseases, (3) social evil, (4) illegitimacy, (5) sexual morality, (6) sexual vulgarity, (7) sexual problems and marriage, (8) eugenics.

Historical order.

These sexual problems toward whose solution special instruction of young people may help are stated here in the order in which they have attracted attention as reasons for sex-education. Thus, for instance, personal sex-hygiene was the chief reason recognized twenty years ago; social diseases began to attract public attention ten years ago; commercial prostitution has been especially prominent in the discussions of the past five years; and only recently has there been emphasis on sex-education with reference to eugenics.

The historical order which I follow in this lecture is not now the order of greatest importance. For example, sexual morality (5) and vulgarity (6) are probably of far greater significance than any of the other sexual problems that offer arguments for sex-education.

Not all sex problems concern youth.

To avoid possible misunderstanding, let me repeat from the first lecture the proposition that sex-education should extend in home and school from childhood to maturity. It follows that these lectures concerning the problems of sex that seriously affect the human race are not all applicable as arguments for instruction in schools or for children of school age. Some of the problems of sex point to the need of special instruction in pre-adolescent or in adolescent years, but some of them concern directly only those who are approaching maturity.

§ 6. First Problem for Sex-instruction: Personal Sex-hygiene

Personal and social hygiene.

It is convenient to group under personal sex-hygiene all hygienic knowledge concerning sexual processes in their personal as distinguished from their social aspects. The distinction between these two aspects of sex-hygiene is essentially on the same basis as that between personal and public hygiene. For example, indigestion and overwork are matters of personal hygiene, while tuberculosis and typhoid are problems of public hygiene because the individual case leads through infection to disease of others. Similarly, such individual disorders as masturbation and deranged menstruation concern personal health directly, while venereal diseases are clearly included in social sex-hygiene.

Personal sex-hygiene needed.

If there were no other reasons for sex-instruction, I believe that it would be worth while to teach such hygienic knowledge of self and sex as would guard young people against harmful habits and unhealthful care of their sexual mechanisms; and which, moreover, would guide them across the threshold of adolescence with some helpful understanding of the significance of the metamorphosis. Many men and women suffer from injured, if not ruined, health because they did not know, especially between ten and fourteen years, the laws of personal sex-hygiene, which concern health in ways not involving sexual relationship. Many boys and some girls are injured both physically and mentally by the habit of masturbation. Numerous girls are injured physically and many mentally because they have not learned in advance the nature and hygiene of menstruation. Many boys are injured both in mind and character because they have no scientific guidance which helps them understand themselves during the stormy transition from youth into manhood. Moreover, there are certain simple hygienic commands that children under twelve should receive from parents and teachers. In all these lines the bearings of personal hygienic instruction are so obvious that we need not at this time stop to consider in more detail this first reason or problem for sex-instruction of young people.

§ 7. Second Problem for Sex-instruction: Social Diseases

Recent publicity regarding vice and disease.

During the past decade the general public has received some astounding revelations concerning the enormous extent of illicit sexual promiscuity, which is immorality according to our commonly accepted code of morals. Along with the evidence as to the existence of widespread promiscuity, has come the still more alarming information from the medical profession that sexual promiscuity commonly distributes the germs of the two highly infectious and exceedingly destructive diseases, syphilis and gonorrhea, known in medical science as venereal or social. When these are acquired by individuals guilty of sexual promiscuity, they seriously and often fatally affect the victim; but of far greater social-hygienic importance is the medical evidence that they are very often transmitted to persons innocent of any transgression of the moral law, especially to wives and children.

The medical revelations concerning the relation of sexual immorality to the plague of social diseases, has come from certain eminent physicians, notably the late Dr. Prince A. Morrow. His translation of Fournier's "Syphilis and Marriage" (1881), his own "Social Diseases and Marriage" (1904), and several of his pamphlets published by the American Society of Sanitary and Moral Prophylaxis, have been authoritative statements of conditions as the medical world sees them.

Social diseases and immorality.

The extent of social diseases is a fairly accurate measure of the minimum amount of immorality, for nothing is better established in medical science than that promiscuity in sexual relations is directly or indirectly responsible for spread of the microörganisms which cause the diseases. If for several generations all men and women limited their sexual relations to monogamic marriage, and the relatively rare cases of non-sexual and prenatal infection were treated so as to render them non-contagious, the social diseases would probably disappear from the human family. Such a statement is significant only in showing the relation of social diseases to sexual promiscuity, for of course, there is no reasonable hope that the venereal germs will ever be annihilated by universal monogamy.

Attack by education and sanitation.

Reduction of the amount of venereal disease must depend upon (1) hygienic and moral education which will lead people to avoid the sources of infection and (2) sanitary and medical science which works either by applying antiseptic or other prophylactic methods for preventing development of the causative microörganisms, or by using germicides for destroying those germs which have already produced disease. Thus the educational and the sanitary attack on the social diseases lie parallel. Both are needed, for, even with all the possible methods of attack, the progress against these diseases will be exceedingly slow.

Those who are interested in the facts relating to social diseases which point to the need of sex-education as one method of prevention, are referred to the pamphlets published by the American Society of Sanitary and Moral Prophylaxis; Morrow's "Social Diseases and Marriage"; Creighton's "The Social Disease and How to Fight It"; Dock's "Hygiene and Morality"; Henderson's "Education with Reference to Sex"; and certain chapters in Warbasse's "Medical Sociology."

Estimated amount of disease.

With regard to the accuracy of the commonly quoted statements concerning the prevalence of social disease, and therefore of immorality, it must be said in all fairness that there has been much guesswork and some deliberate exaggeration. We learn from various books and lectures that fifty, sixty-five, seventy-five and even ninety per cent of the men in the United States over eighteen years of age are at some time infected with at least one of the social diseases. The fact is that there is no scientific way of getting accurate statistics, for unlike other contagious diseases, the venereal ones are kept more or less secret, and numerous cases cannot be discovered by health officers. All the published figures regarding the prevalence of such diseases are merely estimates based upon the experience of certain physicians with special groups of men, especially in hospitals. There is no reliable scientific evidence as to the prevalence of venereal disease in the whole mass of our American population.

Education not concerned with percentages.

However, so far as education is concerned, there is nothing to be gained by dispute as to the possible inaccuracy of the higher percentages,[1] for it is generally admitted that probably over fifty per cent of the men in America and Europe become infected with gonorrhea or syphilis, or both, one or more times during their lives, especially in early manhood. This conservative estimate is sufficient to show that the sexual morals of probably the majority of men are at some time in their lives loose. There is reason to believe that with most such men the period of moral laxity is in early manhood before marriage, which, though not excusable, is explainable on physiological grounds. It is important to correct the wrong impression which is now widespread, especially among women who have read the more or less sensational statements in certain books and magazines, that the quoted figures on social disease mean that from fifty to ninety per cent of all men are immoral from time to time for many years. If that were true, the situation represented by the highest estimates would be hopeless, and we might as well start out to adjust society to a system of recognized sexual promiscuity. Fortunately, it is far from true, for a great many men included in even the conservative statistics of social disease were infected because they strayed from the moral path very few times and in many cases only once. This fact makes the outlook for improved sexual morals and health more hopeful, for probably the majority of young men need help in controlling themselves for a few years only, especially between eighteen and twenty-five.[2]

Established facts.

The reports of medical men regarding the damage done by the social diseases are inaccurate chiefly when they attempt to state percentages of the whole population. They are reliable when they state observed facts, such as the following: It is now established in medical science that (1) gonorrheal infection results in tens of thousands of cases in complications, such as heart disease, gonorrheal rheumatism, sterility of both men and women, blindness of infants, inflammatory diseases of female reproductive organs, and other well-marked sequelæ of the disease; and (2) that syphilis is responsible for a large majority of cases of locomotor ataxia, paresis and certain types of insanity, and also for numerous aneurisms of arteries, many apoplexies, and much disease of liver, kidneys, and other organs. Moreover, syphilis is charged with being the greatest race destroyer. Fournier, the great French specialist, noted that only two children survived from a series of ninety pregnancies of syphilitic women of the well-to-do class. It is probably true that much less than ten per cent of syphilitized embryos ever grow into mature men and women, and even these few survivors are likely to carry in their bodies the germs or the "virus" of syphilis which may affect the next generation.

Social diseases admittedly dangerous.

Such direct statements as the above may be accepted as not exaggerated. However, it little matters in sex-education, except for the purposes of sensational writers, whether statistics regarding the damage done by venereal diseases are more than estimates; for it is sufficient to remember that every physician of large experience agrees that syphilis and gonorrhea are so common and so destructive of health and life that they must be classed among the most dangerous diseases that now threaten the human race. This ought to be sufficient to attract the serious attention of every thinking man and woman.

Double standard of morality.

Thus, in general survey, we see the great problems of social-sexual hygiene caused by diseases that are widely distributed because sexual instincts are uncontrolled. In short, the alarming problem of the social diseases results from masculine promiscuity or the failure of men to adhere to the monogamic standards of morality. In other and familiar phrasing, there is widespread acceptance and practice of the so-called "double standard of sexual morality," a monogamic one for respectable women and promiscuity for many of their male relatives and friends. (See writings of Morrow, especially "The Sex Problem"; also Creighton's "The Social Disease.")

One problem for sex-education.

Our brief survey of the hygienic problems caused by sexual promiscuity and its characteristic diseases is sufficient to indicate one great problem for sex-education. Such social-hygiene problems have been most responsible for the recent and rapid rise of the movement for sex-education, and they must be recognized in any adequate scheme for instruction of young people.

Is sex-hygiene adequate?

Can scientific education hope to solve the sexual problems of society by inculcating such fear of venereal diseases that men will remain true to the monogamic code of morality? Many cynical disbelievers in sex-hygiene answer this question negatively by asking in biblical phrase, "Can the leopard change his spots?" In other words, these doubting ones believe that sexual instincts are so firmly fixed in the nature of many men and some women that there is no hope of radical change through education.[3] There is something in this point of view. It is probably true that even the most radical advocates of sex-education do not hope to secure universal monogamy and consequent disappearance of social diseases. A conservative and rational answer to the above question whether sex-education can solve the problem of social diseases, is that a large percentage of even civilized people are not yet ready to have their most powerful instincts controlled by scientific knowledge. Hence, there is no hope that the hygienic task of sex-education will be finished soon after instruction becomes an established part of general education in homes and schools. At the very best there will be incomplete returns for the social-hygienic aspect of sex-instruction, but already we know for a certainty that enough young men will be influenced to make the teaching justifiable. I feel sure of this because I have met personally many such men and my friends know many more.

According to the investigations made by Dr. Exner, the medical secretary of the Young Men's Christian Association, a great reduction of venereal disease has followed sex-hygienic campaigns in college towns.

Medical treatment.

In another way hygienic teaching may reduce the amount of venereal diseases, and that is by leading infected individuals to seek thorough medical treatment without delay. This, of course, will render the diseased person non-infectious to others. Physicians report that there is now a marked movement in this direction and, moreover, that many infected young men voluntarily seek medical examinations before marriage.

Woman's need of information.

Even if we refuse to believe that social-hygienic teaching will protect many young men from sexual diseases, there is the woman's need of information to be considered. As said before, women more than men suffer the consequences of venereal infections. Therefore, every young woman who considers marriage should know the possibility of danger to herself and her children, and be able to decide accordingly. Of course, even with much knowledge she may marry the wrong man, for correct diagnosis of social disease is not always easy; but if her confidence is betrayed and she becomes infected, she ought to know the importance of immediate and radical medical treatment. Let me illustrate these statements that women should know the danger of venereal disease. One of my college friends neglected an important legal case to travel seven hundred miles in order to tell face to face another college friend that she was about to marry a dangerous man. Being utterly ignorant of the existence of sexual diseases, the girl and her mother characterized my friend's statement by a short and ugly word, and ordered him to leave their home instantly. The marriage occurred and some months later the young woman went to her grave, a victim of gonorrheal salpingitis and peritonitis.

Another case which illustrates the danger of a woman's ignorance: One of my students of many years ago married a minister who infected her with syphilis and kept her from medical attention until the disease was in a highly developed stage, and even then conspired with an inefficient doctor to keep her ignorant of the nature of the disease.

The right to knowledge.

These are not extreme cases, for any physician with large experience knows that such things are common. Medical literature is full of such painful recitals of venereal tragedies. It is not desirable that all young women should know the details of such tragedies, but they should know that dangers exist. Parents and educators will not have done their duty until they coöperate to give all young women the protective knowledge they have a right to demand.[4]

Best people must lead.

There is another way of looking at the possible effect of the social side of sex-hygienic instruction. It is sure to make a decided impression upon many young people of the type that we regard as the best in every way. These will be the leaders of the future and they in turn will help improve conditions. Perhaps it may all work out as the drug problem is being solved. Widespread social and hygienic information regarding the harmful effect of alcohol, cocaine, opium, and other drugs has first of all impressed leading citizens; and these are beginning to control by laws those who cannot be reached directly by education. In some such ways those who are impressed by formal sex-education may lend a hand in influencing many who could not be touched directly by hygienic education.

Legislation needed.

There is no doubt that public enlightenment regarding the dangers of social diseases will soon lead to legislation and public medical work which will contribute greatly towards reduction of the diseases. For example, legislation with reference to venereal disease should require doctors to report cases to health officers, should forbid "quack" advertising of fake "cures," should forbid sale by drug stores of nostrums for personal treatment, should provide dispensaries and hospitals for reliable treatment at reasonable cost, should require medical examinations for marriage licenses and provide for such examinations at moderate charges or at public expense, should require certain sanitary precautions in care of eyes of new-born infants, and should provide for discovery and treatment of congenital syphilis in school children. These are lines in which good laws might help vastly in the war against the social diseases. Moreover, it is obvious that all laws which help control the social evil will work indirectly against the social diseases.

Probable results of instruction.

In conclusion, it seems probable that popular knowledge of the social side of sex-hygiene will reduce the amount of venereal disease (1) by teaching some people the dangers of promiscuity, (2) by adoption of certain sanitary precautions that lessen danger of infection, (3) by leading people to seek competent medical aid which, while often failing to restore the victim's health, will probably eliminate the danger of contagion for others, and (4) by intelligent support of laws that directly or indirectly affect the social diseases.

Social diseases not most important.

I have given great prominence to the social-sexual diseases in their relation to sex-education because along this line there has been developed the widespread interest in sex-instruction as one method of protecting young people against promiscuity. So far as the questions of teaching are concerned, my personal view is that some of the other reasons or problems for sex-instruction are more important, because I believe that educational emphasis on them will give the greatest results in improved sexual conditions of society.

§ 8. Third Problem for Sex-instruction: the Social Evil

So far as the problems of sex-education are concerned, there is nothing to be gained by an extensive review of commercialized prostitution. It is generally accepted that the social evil or prostitution is increased by the common ignorance of young people of both sexes regarding the physical and social relations of sex.

Of course, it is not true that all prostitution is due to ignorance, for it often involves enlightened men and women. However, there seems to be good reason for believing that large numbers of people of both sexes might be kept out of prostitution by very simple sex-instruction. Let us look for a moment at some facts concerning the relation of the ignorance of the women to their entrance into the underworld, and later consider certain reasons why many men patronize the social evil.

Why women enter prostitution.

With regard to the women victims of prostitution, it seems to be generally accepted that economic pressure, feeble-mindedness, bad social environment, and unguided instincts, independently or combined, are the chief causes of their downfall. However, there is a deeper reason why numerous women enter prostitution, for all of these factors commonly operate because of inadequate sexual knowledge. In short, ignorance is the fundamental cause of much prostitution on the part of women. Many a girl with starvation wages, bad social surroundings, sub-normal mentality, or even intense instincts is able to keep her womanhood because she knows the awful dangers of sexual promiscuity. For our present educational purposes, it is sufficient to point out the opinion of competent social workers that knowledge might often counteract the forces that lead women from virtue and down into prostitution.

Men also ignorant.

A large number of men patronize prostitution because they are ignorant in one or more of the following respects. Some of them have drifted into abnormal sexual habits when they were boys, and later into illicit relations. Some of them did not know the effect of alcoholic drinks in leading many young men to their first immoral sexual acts. Some of them have deliberately patronized prostitution because they have accepted as truth the monstrous lie that sexual activity is necessary to preserve the health of men.[5] Most of the men do not realize that prostitution offers great danger to their own health, still greater danger to the health of innocent wives and children, and a greatly shortened life for many women who are the victims of sexual slavery. Most men do not know that dark tragedies are often concealed beneath the apparent gay life of the women who are victims of sexual degradation. These are some of the things of which many young men I have known were very ignorant, and it has been no difficult task to trace a close connection between their ignorance and their vice.