As a practising psychotherapist for more than twenty years, I have had an opportunity to meet and help many Eastern and Western men, women and couples who had emotional and sexual problems because of their conservative religious and cultural upbringing. In the last few years I have shared some of my observations and professional experiences in two books: The Art of Loving in Your Green Zone and Love, Sex and Marriage. In this essay I will discuss some of the problems I witnessed while working with those people and offer suggestions for such people to decrease their suffering and improve their quality of life.


1. SEX AND SIN

I have met many men and women from traditional and religious families who associated sex with sin. Because of their concept of sin they either remained celibate and felt embarrassed because of their sexual fantasies, or felt guilty about their sexual encounters. They were told by their parents, teachers or religious leaders that sex was allowed only inside marriage and only for reproductive purposes. They did not feel they could enjoy sex even with their spouse if they were not going to have children. One man told me that he had not had sex with his wife for ten years. She had told him she did not want to have sex with him because she did not want any more children. I suggest to such men and women that rather than associating sex with sin that they associate sex with affection and love and learn to enjoy it rather than feel guilty about it.


2. NOT FEELING COMFORTABLE WITH THEIR BODIES

Many men and women (more women than men) did not feel comfortable with their bodies. For them masturbation was a sin and they did not feel comfortable touching themselves sexually. Some called it self-abuse. As they got better they realized that their emotional and sexual problems were related to their inhibitions. Gradually they changed their attitudes and started enjoying their bodies. They became aware that what they perceived as self-abuse was actually self-pleasuring. Some Eastern men living in the West were surprised to find out that semen is a secretion like milk rather than an excretion like urine. That is why it is sometimes called love-milk.


3. LACK OF SEX EDUCATION

One of the common factors causing emotional and sexual problems was lack of sex education. I met some couples who had been married for years but whose marriage had not been consummated because they had never been taught about sexuality or healthy intimate relationships. I think it is important that all teenagers receive sex education at home and in schools so that they can make rational and responsible choices about their sex and love lives. When my own nephew and nieces asked me questions about human sexuality I shared with them the following information.

A. Genetic Sex

The human embryo comes into being through the union of a human sperm and ovum. Each of them has 23 pairs of chromosomes, out of which 22 are autosomes and the last one is the pair of sex chromosomes. The mother’s pair is XX chromosomes and father’s pair is XY chromosomes. If the fetus inherits an X from father then we have a XX chromosome baby girl and if the fetus inherits a Y from father then we have an XY chromosome baby boy. That is why holding mothers responsible for the baby’s gender is neither morally nor scientifically right.

B. Anatomic Sex

When we study human embryology and focus on the week-to-week development of the human fetus, we discover that all fetuses start out as female fetuses. If the fetus has a Y chromosome, after a few weeks of development male hormones kick in and the fetus is gradually transformed into a male. When the fetus has XX chromosomes then the baby develops ovaries, uterus and vagina and when the fetus has XY chromosomes then the baby develops testicles and a penis.
If there are problems in normal development then we have children whose sexual organs are not fully developed and they are called hermaphrodites. In Pakistan they are called hijras and unfortunately are socially ostracized and become victims of prejudice and ridicule,

C. Sexual (Gender) Identity

A number of psychologists believe that by the time children reach the age of four they have developed an identity of being a boy or a girl and that identity does not necessarily depend upon the genetic and anatomical sex. It is still a mystery. Most children who have XX chromosomes and have female sexual organs develop a Female Identity and most children who have XY chromosomes and male sexual organs develop a Male Identity but there are exceptions. Those exceptions are called Transsexuals. Male Transsexuals have XY chromosomes and male organs but believe they are females trapped in male bodies. On the other hand Female Transsexuals have XX chromosomes and have female organs but believe they are males trapped in female bodies. Many transsexuals remain quiet about their problem, while some seek psychiatric help and request a sex change operation.

D. Sexual Orientation

Most males who have male sexual organs and a male gender identity are attracted to females, while most females with female sexual organs and female gender identity are attracted to males. They are called heterosexuals. On the other hand those males and females who are attracted to members of the same sex are called homosexuals or lesbians. It is unfortunate how homosexuals and lesbians have been judged and treated harshly by the religious families and traditional communities.

F. Sexual Performance.

Most adult females and males after finding a partner are able to have sexual intercourse and enjoy their sexual life while there are some who have difficulties in their sexual performance and suffer from frigidity in females and impotence in males. Most women who are frigid and most men who are impotent have unresolved emotional and sexual conflicts because of their puritanical or religious upbringing considering sex as dirty or sinful. They need emotional help to resolve their conflicts so that they can have a healthy and enjoyable sexual life.


I met many men and women who grew up in segregated families and communities who did not learn to socialize with the opposite sex and when they were married they had great difficulties being emotionally and sexually intimate. In some families they did not even have privacy for intimacy, which made their shyness even worse.

I also met many young men and women who were not told by their parents about the changes in their bodies when they reached puberty. Some boys were shocked when they started having wet dreams and some girls were terrified when they started having menses. They were scared they were going to die because of mysterious bleeding.

Some people who had sexual difficulties were more inhibited by fear than guilt. They were nervous about the negative reactions of their families and communities. They were scared they would be persecuted and penalized, put in jail or even executed or stoned to death. Some had fallen in love with people from other cultures and religions and had kept it a secret. They felt their private sexual life had become a social, cultural and religious issue and they did not know how to cope with it. As they grew emotionally stronger and more confident they were able to accept their truth without fear and guilt and share it publicly and deal with the consequences. Gradually they learnt to make rational choices and take responsibility for their actions and life choices.

While I worked in the obstetric department in a Women’s Hospital in Peshawar Pakistan I was shocked to find out that many men and women had no understanding of human physiology and did not know that ovulation took place 14 days before menstruation and that the human sperm and ovum live for only 24—48 hours and if they did not make love during those 48--96 hours they would not get pregnant. I met many infertile women who went to holy shrines to pray for children rather than obtaining medical help for their problems.

As more and more people are learning about the biology and psychology of human sexuality and developing healthy attitudes towards sexual relationships, they are associating sex with love and affection rather than with sin and guilt and are open to obtaining professional help when they suffer from emotional and sexual problems in their intimate lives. I hope we see a day when teenagers and young adults receive sex education based on science, medicine and human psychology rather than cultural and religious superstitions, so that they make rational and responsible choices in life. I hope we see a day when people in love are not afraid of moralistic laws and punitive traditions and feel free to grow in loving relationships. I believe growing together is better than growing alone. Unfortunately we still have a long way to go.