7 Ways to Build Healthy Sexuality
Genital Play: What's Normal, What's Not
Masturbation
When Should I Stop Letting My Child See Me Nude

How a child learns to treat the other gender, and how the child feels about his or her own sexuality is an important part of his or her self-image. We prefer to talk about "building healthy sexuality" rather than "teaching sex." Schools, for better or for worse, teach sex; homes model sexuality. This means not only teaching facts of life, but attitudes as well. To help your child develop a healthy sexuality, you must prepare him or her for the physical changes ahead and for the feelings that accompany these changes. Your child also needs to know how sexuality operates in healthy male-female relationships.

The idea of teaching children about sex creates uneasiness for many parents. They may be uncomfortable talking about sex, and they worry about how they come across. They don't want to cause anxiety and shame in their children, but they don't want to promote unbridled freedom either. The most important teaching is done not by lecture or answering questions, but by example. You can always clarify the facts. It's harder to fix attitudes.

1. Touch is the beginning of sexuality. Parents ask, "When do I begin teaching my child about sex?" "At birth," is my reply. In most of your interactions, often unknowingly, you give sexual messages to your child. The earliest message is touch. From the moment of birth on your child will know if you are a touching family. Your infant feels good giving and receiving touch. Caressing your baby's face, massaging her skin, being entranced in an eye-to-eye gaze, and having your baby at breast and in-arms instill early attitudes that the body is good; it's good to touch and be touched. As a result of this high-touch style of attachment-parenting, the child gets the early sexual message to be comfortable giving and receiving touch. He learns that this is one way that human beings show love for one another. Honoring the need to be touched helps a child feel comfortable about herself or himself as a person. This is the beginning of learning to feel right as a "she" or "he."

2. Vive la difference. In the past, women tended to babies and men tended to business. One of the richest changes in parenting over the past twenty years is mothers and fathers sharing childcare, not in competition over "who's better," but in the growing realization that babies thrive on the differences in the way males and females care for babies.

Mothers and fathers hold, look at, and touch babies differently. Babies pat breasts and rub beards. Babies respond differently to male and female voices. Early on, give your infant the message that both sexes can nurture babies, and these little takers will learn to extract the best from both mother and father.

In the early years, a baby learns that mom treats him differently than dad, and when both are sensitive nurturers baby benefits from this difference. Yes, babies usually prefer mother, but dad can be a close second. If dad is gruff, rough, and distant this is baby's early impression of dad, which later may translate into what all men are like. When, however, baby is nurtured by both parents, he or she will see nurturing and sensitivity as the way healthy people normally treat one another, regardless of gender. The challenge is to celebrate the differences in gender and still give both genders equal opportunity for nurturing. Remember, dads, you are the first male your child knows, and moms, you are the first female.

3. Being different does not imply less. Growing sexual persons, especially boys, often devalue the other sex because they think they don't perform certain tasks as well. They ignore the fact that everyone's skills are different. This who-is-better conflict often surfaces in middle childhood when boys and girls engage in team sports. This natural competitiveness, if not reinforced by caregivers and coaches, is usually self-correcting (providing parents mind their sexist remarks). One day while watching kids in a schoolyard run, I remarked, "Girls sure run funny." Our fourteen-year-old daughter shot back, "Boys run funny, too." She was letting me know that my comment was one- sided, sexist, and frankly unnecessary. I apologized. Equal opportunity in school sports has helped foster mutual respect between boys and girls. When we were growing up, boys performed while girls watched and cheered. Now we see our oldest daughter performing as a cheerleader—a highly skilled and competitive sport that keeps her fit and teaches her about teamwork. All those years of soccer, softball, and gymnastics have led her to a love of doing her best. Her squad has made it to national competitions. (And there are boys on many cheer squads.)

It's important for children to learn that both genders are equally valuable. Sexual equality, used correctly, should not mean sameness, but equal value, equal opportunity. It would be a dull and short-lived world if the sexes were the same. One day a couple and their four-year-old were in my office for discipline counseling. Dad dominated the conversation. Whenever mom offered an opinion, he put her down. It became obvious that the power struggle was between the sexes, not between parent and child. The child was visibly disturbed and was getting bad sexual vibes: men devalue women. It's important to model respect for the opposite sex for your children, build up each other in your children's presence, and tell your children what a wonderful mother or father they have. Children who value and respect the other gender are less likely to become adults who harass the other gender.

4. Reinforce the person more than the gender. It's normal and healthy for parents to encourage gender differences, but traditional views on what constitutes gender-appropriate behaviors no longer hold water. In the past, fathers have tended to reinforce more gender-specific behaviors than mothers. Dads would roughhouse with boys, but play quiet games with girls. Playing more gently with a daughter conveyed to her that she was expected to be sensitive and delicate. Roughhousing with a son would encourage him to be aggressive. What was missing? Neither daughters nor sons learned how to be sensitively assertive, and the stereotypes lived on. While over-emphasis on gender blending can be as unhealthy as the old stereotypes, try to play with the child according to the child's temperament rather than the child's gender.

Take cues from your child first as a person, second as a member of a gender. If growing children become comfortable with themselves as people, they are much more likely to be comfortable with their sexuality. I used to fall into the gender trap in my practice. In my office I would automatically greet a little boy with a hearty "give me five," but welcome a little girl with a gracious hug. I now find it more appropriate to take cues from the child and make an on-the- spot decision about whether a hand-hit or a hug would be more appropriate. With my children and with my patients, I see the importance of fostering sensitive behavior in boys and encouraging assertiveness in both sexes. Tenderness and assertiveness in both sexes is a better way to have balance.

5. Foster healthy gender identity. By age two-and-a-half children become aware of gender differences. They begin to identify "girls" and "boys." Girls become aware that girls have long hair and sometimes wear dresses; boys have shorter hair and wear pants. And they become aware that their genitals look different and they "pee" differently. (Four-year-old brothers have been known to taunt younger sisters: "I've got a penis and you don't.") How you approach the differences in external genitalia can help play down the who's better problem. Instead of perpetuating the idea that boys have penises and girls don't, use your comment to equalize the situation, "Girls have a vulva, boys have a penis." A little girl may tend to feel inferior because she doesn't have such an "interesting" piece of equipment, and a little boy may feel anxious that he could lose what he has. A wise bit of teaching here can leave both genders feeling good about themselves.

From birth boys are generally more aggressive and rougher than girls during play, though sometimes the reverse is true. How much of this difference in behavior stems from the X and Y chromosomes and how much from cultural programming is open to question. Gender behaviors are a combination of genetics and environment. Some boys dive headlong into traditionally male activities (trucks, combat), some girls into female ones (dolls, cooking). Many children show very individual and less gender-oriented preferences. Boys can be equally imaginative playing house as girls can be, and girls can be just as rough-and- tumble in pretend adventure as the boys. Girls have more interesting choices when it comes to clothing, and here is where parents see a child's personal taste defy all modeling cues from her mother. The daughter whose mother is always in jeans may insist on dresses only, to her mother's amazement; the daughter whose mother prefers dresses fights tooth and nail to stay out of one, even at the tender age of three. This, of course, may have nothing to do with whether she plays creatively with dolls for hours on end or chooses to practice gravity-defying stunts most of the day. Also, gender behavior may depend on what activities parents allow. A six-year-old boy and his friend were fighting one another. Grandmother advised, "Leave them alone. Boys will be boys." The mother disagreed, "I will not allow my child to be an ill-mannered maniac just because of his sex."

6. Model healthy gender roles. Children develop healthy gender identity when they have healthy gender models at home. Try to model the following attitudes for your children:

• Mom and dad are loving caregivers.
• Mom and dad are fair disciplinarians.
• Mom and dad respect one another.
• Mom and dad convey that they like their gender and their chosen roles.

A new father grieving about not having had enough time with his father, confided to us: "He seldom held us. All I remember was seeing his back and briefcase as he left for work." Some fathers do have demanding jobs that keep them too busy. If this kind of father enjoys his work, though, he will communicate to his children that he is fulfilled in what he does "for a living," and he will be more likely to also enjoy the time he does have at home being a dad. Children benefit from seeing their parents happily and gainfully "employed" because they take pleasure in providing adequately for their family. It's important to give a very clear message that family is more important than a "job." One very sad pitfall in the area of work is that dad can be perceived as the more valuable parent because his worth can be measured in dollars, compared to mom who works for "nothing." Women can be lured back into the marketplace, against their inner wisdom, for this same shallow rationale.

Not only do babies learn from how mom and dad care for them, they also witness how mom and dad care for each other. It is not only healthy, but important, to show affection to your mate in front of your child. If the child sees hugs and kisses and perceives sensitivity between mates, this little sponge learns that it's good for people to show affection for one another. The result is a child who enjoys giving and getting kisses and hugs from the people he loves. When children see one parent always putting down the other, being insensitive to, or even physically abusing the other, they store these action pictures in their attitude file. They either decide that this is the wrong way for daddy to treat mommy (or vice versa), or they accept that strife instead of sensitivity is the normal pattern between the sexes. Either viewpoint plants unhealthy sexual attitudes and expectations in the child. How mates treat each other strongly influences the child's later choice of a mate.

7. Discipline affects sexuality. How a child is disciplined affects, for better or worse, his or her future attitudes toward sex. Children who receive attachment parenting learn to love and trust because they have been loved and trusted. A child who, as an infant, spends hours in arms and at breast, learns to be comfortable touching and being touched. That child learns intimacy. The little person who grows up in a home where mother and father respect each other and their children are likely to view sexual roles as healthy and satisfying.

The child who grows up with harsh, abusive correction may take on the abusive characteristics of the parents or unconsciously look for those qualities in a mate. The child whose expressivity is squelched by over-controlling parents, may have difficulty expressing adult sexuality or may use sex as a tool to control or be controlled by others. The child who never learned "no" may not be able to delay sexual gratification and is more likely to take what he wants without considering the cost. The most important quality of parenting—sensitivity— greatly affects sexuality. One of our goals in discipline is to help a child learn to consider how his actions will affect other people. After all, satisfying sex is basically mutual caring—the ability and desire to satisfy both one's own and another's needs.

We have had many phone calls from distraught parents who have gone ballistic upon opening a bedroom door and discovering two little naked bodies playing "doctor and nurse." This scene, common in even the most moral and loving homes, pushes panic buttons in parents who wonder where they have gone wrong, or react so strongly that the punishment leaves more scars than the innocent "crime." To deal with this inevitable scene it helps parents to know what's normal, what's not, and what to do.

What's normal? General Curiosity. Children are curious, especially about differences, and what could be more fascinating than different genitals? Understand this situation for what it is—normal childhood curiosity at work. It needs sensitive understanding to prevent it from reoccurring. Get behind the eyes of your child. He wants to learn what the other sex looks and feels like. The child is more interested in satisfying curiosity than in sexual arousal. You can tell innocent sexual curiosity from deviant sexual behavior by these characteristics. Innocent acts are occurring when:

• Children are young (under age seven), close in age, and know each other.
• There is mutual agreement; one child is not forcing the other.
• There is usually a game-like atmosphere: playing "doctor" or "I'll show you mine if you show me yours."
• Secrecy is part of the game. As if sensing their parents would disapprove, children retreat into a bedroom, garage, or a private place. (This is true for deviant acts as well.)

What to do. First, to compose yourself and resist the impulse to come on strong toward the children telling them that they have done something "dirty" or "bad." Calmly and matter-of-factly introduce a new activity. (i.e., "Let's go have a snack. I'll help you get dressed.") As soon as a private moment is possible (or right away if both children are yours) have a talk with your child. Convey that you are not angry. If children sense that they have done something bad or that you are angry, they will clam up. Tell your child that it's normal to be curious about another's body parts, and that you understand his curiosity, but that "its not right to touch anyone else's private parts or let them touch yours. I want you to promise mommy that you will keep your private parts private and not touch anybody else's." Let the parents of the other child know how you handled the situation so they can do likewise.

Children can begin to learn the meaning of "private parts" at an early age, when they are learning about other body parts. Private parts are any place that your swimming suit covers. Be aware of your own body language when addressing your child's sexuality. If your child perceives that you are uneasy about sexual matters, he or she may conclude this is a "bad" subject or these are "bad parts." They are good parts, but they are private parts. This concept will be important in teaching your child about sexual molestation. Teach your child that these "special parts" should not be touched or shown to anyone except mommy or daddy during a bath or dressing or to the doctor during a checkup. "If anyone touches your private parts, promise to tell mommy or daddy. We won't get angry. It's good to tell mommy or daddy if somebody touches you, even if they tell you not to or tell you to keep a secret." Teach children the concept of good secrets and bad secrets. "Good secrets are what you have between friends" (and make up some examples). "Bad secrets are when somebody tells you not to tell mommy or daddy. You should never have secrets from mommy or daddy." Begin teaching "private parts" as early as age three so that modesty becomes part of a child's growing sexuality.

To prevent recurrences of genital play, minimize opportunities. Be aware of what children are doing. Don't allow them to be unsupervised behind closed doors. We have a rule in our house that bedroom doors must always be open when friends are over—at all ages. Our teenagers have grown up with this rule and still respect our wishes on this policy. You are applying the same principles to sexuality as you do to all discipline matters: parents set the rules and then set the conditions that make the rules easier to follow. If you sense that your child is still curious, make this a teachable moment: "The body is beautiful. Let's learn more about it. Let's start with a picture book." If your four-to- six-year-old wants to know where babies come from, we recommend the book: by Andry and Schepp (Little Brown, 1979). Be willing to answer your child's questions as they come up. Keep in mind that age- appropriate answers do not have to be embarrassing for anyone. If you start out this way at a young age and continue to dialogue about sex with your child, your child will feel comfortable talking to you about sex as they get older.

Be sure to report the incident to the other parents so that they too can make this a teachable moment. Tell them that you understand the innocence and the normality of childish curiosity, but that you also want to keep it from happening again. Be open, honest, and matter-of-fact. Don't assign blame, and you shouldn't have to worry about upsetting adult friendships.

When sex play is not normal. How do you tell when the line has been crossed from innocent, childish curiosity that needs to be handled with understanding and explanations into abnormal behavior that needs serious attention? It's important for parents to know how to tell when one child is victimizing another. Here are suspicious signs:

• One child entices or forces the other into sex play.
• There is an age difference of more than three years between children.
• The sex play is not appropriate: for example, oral-genital contact between a six-year-old and a three-year-old.
• The event occurs more than once despite your careful intervention and supervision. These are grounds to protect your child from another by terminating the friendship. If the sex play is between siblings, seek professional help.
• If your child has been threatened to keep it a secret.

What to do. For the victimizer, seek professional counseling. It is often necessary to do a complete inventory of a child's self-concept, home, and school environment. If your child is the victim, replay the "private parts" talk. Be sure that your child understands that he is not bad and his body is not bad but that it is wrong for one person to touch another's private parts. The victim may also need professional counseling.

Don't run to call your neighborhood psychologist when your little girl rocks on her tricycle seat or your little boy puts his hands down his pants. Instead, stop and consider why this subject makes you squirm. The very word "masturbation" gives many adults a deeply uncomfortable jolt, accompanied by heavy doses of guilt. If a child pulls his ear or strokes his arm, no one notices. So why do parents ignore the little boy who pulls his ear but worry and scold when he pulls his penis? It's either because genitals are considered bad, mysterious, or off-limits, or they believe that genital rubbing is a sure sign of psychological disturbance. Neither of these are true.

Most children play with their genitals—expect this somewhere between age of two and six. The reason genital fondling bothers adults is that we tend to view children's actions through adult eyes. To a child, masturbation is a normal part of discovering these parts of his or her body and the pleasurable feelings that come from them. In exploring their bodies, babies discover that some parts feel more pleasurable than others. Once these areas are discovered those little hands are frequently found there. To a child, massaging his or her genitals is pleasure. It is not "wrong" or "dirty." Only if a child hears these terms from adults (or picks up on their anxiety) does he or she become worried and confused.

Some religions teach that masturbation is wrong. We do not intend to question this belief or value system. Simply stated, adults who themselves choose not to practice masturbation for moral reasons will have to be wise in how they approach this matter with their babies or young children. There will be ample opportunity for the child as he grows older to be taught how to respect his genitals in a religious sense.

Because children aren't doing anything "wrong" when they explore or stimulate their genitals, there is no need to scold, shame, humiliate, embarrass, or punish them. Above all, avoid conveying that these are bad body parts. Later sexual hang-ups are often due to mishandling of early sexual issues by overzealous but well-meaning adults. These parents, because they themselves were shamed, frightened, and punished, may never have come to terms with their own sexuality.

1. When masturbation is normal. Understand that the desire to use one's body parts for pleasure is part of normal sexual development. While it is not necessary to masturbate to have a positive self-image, enjoying one's body parts contributes to developing healthy sexuality and liking one's body. So occasional genital massage is not dirty, harmful, or a signal of an underlying emotional disturbance or of problem parenting. For most kids, it's a continuing discovery and it feels good. It's as simple as that.

2. When masturbation becomes abnormal. Genital play can become more than just a passing curiosity when it becomes frequent and intense and the child becomes so preoccupied with self-pleasure that he or she withdraws from interacting with others. As is true with any self-gratification, if the habit is an occasional departure from the routine, a quick-fix for boredom, a need for comfort, or an occasional release of pent-up anxiety, it's normal. If the person becomes dependent on this form of self-pleasure to the degree that he or she doesn't reach out in other ways to feel good, it becomes abnormal.

Medical complications from genital stimulation are rare, though in girls excessive and intense friction (rubbing their genitals against something hard like the saddle of a toy horse) can traumatize the urinary opening, resulting in urinary tract infections. (This is less likely to be a problem for boys, since their urethras are longer.) Manual stimulation will not damage tissues (as long as little hands are clean) unless the child willfully inflicts pain on himself or herself due to the obsessive intensity generated. This is a signal to parents that some intervention is needed.

While genital stimulation is normal behavior for a child, it bothers parents and, if excessive, can bother the child. Here are some ways to keep a common practice from becoming a harmful habit.

3. Not in public, please. Dear old Aunt Mary is sitting in your living room and in full view four-year-old Susie climbs on the arm of the couch, wiggles around, and soon has that happy look on her face. Other faces in the room turn red. Witnessing anyone masturbating embarrasses adults. Without making judgments about your child's actions, matter-of-factly advise her that anything to do with her "private parts"—like going to the bathroom—is private. Use this as a teachable moment and nicely explain that you want your child to "go do that where I can't see you—it makes people uncomfortable." Usually the child will choose to stop the activity so he or she can stay near you. Normal social living demands that people often delay their own gratification (or subdue their own feelings) out of respect for the feelings of others. The best approach is to quickly distract the child into a more socially-acceptable activity.

Build a balanced self-esteem. Children who feel good about themselves on many fronts (home, friends, school, activities) are less likely to retreat into habitual genital stimulation. Six-year-old Tommy was going through a poor self- image stage. He wasn't getting along with his parents or friends and didn't seem to fit into school or social activities. Mother noticed Tommy began to spend more and more time behind closed doors in his room. One day, not knowing he was in his room, mother opened the door and discovered him masturbating. She wisely shut the door immediately and walked downstairs before falling apart and calling the child's father—"I caught him doing that." Rather than embarrass her son, mother respected his dignity, and later, father and mother arranged to talk with Tommy together. During their discussion (not a confrontation) Tommy's mother referred to his penis as "your little self." Tommy's father smoothly substituted the term "penis" with a word that mother and son were comfortable with. They seldom referred to "the act", but rather concentrated on the whole person, focusing more on Tommy's withdrawal from the family as the problem needing fixing rather than where his hands were. In the days and weeks that followed, they helped Tommy get more comfortable in outside activities and within the family. He began to spend less time in his room with the door closed.

Chronically bored children often turn to their bodies for stimulation. Keep little minds and bodies active. When the little boy's hands go into his pants or the little girl begins rocking, casually distract them from their self-interests into other activities.

4. Avoid scare tactics. Here are some of the fearful myths about masturbation that years ago came from the mouths of adults:"If you keep that up, you'll get warts on your hands." "You'll go blind.""Stop that, it'll make you sick."

These may have frightened children out of the habit, but they also created unwarranted guilt and damaged self-esteem, resulting in unhealthy sexual attitudes. And, once children discovered that these threats were untrue, advice on other sexual matters became suspect.

Give wise counsel. If you intervene in childhood masturbation, you must carry through with wise advice. If your child is old enough for such dialogue, try this approach (best for dads to talk to boys and moms to girls): "...Johnny, playing with your penis feels good and it is a good part of your body. I did this a bit when I was your age. But too much of this stuff keeps you from exploring other activities that make you feel good. What are some other things you would like to do? What would you like to do together?" Although perhaps uncomfortable for parents, these conversations are teachable moments, healthful to the child's growing sexuality. They also strengthen your parent- child relationship.

5. Employ a substitute teacher. If you are uneasy about discussing sexuality with your child—and many parents are—your child is likely to sense from your body language and strained words that sex is a nasty subject. If your child is a habitual masturbator, ask the child's doctor to explore the subject as part of a checkup. Over the years, hundreds of red-faced parents have asked me to take on this task. I've consented, but with reservations, because delegating an important issue to a substitute deprives the parent of the opportunity to grow in his or her role of authority and counselor. The children may feel the parent is squealing on them, although this probably won't happen if the doctor, or other advisor, approaches this subject as part of a normal sexuality talk, rather than an accusatory confrontation. It's helpful to remind the habitual masturbator: "Remember what Dr. Jones said about rubbing too hard on your vulva."

Give alternative tension releasers. I counseled a six-year-old girl, Lara, who habitually masturbated so much at bedtime that her genitals became sore. Her perceptive mother rightly concluded that the habit was a tension release. We helped Lara by both dealing with the cause of the tension and showing her alternative ways to relieve her anxiety. There had been a lot of recent stress in this child's life: a recent move, new school, new friends. Her parents helped her work through adjusting to these changes by giving her back rubs and playing soothing music as she drifted off to sleep. Not only did she ease off on her masturbation, but she learned that during tough times parents are a valuable resource.

One of the earliest sexuality concepts you want your child to learn is that the body is good—all parts of it. Bathing with your baby is healthy sexual modeling. When your toddler runs into the bathroom as you step out of the shower in your birthday suit, there's no need to dive for cover. That would convey there is something to be ashamed of. But you may wonder, until what age? As with so many aspects of discipline, take your cue from your child. Watch for signs that your child is developing a sense of modesty. When your child begins to cover up, it's time for you to cover up, too. Your child quickly crosses his hands in front of his genitals as you enter the room or carefully closes the door when he uses the toilet or is dressing. That's a modesty cue, and the unclothed time of early childhood has passed. By the age of four or five most children begin reserving their bodies for private viewing, and so should parents.