I first came across the word, naturally, by reading ahead of my grade level; at age 10, I was ostentatiously reading my father’s copy of Margaret Mead’s “Coming of Age in Samoa,” the book that had convinced him to become an anthropologist. I asked my mother, what is masturbation? And I remember her answer: “Touching yourself for sexual pleasure,” she said, neutral and nonjudgmental like the English professor she was.
That was helpful when, soon after, I acquired the original cast album of the musical “Hair,” which presented a new set of vocabulary challenges; at least I understood the line, “Masturbation can be fun.”
Let’s face it, masturbation can indeed be fun, but it turns out to be a subject that many parents feel awkward about discussing with their children. Parents and children sometimes bring their questions and concerns to the pediatrician, but there is surprisingly little guidance or information available in the pediatric literature. And in an informal survey of pediatric colleagues, there seems to be a lot of variation in whether doctors bring up the subject.
I will tell you that I took a certain amount of ribbing from my colleagues for even asking the question, which is not necessarily a bad thing; humor can help defuse a potentially embarrassing subject. Debby Herbenick, a professor at the Indiana University School of Public Health, who has conducted research studies related to child and adolescent sexual expression, said that as an icebreaker for talking with undergraduates, she shows them comments about the now-discontinued Harry Potter Nimbus 2000 battery-operated vibrating broomstick.
If you look at reports from day care providers and parents, Dr. Herbenick said, it is very common to see observations of toddlers touching their own genitals or playing games with their peers that involve some touching. Those reports decrease markedly in slightly older children, she said, from the “older 4s” on up.
“Kids go underground,” Dr. Herbenick said; in studies in which college students are asked to recollect sexual behavior from childhood and adolescence, there are lots of recollections of that behavior from 5 to 9. They’re still doing it, but they have learned to keep it private.
“This really is a normal thing, we could be talking about it more than we are to normalize things for parents,” said Dr. Elizabeth Erickson, an assistant professor of pediatrics at Duke, who was an author of a review article on how pediatricians can help families understand masturbation.
In the toddler stage, she said, small children discover, “this is a part of my body that feels different when I touch it.”
This is often the time of potty training, with lots of attention being paid to the area formerly covered by the diaper, and with children being encouraged to take their diapers off when necessary.
“Parents will report kids touching genitals when they’re bored, or self-stimulating,” she said. Children may rub themselves against stuffed toys or blankets or the arm of the sofa, she said.
“Young children, older children, adolescents and adults touching their genitals is perfectly normal, there are actually images of fetuses where you can see they’re touching the penis or touching the vulva,” said Leslie M. Kantor, a professor at Rutgers School of Public Health. “Where we culturally get confused is that when younger children are touching their genitals they’re doing it because it feels good,” just as other sensual experiences feel good, like stripping down and running through the sprinkler, but parents interpret it as overtly sexual.
So parents of these young children often worry, Dr. Erickson said. They may leap to the conclusion that this is a learned behavior, perhaps suggestive of abuse, rather than an organic and normal part of development.
Though pediatricians reassure parents that the behavior is not pathological, they don’t always offer suggestions for how to handle it, she said. If very young children are masturbating in a very public place, she said, parents can try redirection; don’t make a big fuss, just offer a distraction, and an alternative focus for the child’s attention.
For older children, she suggested explaining, “that’s O.K., but it’s something we do in private,” helping along that process by which children go underground. Bonnie J. Rough, the author of “Beyond Birds and Bees,” suggests that children will develop that sense of privacy on their own, and that parents should be careful not to send the subtle message that masturbation is shameful.
In puberty and adolescence, masturbation is much more directly linked to developing sexuality and to the desire for sexual satisfaction.
Parents ask for advice about their sons, Dr. Erickson said. “There are some folks who’ve been taught there’s an upper limit of normal on this and it can become abnormal or pathologic at a certain point, they can hurt themselves or there’s some unknown unhealthy limit on it.”
Talking with adolescents about masturbation can be connected to talking with them about pornography, and about what they may have seen online, where the evidence is that most children have been exposed, often inadvertently, to sexual images.
Parents can take the opportunity to communicate their own values, she said, and that means thinking through their messages in advance and agreeing on their beliefs. “In other areas, from a young age we’re saying to our kids, it’s very important to do your homework and learn,” Dr. Kantor said. “With sex it tends to be: oh my God, I looked at my browser history on my laptop and it has Pornhub on it.”
Even though there is plenty of evidence that adolescent girls masturbate, “we do leave girls out of this conversation almost totally,” Dr. Erickson said.
Ms. Rough said that parents should not “be afraid of telling our daughters, it’s great to touch yourself, these are positive, healthy, normal things to do that can actually help you communicate with a partner and enjoy your sexual life.”
Whichever part of the conversation you feel ready to have with your child, the message to parents about talking with adolescents is always the same: keep talking.
“You always have a chance to go back and provide additional information,” Dr. Kantor said.
So are there times that parents really do need to worry about masturbation? If it involves other children without their consent, Dr. Erickson said, it’s clearly a problem. In a young child, really persistent masturbation that cannot be redirected may signal stress of some kind, or possible abuse (and it’s also worth checking out whether there is some medical issue, causing an itch or irritation). And if children have real trouble understanding what’s appropriate in public, as they get older, that may also be a sign of other social or neurodevelopmental difficulties; this can be a major problem for children on the autism spectrum, who struggle with the whole range of social cues and proprieties. As they get older, sexual behavior in inappropriate settings, or violations of social boundaries can get these children into trouble socially and even legally.
The “upper limit of normal” for adolescents would be if it starts interfering with daily life, Dr. Kantor said, or if it involves objects that could potentially cause injury. If chafing is a problem (spare me the jokes, I’ve heard them all), provide some lotion or lubricant and don’t make a big deal about it.
Most important, parents should remember that except in those rare cases, this is a normal, standard, healthy and completely risk-free sexual activity.
“It can be a good way of getting to know your own body,” Dr. Kantor said. Though parents may want to add, “but please, you can’t stay in the bathroom for an hour.”
Dr. Joycelyn Elders had to resign as Surgeon General in 1994 after she talked about masturbation as a safe-sex strategy to help prevent the spread of AIDS.CreditStephen Crowley/The New York Times
And finally, I must acknowledge the supremely and even heroically sensible Dr. Joycelyn Elders, whom President Clinton forced to resign as Surgeon General in 1994 after she said at the United Nations Conference on AIDS that masturbation was “part of human sexuality,” and that it might be possible to educate young people about it as a safe alternative to more risky behavior.
“Masturbation is completely safe sex, a way for young people to experience sexual pleasure not with other people, risk-free, and that’s a good thing too,” Dr. Kantor said.