Sex-education. Maurice A. Bigelow
"Hygiene and Morality"; Henderson's "Education with Reference to Sex"; and certain chapters in Warbasse's "Medical Sociology."
Estimated amount of disease.
With regard to the accuracy of the commonly quoted statements concerning the prevalence of social disease, and therefore of immorality, it must be said in all fairness that there has been much guesswork and some deliberate exaggeration. We learn from various books and lectures that fifty, sixty-five, seventy-five and even ninety per cent of the men in the United States over eighteen years of age are at some time infected with at least one of the social diseases. The fact is that there is no scientific way of getting accurate statistics, for unlike other contagious diseases, the venereal ones are kept more or less secret, and numerous cases cannot be discovered by health officers. All the published figures regarding the prevalence of such diseases are merely estimates based upon the experience of certain physicians with special groups of men, especially in hospitals. There is no reliable scientific evidence as to the prevalence of venereal disease in the whole mass of our American population.
Education not concerned with percentages.
However, so far as education is concerned, there is nothing to be gained by dispute as to the possible inaccuracy of the higher percentages,[1] for it is generally admitted that probably over fifty per cent of the men in America and Europe become infected with gonorrhea or syphilis, or both, one or more times during their lives, especially in early manhood. This conservative estimate is sufficient to show that the sexual morals of probably the majority of men are at some time in their lives loose. There is reason to believe that with most such men the period of moral laxity is in early manhood before marriage, which, though not excusable, is explainable on physiological grounds. It is important to correct the wrong impression which is now widespread, especially among women who have read the more or less sensational statements in certain books and magazines, that the quoted figures on social disease mean that from fifty to ninety per cent of all men are immoral from time to time for many years. If that were true, the situation represented by the highest estimates would be hopeless, and we might as well start out to adjust society to a system of recognized sexual promiscuity. Fortunately, it is far from true, for a great many men included in even the conservative statistics of social disease were infected because they strayed from the moral path very few times and in many cases only once. This fact makes the outlook for improved sexual morals and health more hopeful, for probably the majority of young men need help in controlling themselves for a few years only, especially between eighteen and twenty-five.[2]
Established facts.
The reports of medical men regarding the damage done by the social diseases are inaccurate chiefly when they attempt to state percentages of the whole population. They are reliable when they state observed facts, such as the following: It is now established in medical science that (1) gonorrheal infection results in tens of thousands of cases in complications, such as heart disease, gonorrheal rheumatism, sterility of both men and women, blindness of infants, inflammatory diseases of female reproductive organs, and other well-marked sequelæ of the disease; and (2) that syphilis is responsible for a large majority of cases of locomotor ataxia, paresis and certain types of insanity, and also for numerous aneurisms of arteries, many apoplexies, and much disease of liver, kidneys, and other organs. Moreover, syphilis is charged with being the greatest race destroyer. Fournier, the great French specialist, noted that only two children survived from a series of ninety pregnancies of syphilitic women of the well-to-do class. It is probably true that much less than ten per cent of syphilitized embryos ever grow into mature men and women, and even these few survivors are likely to carry in their bodies the germs or the "virus" of syphilis which may affect the next generation.
Social diseases admittedly dangerous.
Such direct statements as the above may be accepted as not exaggerated. However, it little matters in sex-education, except for the purposes of sensational writers, whether statistics regarding the damage done by venereal diseases are more than estimates; for it is sufficient to remember that every physician of large experience agrees that syphilis and gonorrhea are so common and so destructive of health and life that they must be classed among the most dangerous diseases that now threaten the human race. This ought to be sufficient to attract the serious attention of every thinking man and woman.
Double standard of morality.
Thus, in general survey, we see the great problems of social-sexual hygiene caused by diseases that are widely distributed because sexual instincts are uncontrolled. In short, the alarming problem of the social diseases results from masculine promiscuity or the failure of men to adhere to the monogamic standards of morality. In other and familiar phrasing, there is widespread acceptance and practice of the so-called "double standard of sexual morality," a monogamic one for respectable women and promiscuity for many of their male relatives and friends. (See writings of Morrow, especially "The Sex Problem"; also Creighton's "The Social Disease.")
One problem for sex-education.
Our brief survey of the hygienic problems caused by sexual promiscuity and its characteristic diseases is sufficient to indicate one great problem for sex-education. Such social-hygiene problems have been most responsible for the recent and rapid rise of the movement for sex-education, and they must be recognized in any adequate scheme for instruction of young people.
Is sex-hygiene adequate?
Can scientific education hope to solve the sexual problems of society by inculcating such fear of venereal diseases that men will remain true to the monogamic code of morality? Many cynical disbelievers in sex-hygiene answer this question negatively by asking in biblical phrase, "Can the leopard change his spots?" In other words, these doubting ones believe that sexual instincts are so firmly fixed in the nature of many men and some women that there is no hope of radical change through education.[3] There is something in this point of view. It is probably true that even the most radical advocates of sex-education do not hope to secure universal monogamy and consequent disappearance of social diseases. A conservative and rational answer to the above question whether sex-education can solve the problem of social diseases, is that a large percentage of even civilized people are not yet ready to have their most powerful instincts controlled by scientific knowledge. Hence, there is no hope that the hygienic task of sex-education will be finished soon after instruction becomes an established part of general education in homes and schools. At the very best there will be incomplete returns for the social-hygienic aspect of sex-instruction, but already we know for a certainty that enough young men will be influenced to make the teaching justifiable. I feel sure of this because I have met personally many such men and my friends know many more.
According to the investigations made by Dr. Exner, the medical secretary of the Young Men's Christian Association, a great reduction of venereal disease has followed sex-hygienic campaigns in college towns.
Medical treatment.
In another way hygienic teaching may reduce the amount of venereal diseases, and that is by leading infected individuals to seek thorough medical treatment without delay. This, of course, will render the diseased person non-infectious to others. Physicians report that there is now a marked movement in this direction and, moreover, that many infected young men voluntarily seek medical examinations before marriage.
Woman's need of information.
Even if we refuse to believe that social-hygienic teaching will protect many young men from sexual diseases, there is the woman's need of information to be considered. As said before, women more than men suffer the consequences of venereal infections. Therefore, every young woman who considers marriage should know the possibility of danger to herself and her children, and be able to decide accordingly. Of course, even with much knowledge she may marry the wrong man, for correct diagnosis of social disease is not always easy; but if her confidence is betrayed and she becomes infected, she ought to know the importance of immediate and radical medical treatment. Let me illustrate these statements that women should know the danger of venereal disease. One of my college friends neglected an important legal case to travel seven hundred miles in order to tell face to face another college friend that she was about to marry a dangerous