WHY FEMALES DON’T PROMOTE ORAL-GENITAL STIMULATION?
A few females reciprocate genital stimulation but if they reciprocate it is a good gesture and gives an intense feeling of self satisfaction and recognition to the male partner. He expects it. But most of the females prefer being oro-genitally stimulated because it leads to orgasm very easily. Even then they very rarely oblige the male in return.
Female’s reluctance may have resulted from shyness, igonarance of what to do or fear of indecency or perversion. The possibility and fear that man might ejaculate in the process is further deterrent. But certain women in Paris, and Denmark etc. each are noted to have no hesitation in deliberately bringing a man to orgasm in this fashion.
What are the standard procedures of oral genital contacts?
Usually a man initiates and gently caresses the clitoris, the minor lips and the area of introit us with his tongue, occasionally sucking and nibbling them. Saliva produced acts as an extra lubricant and females enjoy it till orgasm. Women who are lucky to be excited this way get satisfaction of their lives reaching orgasm on more than 60 percent occasions.
In the male the glans is the primary focus of excitement. Gentle stroking of the frenulum with the tongue and lips and sucking the glans while firmly holding the penis and grasping and pulling gently at the scrotal sac with the other hand, gives the pleasure.
If the genitals are clean and body is perfumed then objections are difficult to support on hygienic grounds.*107\301\2*

Much ado has recently been made about taking a sexual history. A process akin to contact tracing has no place in the family planning consultation. Open-ended questions such as, ‘Do you think you could be at risk of HIV infection?’ are usually more revealing than closed questions such as ‘How many sexual partners have you had?’ If a doctor is very worried about the possibility of a sexually transmitted disease then the patient should clearly be referred to the genitourinary medicine clinic. Raising the subject of HIV in the consultation is relevant these days even if the patient does not feel so. A simple introduction is to mention that contraception can protect against pregnancy and infection. Methods such as barriers may do both jobs but patients and their partners will need to consider whether they need a highly effective contraceptive method combined with a barrier for protection against infection. With so much media coverage about HIV it is becoming easier to raise this subject but many patients will still feel they are not at risk.

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The organization of clinics, public notices, reception services, appointment systems and records needs to be sensitive to local needs. Texts should be translated carefully and displayed the right way up. It is an advantage if staff can be recruited from ethnic minorities. Family or address grouping of records may be useful, but it is important to watch that this does not lead to an impersonal and racist relationship where staff call for patients by their address rather than their names. The domiciliary service is an appropriate use of family planning nurses for women who are less mobile because of larger families, fear of racial harrassment or who find it socially and practically difficult to go out without their husbands who are working long hours. The home visit, by its visibility, is an advertisement for local services to neighbours and friends.

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He became unable to look after himself and went back to the parental home where his parents cared for him, indeed smothered him. He felt he was treated as a child. In addition to needing physical care like a child, such as washing and toileting, he felt put down and emasculated. He could not see how he could live out the remainder of his life like this.

He arrived to see the doctor in a wheelchair. The disease had resulted in total inability to walk and in some loss of hand function. In addition his speech was affected. This meant he had to take a deep breath and run his words out in little quick bursts which exhausted his energy, and he had to rest and start again. The doctor’s technique of asking an open-ended question and allowing the patient to talk at length was thus unusable. Comments had to be phrased in a more direct way so that he could make short replies. The doctor needed to try to pick up on his feelings so that he could either accept or reject any assumptions made. It was clear that he found this enabling and the doctor was conscious of the need to allow him to be a man, and be treated like one, with difficult issues addressed and not evaded or ignored.

He very much wanted to utilize the remainder of his life, hopefully with a sexual relationship, but was diffident about the response he would get as he was not ‘a good catch’. One day the doctor commented, ‘Only the outside of you is changed, the old you is still there inside.’ His smile lit up and he said, ‘Too right – on the button.’ This recognition was very important to him. His mind was crystal clear, only his body would not respond to his demands on it. His need for independence was discussed and he eventually found sheltered accommodation where he was again able to take responsibility for much of his own life. He has since met a partner and has a happy relationship.

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There are no simple answers but discreet adultery has always been an answer. There are, needless to say, considerable dangers to this approach and many people prefer to relate to their sex-objects in fantasy during masturbation rather than in reality. Clinical experience shows that people who have multiple fantasies of different members of the opposite sex are more likely really to enjoy the opposite sex than are the bedroom cowboys who misuse the opposite sex in reality. Everyone wants to be happy, to love and to be loved, but every deal in life has a price and marriage is no exception. Other men and women exist in the world around the loving, married couple and they have to be dealt with. Each individual will have to find his or her own way of coping with this problem and we have given several hints and tips in the book. Most women want and need clear lines of commitment and are very sensitive to any signs of withdrawal of love. Women appear to be much more love-dependent than are men – even little girls demonstrate this – and this makes them vulnerable to losing love. True, they can build up the ‘strokes’ they need from other sources, including their children, but deep down most women want a loving, secure relationship at the heart of it all.

Many marriages get to the stage in which the individuals are separately counting the cost of their loving commitment to one another. The one who receives too few strokes is vulnerable to an extra-marital affair.

Unfortunately, many people look for unattainable and unrealistic perfection within their marriage, demanding perfection of their spouse when they are not themselves perfect and forgetting the simple fact that everybody is a package deal. You cannot buy life in units of perfection – life is really only a heap of things that have fallen together in a particular way that you are trying to make the best of.

From the point of view of attachment, a mature adult is one who can both give and receive love. Life, to be successful, depends on maintaining a balance of dependence on and independence from others.

A mature person can ask for love when he of she needs it and, knowing he or she will get it, feels confident to give love to others. It is difficult and probably impossible to extend love to others in a mature way if one has not received it or is receiving none oneself. To this giving and receiving of attachment love, genitality is added in adulthood and this further deepens and strengthens the loving bonds.

There is no more an ‘ideal love’ than there is an ideal marriage. We are all complex,

ever-changing beings whose ability to give and receive love varies from day to day and from year to year. What a shame it is that more couples do not realise this as they cast around the sexual arena, or go for professional help in an effort to improve their lot when in reality what they already have is potentially pretty good.

Perhaps the final thought should be along these lines.

In matters of love – and for that matter, sex – don’t commit the grievous error of making the best the enemy of the good. Remember that the ideal doesn’t exist in this world.

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Although men have fewer problems with their genitals than do women, a monthly

self-examination is recommended. It is best carried out after a bath or shower in the standing position. The foreskin, if present, is fully retracted and the penis, including the opening of the urethra, inspected for any signs of discharge, ulcers, spots, inflammation, warts, or other lumps. Next, the scrotum is similarly examined and then each testis in turn by placing the thumb on top and the index and middle fingers below. By rolling the testis between them any lumps or changes in size, shape or tenderness can be detected. If any abnormality is found, consult your GP.

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First, the person’s psychosexual development may have gone ahead more or less normally but, because of previous experience or suppressive rearing with regard to intercourse, intercourse causes too much anxiety for it to be really pleasurable. This can result in sexual dysfunctions of various kinds or a tendency to go off at a tangent from intercourse into activities which approach it, purely for pleasure. In this way, a man may be willing to have intercourse but in fact enjoys orgasms more when mutual masturbation or oral sex is involved. Many cases of

non-consummation of marriage fall into this category. ‘Deviation’ seems an appropriate word because the aim is right yet it slightly misses or deviates from its target.

The other basic cause of perversions or deviations are distortions in psychosexual development. In these types of perversion the person grows up fixed at a certain stage of childhood sexual development or returns to it because progress to a later stage involves too much fear, guilt, anxiety or pain. After a difficult time with a member of the opposite sex an individual may return to an earlier stage. Usually, he or she recovers rapidly but the examples show how we can move up and down the ladder of psychosexual development. When psychosexual development goes awry like this the individual is a good distance away from heterosexual intercourse and the term perversion is probably more appropriate. We think that it is important to point out that the word applies to a perversion of development rather than the actual practice involved.

Apart from the most commonplace deviations or perversions there are several real disadvantages to being locked into non-intercourse sex as your main or only means of sexual release. First, many of the opposite sex will find you strange or unacceptable; second, you will have difficulty finding suitable sex partners; and last, you could get drawn into all kinds of

subcultures in society, many members of which are unusual or unacceptable in other ways.

Deviations and perversions are usually thought of as being the almost exclusive preserve of men but the causes from which they spring apply to both sexes and, in our culture, even more to women. Women may, because of their nature, be less prone to respond to the damage inflicted on them during rearing by becoming deviant. They simple become less sexually efficient. Alternatively, they may be more ashamed of the need and so repress it more, or they may be better able than men to meet the need in fantasy during intercourse and masturbation. Men also have more to learn about sex than do women and as a result are more vulnerable to mislearning.

One theory of perversions in men attributes it to repeated masturbation while fantasising perversely during adolescence; the resulting orgasm acts as a reward and reinforces the tendency to enjoy the thought of the perversion. Because perverse fantasies are common in adolescence but perversions in adults are comparatively rare the theory is unlikely to hold true for the majority, but it can be applied in reverse when treating deviants. In this technique, which is applied to both men and women, the individual is advised to masturbate frequently to their usual perverse fantasy but to change it at the last moment to a fantasy of normal intercourse. By association with orgasm the heterosexual fantasy increases in strength and erotic power. Gradually it is extended backwards in masturbation so that, eventually, the whole of the associated fantasy is of intercourse and the interest in the perverse activity fades.

The characteristics of a full-blown perversion are its compulsiveness and its fixity. The person has to do it and cannot easily stop doing it. He cannot overcome it by reason, fear, shame, threat of punishment, or even exposure. Lesser degrees, which can be described as borderline cases of perversion, exist, particularly in women.

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Warts are transmitted venereally and appear after quite a long incubation period anywhere on or in the genital and anal areas. At first they take the form of hard lumps in the skin but they soon turn into typical warts which can be more prolific than those which appear elsewhere on the body. They can be treated with substances such as podophyllin or be removed by other means. Talk to your GP about them or go to a Special Clinic.

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