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Dealing with Masturbation
Q: I found my six-year-old son masturbating. I've explained to him on several occasions that it was not wrong or bad for him to do, but that he needed to do it in privacy. Most recently my son and his seven-year-old step-cousin were playing house in his room and while he was under the sheets he decided to do this again. I questioned him and he told me what he'd done. I know we have all played some form of doctor. What should I do?
A: First, it sounds like your attitude and reactions towards your son's masturbation have so far been on target. It is important for parents to avoid creating a sense of guilt for a child who masturbates, as it is a perfectly normal aspect of development. As you have done, it is important to teach children that it is not a social activity done with others, but it should be done alone privately in a room. Modesty usually begins to appear between ages four and six; there are wide variations among families and various cultures.
Masturbation is a problem if your child feels he always needs to do it and/or it begins to interfere with the other activities in his life (for example, school or playing with friends). If an older child is still openly masturbating, it may provide a clue to a larger problem of inappropriate social development.
The issue of "playing doctor" is a tricky one. In many cases, children are simply acting out images to which they have been exposed. Exploration of the sexual organs with other children is part of normal sexual development. However, it is important to set limits on this type of behavior. Laying ground rules like "you may not touch other people's private parts," or "you may not show your private parts to other children" is an appropriate step for parents to take. Furthermore, this sort of discussion is an opportunity to remind your son again that he can always ask you questions about his genitals if he is curious. Keeping lines of communication open now will set a good precedent for the future when confronting issues of sexuality as your child enters puberty and matures.
If you feel that your efforts are unsuccessful, and the public masturbation or an unacceptable type of playing doctor continues, then it would be appropriate to discuss this with your child's pediatrician.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.