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CHILD SEXUAL DEVELOPMENT
by Loretta Haroian
Editor's Note: The late Dr. Haroian was a Professor at the Institute for
Advanced Study of Human Sexuality for many years. This monograph was
prepared for student use in the mid-1980's, and has been a part of the
education of many sexologists. It is time it was made available to the
general public, and the many teachers of sexuality education to our
young people. The references to DSM-III are a bit outdated, but the
information is still useful.
David Hall, Ph.D.
Editor
PART I
Sexual Health
Sexual health is more than the absence of sexual pathology. The anatomy,
gender and function of the human body is the foundation of identity. The
awareness of the sexual self as an integrated aspect of identity begins
in infancy with the attitudes about the physical body communicated by
the caretakers.
The sexual response cycle as described by William Masters, M.D. and
Virginia Johnson, M.A., is present at birth, and there is evidence that
the neurological maturation necessary to produce penile erections occurs
in utero. The development and expression of the erotic response
throughout the human lifespan is not a well studied phenomenon, and
normative data have not been compiled for sexual behaviors of childhood
and adolescence. As we know it, the erotic response consists of a
complex interplay of physiological and psychological factors that are
highly susceptible to familial, religious and cultural folkways, mores
and attitudes. The styles of acceptable sexual attitude and expression
fluctuate historically and culturally between generally positive and
generally negative polarities. At this time, our own restrictive culture
time is still preoccupied with imposing sexual constraints rather than
promoting sexual competencies as a basic value system. We are certainly
less zealous in this pursuit than the repressive Victorians, but fears
of sexual excess and pleasure leading to a fall from grace are deeply
imbedded in the Judeo-Christian ethic. The impacts of this often
unconscious attitude on child rearing are the overt and/or covert
discouragement of sexual interest, curiosity, expression and sexual
behavior of children in the presence of adults and the continual
obfuscation of the scientific answer to the question "What is normal?"
Sexually permissive cultures not only allow a less fettered expression
of adult sexuality, but may give little attention to the sexual
behaviors of children as long as they are not blatantly displayed.
Sexually supportive cultures, believing that sex is indispensable to
human happiness, encourage early sexual expression as a means of
developing adult sexual competency and positive sexual attitudes. The
children in sexually permissive and sexually supportive societies
display a similar developmental pattern that is not apparent in sexually
restrictive and sexually repressive societies:
In infancy, there is usually manual and oral genital
stimulation of children of both sexes by parents as a means of
comforting and pacifying them (most frequently between mothers and sons).
In early childhood, masturbation alone and in groups, leads to
exploration and experimentation among children of same and opposite gender.
Late childhood (prepubescent) is characterized by heterosexual
role modeling and attempted intercourse (girls may begin having regular
coitus with older boys).
In pubescence, girls rapidly accelerate into a phase of
intense sexual experience, culminating in the acquisition of basic
sexual techniques at the adult level. Boys follow a similar pattern, but
their learning process is not as rapid or complete because they are
usually experimenting with younger girls. Heterosexual patterns replace
masturbation and homosexual activities for the majority of both boys and
girls.
In adolescence, there is increased sexual activity with peers
and adults for both boys and girls; and it is believed that birth
control is facilitated by the practice of multiple partners. Marriage is
common for late adolescent girls, but boys may delay marriage for
economic considerations and continue their adolescent sex patterns for
longer periods (Ford and Beach, 1951)
History
It would appear that human sexual expression follows a logical, orderly
and self regulating developmental pattern in much the same way as other
aspects of human behavior and that psychosexual disorders may be the
result of the interruptions of that sequential growth process. It is
well to remember that prior to the Victorian idealization of childhood
innocence, children were commonly used and abused physically and
psychologically. Eighteenth century aristocratic tradition imposed a
barrier between parent and child. It was the height of bad taste to love
one's spouse and children, as parenthood was thought to render both men
and women less fit for amorous adventure. Infants were removed from
their parents and suckled by wet nurses; mortality was high, even for
children who were well cared for. Infanticide was the major method of
population control, and infants were abandoned, neglected and
intentionally killed by drowning, burning, scalding, potting and
overlaying. Those who survived were often maimed or crippled to make
them more poignant beggars and were at the mercy of unscrupulous and
exploitive adults. Sexual exploitation of children was freely indulged
in until the latter half of the 18th century, at which time it was fully
repudiated. This was a decisive turning point in parent child
relationships in that parents began to punish children for their sexual
curiosity and activity (DeMause, 1974).
The Victorian era was a period of sexual schizophrenia for children. The
cultural dictum that childhood was free of, and was to remain free from,
sexual knowledge, interest and behavior, was contradicted by a constant
and continual adult preoccupation with, and surveillance of, children's
sexual potential. Freud's attempt to bring some sanity into this
schizophenogenic bind was theoretically helpful; however, the sadistic
trend in anti-masturbatory therapy accelerated when people became aware
of infant sexuality (Spitz, 1952).
The repression of sexuality made any expectation of sexual health
improbable, if not impossible, to achieve. It produced a pervasive
negative preoccupation with the sexuality of others and a category of
emotional disorders labeled "psychosexual." In keeping with the
contradictions of the time, the sexual referent to all nonsexual
symptomatology was diligently searched for or speculated about; and
direct treatment of sexual symptoms was bypassed in favor of analyzing
the "psychosexual" stages of childhood development. Although the
expectation of both therapist and patient was that healthy sexual
function would be restored by the exploration of the parent-child
bonding relationship, this was rarely, if ever, the result of
psychoanalysis.
Sexology
The mental health community continues to have a poorly defined concept
of sexual health and is in fact only called upon to attend those who
have experienced sexual trauma, dysfunction and/or sexual pathology.
Although sexuality (i.e. sexual interest, sex drive) is considered by
many to be the life force, sexology (sexual science) is less than 100
years old. Clinical sexology (the diagnosis and treatment of sexual
concerns and dysfunctions) as a specialty is newer still. Sex therapy
has been a viable and identifiable health specialty since the 1960s, and
the clinical sexologist is a phenomena of the late 1970s. However, the
clinical child sexologist is a professional category of the future. Even
so, pediatric professionals in both medicine and mental health are
consulted by parents, caretakers, authorities and occasionally, youth
themselves about sexual matters. It is no longer questionable to
consider sexual health as the absence of sexual pathology, because
sexual pathology is often a religious-cultural definition which fails to
consider the broad range of human sexual activity and its developmental
aspects and measurable frequencies, as well as its impact on the quality
of human life.
Sexual Rights of Children
In the western culture, great controversy has been perpetuated over what
adult (parent and professional) attitudes about children's sexual
expression should be. Many child rights advocates believe that children
are a disenfranchised minority in the age/class system and state that
the privilege and responsibility of sexual behavior is one of the many
human rights denied them. They suggest that the proper adult stance is
one of permissiveness to encouragement (Farson, 1974; Yates, 1978). This
argument is more than vaguely akin to the rhetoric of the pedophile
groups who have a vested interest in the relaxation or abolishment of
child protective (albeit restrictive) laws. Many child experts more
conversant with the vulnerabilities of children in a complex pluralistic
society opt for laws and social custom that, although somewhat limiting,
provide protection from unscrupulous adults. Children, by definition,
are not consenting adults in sexual matters and may need protection from
the liability of sexual contracts in the same manner that they are not
held accountable for business or labor contracts.
This position does not suggest that there is inherent harm in sexual
expression in childhood; in fact, we have considerable evidence to the
contrary. Sexologically, it is based on the knowledge that the benefits
of free sexual expression of children can only occur in a sexually
supportive society: a society in which all people have sex for sexual
reasons, one in which sexual knowledge, skill and pleasure are valued
for both males and females. A society that encourages sexual competency
rather than constraint and in which every man, woman and child can say
"yes" or "no" to sex without prejudice or coercion. To encourage
children to be sexual in a sexually repressive or permissive/ambivalent
culture is to exploit their healthy sexual interest, as they will be
left alone to deal with a double standard and the sex-negative,
self-serving attitudes of peers and adults.
PART II
Development of the Erotic Response
In the absence of normative data on the behavioral manifestations of the
development of the erotic response from birth through adolescence, we
must, for the moment at least, hypothesize a normal distribution of an
infinitive population. We assume then that there will be some highly
sexed children for whom sexual concerns and sexual expression will be a
dominant theme, positively or negatively expressed in their life as a
whole, with some fluctuation in the various stages of development and in
response to certain circumstances. There will be a like number of
children for whom sexual concerns and expression are a consistently low
priority in the organization of their life as a whole, with some
fluctuations in the various stages of development and in response to
certain life events. The middle 68% is hypothesized to fall equally
distributed between these two extremes and to have a moderate focus on
the sexual aspects of human existence with the aforementioned
fluctuations. This group would be more responsive to the external
cultural attitudes about sexuality and would be more easily influenced
by external events (i.e., they would be more liberal in sexually
permissive times or cultures and more conservative in sexually
restrictive times or cultures).
With the normal distribution of the population as a theoretical
baseline, it would appear that a wholesale advocacy of more sexual
expression in childhood would be as oppressive to the children at one
end of the distribution, as a societal expectation of no sexual
expression in childhood would be to the children at the other end of the
continuum. It is a romantic notion that the encouragement of sexual
freedom in childhood would produce a society of adults who rise to
unparalleled heights of sexual intimacy and ecstasy and who are devoid
of sexual dysfunction. If we can hypothesize the normal distribution of
sexual interest and drive, can we also project the fluctuations that are
subject to age, stage and life events? A close look at the developmental
and sociological literature allows for some cautious extrapolation.
Keeping in mind that developmental criteria for normative age and stage
behavior are, to a degree, culture-bound, we can project some reasonable
parameters of expected sexual behavior.
Overview
There are four stages of childhood and adolescence in which the focus of
the body shifts between a primary and a secondary concern. The first
stage is from birth to approximately 6 years of age. The physical body
is primary; and sexual interests, curiosity, arousal and behavior are
spontaneously expressed unless or until the child is taught to repress
or inhibit her/his pleasure orientation.
The second stage is from approximately age 6 to pubescence
(approximately age 12). The physical growth ratio slows, the basic gross
and fine motor coordination is accomplished and reliable and the primary
attention of the child shifts to the mental realm. The desire for sexual
pleasure continues; however, most children are thoughtful and
discriminating about their sexual
behavior and expressions. Their needs for privacy and autonomy
characterize this stage.
The third stage is pubescence to early adolescence, and the age range is
highly variable: approximately ages 13 to 15. As the hormones come into
play, the body is once again primary, with rapid growth spurts, the
development of secondary sex characteristics, sensations of increased
intensity and a new awareness of the physical self and its impact on
others in the social sense. Sexual behaviors respond to a stronger
biological mandate, becoming a preoccupation which may be characterized
by poor social judgment, high risk behavior and lack of discrimination.
The fourth stage is mid to late adolescence; and again, the age range is
variable: approximately age 16+. The body growth rate slows,, the
hormonal balance is achieved, the secondary sex changes are incorporated
into the body image, the sexual response cycle is accommodated through
masturbation or partner sex and sexual gratification is integrated into
the context of a relationship.
The sexual maturation of a child reflects the overall pattern of
development, from absorption in and dependency on the family of origin
through the gradual acquisition of a sense of the autonomous self, to
the confidence and desire to establish an intimate bond and form the
family of choice. The erotic response of infancy is global,
undifferentiated and polymorphously perverse. In childhood, it moves
toward a genital focus (more surely for boys than for girls) and is
expressed through purposefully directed masturbatory activity and
perhaps some negotiated social interaction (often with same sex
partners). At pubescence, the genital focus intensifies, the acquisition
of opposite sex partners gains importance for heterosexual youth and
sexual experience per se is the paramount goal. In adolescence, this
motivation of curiosity and self gratification emerges into one of
sexual reciprocity and mutual sharing. Partnerships are increasingly
stable, interdependent and emotionally intimate. It is well to note that
this developmental schema appears to be stable in all cultures, whether
they be sexually repressive, restrictive, permissive or supportive;
however, it is enhanced by, but not dependent on, the child's ability to
engage in sexual behavior and is seen as a mental construct in the
absence of sexual experimentation. There is considerable evidence that
adult sexual health and pleasure are positively correlated with age
appropriate childhood sexual behavior. The interplay between the
individual sex drive, importance of sex in a person's life and the
sexual values of the culture (sex-negative or sex-positive messages)
will determine the opportunity for sexual behavior in childhood and
adolescence. The strongly sexed child may struggle through what
constitutes a repressive childhood in a sexually negative culture, but
emerge as a sexually healthy adult because s/he took every possible
opportunity to be sexual and maintained a positive sexual focus despite
censure and sanction (typically a male pattern). More at risk in our
culture is the moderately sexed child or low sexed child who accepts the
culturally negative values, is sexually inactive and unaware during
childhood and finds him/herself out of phase with the sexual
expectations of adulthood (typically female pattern).
Although it is currently popular to attribute all sex specific
differences to cultural factors, it may well be that there are inherent
differences; these constitute a major child rearing concern. A close
look at American child rearing practices suggests that in terms of adult
attitudes, boys exist in a heterosexually permissive culture. There is
some expectation that "boys will be boys," which includes sexual
experimentation and behavior; and as long as they do not blatantly
flaunt their sexual interest and activities in front of adults, they
receive little censure. Girls, on the other hand, are reared in what is
essentially a sexually restrictive society in that their sexual
interest, and certainly sexual behavior, is neither sanctioned nor
ignored by adults.
Conversely, girls are expected to be nonsexual in childhood and
adolescence. Sexual interest, curiosity and, especially, sexual
experience cause girls to be devalued by family and peer group alike.
Sexual innocence, inexperience and ignorance are cultural values for
girls. They are permitted to express curiosity and receive information
about their future reproductive function as their gender role is
programmed. Sexual intercourse is presented as the gift they are to give
the man they love--a marital duty, necessary for impregnation. They
might, on occasion, enjoy it, but the pleasure aspect is reportedly
dependent on love and is not considered sufficient reason for their
engaging in sex. (Men have sex because they love sex, women have sex
because they love the man). Girls are taught to withhold and begin to
use their sexuality as a negotiable commodity. Concurrently, they are
taught to devalue women who sell their sexuality, the prostitute being
held out as the greatest threat to the sanctity of female virtue and
family values. Girls are expected to be the guardians of cultural mores
by restricting or diverting the male sex drive.
Boys are taught that it is their nature and their right to pursue sexual
gratification, but that girls who, like themselves, seek sexual
experience and pleasure, are less valued in society than girls who deny
them sexual favors. Boys may be more egalitarian in their attitudes
about their "sexual partner," expecting her to be uninhibited, willing
and responsive. Although they appreciate and enjoy sex with a responsive
partner, they expect her not to engage in sex with others, even though
they may give themselves permission to do so. Often, without conscious
awareness, they devalue the sexually responsive girl that they enjoy and
dedicate themselves to a relationship of sexual frustration with a girl
who uses her sexuality for secondary gain.
The girl who, true to the double standard, has sex to please (and
control) the boy, rather than to please herself, offers a sense of
security to an unsure male. If she does not enjoy sex or pretends that
she is disinterested except to accommodate her partner, he need not
worry that she will actively seek or willingly respond to sex with
others. He may seek sex for pleasure outside his primary relationship
and value, in a social sense, his non-sexual mate. If her prudishness is
a sham, she may also seek outside sexual gratification and be seductive,
responsive, assertive and/or experimental with another partner.
These adult patterns have antecedents in childhood and are easily traced
through the ages and stages of development.
Birth to One
The first year of life is almost a purely physical experience for the
infant. The growth functions are under better control as the body
chemistry and the nervous system adjust to the post-natal environment.
The increasing maturation of the neurological system, the adaptation to
physiological independence, the ability to attend visually, the
acquisition of basic gross motor coordination and the differentiation of
self from the rest of the world through kinesthetic awareness, are all
primarily physical tasks. The formation of the symbiotic bond and the
quality of the interaction between child and caretaker is the foundation
for the attitudinal structure of the child. The attitudes about the body
and body functions are the bases for comfort or discomfort in sharing
bodies in sexual intimacies and are also the basis for self acceptance
and self-esteem in a much broader context. As early as four weeks of
age, there is unmistakable psychological interest in the bodily
functions. Infants will display a sense of well-being after completion
of a meal, they enjoy their bath and contacts with mother's body and
they respond to the snugness of being wrapped or held. They have a
positive response to comforts and satisfactions and negative responses
to discomforts and denials. They are wakeful, attentive and comforted by
handling of the body, bathing, nudity, the caretaker's voice, closeness
to another person, movement and genital sensations. They fret or cry
when the alimentary tract or the eliminative organs are not functioning
smoothly, and they express demands and discomforts through crying and
body language.
At about 4 months, the child will cry for social stimulation alone and
during breast feeding, will gaze intently at the mother's face. The
neurological system has matured to the point that his/her hands pass the
mid line of the body; and for the first time, s/he touches and is
touched simultaneously. During the second 6 months of the first year,
the infant has a compelling urge to use his/her hands for manipulation
and exploration. The pincer grasp develops, and her/his hand is no
longer predominantly fisted. The fingers are more nimble, and s/he
fingers his/her fingers. The process of self-discovery begins as one
attempts to explore his/her world through hands and mouth. The
genito-urinary system is coming under better control, and some girls are
dry through their naps at this age. Near the end of the first year, the
emotions of affection, jealousy and sympathy can be evoked.
Age 1
The 1-year-old child likes an audience, enjoys applause and may be the
very center of the household group. Responses from others to his/her
thespian antics help him/her develop a sure sense of self-identity, as
does the new skill of casting and releasing, which is the compliment of
grasping behavior, learned at an earlier stage. Dropping or casting is
the neurological forerunner of counting, bowel and bladder control and
orgasm. The 1-year-old is much more mobile and autonomous, and if not
walking, is cruising and can attain a sitting posture without help.
Although there is a primitiveness about their posture and coordination,
the assumption of the upright posture emancipates the hands for more
sophisticated exploration and manipulations. The hands are not yet agile
at the wrists, thus the purposeful stimulation of genitals is not often
observed. Children at this age do show an increased interest in the
products of elimination. Girls laugh when urinating and both genders
love their bath and love taking off their shoes. They enjoy a bath with
older siblings, and they resist being dressed. They like to undress
themselves and run naked, especially out of doors, and if left alone,
divest themselves of all clothing except their T-shirt, which is beyond
their capability. They play alone on waking, and genital play is common,
as is feces smearing if the necessary ingredients are available.
Punishment and shame are commonly administered by parent to children of
this age in connection with bowel and bladder function, and the child
may begin to scold him/herself or cling to mother after an eliminatory
accident.
Age 2
The growth continuum seems to take a giant leap at the second year. Two
is an age and stage which is especially meaningful in terms of adult
sexuality. Their neurological maturation has progressed through
perpendicular and horizontal phases, and now they come into the circular
phase. They have achieved the ability to rotate the forearm, which not
only means they can turn the doorknob, but can effectively and
purposefully stimulate their genitalia. The major focus of their life
has to do with bowel and bladder control; thus, much attention is
directed to the pelvic area of the body. As they are in the process of
sphincter control, they utilize these systems, along with genital
manipulation, as tension release outlets. Most children at this age can
differentiate between bowel and bladder, have fewer accidents and may
demand to do it "themselves." They are concerned about failures and
successes and may scold or give themselves credit for what they consider
bad or good behavior. They may be unable to move, may scream for help if
they accidentally wet their pants and may demand that father attend
their toileting when they need assistance.
The function of the genito-urinary system is not a simple local
reaction. It is a total response of a total organism which is a
developmental or maturational coordination of the involuntary mechanisms
of the vegetative nervous system and the higher brain centers. The
elaborate neurological network that allows for kinesthetic awareness and
voluntary control of bowel, bladder and sexual system functions is
basically complete within the first five years of life, although all
systems remain highly susceptible to psychological vicissitudes in
childhood, adolescence and adulthood.
Conscious control over the retention and release of bowel and bladder
function is achieved by most children by age 6, if not before, and is
considered a major developmental task of early childhood. Much
parental/caretaker attention is directed toward the child's establishing
a pattern of elimination that is physically healthy, culturally proper
and socially aesthetic. The same attention has heretofore been denied
the sexual function, which is governed by the same need for kinesthetic
awareness, conscious control of retention/release and skill training.
Adult sexuality has the added dimension of a socio-sexual component; for
in contrast to bowel and bladder function, it is experienced and
expressed in the context of a relationship and needs to be a reciprocal,
mutually satisfying and erotic, interpersonal exchange.
Many 2-year-olds have problems going to sleep and may have nonproductive
sensations of needing to void. They may awaken during the night to go to
the bathroom (especially girls), and they love to be in the bathroom
with other family members. They still like to be naked; they love to
romp, flee and pursue, to fill up empty things, put in and pull out,
tear apart and fit together, to taste, touch and rub. They have a
genuine interest in mother/baby relationships, they love water and doll
play; and both boys and girls pretend they are the mother of their
dolls. They may become shy or affectionate with mother or caretaker; but
in the later half of the second year, they emerge into an exasperating
transitional stage which is equally balanced between alternatives. They
are unable to think of one choice to the exclusion of the other, and
they're aptly called extremists. They are conservative, ritualistic and
paradoxical. They are learning opposites. If isolation to their room is
used as a punishment or control, they may develop stable patterns of
self stimulation in association with this new sense of independence and
autonomy.
Age 3
Three is coming of age. It is characterized by a high degree of self
control. Three likes to please and comfort and enjoys sedentary pastimes
that use fine motor coordination. Many 3-year-olds have gained
inhibitory control of sphincters and can almost toilet themselves during
the day. They have an interest in persons and watch facial expressions
for the purpose of finding out what they indicate. Three expresses
affection, says, "I love you" and can affirm his/her own sex ("I am a
boy"), but often in the negative ("I am not a girl"). They verbalize sex
differences. Girls often try to urinate standing up, and there is a
desire to touch mother's breasts. Threes have a great interest in
marriage to the other parent and want the family to have a baby. There
is some basic questioning as to where a baby comes from and an intense
desire or need to relive their own infancy. They may act out being a
baby, want to have a bottle or nurse at the breast and be carried in
competition with a new sibling, even if the family does not have a baby.
Three-year olds can be a delight during the day, but wakefulness at
night is common; and often, a 3-year-old has a very active night life.
Dreams begin to be reported, and they may be very frightening even
though the child cannot recall or relate them. Three is also the age of
imaginary playmates on whom most of the bowel and bladder accidents are
blamed. The 3-year-old will share stories of his/her imaginary playmate
with mother, but s/he needs and wants stories about him/herself from
her. Three wants to know everything about when s/he was a baby and wants
the stories repeated over and over. This apparently solidifies a sense
of self. Three is beginning to be able to make simple choices if the
alternatives are clear. Worry, thoughtful concern and memory indicate
significant mental growth. Threes will link events and reintroduce a
topic of conversation with new insights. Three-year-old J was fascinated
by her mother's method of determining the respective sexes of a litter
of kittens. After the death and burial of one of the kittens, she
thoughtfully remarked, "I bet God had to look under her tail, too."
In the later half of the third year, the child begins to feel great
tension and expresses it through many compulsive patterns, such as
stuttering, eye blinking, nail biting, thumb sucking, nose picking,
masturbation, spitting and/or chewing on hair or clothing. It is an age
of emotional extremes in which three seems to be strengthening his/her
will by practicing domination. S/he may be extremely commanding and
demanding with adults as well as peers and may be intensely jealous of
his/her parents? attentions to each other, trying to separate them from
affectionate embraces or demanding to be included. Three-and-a-half
shifts rapidly between extreme shyness and exhibitionism, all in the
quest of positive attention. His/her feelings are easily hurt by failure
or by people ignoring him/her or not doing what s/he wants them to do.
Threes' attempts at social interaction vacillate between demanding
insistence and obsequiousness. The intense need for attention,
preoccupation with bodily functions, interest and curiosity about
reproduction and increased ability to communicate verbally with adults
can culminate in a pseudo-mature seductive posture, especially in female
threes who have been socialized to be more tractable than many male
3-year-olds. It is quite common at a party of adults to see the
3-year-old daughter of the host comfortably curled up in the lap or laps
of a succession of male guests capturing their attention with her
interpersonal magnetism.
She may even request that her "new friend" put her to bed and may hold
thoughts of him and make reference to him for days or weeks after the
party. This behavioral pattern is not exclusive to girls, but is
somewhat more pronounced, is better tolerated in terms of gender role
stereotypes and receives positive reinforcement from the involved
adults. Similar behavior in boys may be discouraged by negative
responses or extinguished by lack of response from most adults.
The potential for sexual stimulation in this situation is obvious, and
available data confirms the incidence of pedophilic genital fondling at
this age. The accessibility and vulnerability of the child may be beyond
the capable limits of an adult male with poor impulse control. The
sexualization of the adult-child relationship is not sin qua non a
psychological trauma. The sex histories of many adult men and women
contain such experiences that were not traumatic or that caused little
concern until the sexual activity escalated beyond looking and fondling
or until the situation was discovered and responded to negatively by
other adults.
Age 4
Four-year-olds are out of balance, with both their muscles and their
mind. The 4-year-old is not quite as sensitive to praise as s/he was at
three; instead, s/he praises him/herself through bragging. Four is a
great talker. Questioning comes to a peak at this age, and his/her
imagination knows no bounds. S/he is a fabricator and alibier and will
dramatize any experience. Four is a master at anti-social conduct, likes
to call people names (often body parts or bathroom words), becomes
defiant, emphatically refuses anything that is not to his/her liking and
may run away from home. Actually, the 4-year-old is developing a strong
sense of family and home, with mother and sometimes father often quoted
as the court of last resort. "My mother said so," is the definitive end
of many arguments at this age. Four-year-olds are truly social beings,
and they are most relaxed and happy when they are alone with one adult.
There is some hint of tribal sociology in the group life of 4-year-olds
in nursery school, wherein groups form spontaneously with specific rules
and regulations. Both boys and girls like to play house and may indulge
in considerable household activity, including dressing and undressing of
their dolls. Four-year-olds are intensely interested in death and may
continue to have bad dreams, especially about wolves. They are
preoccupied with their belly button as something to consciously cover or
expose and may still believe that babies are born through the navel.
They ask where babies come from and may continue to believe that they
are purchased at the hospital, regardless of the explanation given. In
terms of genital play, they may play "show" with other children, boys or
girls; and although they may want bathroom privacy for themselves for
bowel movements, they are not so concerned about privacy for urination;
and they have a continuing interest in watching everyone else in
bathroom activities. They may grasp their genitals when under stress,
and stable masturbation patterns from age 3 may continue.
This is an excellent age to test the reproductive interest of the child
with accurate and more detailed explanations about procreation.
Especially if their environment includes pregnant women or newborns,
their curiosity will be stimulated; and they are quite capable of
hearing the accurate details. If they continue to report that babies get
out through the navel or that they are purchased at the hospital, it is
not necessary to make an issue out of correcting their misinformation.
At a more appropriate time, you may again tell the story of
reproduction; and eventually, the information will be assimilated and
reported correctly. Many children are quick to grasp the concept of
intercourse and may make delightful, albeit inconvenient, reference to
their new knowledge. Four-year-old A in a conversation with his mother
said, "I'm a boy, and I have a penis; you're a girl, and you have a
vagina. We could put ours together. Do you want to, Mom?" Mother
answered appropriately that boys and mothers don't put theirs together,
just mommies and daddies: "When you're a Daddy, you will put it together
with your wife."
Age 5
Five is a golden age. Development is a smooth organization and synthesis
of earlier experiences. Mother is the center of five's world: s/he likes
to be with her, please her, watch her, help her and be affectionate to
her. "I love you, Mommy" is expressed frequently in a burst of emotional
exuberance and quite often accompanied by hugs and kisses. Boys
especially may derive mischievous joy from romancing Mother with tight
hugs and long kisses in public or in front of father. Five's want to
please, they want to do what's right and they like the social
interaction of asking and receiving permission. "May I have a cookie?"
and "I'm going to the bathroom now, Mommy; is that all right?" are
common verbalizations of the 5-year-old and are a welcome change from
the obstreperous four. Mothers are often more comfortable with the
closeness and dependency of the 5-year-old girl and may be less so with
a boy. Although cultural role stereotypes do not endorse dependency as a
male value, a boy's need at five to be close and loving with his mother
is essential as he, like his female counterpart, moves from the
make-believe, fantasy world of infant to the conscious reality of childhood.
Fives are stark realists and want the details of life and living. Death
and after death, sex and reproduction are favorite topics for their
emerging intellectual philosophizing. They express a greater awareness
of time and can talk about past and future. They compare differences
between the bodies of girls and boys and show increased awareness of
differences between the sex organs of children and adults. With greater
awareness of gender identity, boys may reject girls' toys; but both boys
and girls want a baby and may dramatize the event by enacting what they
know and have assimilated about reproduction. They may attempt
intercourse if the setting is conducive and may put a doll under their
clothing or between their legs to simulate pregnancy and birth. They may
verbally recall being in mother's stomach or futurize a baby, in their
own stomach. Boys may still occasionally say, "When I grow up to be a
Mommy," but respond upon questioning that they are destined to become
fathers if they choose to parent. Fives talk of marriage, but expect to
marry a family member and live at home with their baby. They may be
upset and feel abandoned if the parent insists that they will marry a
stranger and leave home.
During this time, increased fine motor control is much improved; and
although the belly button may be omitted from human figure drawings,
genitals are often added, much to the consternation of the kindergarten
teacher collecting displays for public school open house! Sex talk is
often embarrassing to parents, even though it is honest and forthright
on the part of the child. Five-year-old B said, "Sometimes I see one fly
sitting on top of another fly." Her mother replied, "Flies are like
that." She continued, "I've thought and thought, and I've finally
figured it out. That must be her big brother giving her a piggy-back ride."
Fives are basically in emotional equilibrium and evidence inhibitory
poise. They can assess social situations and often respond
appropriately, delaying their gratification to the proper time and
place. They may continue some tension reduction behaviors that are
annoying to adults, such as a thumb sucking or holding and rubbing of
genitals; but pressure to discontinue the tension relieving behaviors
may produce more tension, resulting in even younger patterns of behavior.
Fives have trust and confidence in themselves and others, but only to a
point. Negative experiences with a person or expectations beyond their
comfort level produce worries and fears that will be communicated to
parents or produce symptoms of anxiety. A 5-year-old will often report
sexual overtures or sexual behavior, especially from or with an adult,
to mother in a matter-of-fact way. Quite often, they have already turned
down the invitation; and little needs to be made of it. Five-year-old K
reported to his mother that a 12-year-old neighbor girl wanted to see
his penis and offered to show him her genitals in return. He had a
social conscience and explained, "You know, Mom, she doesn't have a
brother to look at, but I told her if she wanted to see a penis, to ask
her dad because he has one." Although there is little reason to suspect
peer sex play is a negative experience for 5-year-olds, parents may be
uncomfortable with it and hypothesize dire consequences at a later date
in order to give themselves permission to prohibit it. In point of fact,
every child is initially subject to the value system of his or her
parents and the arbitrary rules of the household. It is best to be clear
about what the rules are without burdening the young child with fear,
doubt and guilt.
Five is an age of fears of violence, the unknown and power (e.g.,
thunder, darkness, abandonment, retaliation and punishment) that may
cause nightmares and inability to sleep alone through the night. It is
wise not to inadvertently include sexual concerns in this matrix of
anxiety. Fives also have fantasies of omnipotence (Superman) and a sense
of humor (tricks, riddles, bathroom jokes, etc.) that can be marshaled
to combat their worries and fears. Stories with victorious or humorous
outcomes can replace their bad dreams, worries and fears. Five-year-old
C dreamed that a snarling wolf came into his bedroom and wanted to bite
off his penis. His therapist rewrote the dream so that the wolf was
snarling because he was hungry and he had a thorn in his paw. When he
saw C's penis sticking up (as it often did during the night), he thought
it was food. C woke up and helped the wolf get the thorn out of his paw
and fed him some dog food, and they became friends. He gave the wolf a
name, and the wolf agreed to watch over him while he slept so no harm
could befall him. This revised scenario caused C to gleefully announce
that the wolf probably thought that his penis was a weenie, and he
revealed that a nursery school companion used that term to designate his
penis.
Age 6
Six is the center of his/her own universe. S/he wants to be first, wants
to win and wants to be popular and well liked. S/he is impulsive,
indecisive, volatile, compulsive and excitable. Six is plagued by
bi-polar opposites that vie equally in the decision making process. No
matter what six decides, s/he is sure the alternative should have been
chosen. Six forgets his/her manners, is active, restless and overextends
to accident proneness. Six is replacing milk teeth with permanent teeth,
is physically less robust and is susceptible to infectious diseases and
somatized stress. S/he has many fears (wild animals, ghosts and
subhumans, strangers, physical injury, deformities, dark, God, being
buried in the ground and mother dying) and at times, seems overwhelmed
with his/her growing awareness of the complexities of life. Six-year-old
L reported that when his penis got hard, he hit it to make it go down.
When questioned, he admitted that it felt good when it got big, but
queried, "Have you ever heard of the story of Pinnochio?"
Six is egocentric, thinks s/he knows it all, believes his/her way is
right, projects his/her emotions and thoughts on others and cannot
contemplate the full person hood of others. His/her dual life at school
and home is hard to balance internally, and the academic and societal
demands of school may produce younger patterns of behavior at home or
the wish to be a baby again to escape responsibility. The sense of self
as a member of the first grade allows the child to defy and be critical
of parents and siblings. "So what?" is a favorite response in family
interactions. Sixes love and hate mother, but are most dependent on her
for emotional sustenance. Six is expansive or over controlled on a
minute-by-minute basis. They are curious about anatomy, but may be
highly critical about the nudity and/or masturbation of younger
siblings. They like to talk to mother privately about many topics
including sex, marriage and death. Girls especially like to talk about
having babies, and both boys and girls want a baby in the family to take
care of and hold. They are curious about how the baby gets out and how
it gets in. They want details, but may be disturbed about thoughts of
coitus and/or delivery. Six-year-old W remarked that she would be
"embarrassed to have a baby with a doctor present." After a lengthy
discussion of the history of childbirth, midwifery and infant and
maternal mortality, etc., she philosophically proclaimed that she would
have a physician in attendance because "even though it would be
embarrassing, it would be better than dying."
If sex talks with mother are open and comfortable, girls may ask to see
their mother's vulva. Some women are quite comfortable in complying with
this request, while others are not and may provide pictures of adult
genitalia and encourage the use of a mirror to inspect her own instead.
Boys and girls look at father in a new light as they imagine the details
of parental sexual interaction, and their questions may persist over a
long period of time and may be quiet personal. They have an increased
ability to conceptualize sexual information at this age; and even though
it may have been available at earlier ages, it has new impact and
meaning at six. Obviously, the quality and quantity of sex talk between
parent and child is dependent on the parent's comfort with and
willingness to entertain the subject. Children are quick to sense
parental discomfort or unwillingness to discuss sexual topics and many
inhibit their interest and curiosity and/or reserve the topic for peer
discussion. The primary nature of the body and the attention to physical
concerns in the first five or six years of life stimulate a spontaneous
flow of questions and comments about sex, anatomy and physiology from
the child and offer a multitude of opportunities for a parent to
introduce appropriate levels of sexual conversation. Conversely, it is
easy to inhibit the sexual spontaneity of the child and pass up the
opportunity to carefully weave the threads of sexuality through the
fabric of childhood. In doing so, parents forfeit awareness of the
child's sexual development and nullify their influence in the tumultuous
adolescent years when sexuality is a primary developmental task.
Some sixes show a marked interest in anatomical differences; and playing
"show" and "doctor" help satisfy that curiosity, especially for children
who haven't had opposite gender siblings or playmates. Six-year-old K
was crying because her 14-year-old brother had locked her out of the
bathroom. Her mother explained that he wanted his privacy because his
penis was beginning to grow. K continued to cry and bang on the door as
she replied "But he's my brother, and I want to see his penis grow."
Penetration, either in masturbation or mutual sex play, is most likely
to occur at this age and may be vaginal or anal (simulating the taking
of body temperature anally, which is in their experiential background).
Sex play with older children is also common, and a 6-year-old's interest
and curiosity about sex may be easily exploited by older siblings or
extended family members and caretakers. Sixes are much more apt to
report to mother sexual contacts with older children or adults than peer
sex play, which most often goes unreported.
Significant changes in the sexual focus of the child occur somewhere
between the ages of 5 and 7. Freud suggested that this was the onset of
sexual latency and that the healthy child ceased all sexual interest and
behavior and was vulnerable to sexual trauma if his/her environment was
not devoid of sexuality. Sexologists find little or no evidence to
support the latency theory, despite its durability as a concept in
analytical psychiatry and its continuing influence among the clinical
mental health community. Observation of children does reveal a higher
order of development and an organization of behavior that might lead to
the hypothesis of sexual latency; however, sexual interest and behavior
is a durable, and ever-present phenomenon throughout the tenure of
childhood. The significant change has to do with the child shifting from
bodily concerns to mental concerns.
Age 7
Seven is an age of assimilation. Self-absorbed in a world of his/her
own, 7-year-olds order and assimilate knowledge, experience and
philosophical and psychological constructs through reflective fantasy.
Seven learns the meaning of things and people and develops "feelings"
about them. The importance of his/her mental activity produces
moodiness, shyness and extremism. Seven feels no one loves him/her,
everyone hates him/her, s/he can never do anything right, things are
never going to work out, s/he always loses and everyone has it better.
Seven broods over things in terms of the impact they will have on
him/her. S/he sees people and things in perspective and achieves a new
sense of self through detachment from mother. Relationships with others
are important, relinquishing dependency on mother; and sevens often fall
in love with their second grade teacher. Speech becomes increasingly
important as the personality development fosters self-reliance. With
verbal negotiations and reminders, sevens can become handy helpers. They
are assertive, have definite ideas and mutter, argue and sulk if they
are treated like a child. Sevens are not good losers and easily drop
into self-pity and self-righteousness. Seven is ashamed to cry, doesn't
want peers to laugh, hates to be teased and fears humiliation. S/he
blames others, create alibis for their shortcomings and may engage in
behavior that is labeled lying and stealing by adults. The emerging
ethical sense is in the process of sorting out the import of actions on
self and others; and what appears to be dishonesty is more accurately
described as advantaging self with the result, if not the intent, of
disadvantaging others. Seven is reflective and self-critical and is
often called the "eraser" age. They persevere and repeat always with the
anticipation of an improved result. They have growing awareness of time
and space orientation and can tell time, but cannot keep track of it.
They are less fanciful than they were at six, and they have an interest
in cause and effect and how things actually work. Sevens can bathe and
dress themselves, but may need help in getting started and reminders to
stick to the task until it is completed, as they have a tendency to get
distracted. They often love their bed and do not resist going to bed,
but may lay awake for an hour or more and develop nighttime rituals to
combat fears and tension.
Few report regular masturbatory rituals at this age, and masturbation
tends to be spontaneous rather than premeditated. Sevens may begin
wearing their underwear under their night clothes for a sense of
security. Few sevens still wet the bed; and if they arise to toilet
during the night, they do not need help. Sevens have many tensional
outlets that are seen as bad habits to parents. Thumb sucking may
persist, but usually it gives way to nail biting, nose picking,
fidgeting, loose tooth wiggling and holding or rubbing the genitals.
Their insecurity and withdrawal tendencies include sensitivity about
exposing their bodies. They are embarrassed if younger siblings are
blatant about nudity and/or sex, and they are especially sensitive about
the opposite sex sibling or playmate seeing them without clothing. If
stimulated to think of sexual things, sevens may draw sex pictures.
They are curious about pregnancy, especially if there is a baby expected
in the family. They know that having babies can be repeated, and they
express a desire for a same-sex sibling. They want answers to their
sexual questions recounted, and many enjoy private sex talks with
mother. They love to feel the baby kick, they have more interest in how
the baby gets out than in and they have practical questions about
delivery, such as cost, mother's hospitalization, post natal events,
etc. Seven may have a romance, write notes, give gifts and fantasize
marriage; but the loss of the boyfriend/girlfriend is accepted as a
matter of course. They have interest in sex role differentiation and
less concern with anatomical differences. A 7-year-old boy with
interests and behavior considered female may illicit derision and
teasing from peers. Usually called "sissy" or "girl," the term "homo"
may be introduced at this age and used as a synonym for effeminate.
Girls do not suffer the same derogation, even if they are labeled
"tomboy." Sevens have grown out of their baby look and their baby ways.
They are not cute and cuddly and do not elicit the same responses from
adults.
Age 8
Eight emerges from 7-year-old inwardness to expansiveness. Reminiscent
of the out-of-bounds 4-year-old, eight is truly four plus four. Eights
are speedy, adventuresome and confident in their ability to accomplish
new feats and challenges, both physically and mentally. They are
curious, energetic and robust. They are in perpetual high gear. It is an
age of excess; and although their boisterous bravado is an age norm, it
often is more pronounced in boys than in girls. This onset of
prepubescence finds the sexes drawing apart in terms of gender role
behaviors and segregating into same-sex groups for work and play.
The sense of self is demonstrated in gender identity and status
concerns. Eights need and often ask for praise. They are extremely
sensitive to criticism and are easily humiliated if their shortcomings
are publicly pointed out. They retain a close attachment to mother as
they are detaching from dependencies in other relationships. Mother is
their confidant for worries, fears and confessions of misdeeds. "Mom, I
have to tell you something, but promise you won't tell Dad" is a common
preface to revelations of worrisome situations. It is important to keep
these confidences to ensure an ongoing trust bond. If the incident is
something that father should eventually know, the child can be
encouraged to confide in father and, helped by an understanding mother,
to select the best time and method if father is difficult to approach.
Trust between parent and child can easily be lost forever by not
respecting the privacy needs of the vulnerable 8-year-old, sacrificing
the coveted role of sexual consultant in the upcoming teen years. When
asked if they would be the first or last to know if their child were in
serious trouble (pregnancy, V.D., drugs, etc.), most parents of teens
usually answer "first." When children of these parents are asked the
same question, they invariably answer "last." Scores of adolescents seek
sex counseling, abortions, medical care for V.D., etc., without parental
knowledge, not to mention teens who run away from home or commit suicide
due to problems they feel they cannot entrust to the family for help and
support.
Eight is less dependent on teacher as the peer group becomes
increasingly self regulating. Interest groups are spontaneously formed,
with rules and regulations adapted as they are needed. Eights can give
and accept just criticism from peers, have a germinal sense of justice,
can negotiate, abide by rules and can admit wrong-doing if allowed to
justify, qualify and explain what they believe are mitigating
circumstances. Eights like to challenge themselves and to master skills.
They are dramatic and expand into new worlds through fantasy,
exaggeration and wishful thinking. They collect, organize, serialize and
horde. They love money: they like to save, spend, barter and bargain.
They have a curiosity about life in other countries, the origin of life,
procreation, marriage and babies. They want to know more about the
insides of the human body and the insides of the earth and the geography
of heaven. Their sex interest is academic rather than erotic; however,
the greatly enhanced peer group activity is conducive to group
masturbation and homosexual or heterosexual experimentation. Younger
children and/or girls are often allowed into the secret boys' club for
sex play and denied admittance at other times. Passwords, initiation
rites and membership dues are often focused around sexual and/or
monetary issues; and privacy is insured by an appointed look-out in the
club treehouse or fort.
Eights are glad to be alive. They do not dwell on negative thoughts,
they arc more comfortable with adults and they are beginning to doubt
the infallibility of parents. They like to tease and test adults with
jokes, riddles and exaggerations.
Physically, eights are graceful, coordinated and sure of their bodies.
Despite prepubescent lengthening of arms and increased hand size, fine
motor performance is smooth and reliable. Eights like to draw the human
body in action and may include sexual and eliminatory activities in
their graphic repertoire. Their tensional outlets are minimal at eight,
but may include a need to urinate or a pulling at their pants, either at
front or back. Other outlets such as thumb sucking, nail biting, etc.,
drop out or are systematically phased out by the child determined to
master his or her own impulsive behaviors. Eights are competitive with
others, as well as being in continuous competition with themselves. They
set up obstacle courses for themselves, rewarding and
withholding rewards for their own personal demands. Eight is
increasingly aware of him/herself as a person. They are more conscious
of how they differ from others and want to be recognized as individuals.
They respond well to special privileges, "because they are eight"; and
in keeping with their increased interest in sex (specifically, father's
part in reproduction), appropriately inscribed sex books are a perfect
gift for the 8-year-old.
There is much confusion over sexual facts at this age, and many children
are not knowledgeable enough or comfortable enough to ask parents the
appropriate questions. Parents may be willing to answer if asked and
assume that if the question is not forthcoming, it is too early to offer
information. Both boys and girls are curious about the total process of
reproduction, and few can accurately piece together the information
received thus far. They are also beginning to be interested in boy/girl
relationships and may be involved in sex play (often with older children
who may have established coital expectations). Eights expansive
curiosity and daring, their admiration for older children and their
susceptibility to a reward system combine to produce an easily
exploitable sexual situation. Eight-year-old C wanted desperately for
her mother to have a baby. Her mother said she and her new husband were
trying to have a baby, but with little success. When C found out that
her mother was taking birth control pills to prevent conception, she
angrily refused to communicate with her mother or her stepfather and
vowed to have her own children when she grew up. One day she queried her
therapist, "If you want to have babies when you grow up, do you have to
practice when you're young?" After assurance that most women do not have
difficulty getting pregnant and that prepubescent practice was
unnecessary, C revealed that her friend P, aged 12, was suggesting that
if she didn't practice now, she might not be able to have a child when
she grew up. He was also kind enough to volunteer his services in this
regard.
Although eight is the age of separation into same-sex play and interest
groups and a critical appraisal of the difference between boys and
girls, a child's "best friend" may still be of the opposite gender. Sex
information is often exchanged in this dyad, with each child sharing
information from other sources as well as his/her own conclusions and
concerns. Boys with a female confidant are fortunate because they are
more likely to learn about menstruation, and girls are more apt to be
interested in the sexual function of the man's body (beyond just
planting the seed). After reading an age appropriate sex book,
8-year-old S remarked to her mother, "I have to read the chapter on the
man a few more times before I get all that vas deferens stuff straight."
Eights maintain a high interest; and the importance of accurate sex
information cannot be over-emphasized, as the amount of information to
be assimilated is well beyond that which is mastered in a typical "birds
and bees" lecture. Books of their own, lovingly inscribed by their
parents, endorse a child's interest and curiosity about sex and provide
a reference that can be returned to and shared with friends. Graphic
depiction, photos or sketches, are also important learning aids as our
culture becomes increasingly visual. Books and pictures about the body
and sex help children understand that human sexuality is a legitimate
academic subject that can be explored objectively as well as
subjectively. They learn to satisfy a good deal of their sexual
curiosity vicariously and become less dependent on trial and error
learning. Most eights read well, love comics and picture magazines
(especially catalogs) and enjoy being read to. Children who have
difficulty reading or dislike reading may stick with a sex book because
they are vitally interested in the subject matter. Age appropriate sex
books are needed by both boys and girls, but may be considered more
crucial for boys, as boys tend to get more sex information from friends
and printed material and less from conversation with parents than girls
do. Eights want to be good and they seek permission, praise and parental
endorsement. They like to collect things and to admire their
possessions. A growing library of sexual reference materials, endorsed
by parents, bequeaths automatic status among peers, ensures continual
sexual dialogue between parent and child and minimizes the possibility
of sexual exploitation by more knowledgeable children or adults.
Age 9
Nine is an intermediate age--no longer a child, but not yet a youth.
Characterized by self motivation, nine can put his/her mind to things on
his/her own initiative. Nines are less dependent on environmental
support, like to plan in advance and have to "think about things" first
before doing them. Nines can sustain repetitive tasks and are interested
in perfecting skills. They are capable of objective self appraisal and
are critical of others as well. Nine is often called absent-minded, but
s/he is actually mentally preoccupied. They like to identify, classify,
seriate and categorize. Nines have insight and can give accurate
descriptions of the character traits of individuals and the dynamics of
specific relationships. These estimates of people and their interactions
can be penetrating and candid. Nines have a keen emotional and
intellectual interest in justice, punishment, privilege, rules and
procedures. They are basically honest, can accept blame and are
preoccupied with "fairness." They have a loyalty and pride in home and
family, but do not want to be babied by their parents. They often prefer
peer activities to family doings, and they ask to bring a friend on
family outings. They love to talk and build friendships of depth and
duration. Clubs are still popular, with passwords, dress codes, rituals,
secret meeting places and taboos helping to establish a sense of
camaraderie and brotherhood.
School and interest groups include both boys and girls, but spontaneous
groups and birthday parties are usually unilateral. Boys roughhouse and
wrestle; girls giggle and whisper. They tease each other about opposite
sex friendships, and each group cordially disdains each other. The
love-hate vacillation between sexes at this age abounds with
prepubescent energy. The 9-year-old's sense of independent self is
accomplished in terms of age (detachment from parents) and gender
(differentiation of the sexes). This reinforced gender role identity,
expressed at nine most often in the negative preoccupation with the
traits and characteristics of the opposite sex, allows for subsequent
heterosexual attraction. Girls are nearer pubescence than boys at nine,
but both are increasingly aware of their impending transformation. They
are interested in sex information in an intellectual, realistic sense,
but may not connect it to their own social interactions. Boys and girls
are interested in babies, have affection for and patience with younger
siblings and can be depended on for short stints of baby-sitting or
childcare. They are more interested in their own origins and functions
than those of the opposite sex. They may show little interest in
reproduction if questions have been answered earlier. They may have a
girlfriend or boyfriend, but usually in name only. They may share this
friend with a friend, expressing no jealousy. This rather impersonal
relationship may in fact have been arranged by a friend; and although
notes are passed, Valentines exchanged and the boys may seek a kiss as a
conquest, these relationships tend to be off-again/on-again with little
personal involvement. Kissing games are common at mixed parties, but
most parties at this age are gender specific. Nines are shy in formal
boy-girl situations, and they may be shy about undressing, even in front
of younger siblings of the opposite sex if a same sex peer is visiting.
There is a heightened differentiation of boys and girls of this age, and
they remind each other of appropriate gender role behavior. Sex talk is
reflected in swearing by both boys and girls; bathroom talk is still
used, but sex words and jokes are increasing. They may shock mother with
crude jokes, riddles and rhymes and need much help in defining words and
concepts, as well as differentiating funny, acceptable sex jokes from
gross, offensive ones.
The ethical sense is rapidly developing at this age, and nines feel
guilt and shame when they fall short of their own expectations and/or
the expectations of others. Their critical and judgmental abilities are
often sharp, and their need to know themselves through recognizing their
differences from others sets the stage for the possible development of
prejudice. Although their intellectual realism and overriding sense of
fairness can be appealed to, the roots of sexual prejudice are often
left unchecked at this age. The terms "fag" and "homo" are used as
pejoratives even though they may be poorly understood. Boys control
their friends and taunt their enemies with these words and in doing so,
contribute to their own homophobia. Few adults address this issue as
they might tackle a similar situation involving religious or racial
prejudice. Although some adult homosexuals recall incidents in childhood
which they identify as precursor to their later sexual lifestyle,
9-year-olds are not conscious of their future sexual preference. If they
learn to view homosexuality as a despicable state, they will suffer
severe cognitive dissonance when they later find themselves attracted to
same-sex partners or when they discover a valued friend to be gay. The
terms "fag" and "homo," like "MR" and "spastic" and various racial or
ethnic derogations, are most often used as generic insults without
empathy for the sensitivity of any person for whom the reference is
applicable. A significant component of homophobia is ignorance; and when
the terms are used, they should be defined and explained by a
knowledgeable adult. Boys tend to use "fag" and "homo" to describe
immature and/or effeminate behaviors of their peers; thus, a discussion
of the differences between androgyny, homosexuals, transsexuals and
transvestites is appropriate. If terms are used in response to affection
or physical closeness expressed between boys, a discussion of our
cultural stereotype of masculinity as the denial of feelings and
emotional needs can be initiated.
Age 10
Ten is an age of glorious equilibrium, with many qualities of adulthood.
The gender differences are pronounced, with girls manifesting social
behavior which is considered more mature. Ten is impressionable and
adaptable. One can appeal to the reason of a 10-year-old because his/her
mental process can objectively consider the fundamentals of human
welfare. Fifth graders are interested in social problems. It is a phase
in which ideas can be broadened and it is an age of prejudices. Adverse
conditions can lead to delinquency and gang violence, including sexual
violence.
At this age, tendencies and abilities emerge that are predictable of
adult traits and careers. Leadership is assumed by some children, and
individual differences are accepted. Tens have opinions about everyone
and everything, and their descriptive appraisals include the positive
and the negative aspects, pronounced matter of factly. Tens enjoy family
and groups, are capable of hero worship and love to share secrets. Boys'
activities tend to focus around gross motor games and sports, and their
spontaneous play is action oriented, with one challenging the other to
informal bouts of wrestling, racing, climbing, etc. At 10, many boys are
involved in organized team sports that focus the family on their
performance.
Girls' physical touching is affectionate rather than aggressive. They
hold hands or walk with their arms around each other, and they are more
interested in relationships. They gossip, write notes, keep diaries and
play dolls to act out their interest in romance, weddings, marriage and
children. Girls are more interested in and aware of interpersonal
relationships and will begin and end relationships based on their
evaluation of the personal qualities of the other person. There is less
team play or team spirit (i.e., accepting faults and inadequacies along
with talents and strengths) in girls than in boys. Girls operate in
smaller, more personal groups, and they are more aware of themselves,
their appearance and their expectations of others. Girls have more
interest in love and romance, and peer boys are a consistent
disappointment in this regard. Girls at this age are often in love with
a considerably older boy or adult male. Girls and boys are about equal
in size; however, many girls will experience nipple enlargement and the
beginnings of pubic hair in their 10th year. Girls have an increasingly
practical interest in menstruation, some looking forward to it as a
symbol of maturity and others resisting and denying that it will happen
to them. Girls are less likely to tell sexual jokes, but are interested
in the parental sexual relationship and may ask personal questions about
it. If parents are divorced and dating, daughters may probe for the
intimate details of their new relationships. The balance between open
communication and confidentiality of intimate relationships may be aided
by the use of age appropriate sexual reference books. Some 10's are
embarrassed to receive sex information and even deny reading sex books.
Many are embarrassed to be seen without clothes on, especially by
opposite sex siblings or opposite sex parents. This shyness is
especially true when secondary sex characteristics begin to appear, and
it is exacerbated if they are teased about their body changes.
Boys are less likely to question parents about sexual matters and more
apt to repeat sexual and elimination jokes and rhymes and to use sexual
words as pejoratives. Most are aware of the male's role in reproduction,
understand the fundamentals of intercourse and have had some sexual
experience. Few have noticeable physical changes, but may require
bathroom and dressing privacy from mother and sisters. These same boys
may peek at sister and friends whenever possible. Boys begin to
differentiate sex jokes that can be appropriately shared with mother or
girls, and a few 10-year-old boys develop a strong attraction for a
specific girl. Boys and girls consider their mother a friend, confide in
her, request private time with her and think up nice things to do for
her (e.g., surprises, breakfast in bed, etc.). Fathers are often
idolized, and companionship with father is sought by both boys and
girls. Tens respect their parents and want them to be fair--not too
strict, but not too easy.
Ten is good with siblings under five, but has real problems with
siblings from six to 10 and is often considered a nuisance and a pest by
older siblings. Friends are paramount at this age and ever-present if
allowed. Sleeping over is a favorite activity, and sex talk and
experimentation is common. Few children are encouraged or allowed to
entertain opposite sex friends overnight, so there is a tacit parental
endorsement of same-sex acts. Most children feel that same-sex
experimentation is normal and age appropriate, but that heterosexual
coupling should be reserved for adulthood and reproduction. That is not
to say the heterosexual play does not occur at 10, because it does for
some. However, it is wise to consider that the age specific division of
the sexes, the earlier focus on reproductive information and the
parental unconcern over the sexual potential of same-sex friends all
combine to produce in the mind of a 10-year-old, a tacit adult approval
of homosexual experimentation, all the while producing quite a different
mind set about heterosexual experimentation.
Age 11
Eleven is the age of beginning adolescence and a time of perpetual
motion; the inner hormonal activity produces a new awareness of the
physical self. New feelings and sensations are physically expressed in
accelerated growth and gender specific anatomical differentiation, as
well as in gross and fine motor movements, facial expressions, emotional
swings, verbal excesses and boundless curiosities. Sixth graders can be
the life of the party, but are often described as pests. They are
critical of parents and other adults and argue for the sake of argument.
It is the age of the worst rejection of mother, but they are also
rebellious with teachers. They may hate school and attend only to have
contact with friends.
They are resistant to logic and reason, have discovered the relativity
of right and wrong and have no guilt over wrongful acts perpetrated in
self-righteous anger or to get revenge. They swear, cheat, steal and lie
to get out of jams. Some report occasional smoking and drinking. The
group continues to be important, and interpersonal relationships are
paramount. Friends continue to sleep over, but there is a great deal of
breaking up and making up. Jealousy, quarreling and fault-finding is at
an all-time high, with boys somewhat less intense than girls in
interpersonal matters. Boys maintain more of a group spirit and are
often naughty and disruptive in the classroom and on the playground.
Many girls are still in an anti-boy stage and have a consuming interest
in horses. As girls begin to develop secondary sex characteristics, they
gain status among other girls and popularity with the boys. The more
mature boys court and tease the developing girls, wanting to know bra
sizes, trying to see up skirts, etc. Recreation centers are the meeting
place, for the physical female form is well serviced in the athletic
arena. Not only is sports attire revealing; but, if well directed, the
periodic water balloon fights produce a spontaneous wet Tshirt contest.
Female athletes do well socially in the sixth grade because of proximity
to sports minded 11-year-old boys. Athletic prowess is still the major
rite of passage for American boys, and they are preparing for junior
high and senior high school competition.
Elevens are gaining increasing understanding about sex and elimination
functions. Understanding sexual complexities at 11 is facilitated by
discussing sex as a body function. Moral and social considerations are
better left for later. Eleven has been described as a "nothing age"
because sixth graders await promotion to junior high with anxious
anticipation laced with varying degrees of trepidation. This transition
is somewhat dependent on public school patterns (i.e., K-6, K-8,. etc.);
however, for most youngsters, junior high represents P.E. and showering
at school, often in group showers. For some, this may be their first
experience of public nudity, coming at a time of intense concern over
the acceptability of their changing body.
Age 12
Twelve is the age of enthusiasm, initiative and diplomacy. The peer
group gains in importance; however, relationships with adults are
characterized by reasonableness, objectivity, empathy and insight.
Twelves are emotionally less volatile than elevens or thirteens; they
are self disciplined, have greater self-control and accept and fear
control and direction from teachers and others. Twelve is an
intellectual age in which mental tasks intrigue and inspire. Twelves
like to debate political and civic issues and plan group projects. They
have sustained capacity for fact learning and an increase in conceptual
thinking. They are more literate, more articulate, more realistic and
more tolerant. They often write letters to public figures, start
businesses, enter contests, publish newspapers, etc., extending
themselves well beyond the world of childhood. Their health and stamina
is basically sound and reliable. Girls experience their most rapid
growth in both height and weight, achieving 95% of their mature height.
Breasts fill out and nipples darken, axillary hair sprouts, menarche
occurs near the end of the 12th year and freckles appear. Body odors
change and intensify, and hygiene needs increase. Some girls may express
self-consciousness about breast development by attempts to minimize
their changing form, while others augment nature and flaunt their new
proportions. Girls need acknowledgment and endorsement of their emerging
sexuality from family members if they are to integrate their sexual self
into their total self-concept. It is important that parents neither
over-value nor under-value (ignore) the physical changes of pubescence,
but rather that they celebrate reproductive potential as the passage
from childhood to adulthood that it truly signifies. It is an artifact
of complex civilization, not biology, that girls will probably delay
childbearing for close to another decade even though the physical and
psychological readiness to reproduce is a phenomenon of adolescence.
Many girls look forward to menarche, but even so, may be ambivalent when
it occurs. Twelve-year-old A, eagerly anticipating menarche, began her
first period on a Friday and that evening, asked to spend the night with
her grandma. Her mother asked if she had included sanitary napkins in
the overnight bag. She had not and asked if it was necessary. Mother
explained that Grandma would not have any at her house and that she
should take at least two. As A went off to get them, she muttered, "this
having your period isn't as wonderful as I thought it was going to be."
As girls adjust to the rituals of menstruation and their periods become
more uniform in nature and regular in occurrence, they become more
positive about growing up and more knowing about sexual matters in
general. Because the early periods are not usually accompanied by
premenstrual signals, most girls experience the embarrassment of
spotting, and/or they may be excused from P.E. or showering, which
serves notice to peers that they have reached the milestone of
menstruation. Girls who mature more slowly may be pleased that they do
not have to experience the inconvenience of menstruation and/or
concerned that they are not one of the group. Girls talk in the abstract
about sexual matters and may need to clarify previously held
misconceptions with peers, parents and/or other adults. Sometimes, a
specific teacher develops a reputation as a reliable source of sex
information and is queried regularly to clarify the myths and
misconceptions that reliably surface during these junior high years. It
is remarkable that despite their inaccuracies, sex jokes and stories are
perennial, resurfacing at the same age generation after generation.
Boys are more interested in hearing and repeating sexual jokes and in
acquiring sexually graphic materials. Twelves have a good sense of humor
and wit and love the double entendre. They can be embarrassed by sexual
situations or jokes, especially if the joke is on them, i.e., sexual
naiveté or ignorance in the midst of others' knowing. Understanding the
sexual components or meanings of heretofore nonsexual words and actual
sexual vocabulary is a major task of the pubescent child. It is a rite
of passage that separates childhood and adolescence. Boys are usually
more conversant with sex words and meanings than girls, but they too
must learn. Social custom dictates that if you understand the sexual
implication, you acknowledge that understanding. If you do not
understand, you ignore the implied sexual connotation. You never attempt
to learn by asking the meaning or definition because this is the age of
jokes and secrets. The harder you try to find out what was funny, the
more secret the information becomes and you become the joke.
There is a wide range of physical growth differential among 12-year-old
boys, but the majority show some evidence of beginning puberty. Growth
of the penis and scrotum is common and may precede or succeed pubic
hair. Pubertal fat is most common at 12, but gradually emerges into
accelerated growth and a myriad of secondary sex characteristics, e.g.,
broader shoulders, longer arms and increased muscle density and
definition. Twelve-year-old boys are becoming more interested in sex,
especially their own sexuality. They are more fully aware that sex
occurs for reasons other than reproduction, and heterosexual boys begin
to acquire pictures of nude females. They tend to think of sex as dirty,
want accurate information and would prefer to seek information from a
neutral adult. If they do consult with a parent in sexual matters, it
will more often be the mother for specific information rather than a
full discussion of sex in general. In the absence of a sexual confidant,
boys will seek out information from printed sources and have bull
sessions with peers to discuss sexual matters to the extent of their
pooled knowledge.
Masturbation increases in frequency, may be experienced alone or in
groups and may or may not produce ejaculation. Erections occur with or
without external cause and may happen spontaneously at inappropriate
moments, causing embarrassment and anxiety about future situations.
Externally triggered erections may also be embarrassing, as they are
caused by various stimuli often deemed inappropriate by the boy (e.g.,
sex talk, shuffling or physical contact with male peers, fear, rage,
embarrassment, etc.). Twelve-year-old heterosexual boys are interested
in girls; and although most prefer group activities, some fall in love
and openly express their affectionate feelings. Kissing is a favorite
activity; however, having a girlfriend or boyfriend is more a social
phenomenon than an interpersonal one. The assignment of couple status
has little or no interpersonal responsibility. It is changed frequently
without emotion and is often decided by a group or a "marriage broker"
within the group. A few boys at this age, or seventh grade boys who may
be in or closer to their 13th year, may actively seek sex with girls.
They do not ask permission, thus exempting the girl from verbalizing
responsibility, but begin simply to see how far they can go. It is
common for junior high girls to stay overnight with a friend and arrange
to meet boys who are doing the same. Boys are always aware of girls'
slumber parties and make themselves available. When sex occurs between a
boy and a girl of this age, the boy tells his friends who, in turn,
question him for details. He acquires status among peers as they learn
about sex acts, socio-sexual negotiations and their female peers. Girls
do not confide in their friends, neither are they questioned by their
friends about sexual encounters.
Thirteen-year-old B performed cunnilingus on 12-year-old F. He was the
first in his circle to have the experience, and so he became the "man of
the hour" among his curious friends. The information was passed to the
girls, who were shocked and unbelieving, but none asked F for
confirmation, denial or details. This pattern is stable through high
school, with boys talking and sharing sexual experiences for knowledge
and endorsement and girls gossiping about the sexuality of others but
rarely, if ever, sharing first-hand sexual experiences and concerns. One
female high school senior remarked, "you don't tell anyone anything
about sex that you don't want repeated, not even to your best friend,"
the result being a large number of sexually naive and uninformed girls,
who have misconceptions and misinformation about sexual matters. They
depend primarily on experiential learning for sexual knowledge and rely
on boys to teach them how to be sexual.
In the seventh grade, the group is becoming increasingly important as an
arbitrator of fad, fashion and mores. Groups and sub-groups dictate
clothing styles, behavior and language. There is competition between
groups and within groups, the main purpose of which seems to be the
integration of a post-pubertal sexual self and the rudiments of mate choice.
Homosexual 12-year-olds may or may not be involved in sexual activity
with peers even though there is more opportunity for them than there is
for many heterosexual youths. Some heterosexual twelves are still
engaging in sexual activity and exploration with same-sex peers. Many
adult homosexuals retrospectively report gradual awareness of not being
turned on to opposite sex peers at this age, but few twelves declare
themselves homosexual or bisexual.
Age 13
Thirteen-year-olds are usually in the eighth grade, and adolescence is
well underway. They withdraw from the family circle and at home, may be
critical of parents and siblings. They are worried about aspects of
self, especially that others won't like them. Self-absorption and
rumination allow for internalizing awareness, which is the hallmark of
this age. This solitude is not escape from reality, rather it is time of
self-examination and rehearsal of future events. Reflection releases the
13-year-old from the tyranny of instinct and creates a sense of
increasing "will power." Thirteen's growing intelligence is manifest in
his/her pleasure in rational thought. Thirteens are interested in
psychology, probability and hypotheses. They are sensitive to criticism
and keenly perceptive of the emotions of others. They are given to self
appraisal and may be quite objective. Thirteen and a half-year-old M
announced to her mother that she felt that she was passing into a new
stage, asking, "don't you notice that I haven't been so obnoxious lately?"
The 13-year-old can be quite a trial in the family constellation.
Thirteens need privacy, often secede from the family and have difficulty
with siblings aged 6 to 11. Thirteens are moody and uncommunicative,
critical of parents, siblings and friends. They have fewer friends and
are less apt to be interested in girl/boyfriends at this age. They make
firm declarations about neutrality and few "date" at 13. Boys are
catching up with girls in size, but girls complain about their
awkwardness and clumsiness. Boys and girls are preoccupied with personal
appearance and their effect on others, with much time spent studying
their reflected image. The mirror is their best friend, worst enemy and
constant companion. It provides self-discovery, self-assurance and doubt
and plays a constructive role in defining the realistic sense of self.
Thirteens compare themselves to movie stars, TV personalities and
characters of literature. School, playground and neighborhood offer
additional opportunity for comparison and definition as 13 identifies
similarities and differences between him/herself and others. School is
often the optimal environment for 13s. Their interest is broad,
encompassing science and liberal arts. They are curious, interested and
willing to tackle subjects in depth. They are hungry for facts and love
to be the expert. They are capable of inductive and deductive reasoning
and like to consider complex problems that have no easy answer. In the
proper setting, they like to entertain sexual concerns, such as, "if
population control is desirable, why is the Pope against the Pill?" They
are curious about birth defects, twins, multiple births and ask the
age-old questions about cross species fertilization. They are interested
in birth control, venereal disease and the fertility cycle of women.
Boys and some girls still have many misconceptions about menstruation
and fertility that can be easily cleared up at this age. Most report
that they are too young to have intercourse, but they expect to do so
when they are older.
The 13th year is pivotal as the body becomes primary once again. The
adult body image forms as the individual genetic structure and
environmental factors determine body build, chemistry, posture,
coordination, appearance, voice quality, facial expressions, inner
attitudes and tensions and overall state of health. The mind expands
dramatically in range of interest and ability to reason, reflect,
concentrate, accumulate and assimilate facts and exercise independent
thought. Personality emerges as a complex interplay of mind and body as
each individual assimilates these somatic events and mental machinations.
Most girls at 13 are child/woman in appearance and behavior. They may
arrive at school in pigtails and jeans one day and in a dress, nylons,
make-up, coiffured hair and magenta fingernails with decals the next.
They vamp their favorite male teacher and keep diaries full of romantic
hopes and dreams. Most have achieved 95% of their adult height and are
menstruating. They are continually concerned about changing body
contours, but their central sexual focus is menstruation. Most
anticipate it and are relieved when it occurs; however, they may resent
the necessary rituals once it arrives. Their periods are usually not
painful, neither do they usually conform to the usual 28 day cycle.
Girls are ambivalent about others knowing that they are menstruating and
most do not want to buy their own sanitary napkins, feeling that it is
too embarrassing. Thirteen-year-old M started her first period on a
Saturday and asked her mother not to tell her father and brother. When
mother replied that she already had, M asked with great anticipation,
"what did they say?" Mother replied, "they are both happy for you." She
was delighted and asked if the family could have Sunday dinner in the
dinning room with the good china and crystal. When her mother agreed
that a celebration was appropriate, she asked if she could invite the
extended family. Her mother advised that it was pretty short notice, but
perhaps one aunt and uncle might be able to come. M remarked, "maybe we
shouldn't call them because it would be pretty embarrassing to tell them
why they are invited, but we celebrate every other important occasion in
our family." As a culture, we fail to celebrate fertility and see it
rather as a disadvantage if not an outright danger of adolescence. This
contradictory message regarding the relative merits of maturity is not
lost on teens.
The 13th year brings more definite maturational changes in boys also.
Most begin their growth spurt in height, closing the gap in the
differential with girls. There is rapid growth of genitalia in more than
half of the boys, and pubic and axillary hair grows in about two thirds.
Facial changes are marked with darkened hair at the corners of the upper
lip, disproportionate nose growth, increased angularity of face,
enlargement of the Adam's apple and cracking or deepening of the voice.
Erections occur with direct physical stimulation, erotic fantasy and in
response to sex talk, the viewing or reading of sexually explicit
materials and spontaneously or in response to nonsexual forms of body
contact or excitement. The latter non predictable erections are
troublesome and may cause boys to worry and become preoccupied with
attempts to prevent or avoid inappropriate arousal. Only about half of
the boys have ejaculations before their 14th year, but most know about
them. Masturbation may increase significantly and be accompanied by
guilt if they have not been raised to know that it is normal. Nocturnal
emission or masturbation are the most common first ejaculatory
experiences. Many boys are interested in having sex with girls at 13,
but are too direct and abrupt to facilitate encounters with any but the
most interested and willing girls.
The more sexually popular boys and girls have important, gratifying
relationships with each other. Boys become more interested in selecting
girls to "go with," even though couple dating is still a rarity. The
group is the most visible social structure, and conversation is the
major group activity. It is the fortunate 13-year-old who has an
opposite sex confidant, for he/she will have a continuing source of
information on, and explanation of, the mysteries of the thoughts and
behaviors of the opposite sex. Membership in these social groups is
through peer selection, and group members usually demonstrate above
average social skills. Group membership provides opportunities for
varying levels of personal interaction and ensures continuing social
confidence and enhancement of personal understanding, sex knowledge and
relationship skills. The shy, less social children who are excluded from
group membership are disadvantaged, and this handicap is compounded by
their inability to practice socio-sexual skills. They develop
compensatory avenues of self-expression and may distinguish themselves
and gain positive recognition, or they may satisfy their need for peer
recognition and acceptance through asocial behavior and associations.
Thirteen is a year of final division between childhood and adolescence.
Thirteens have passionate interests and may put away their childhood
books and toys. Their rooms are usually unkempt, but begin to depict
their personality as they plaster posters and pictures on the walls.
Their clothes are self-selected and reflect their self-image. The
telephone is more important to them than the TV, and the radio or stereo
may signal their presence. They like sports and physical activity, and
physical education may be their favorite subject at school. Boys like to
play contact sports with girls, and basketball is a favorite, probably
because it is constant activity. Thirteens are extremely critical of
their parents, especially their mother, and make frequent derogatory
comments suggesting she is a product of the Dark Ages. Many 13s like to
read, with comics giving way to romance, mystery and sports books and
magazines. Thirteens usually travel with a friend or in groups; and
often they will meet up at the movies. Girls especially identify with
movie characters and try not to cry or be scared in movies, but are
often unsuccessful at controlling their emotions. Thirteens exchange
pictures and carry them in their wallets. Boys and girls may also
exchange tokens of commitment and relationship. Thirteen likes to feel
independent, resents authority and is insulted if treated like a child.
It is not uncommon for parents and family to need a vacation from their
13-year-old, and it's a good age for them to go to camp or spend a week
or more away from home with relatives. Thirteens respect teachers and
adults that are firm, fair and treat them like a reasoning adult. They
are quick to group up and play practical jokes on authoritarian teachers
who treat them like children.
Thirteens are ruled by a developing conscience. Although they sometimes
tell half-truths to avoid confessing misdeeds and may, for "good
reason," cheat or occasionally steal, they almost never report the
wrongdoing of others. Squealing on others is the ultimate ethical crisis.
Age 14
Fourteen is a year characterized by fulfilling the self; and individual
instruction, guidance and counseling are important. It is an age of such
self-absorption that many child experts recommend that the ninth grade
be held in separate schools so as not to mitigate this interest in self
by the temptations to regress to younger patterns or to overextend
themselves by competing with older children. Psychology, philosophy,
sociology and astrology all provide insights to the 14-year-old who
eagerly searches for his or her future path. Sure of him/herself,
capable of give and take, 14s generate a friendly, relaxed atmosphere in
their peer group and the home as well. They experience few tensional
outlets and wear their bodies well. They can listen and comprehend
before responding, often with humor and/or dramatic gestures for
emphasis. Fourteens are healthy and robust and will often continue their
regular routine if they have a cold or other minor ailment. Most girls
are physically mature, with all secondary sex characteristics near
completion and menstrual cycles regular (although many are as long as
45-50 days). Many have premenstrual symptoms (cramps, headaches,
backaches or general tension or nervousness), and menstrual discomfort
the first day causes some girls to lie down for a couple of hours, miss
a meal or take medication. Many girls report experiencing a physical
response in their involvement with boys. It may be global rather than
genital and is often confusion to the girl who is poorly informed about
sexuality. Girls may begin masturbation in response to this arousal,
many for the first time.
Boys, who tend to be maturationally a little behind girls, experience
their most rapid growth spurt at 14. It will be another year, however,
before they actually look like men. At 14, the ratio of body fat to
muscle decreases, body hair increases and darkens, sideburns elongate,
voices may crack suddenly and what appears to be hoarseness from a cold
very often remains. Most boys have ejaculated by the end of their 14th
year, and most develop a regular pattern of sexual activity after their
first ejaculation. Many are extremely modest, especially about nocturnal
emissions and despite increasing societal tolerance, many experience
significant masturbatory guilt. Sex education is needed and eagerly
sought by 14-year-olds. They now want to work out their own personal
sexual attitudes and need information to do so. They need to know and
discuss the broad spectrum of human sexual behavior. Most 14s express
happiness at being themselves; and although they might make some
improvements, they would really not want to be someone else. Most of
their worries and fears are anticipatory and are resolved when the
feared situation is experienced. All in all, 14's problems are not
major. They experience some moodiness and some temper; however, their
outbursts are of shorter duration and are less emotionally devastating
than they were at 13. They have a sense of humor and philosophical
outlook which makes 14 a joy to welcome back into the family. Their
dissatisfactions about self include any departures from the perfect
physical form; and most want to be taller, shorter, thinner, prettier,
bigger, etc. Boys may begin lifting weights to attain a more manly
physique, and both boys and girls may experiment with dieting. (Bulimia
and anorexia nervosa may develop in this context.) As 14s adjust to
themselves as independent individuals, fully involved in mastering life
for themselves, they periodically overextend themselves. Their sense of
time and energy is boundless, and they are apt to over commit themselves
and lose the balance required to function optimally in all aspects of
their life.
Many are out of bounds and overextend themselves in relationships. Some
14-year-old girls begin to date older boys and initiate regular partner
sex, but most 14s are still group oriented, pairing off occasionally at
parties and informal get-togethers. Pairs may be stable from party to
party, but "who likes whom" is the ongoing focus of endless
conversations, with allegiances shifting often. Boys are less interested
in hobbies and more interested in girls and social interaction, but are
still unsure and may ask a girl what she would say if she were asked to
go out or may depend on a friend to ascertain her response in advance.
Going steady is not common, and many express that "it would tie me
down," Sports are important for most boys as a rite of passage for the
most athletically talented and as a team member and a physical test for
the less adept. Sports are less important to girls; however, the
athletically talented girl may excel in her chosen sport at this age.
Fourteens are not plagued by conscience but are sensitive to the effect
of their behavior on others. They like to argue, but their arguments do
not have the do or die quality they had at 13. It is more of a game to
them to exercise their increasing ability to logically defend a position.
Fourteen is characterized by changing social relationships. They are
better with younger siblings, self-conscious in the presence of and
critical of older siblings. Their own peer group is all important, and
they have many best friends, not just one. Friendships seem to be less
determined by similarity of interest or activity; and in fact, a 14 may
be attracted to opposites. Talk is the primary group activity, and 14s
can talk out their difficulties. Although girls are more adept in social
relationships, boys have their groups as well, characterized by
exuberant humor and raucous good times. Popular boys may choose to
protect a vulnerable boy and are better able to do so than girls who
attempt a similar stance with an unpopular girl. Boys show increasing
interest in girls and may attempt to extend casual encounters. They mix
better at parties, and girls who are chosen by a boy may begin to show a
deferent attitude. A girl may turn down opportunities with other boys
before she has been asked by the boy of her choice. Fourteen-year-old
girls often prefer older boys because they have more social poise.
Parties at this age are spontaneous gatherings of groups, with some
pairing off for private moments. Couples are fluid and change often,
with little intimacy or commitment. Their significance is more social
than personal--even going steady is a short-lived experience for most
14-year-olds. The most stable pairs are 14-year-old girls and older
boys. Reputation is important, and friends can enhance or detract from
status in the microcosm of the high school. The telephone is the
essential apparatus of adolescence, more important than TV, even for
hospitalized teens. Radio is important, with music programs favored; and
stereos and private telephones are often requested as Christmas and
birthday gifts. Music preferences and clothing styles are reliable
signatures of the developing personality. Boys interested in cars,
driving is on the rise and some develop an undeniable need to drive and
borrow cars despite the risk of accident or punishment.
The high school locker room for many 14-year-olds is their first
experience at public nudity. Most 14s manage to overcome their shyness
and are quickly comfortable in varying stages of undress. A few are so
shy that they request to be excused permanently from P.E., or some just
never show up. This milieu is especially problematic for the homosexual
youngster, who may be over stimulated by mass nudity of his or her
eroticized gender. It is especially traumatic for boys, who are more
stimulated by visual imagery and whose arousal is visible to all.
Physical Education instructors need to be reminded that to require a
homosexual adolescent to take part in locker room nudity can be every
bit as stimulating as expecting a heterosexual boy to dress and shower
with the girls.
Age 15
The year 15 causes a dramatic shift in focus and energy. Fifteens
withdraw and inwardize their energy to the point that they are seen as
lazy, apathetic and unmotivated. They develop a thoughtful, serious and
quiet demeanor to set off the exuberance and enthusiasms of 14. They
give attention to detail and to the details of thought and expression to
the point of perfectionism. Their need for increasing independence
causes problems at home. A Cold War with parents is not uncommon, and
open defiance is the response to being treated like a child. They have
fantasies of travel and of sex. They are gregarious with friends and
often solemn at home. They don't want to accompany family, especially to
school functions, and will often refuse to sit with family, even at
church. A same-sex best friend is their constant companion, and this
close relationship is a maturity achievement.
Fifteen is the threshold of adulthood, with independent personality
patterns being a hallmark of this age. Fifteens love or hate school.
They may be academically or vocationally motivated, or they may drop out
of school and evidence attributes of low self-esteem. They may become
delinquent, and there are easily definable stratified groupings in every
high school. Self-confidence and self-esteem may become their major
problems and are related to sexual adjustment and the ability to
negotiate relationships. Fifteens need objective information about human
nature and behavior. They have high tension, may somatize their stress
and may see psychiatrists or other mental health personnel.
Girls finish off their secondary sex development, and a few stragglers
finally start their periods. Periods are regular, and most girls have
premenstrual symptoms and moderate to severe cramping with the onset of
menstruation. Boys are finishing up their secondary sexual development.
The genitals are adult size, body and facial hair show adult patterns
and configurations, they reach 95% of their adult height and their body
is in better balance and proportion. By age 15, most boys have
established a regular pattern of sexual outlet; they have fewer
erections to nonsexual stimuli and may have fewer sex materials around,
as fantasy alone is sufficient for arousal. Their masturbatory frequency
increases, and some have regular sex with girls. Gay teens may fall in
love, have sex and understand that they are homosexual.
Management of partner sex is problematic even if the partner is willing.
Where and when to find a private place for a sexual encounter is a major
concern, as are birth control and venereal disease protection if they
are sexually active with a number of partners. Most girls are worried
about reputation and fear being found out, but may decide to have
intercourse if they are in love, if they trust the boy and if the
relationship seems secure. Boys, experiencing the sexual urgency of
adolescence, attempt to persuade, manipulate and coerce girls into
actual coitus. "If you love me, you will let me put it in," "if you
don't, someone else will" and "if you let me put it in, I'll pull out in
time," are dilemmas the mid adolescent girl is called upon to deal with
as she negotiates the relationship or potential relationship that
affords her social status and a sense of personal worth. Girls have been
raised to understand the importance of the primary relationship and to
feel responsible for maintaining it. Now they must deal with the needs,
expectations and requirement of the boys who are the necessary other
half of the dyad. The culture says, "if you're easy and give them what
they want, they will leave you." The boys say, "if you don't give me
what I need, I'll have to find someone who will." It is a social
dilemma. Actually, coitus with a mid adolescent boy is rarely the event
of a young girl's life. Reminiscent of stories of wedding night
disappointments, boys tend not to last long enough or be cognizant
enough of their partners to provide the ultimate experience. They want
sex, often become angry and disgruntled if it is withheld, and girls may
fall quickly into a pattern of duty sex. Adolescents who delay
intercourse and establish patterns of effective petting become more
creative sex partners. Boys learn to last longer, and girls are more apt
to become reliably orgasmic with their partner if foreplay is extensive
(Hamilton, 1978)
Girls who only date occasionally may find it easier to delay
intercourse; however, some girls use sex in their attempts to secure a
steady boyfriend. Boys who don't go steady may have fairly regular
partner sex with these girls who have established a casual sex pattern.
Some boys just "go for it with every girl," often to the amazement of
their peers, and develop socio-sexual skills that assure them an
increasing number of interested partners. Sexually naive girls may be
inordinately attracted to these entrepreneurial boys and may eagerly
contribute their virginity in the process (virginity usually does not
become a burden until late adolescence).
Fifteen-year-olds are followers and can get in trouble with the
proverbial bad companion. Fifteens are prone to worry about others,
friends and family and the world. They have interest in a depth of
things that touch their life (e.g., race, religion and sex). They write
reports and term papers and debate or organize panel discussions on
topics such as prostitution, homosexuality and pornography.
Fifteen-year-olds want to be free to come and go at will and to answer
to no one. Their uncommunicativeness about their comings and goings
causes parents to worry about involvement in sex and drugs.
Fifteen-year-olds take offense at this parental paranoia, even if they
are not involved in these activities. They have an ethical sense; their
conscience bothers them if they don't live up to their own standards.
They can err out of ignorance and will try to get away with things that
they know are disapproved of (usually behaviors that are reserved for
elders, such as R-rated movies, pornography, sex, smoking, drinking,
etc.). They can accept blame, but will argue the point if they feel that
the restrictions are undue. Church attendance is fairly low at 15, and
some who have gone to church all their lives drop out of regular church
attendance at this point. Some youngsters who have not had regular
church attendance heretofore begin to attend for the first time during
their mid teens. There is security in the church's strict attitudes
about sexuality, and many adolescents attempt to make sexual decisions
through religious guidelines. Mature 15-year-olds may feel doubly
constrained at this age because they are ready to have many things that
are reserved for 16-year-olds, such as partner sex, driving,
independence, privacy, etc. In terms of sexual behavior, necking and
petting are the chief activity in the heterosexual couples, with more
than half the boys and two thirds of the girls reporting that they are
still virgins. ( See more recent statistics for these numbers. Ed.)
Age l6
Sixteen is pre adult by law and custom. They respond to the expectations
of law and society and seem more grown-up in every way. They are
characterized by self-assurance, a sense of independence and social
poise. The group is still important, with increased pairing for longer
periods of time. Driving is a reality, and most couples have access to a
car. Family relationships are improved, but friends continue to be more
important. A 16-year-old may seek consultation from parents if problems
arise; usually, boys will consult their mothers. Some girls may prefer
their fathers unless he is entrenched in a double standard and attempts
to unduly restrict their freedom. Both boys and girls expect to marry
eventually, with girls more positive about the details. Few boys say
they do not intend to marry. Both look for partners with intelligence,
job skills, good temperament, stability and reliability. Girls stress
love and interpersonal relationship skills. Sixteen has him or herself
well in hand and takes a broad and philosophical view of things. They
are tolerant of differences in others, and they can hold their own
ethical position without condemning those who differ. Sixteens are
concerned about the individual effort needed to succeed and can hold
themselves apart even from the group by which they are defined. Sixteens
usually have a fairly even disposition, they control their feelings and
check their own negative judgments of others. They are independent and
rarely abuse appropriate freedoms. They tend to treat themselves as an
equal in relationships with adults, and they try hard to be what they
have decided they want to be. Often, they are their best selves.
Sixteen's health is good. Their major complaint is acne and for some
girls, menstrual cramps. Boys finish off their pubertal development;
most shave at least once a week, and some sprout chest hair. Height is
about 98% complete, and they have a firmer physique, especially those
boys who are athletically active. Sixteens are interested in work,
money, clothes, cars, music, sex and drugs. Boys' interest in girls
increases; and although graphic sex materials are still used, fantasy
alone is a reliable and increasing method of initiating the male sexual
response cycle. Masturbation continues to be the major sexual outlet for
most boys; however, kissing and mutual masturbation are favored
activities of even informal pairs. Many girls and some boys at this age
feel they "are not ready" for sexual intercourse, but few can explain
their criteria of readiness. Girls fear pregnancy and their reputation.
Birth control is a management problem, especially if they are reluctant
to engage their mother's help. Some young couples go to a clinic
together to select a birth control method, which reassures the girl's
fears of security, reputation, etc.
More boys are interested in relationship sex, see girls as equal
partners and want the security of going steady. Boys press for
intercourse and greater sexual diversity. There are fewer foraging boys,
but there are more girls looking for recreational sex than in times
past. Both boys and girls are attracted to casual sexual opportunity and
feel restricted by sexual commitment in a relationship. They use the
term "cheated on" and feel that it is wrong to have sex outside of a
committed relationship. There is a characteristic pattern of breaking up
and reconciling in relationships, which exemplifies the freedom versus
security dilemma of mid adolescence, but both partners believe they
should at least try to be honest in their relationship.
Cars give sexual privacy, but many 16s have sex at home, especially if
both parents work. Some parents who value their own sexuality and
acknowledge the adolescent need to be sexual, endorse sex at home for
their teenagers. Adolescents are disturbed if during their teen years,
their parents' marriage fails and they are called upon to deal with a
dating parent. In sexually committed relationships, problems develop;
boys usually want sex more than girls, and they pressure a girl to have
sex when she doesn't want it. Boys ejaculate too fast, may not
effectively stimulate their partner to orgasm and deal with the age-old
problems of jealousy and possessiveness. Management of an adolescent's
sexually active lifestyle is so complicated, (e.g., the decision to have
sex, finding a time and place, fear of being caught, fear of pregnancy,
no one to confide in, etc.), that there is little or no time spent, or
help with, learning sexual skills or becoming good sexual partners.
Couples who agree not to engage in intercourse but who continue mutual
masturbation may become highly skilled in foreplay, including oral sex;
however, girls who, for one reason or another, refuse to have
intercourse often accept oral sex as the forced choice between coitus
and resent their involvement in it.
The concept of "sweet 16, never been kissed" is nostalgia rather than
reality. There is a growing number of stable pairs at 16 that are
characterized by good grades, extra-curricular involvement, cooperative
attitudes at home and school, responsible behavior, part-time job and/or
athletics and regular partner sex with the use of effective birth
control. It may well be that the security needs formerly met at home
(family of origin) are being shifted in mid adolescence toward the
intimate bonding of the future (family of choice). Even though autonomy
is virtually impossible at this age, it is well to remember that in the
first half of the 20th century, it was possible at 15 or 16 to marry and
support the family of choice independently.
Boys at 16 have a stronger tribal sense than girls of the same age. They
are more competitive with male peers and seek status by achieving
acceptance and recognition from older boys and men. They want money, a
car, power at school (student government, athletics, special skills or
talent, etc.) and a girlfriend. The girlfriend is a status symbol and
signifies success in the sociosexual arena. She is important, but not as
important to him as he is to her. Both boys and girls have to succeed
with the boys. A male high school senior explained, "girls are status
and security, but they can be more trouble that they are worth. If you
really want to make it, you have to spend a lot of time with the guys.
Girls can hold you back because you have to be on your best behavior and
you have to take care of them. You can be crazy and gross with your
friends. You can talk about sex,
race your car, stay out all night, play practical jokes, learn to drink
and dope with the guys and everyone takes care of himself. You just
can't feel free with a girl; it's too much responsibility."
Sixteen-year-old boys want a girlfriend to take to the dance because
going stag is its own form of sociological torture, but they want to go
out drinking with the big boys: "as soon as you get your car, you try to
find someone who can buy" (liquor).
Dating a popular girl is instant status for a boy, but she is expected
to "be there," to wait, to come down on the field after the game, to
understand when other things take priority. If she becomes possessive
and demanding, the relationship is in jeopardy because the boy loses
status if he is controlled by a girl. Having a steady boyfriend who has
status among his peers is status for a girl. She is considered fortunate
if she does not have to worry about a date for important school
occasions or for Friday and Saturday night. Attractive, popular,
achieving girls who are involved in school affairs, have a job and a
car, etc., but who do not have a boy friend, devalue themselves in
comparison with less talented girls who are able to acquire and maintain
a steady relationship. To anxiously wait to be asked to important school
events and/or to miss going because no one asked you is a painful
adolescent experience. This situation may occur for girls who are so
attractive or smart or active that boys assume they are taken or that
they would not be interested in them, as well as for girls who fall low
in the sexual marketplace because of inadequacies.
Girls who are considered "one of the boys" may also have problems with
the cultural values of the high school. These girls may be every boy's
best friend and confidant. Girls who are comfortable with boys, who
don't hassle them with unwanted expectations and who accept them as they
are may not develop the socio-sexual skills needed for the friendship to
become a dating relationship. These girls may even have sex with boys
and still be considered a best friend, not a "lover" or a
"date."
Although there are many patterns and variations, it is evident that sex
is much more complicated than function and skill. Sexual needs,
gratification patterns and experience are the expressions of the total
self and are intricately woven through the fabric of life as a whole.
PART III
Editor's Note: The current DSM-IV has the same code, and additional
information on these disorders.
DSM III and Psychosocial Disorder in Childhood
The Diagnostic and Statistical Manual of Mental Disorders, Third Edition
(DSM-III), divides psychosexual disorders into four groups. Gender
identity disorders are characterized by the individual's feelings of
discomfort with an inappropriateness about his or her anatomic sex and
by persistent behaviors generally associated with the other sex.
Paraphilias are characterized by arousal in response to sexual objects
or situations that are not part of normative arousal activity patterns
and that, in varying degrees, may interfere with the capacity for
reciprocal affectionate sexual activity. Psychosexual dysfunctions are
characterized by inhibitions in sexual desire or the psychophysiological
changes that characterize the sexual response cycle. Finally, there is a
residual class of other psychosexual disorders that has two categories:
ego dystonic homosexuality and psychosexual disorders not elsewhere
classified.
The only category specifically related to children is 302.60, Gender
Identity Disorder of Childhood
The diagnostic criteria for this category for females is:
A. Strongly and persistently stated desire to be a boy or
insistence that she is a boy (not merely a desire for any perceived
cultural advantages from being a boy).
B. Persistent repudiation of female anatomic structures, as
manifested by at least one of the following repeated assertions:
1. That she will grow up to become a man (not merely
in role).
2. That she is biologically unable to become pregnant.
3. That she will not develop breasts.
4. That she has no vagina.
5. That she has or will grow a penis.
C. Onset of the disturbance before puberty.
The diagnostic criteria for males:
A. Strongly and persistently stated desire to be a girl or
insistence that he is a girl.
B. Either one or two.
1. Persistent repudiation of male anatomic structures
as manifested by at least one of the following repeated assertions:
a. That he will grow up to become a woman
(not merely in role).
b. That his penis or testes are disgusting
or will disappear.
c. That it would be better not to have a
penis or testes.
2. Preoccupation with female stereotypical
activities, as manifested by a preference for either cross-dressing or
simulating female attire or by a compelling desire to participate in the
games and pastimes of girls.
C. Onset of the disturbance before puberty.
Paraphilias
The essential feature of disorders in this sub-class is that unusual or
bizarre imagery or acts are necessary for sexual excitement. Such
imagery or acts tend to be insistently and involuntarily repetitive and
generally involve either 1) preference for use of a non human object for
sexual arousal, 2) repetitive sexual activity with humans involving real
or simulated suffering or humiliation or 3) repetitive sexual activity
with non consenting partners. Since paraphilic imagery is necessary for
erotic arousal, it must be included in masturbatory or coital fantasies
if not actually acted out. In the absence of paraphilic imagery, there
is no relief from erotic tension; and sexual excitement and/or orgasm is
not attained. The imagery in a paraphilic fantasy (rape, S&M,
bestiality, etc.) or the object of sexual excitement in a paraphilia is
frequently the stimulus for sexual excitement in individuals without
psychosexual disorder. Paraphilic imagery or the use of objects would be
considered normative in childhood masturbation sexual patterns because
of children's limited sexual knowledge and options. In that regard,
fetish behavior is not included as a diagnosis in childhood. Before the
onset of post pubescent partner sex, the criteria of "repeatedly
preferred" (to partner sex) is not assessable; and when masturbation is
the only sanctioned or available sexual option, the use of inanimate
objects to enhance the experience is common. When other options
(partners) are sanctioned and available, the "exclusive or consistently
preferred" use of inanimate objects is considered a fetish.
Although the age of onset for fetishes is in childhood or adolescence,
paraphilic attachments of childhood and adolescence may recede in their
importance or degree of dependency when other sexual options become
available. For example, the panty fetish (one of the most common) may
begin in childhood as a young boy stimulates himself with thoughts of,
procurement of and masturbation with or into female panties. However,
the adult obsession with collecting panties for sexual use, accompanied
by diminished erotic response to partner sex, is not necessarily the
eventual result of this early childhood fixation. The adult transition
to gratifying partner sex may be smooth and uncomplicated, with
childhood sexual patterns giving way to appropriate adult patterns as
increasingly varied sexual options and opportunities become available.
The adult male's interest in panties as a sexual stimulant may remain,
but may become less important in the overall adult sex pattern.
Fantasies about panties as a part of sexual arousal and/or masturbation,
the purchase of panties as a personal gift to the partner, requesting
the partner to wear panties as a part of sexual foreplay, etc., may not
be considered a fetish because it is not the consistently preferred,
necessary or exclusive sexual pattern.
Sometimes a young boy's erotization of panties leads him to public
behavior that is socially unacceptable. Stealing panties from family
members or from clotheslines and peeping, especially in the windows of
neighbors, may bring a child to the attention of the police or mental
health professionals; and treatment is required. The behavior is asocial
and may be obsessive, but the diagnosis of fetishism is still premature:
This and other asocial behavior such as public exposing of genitalia,
may or may not be accompanied by a mental disorder; and a differential
diagnosis is imperative. Given the contradictory and confusing way that
Western culture handles sexual development, it is erroneous to assume
that asocial sexual acts of children are vis-a-vis
characterological pathology.
Psychosexual Dysfunctions
Psychosexual dysfunctions, characterized by inhibitions in sexual desire
or the physiological changes that characterize the sexual response
cycle, are undiagnosable in children, although there is reason to assume
that they may be manifest. There is no help for children who have
developmental sexual problems (e.g., arousal, orgasm, pain, guilt, low
sensation, etc.). Lack of knowledge and misunderstanding is a major
problem, and most children and adolescents worry about being normal.
What is still lacking in any shape or form in childhood is an open
discussion about sexual anxieties, sexual expectations, different sexual
acts and feelings about sex. In one study, 33% of girls (14-18) were not
sure if they had an orgasm because they had no idea what it was supposed
to feel like. Most post pubescent adolescents masturbate, but the
majority feel guilty, ashamed, dirty, stupid, embarrassed or abnormal
after the act (Hass, 1979).
Although are no studies on sexual dysfunction in childhood,
retrospective sex histories of adults and case histories of children in
psychotherapy suggest that all is not well. We have underestimated the
significance of sexual interactions and fantasies in childhood. Until we
better understand the development of the erotic response through
childhood and adolescence and until normative behavior gradients are
established, children's sexual needs will not be properly addressed by
the mental health community.
Ego Dystonic Homosexuality
Undesired homosexuality is undiagnosable in childhood. Although many
adult homosexuals retrospectively identify indications of their adult
orientation in childhood events, same-sex experimentation in childhood
is a common experience in the sex histories of heterosexual adults. It
is well to remember that homosexuality is a behavior which is dependent
on the preference of same-sex partners. The adolescent discovers and
defines the elements of sexual attraction, unique and individual to
him/herself as an ongoing process of differentiation. The homosexual
discovers that s/he is sexually excited by same-sex stimuli in the same
way that the heterosexual discovers that s/he is excited by opposite sex
stimuli; and within these categories, they both discover even more
specific attractants (e.g., body types, body parts, sex acts, positions,
odors, words, etc.). It is possible for a homophobic adolescent to be
disgusted with his or her feelings of attraction to same-sex peers and
to fear the consequences of a Gay life; however, ego dystonic
homosexuality would rarely be diagnosed before early adulthood. We have
come to understand that even the most serious love affair with a
same-sex partner may not be generalized to an ongoing same-sex
attraction; thus, adolescence is too early to make a definitive
diagnosis. The lack of child sex syndromes described in DSM III does not
mean that children and adolescents are free from sexual problems or that
clinicians are not consulted about the sexual behaviors of children and
adolescents. Sexual problems of children, as seen on an out-patient
basis by mental or physical health care professionals, are usually
public or semi-public behaviors that cause adults (usually the parent)
embarrassment and concern because they are a departure from society's
expectations. There are many sexual events and/or behaviors that cause
children to be referred for psychological evaluation. The parents'
decision to seek professional consultation is the solution to their
feelings of worry that the child is not normal, fear that if they don't
intervene, the child will grow up to be a sexually deviant adult, doubt
that they have the knowledge or skill to change the behavior pattern and
guilt that they have caused or contributed to the undesirable behavior.
Gender Identity Disorder in Children with Normal Genitalia
Gender Identity Disorder (GID) is a persistent belief that one's gender
has been wrongly assigned and a persistent repudiation of one's assigned
anatomical gender. In children, it is often confused with homosexuality;
and parents seek diagnosis and treatment for their child in response to
symptoms of opposite sex mannerisms and behavior. Their concerns include
embarrassment to the family members, stigmatizing of the child and
potential homosexuality. Actually, the adult manifestation of GID is
transsexualism, expressed as the feeling of being trapped in the body of
the opposite sex.
Gender Behavior Disorder
Gender behavior disorder in children (mostly males) is characterized by
cross gender or androgynous behavior that is learned and reinforced by
the environment rather than being linked to a persistent belief that
they are, in fact, the other sex. The adult manifestation of GBD is
transvestism and effeminate behavior. It is important to differentiate
GID from GBD in the diagnostic process. The child who believes s/he is
wrongly assigned suffers from chronic and severe cognitive dissonance,
whereas children who know their anatomical gender but who enjoy
androgynous behavior will suffer only if the environment is punitive and
non supportive. Sexual reassignment of children is considered only in
cases of gender dysphoria or non-specific amorphous genital structure. A
GID adult with normal genitalia might request gender reassignment
surgery as a matter of choice.
Excessive or Compulsive Masturbation
Masturbation frequency is highly variable in an individual child, as
well as between children. Although normative frequency data for specific
ages is unavailable, children are often referred to clinicians for
excessive or compulsive masturbation. This is a subjective
quantification taken to mean that the child is preoccupied with
masturbatory activity to the exclusion of other age appropriate pursuits
and/or that the scope of the masturbation activity is resulting in
stigmatizing censure from others that may create secondary adjustment
problems for the child.
Sexologists believe that masturbation is a viable sexual activity
throughout the life span and that it need not be considered a poor post
pubescent substitute for sex with a partner. Research in female
sexuality (Hite, 1976) and the treatment of anorgasmia in adult women
(Barbach, 1975; Chapman, 1977; Dodson, 1974) suggest that masturbation
to orgasm is an important developmental step and possibly, a
prerequisite to becoming reliably orgasmic in adult partner sex. It is
often a treatment of choice for male and female sexual dysfunction
(Kaplan, 1979) and is reported as a childhood activity of some
importance by most adults (Hass, 1979; Hite, 1976, 1978; Kinsey, 1948,
1953).
Sexologists suggest that young boys be encouraged to prolong the arousal
stage of their masturbation so as not to condition a rapid stimulus
response bond between erection and ejaculation. Young girls should be
encouraged to look at and identify their external genitalia and to
connect their erotic feelings and sexual response cycle to appropriate
genital body parts along with others they might already have. Parents
need to understand that childhood masturbation is a normal and
beneficial behavior that needs to be managed to coincide with social
etiquette.
Precocious Sexual Interest and Behavior
Clinicians are often consulted by parents who are anxious about their
child's interest in sexual topics, masturbation or sex play with
siblings and peers. If the child's basic interest in sex is complimented
by unsupervised opportunity to engage in trial-and-error learning with a
partner, sexual rehearsal play is predictable. Some sexologists suggest
that not only is sexual rehearsal play quite predictable in children, it
is advisable and should be encouraged in order to forestall adult sexual
problems (Money, 1975; Yates, 1978).
Intense and continued or intermittent sexual interest in children should
be accommodated as any other interest would be. Age appropriate books
and conversations with parents endorse the child's curiosity about this
important part of life and encourage an open and unashamed quest for
sexual knowledge. In contrast, a child who shows little interest or
curiosity about sex should not be overwhelmed with sex information by
over-zealous parents. Some children personalize their sexuality very
early and are uncomfortable with candid sex conversations. They
appreciate appropriate sex materials to be used in private and
occasional one-on-one talks with a parent to clear up any troublesome
sexual ideas or feelings. A few parents may worry about a child with low
sex interest, but lack of sex interest is more often considered normal
in children. Of greater concern is the child who is very public with sex
talk and sex play, masturbation with self or with peers. Parents are
concerned that the child is abnormal genetically or hormonally, that
s/he will be censured by other adults and children, that his/her sexual
behavior will reflect badly on siblings and family, that s/he will be a
target for sexual abuse or exploitation by adults or that s/he will grow
up to be promiscuous or perverted.
Three-year old D was a highly sexed boy who had been involved in sex
play with age mates and an older child. He asked his therapist if she
wanted to put her mouth on his "dinky." When she replied in the
negative, he pleaded "you'll like it," "I'll pay you money," "I'll be
your best friend." When asked if he liked to "play dinky," he frowned
menacingly, clenched his fists and aggressively replied, "yes, I like
it, and I'm not going to stop!"
Children who are pseudo-mature in any sense are special children with
special needs. They demand more from parents and may be considered a
blessing or a curse, depending on the value system and resources of the
parents. Intellectual genius, superior athletic potential and
exceptional musical talent are all considered valuable gifts that should
not be wasted. The child who is sexually precocious in development or
interest is, in contrast, shunned and pitied. The parents of these
children need help, not only in the management of the child's behavior,
but also in considering that precocity in this area need not be thought
of as an affliction.
Children Who Report Sexual Contact with an Adult Which Cannot Be
Substantiated
Psychological literature and the popular press report and often
sensationalize the plight of the traumatized child whose story of sexual
activity with an adult is not believed and, conversely, of the
victimized adult who steadfastly denies the sexual accusations of a
child. The most commonly reported pedophilic situation is that of the
adult male and the prepubescent female. This is not to say that sex
between an adult female and a prepubescent male does not occur, but it
would probably not be reported; and if it were, it would probably not be
considered a traumatic experience for the child.
In Western culture, there is a time-honored tradition of young boys
being sexually initiated by an experienced older woman. Girls, in
contrast, are considered permanently damaged by early sexual initiation
by an adult male. The society's attitude that the child has been damaged
by a sexual experience is extended to boys only if the sexual encounter
is homosexual or if residual physical damage is sustained. Sexual
behavior between an adult female and a female child is the least
reported pedophilic possibility and is of least interest to law
enforcement and the community at large.
It is difficult to generalize about adult/child sex because of the
variability of age and sex in any individual case. It is important to
note that if the sexual encounter occurred and if it was traumatic for
the child, the diagnostic process with a clinical child sexologist is
therapeutic. Psychotherapy consists of talking about traumatic
situations in order to bring the experience into cognitive awareness and
to work through the feelings engendered by the event. Properly handled,
a sexual trauma is no exception to this process. A client is ill served
by a therapist who feels that the child has been permanently damaged by
the experience and relates to him/her as a victim.
Many adult women have reported satisfying non traumatic prepubescent
incestuous relationships from which they graduated to post pubescent sex
with peers without undue incident. In contrast, many patients in
psychotherapy report unresolved conflicts in association with childhood
sexual experiences; and there is some evidence to suggest that the
greater the age differential between participants, the greater the
potential for trauma. It is important to note that most reported
pedophilic sex is incestuous and that incest is a family rather than an
individual pathology.
Post-pubescent Sex with a Partner, Heterosexual
Sexologists have attempted to deal with the question of sexual readiness
in terms of chronological age; and there is a reasonable consensus that
around the age of 16, adolescents are physiologically and
psychologically ready. The older adolescent is interested in forming
primary relationships outside the nuclear family, and sexual sharing is
an integral part of these relationships.
Sexuality is a major concern of adolescence; and in that regard,
adolescents are poorly served by the professional community, the family,
the school and the culture (Hass, 1979).
The professional mental health worker sees a small fraction of
adolescents and may or may not address sexual issues. Family members
have little credibility in sexuality if the foundation was not
accomplished in childhood. The school is still concentrating on
reproductive biology and venereal disease, while the adolescent needs
help with socio-sexual issues. The culture simultaneously stimulates and
misinforms, encourages and prohibits, punishes and rewards the
adolescent for sexual interest and behavior.
The revered notion that sex is natural, happening with style,
sensitivity and spirituality when two people love each other, is a myth
that significantly departs from most reported first encounters. It does
however, perpetuate a rationale for those who oppose real sex education
and dooms the teenager who is misinformed by the exploitive messages of
the marketplace.
Post-pubescent Sex with a Partner, Homosexual
Increasingly, counselors and therapists are consulted when parents
suspect or know that their adolescent is in love with a person of the
same sex. Even though societal attitudes are relaxing and homosexuality
is no longer a disease category in the APA DSM-III, for the individual
family, it is a major trauma. Professional consultation is sought by the
parent with the initial purpose of curing the errant behavior, but the
family system is the actual patient or client. Both parents and child
need to know that a same-sex love affair does not automatically mean
that either participant has a homosexual orientation or that a
heterosexual love affair guarantees a heterosexual orientation. It may
be that the love object happens to be of the same sex, but the love
feelings are unique to that individual and may not be generalized to
others of the same sex. Perhaps a bisexual resolution will occur, with
either or both sexes being available as primary partners throughout a
specific life phase or across the life span. Additionally, the first
same-sex love may be the expression of an exclusively homosexual life
pattern to come. It is well to keep in mind that the child is doing what
comes naturally. Children experience their erotic and love feelings in
association with certain people and events and not in association with
other people and events.
Occasionally, an adolescent will seek consultation about homosexual
feelings or experiences without parental knowledge. A few adolescents
are totally unaccepting of homosexuality and are repulsed by any
same-sex attraction they might feel. They are traumatized by a same-sex
approach or experience, even though they may have been a willing
participant. They seek professional help to get rid of whatever is
causing their attraction to and by members of the same sex.
Most parents fervently hope that their child's same-sex preference is a
phase they are passing through, and they are unwilling to disown their
homosexual child. Some families or individual family members may be
unwilling or incapable of accepting homosexuality, thus precipitating
the Gay adolescent's premature emancipation from family.
Sexual Concerns of the Physically and Mentally Disabled
The myth of the sexual innocence of childhood is most secure in the
homes of the disabled child. Close parental supervision, limited
autonomy with peers, identity as a physically disabled child or child
with special needs and rejection by peers as a potential sex partner all
contribute to the negation of sexuality of the physically or mentally
disabled child. Disabled children have sexual curiosity and sexual
feelings. Despite the conspiracy of silence, they need basic sexual
knowledge and information regarding how they can be sexual, given their
specific limitations. As adolescents, they need opportunities to
experience their sexual response cycle, to learn what their individual
sexual limitations and abilities are and perhaps, more importantly, how
to negotiate for sex with a partner, especially the orthopedically
handicapped, who are assumed to be incapable of being sexual by most non
disabled people.
A physically healthy child with mental retardation poses another type of
problem. They may be quite normal in physical and sexual development and
as an adolescent, may be attractive enough to be selected as a potential
sex partner by a peer or an adult. Impaired mental function may,
however, disallow good judgment in sexual situations. Their own sexual
desire, coupled with this lack of discrimination, makes them an easy
target for sexual exploitation. The mentally retarded child needs
explicit sex education; reinforced, plainly stated rules about
socio-sexual conduct; adequate supervision and effective birth control
at the appropriate age.
Families of disabled adolescents who live at home and caretakers of
institutionalized teens, need to facilitate the sexual opportunities of
their charges. Even if s/he can acquire potential partners, the disabled
adolescent needs a safe place, privacy and, perhaps, some physical
assistance to have a successful sexual experience. The issues of birth
control and paid partners are complicated for adolescents or young
adults in institutions or on public assistance, as charges for these
services are not reimbursable by third party payers. As a society, by
default, we have decided that the disabled shall not have sex lives. The
advocacy groups for individuals with special needs have not provided or
demanded sexual equality and sexual rights, which, for many disabled
people, are as important as access to public buildings or the Special
Olympics.
Sexual Guilt as a Factor in the Treatment of the Hospitalized Child
Psychological services for the child hospitalized on the medical or
surgical ward have become standard practice in many hospitals. In both
routine ward service and psychological referrals, the alleviation of
sexual guilt with regard to masturbation is often a significant factor
in the understanding and treatment of the physical illness. From the
concrete thinking of the young child to the maturing moralism of the
teenager, the cause-and-effect rationale is predominant. The simplistic
link from bad thoughts to bad deeds usually includes the forbidden
sexual behaviors. A frank discussion about masturbation, what it is and
what it isn't, allows the therapist to assuage the child's guilt about
masturbation, to demythologize and disconnect sexual behavior as the
cause of the injury or illness, to impart accurate information and to
give permission for continued masturbatory behavior in the hospital,
helps to facilitate trust in the therapist about these personal concerns
and others (e.g., recovery, abandonment, death, etc.).
Most adults are ambivalent about children's masturbation. Medical and
hospital personnel may need some help in understanding the purpose of
dealing with masturbation when health concerns are primary. Masturbation
is an effective tension- and anxiety reducer in children and adults, and
it is self affirming. It is an activity that reclaims the body and
offsets intrusive hospital procedures. The cessation of a regular
masturbation pattern constitutes an unnecessary deprivation and added
stress to an already stressful situation.
Child Prostitution and Kiddie Porn
The exploitation of children is an anathema in our humanitarian society.
We have laws to protect children from unscrupulous adults; however,
there is a societal reluctance to intrude on the autonomy of the nuclear
family. The campaign for the recognition of the battered child as a
syndrome of ongoing abuse was hard-fought in the 1960s. No one wanted to
believe or admit that it was a widespread phenomenon that had crossed
all educational, socioeconomic, racial, ethnic and religious lines.
Child prostitution and kiddie porn are similarly societal problems that
adults are trying hard not to address. Runaways who become street
children, with no jobs (many are too young to work legally), no money,
no shelter, etc., quickly learn that they have only one negotiable
commodity-- their sexuality. Male or female, they can sell their bodies
to adult men. Although the ranks of street children relegated to
prostitution and other forms of sexual exploitation grow consistently,
some children are encouraged by a parent into prostitution to augment
the family income and upgrade the standard of living of mother and
siblings. These children are usually female, living with a mother as a
single parent. Girls in this situation are more apt to come to the
attention of authorities and be referred for evaluation and therapy than
street children, who are rarely seen professionally. Any individual can
be psychologically evaluated and can benefit from the self-knowledge
gained in psychotherapy; however, child prostitution and kiddie porn are
broad spectrum societal problems that will not be alleviated by
individual psychotherapy.
Other Symptoms of Sexual Significance
Peeping Toms, stealing underwear and sex with animals are asocial and
illegal activities which may be transient attempts to satisfy child or
adolescent sexual curiosity, or they may be the development of aberrant
patterns of voyeurism, fetishism and bestiality. The behavior may be in
response to a lack of knowledge or an expression of underlying
psychopathology. It is helpful to the child if the differential
diagnosis is made by a therapist who doesn't over-react to the symptoms.
It is well to remember that society's messages about sex are
contradictory and confusing to children and adolescents. Whether the
resultant dissonance is expressed as private worry, fear and doubt or
erupts into public behavior, children are well served by accurate
information, endorsement of the normalcy of sexual feelings and desires,
their right to be sexual and an opportunity to learn culturally
acceptable socio-sexual behavior and skills.
References
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