Notes from an emergency room doctor: There are
certain words that you can't say in the media.
Despite the fact that it's in all too common usage
in daily language, you can't say the "F"
word. Not even if you're Madonna on Letterman.
Now it seems that the "M" word has dire
consequences too. The "M" word is masturbation.
Dr. Jocelyn Elders, President Clinton's recent
and former surgeon general was fired for mentioning
the "M" word. Dr. Elders’ dismissal
came because of comments she dared to make during
the World AIDS Day Conference at the United Nations
in 1994. "Masturbation," she said, "is
something that is a part of human sexuality and
it is part of something that perhaps should be
The furor and firing that followed seems more
consistent with age old phobias about masturbation
than the real issues. Certainly Dr. Elders angered
many people with her voice, often strident and
uncompromising, in pursuit of an agenda encouraging
early sex education, distribution of birth control
materials and condoms in schools, and promotion
of Medicaid funding for abortions. Any efforts
she might have made to encourage parental guidance
and self-restraint were not well publicized or
perhaps were subordinate to her other goals.
But the issues she raised and tried to deal
with - the problem of teen sex, teen births, and
AIDS - can only be addressed from two spectrums.
The political left would say the problem could
best be solved by school sex education programs
and the easy availability of birth control and
condoms. The political right would oppose that
solution and call for a renewal of "family
values" and "abstention."
But teen pregnancies and the spread of sexually
transmitted diseases will not be subdued simply
by the tactics of fear education about AIDS and
pregnancy, or by a plea for "righteousness."
Dr. Elders’ remarks about masturbation were more
on the mark of how to deal with the diseases and
excesses of sexuality in America than most of
her previous policy statements. Despite the fact
that the "M" word is distasteful and
embarrassing to many, its importance as part of
sexuality and part of the process of preventing
disease and pregnancy ought to be discussed.
Perhaps the next surgeon general will be able
to combine political tact with political courage
and renew the debate about masturbation and sex
If we are to reduce unwanted pregnancies and
sexually transmitted diseases, we ought not to
just advertise birth control or condoms versus
abstinence as options; we ought to advertise the
Masturbation is having sex with the only person
whose sexual history you can completely trust.
And, if you must have sex with a partner, mutual
masturbation is the safest sex of all.
Dr. Elders’ mention of the "M" word
was embarrassing and distasteful to many people.
But prudishness ought to have no part in the public
discussion of a serious issue.
During the 19th century, masturbation was considered
a disease. Doctors described its neurologic consequences
as epilepsy, blindness, headaches, and memory
loss. At one time it was even considered a virulent
disease. Two patients were admitted to New Orleans
Charity Hospital, one in 1872 and the other in
1887, for treatment of masturbation. Both died
there. The cause of death was listed as masturbation.
Today, hospitals have other lists of sexually
related deaths - due to AIDS, teen pregnancies,
and premature births by teenage mothers. Perhaps
Dr. Elders, with her departing comments, was right
in encouraging more educational options for our
sexually active youth. We ought to encourage abstinence.
We ought to encourage safe sex. And, yes, we ought
to talk about masturbation during sex education.
The "M" word is, perhaps, the most practical