by 
Rev Chil Pediatr 2011; 82 (5): 454-460
75 YEARS AGOSEVENTY-FIVE YEARS AGO
Sex education should begin at home and continue in school
Published in Revista Chilena de Pediatría 1931; 384-387
Authors: W. Coutts and G. Morales Beltrami.
Comment: Luisa Schonhaut B.1 and Teresa Millán K.2
1. Department of Paediatrics, Faculty of German Clinical Medicine – Development University.
2. Department of Pediatrics Campus Occidente, Universidad de Chile.
Key words: Pediatric history, sexual education, antivenereal campaign.
Keywords: Sex education, antivenereal control, pediatric history.
“Our body is sensitive and sexed from head to toe and the construction of sexuality is born when life is given to us and in a process of constant communication and individual and social enrichment”
Introduction: historical context
Sexuality is a homeschooling sphere that encompasses all dimensions of the person biologically, psychologically and socially, it is therefore an inherent and integral part of the human being from birth and throughout his life.
” Sexuality is conceived as a natural appetite for the human being as they are eating, drinking, working, sleeping, having fun. However, something makes it impossible to talk about it openly as we do about eating or working. None arises so surrounded by mysteries, so in need of privacy and worship, so intrinsically linked to ethical requirements, as sex.” (A. Roa 2007)1. In our Western tradition, sexuality has been a subject handled in the form of a taboo , being the country witness a cultural clash, between an indigenous people who lived sexuality freely and naturally versus a clerical and repressive Spanish nation.
In this scenario of sins and taboos, pediatricians and gynecologists could not maintain a passive attitude, because sexually transmitted diseases accounted for a high percentage of infected young people and were one of the main causes of general and infant mortality. Although this was a public health problem at the universal level, the prevalence in our country was even higher2. Statistics of the time indicate that during the first half of the twentieth century a high percentage of the population was infected with syphilis and gonorrhea, 70% of those infected were between 16 and 25 years old and it was estimated that about 3% corresponded to children and adolescents3; Congenital syphilis accounted for 8.7% of under-1 mortality and the leading cause of mortality.4
Coutts published in 1931 the follow-up statistics of 358 ” syphilitic Chilean mothers”, among which 1,339 pregnancies were counted, whose evolution was “abortions 557, stillbirths 123; 292 early childhood deaths and only 367 alive at the time of examination.”5 On the other hand, in the analysis of premature infants admitted to the National Children’s House in 1941, maternal lues, isolated or associated with another cause of prematurity, reported ” the highest mortality with respect to a certain etiological factor of prematurity”6.
Similarly, Dr. Salvador Allende considered the antivenereal campaign as part of the “fight against crime”, another of the important problems afflicting our young country. “There are individuals who are characterized by their negative psychism, who are capable of committing the most cruel crimes, and are those who, due to alterations or atrophies of the genital apparatus, caused by venereal diseases, change their character and personality, and honest and industrious individuals can become dangerous beings for social harmony. ” For him, the high prevalence of sexually transmitted diseases in the young population was explained by physiological and social factors, “… due to an early puberty, which would be the physiological factor, and the absolute ignorance in which most of them live regarding the most elementary precepts of preventive medicine and their null sexual education. This would be the social factor” (Allende, Tesis para optar al título de Médico, 1933)3
At a time when the biology of pubertal development and sexuality were still unknown, it was necessary to confront energetically the social factor, that “wave of sexualism that has been unleashed upon the civilized world.” (Coutts 1933)7. The fight against venereal became one of the main axes of the Health Policies of the first half of the twentieth century, which implied opening the issue of sexuality and related diseases and freeing them from religious stigmatization, in order to carry out effective prevention8.
In 1927 the Government organized the “Antivenereal Struggle” as a nationwide program, following the models that had been tested in the old world. Curative or direct strategies and indirect measures were implemented, including an intense propaganda campaign and the distribution of ” prophylactic ointments”3. The messages of self-care and responsible sexuality, as keys to having healthy children, were transmitted even in the booklets of Childcare, distributed to all mothers in the country, in them it was recommended “If you are syphilitic, tubercular, alcoholic or drug addict (cocaine, morphine, etc. etc.), do not father a child before you have been cured. Syphilis, alcoholism, drug addiction, degenerate the race and produce in children intellectual backwardness, perverse instincts, madness, epilepsy, etc.”9.
In this context, sex education was raised for the first time in our country. Coutts proposed “teaching children early in schools, sexual hygiene and how to prevent venereal diseases; educate parents and convince moralists of error. Only in this way will we do good in the face of evils that have no other solution.”7
For the antivenereal strategy to be effective, it was necessary to recruit the different social actors, including pediatricians; Surely that was the reason that led to the publication of the article ” Sex education should begin at home and continue in school” in the Chilean Journal of Pediatrics in 1931; In it, Waldemar Coutts, then technical head of the Social Hygiene Section of the Health Directorate and Guillermo Morales Beltra-mi, technical deputy chief of the same division, illustrate the debate regarding sex education that was ignited more than 75 years ago, and remains, with different nuances to this day.
For many years now, there has been talk of the need for sex education among children and many countries have instituted this practice in their schools while struggling to enlighten parents about their duties towards their offspring.
The harvest has been fruitful, but not enough to justify the efforts and money spent for these purposes. The reason for this lies mainly, in our view, in the fact that not all parents have the same beliefs; While some understand the reality of the facts that science strives to prove to them, others do not want to hear the compassionate voice of their fellow men and entrench themselves behind doctrinaire precepts.
The child, like all animals, has his own instincts and tendencies; But we don’t know their scope until we interpret them in social terms. To this end we must be able to place them in an embryonic social state and consider them as survivors of primitive activities linked to infinite ancestors.
If the normal development of the child’s personality is suppressed or inhibited, if the free expression or satisfaction of his desires is hindered, a compensatory antagonistic reaction is often awakened in him that transforms him into a rebel against all moral precepts for the rest of his life. This, in our view, is why the pernicious habits acquired during the first five years are often deeply rooted in children.
Many authors have protested against prejudice and forgetfulness of one’s own childhood by assuming that childhood is asexual or presexual. The immense alterations that occur at puberty are not born out of nowhere; Before reaching this state there is, without a doubt, a gradual development of what will later be fundamental characteristics of both sexes.