It’s no accident we’re getting the hump

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The size of a boy’s testicles, according to Dr. Laura Bachrach, is the gold standard for assessing the arrival of male puberty. What you do – for strictly scientific purposes, of course – is use an orchidometer, a string of oval wooden or plastic beads of increasing size. To use the device, you gently pull the testicle to the bottom of a boy’s scrotum and use touch and sight to find the bead that matches it in volume. Be careful not to squeeze*!

Pubic hair, by contrast is “very very misleading” because it is a later, less predictable indicator. You can try urine analysis (testing for the presence of sperm in urine), but that’s expensive. And you can just ask boys whether they ejaculate, but researchers understandably tend to be nervous about that these days, especially in the US, where a recent study confirmed a trend in recent times, long noted in girls, towards earlier puberty. It seems you can still just about get away with measuring testicles, though, if you slip the procedure into scheduled “well-child” health examinations.

What you definitely can’t do, if you want to determine the age of puberty hundreds of years ago, is jump aboard your Time Machine to go back in history and measure the testicles of boys in the Olden Days.

We can read about what ancient scholars thought, but it’s hardly science. Aristotle, well over two millennia ago had this to say on the subject:

When twice seven years old, in the most of cases, the male begins to engender seed; and at the same time hair appears upon the pubes, in like manner, so Alcmaeon of Croton remarks, as plants first blossom and then seed. About the same time, the voice begins to alter, getting harsher and more uneven, neither shrill as formerly nor deep as afterward, nor yet of any even tone, but like an instrument whose strings are frayed and out of tune; and it is called, by way of by-word, the bleat of the billy-goat. Now this breaking of the voice is the more apparent in those who are making trial of their sexual powers; for in those who are prone to lustfulness the voice turns into the voice of a man, but not so in the continent. [The History of Animals, Book VII, Part 1]

Armed with the modern knowledge that pubic hair is prone to give dodgy data, we need not be overly respectful of the great sage’s opinion, although we might be more so if his Method had been written up – especially on how he could tell the “lustful” boys from the “continent” ones, and what his sample size was.

My theory is that Aristotle and some medical authorities of classical times put the age of male puberty in those days too low. Only the wealthiest class could afford the services of a doctor: these boys would have been exceptionally well fed, and it is now known that a rich diet leads to puberty several years earlier than typically experienced by impoverished children of either sex. Likewise, Aristotle would surely have known less about the bodies of street ragamuffins than those of the athletic young lads whose naked bodies he saw regularly at the gymnasium – boys from prosperous families, whose fathers could afford to send them for training.

But we can do better than Aristotle. An ingenious recent study by Dr Joshua R. Goldstein gives us evidence of a steady long-term decline in age of male sexual maturity since at least the mid-eighteenth century using, believe it or not, mortality data from meticulous records kept in several countries.

In girls, the so-called “secular trend” toward younger menarche can be documented because individual health records recording first menstruation can be compared over time. For males, no comparable medical evidence exists. Goldstein’s study takes an indirect approach making use of the fact that all human populations studied show a rise in mortality among males toward the end of adolescence. This rise, caused by increases in violent, accidental, and disease mortality, is known as the “accident hump” and it coincides broadly with peak male hormone production. So if you can show a change in the age of the accident hump you have a strong indication of a changing age of sexual maturity. Clever, no?

The records for this purpose go back to 1751 in Sweden and the mid-nineteenth century in Denmark, Norway, the United Kingdom, and Italy.

For all countries, the timing of the accident hump fell steadily downward from the mid-eighteenth century to the mid-twentieth century. “Improved nutrition and disease environments, both of which have been shown to influence the production of testosterone, appear more plausible explanations for such long-term secular change than changing risk environment,” wrote Goldstein.

Goldstein and Aristotle appear to agree on one point: the significance of voice change. As Goldstein wrote:

An additional piece of evidence in favour of a biological explanation for the secular trend in the accident hump is that another correlate of male sexual maturity, age at voice change, has also shown secular change. Daw reports that age at voice change in the boys’ choir lead by J.S. Bach in Leipzig in the mid-eighteenth century averaged around 18 years, but that in twentieth century London age at voice change was closer to 13 years.

Now that is a whopping change, is it not? And this brings me to a key reason for Heretic TOC’s deliberations on the matter: there is a huge irony in the fact that the sexuality of the young is being ever more drastically denied and suppressed at a time when they have never been more sexually mature in physical terms.

Formal research confirms the picture. Studies give a range of outcomes depending on the method and the population surveyed, with racial differences being a factor. To take just one set of results over a lengthy time period up to the present in a single country, German researchers found that in 1860, the average age of the onset of puberty in girls was 16.6 years. In 1920, it was 14.6; in 1950, 13.1; 1980, 12.5; and in 2010, it had dropped to 10.5. A similarly declining age been reported for boys, albeit with their puberty occurring about one year later in each set of investigations.

It might have been expected that the trend to earlier puberty would have halted half a century ago in the developed countries, once children reliably began to experience the relative rich diet of modern times. But that has not happened, and ever-earlier puberty is now being linked to growing levels of childhood obesity.

Obesity is bad news for kids, of course, and ever-earlier puberty is terrible news for paedophiles too. As if things were not already bad enough for us, we now face the alarming possibility that real kids will disappear altogether. As soon as they stop being babies we’ll just be left with fat adolescents! Aaarrrgh! It’s every paedo’s worst nightmare! Maybe, with no children around, true paedos as opposed to hebephiles will also become extinct, thereby presenting the world with a fortuitously bloodless Final Solution to the paedo problem. But at what a price: grotesquely ugly fat kids, largely housebound, barely able to waddle around, and many of them suffering from obesity-related diseases such as diabetes. O brave new world!

Keep calm, though, we aren’t there yet. Unlike climate change, the problem is undeniable and there is a strong motivation to tackle it.

So let’s consider what puberty means in terms of a child’s awakening sexuality. The first point to note is vital and often overlooked: while there is certainly a correlation between the approach of puberty and increasing libido, it is nowhere near a one-to-one match. Some kids, for whatever reason, become highly sexual in early childhood, many years before puberty. Any number of examples could be given from sexual episodes observed between kindergarten kids (see Mickey and Maria make out in kindergarten) but my favourite of recent times is “queer kid” Noah Michelson’s personal account of his childhood lusts and longings in “Dancing In His Underwear for the Garbage Man”.

As for what is more “normal”, or usual, too little research has been undertaken. One recent study (Ostovich & Sabini) puts first recalled sexual arousal in men on average at 1.9 years before puberty. This study relies, unreliably, on asking men to think backwards from when they first noticed having pubic hair. Even allowing for inaccuracy, though, it is plain there is usually a substantial period of around two years during which boys are significantly sexual not just as preteens but even before they hit double figures. Thus they will typically still be prepubescent (Stage 1 on the Tanner Scale: small genitals and no pubic hair at all) at the age when typically they have already experienced sexual arousal. In my case it was definitely three years. How about you?

It is often incorrectly assumed that all the major developments of sexual maturation take place during pubescence (typically from 11-14): enlargement of the genitals, pubic hair, breast growth and menstruation in girls, sperm secretion and ejaculation in boys. But there are major changes going on beforehand, beginning with a “mini-puberty” known as adrenarche around ages 6-8, as Heretic TOC noted last year in The magical age of 10?

In that blog I was reporting on a paper published in 2000. Another study, just out, is “Middle childhood: An evolutionary-developmental synthesis”, by Marco del Giudice, a researcher known to me through Sexnet. Free full-text download. Those with a particular interest in the evolutionary aspect can read about it from the man himself.

Briefly, adrenarche is when the adrenal glands begin to secrete increasing amounts of androgens. These can convert to the sex hormones oestrogen or testosterone in the brain, where they have powerful effects on sexual brain development and functioning. Adrenarche provides the brain’s framework for the different sexual psychology of boys and girls, which is then followed by gonadarche, when boys’ testes and girls’ ovaries are awakened at the beginning of puberty.

Thus there is lots going on inside sexually before it becomes visibly apparent outside.

“It is no coincidence,” we are told, “that the first sexual and romantic attractions typically develop in middle childhood, in tandem with the intensification of sexual play.”

Now, here’s a thing no one seems to have focused on: if the age of puberty is falling, then presumably so is the age of adrenarche that leads to it. If so, then the “sexual and romantic attractions” of prepubertal children are being experienced and undergoing “intensification” earlier.

I leave heretics here to ponder the implications.

 

*Legal disclaimer: this is a JOKE. Heretic TOC is not advocating unauthorized examinations.

ATSA agonising gives grounds for hope

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Angst and turmoil within the ranks of the Association for the Treatment of Sexual Abusers (ATSA) has been brought to Heretic TOC’s notice this week thanks to a leak from internal discussions.

I did not personally encounter the Deep Throat of this episode in a dimly lit underground car park and do not know his identity (or hers); but the information is highly credible and was transmitted to me indirectly by a source I will be happy to credit later for this scoop, providing no one is going to be compromised.

The leak, from a thread on the ATSA listserve, sees David Prescott, a former president of the association, debating a couple of weeks ago with Steven Sawyer, a psychotherapist in private practice, and Jon Brandt, director of a home for teenage boys on probation.

Prescott had pointed out that there is an ongoing class-action lawsuit regarding Minnesota’s civil commitment program for sexual offenders (MSOP), contesting whether the program is constitutional. He noted that the main local newspaper, the Minneapolis Star Tribune, had described the current state of affairs as an injustice.

Prescott’s view, which did not surprise me as I know him from Sexnet, was broadly liberal. Having himself worked briefly in the Minnesota program, as he declared in this listserve exchange, he had come to accept that even if it might be possible to justify civil commitment for some offenders, Minnesota’s record was highly dubious. The program had been in existence for 20 years. Prisoners were supposed to be released after successful treatment, but after all those years, and with over 700 prisoners going through the program, only one person had ever been released for a significant length of time.

He asked:

“Where do our ethical and moral obligations begin and end? Given the prime directive of the helping professions, ‘First, do no harm,’ this seems a worthwhile question. Much of the media accounts have focused on the appalling lack of courage and fortitude of state lawmakers and officials in addressing MSOP and its legal context. In fact, this has been going on years.

“How long does one have to work in a dysfunctional system before one becomes a de facto collaborator with it? … At what point are we causing harm to our clients through our involvement? Many of us have heard clients say, ‘If you really want to help me, Doc, get me out of here.’ How many have to say this before they have a compelling point?”

Sawyer’s response was defensive, along the lines “We’re not to blame, it’s the courts.” He said they were the ones making the decision to impose civil commitment on an offender, and also when to release that person. The clinicians just provide treatment. So he thought criticising them was “a bit harsh and unfair to well intentioned, professional, and talented people”. They could not be held responsible for what was outside their control.

Prescott took him to task for passing the buck, saying it is “an abdication of our professional responsibilities” just to blame the system.

Brandt agreed, pointing out that earlier this year a federal judge had declared MSOP to be a “clearly broken” system. Brandt went further, too, saying civil commitment in general was an ethical minefield for every professional who is party to it, and indeed all therapy with incarcerated offenders, whether in civil commitment or serving an ordinary prison sentence, involved an ethically problematic “dual relationship”. He was referring to the conflict of roles inherent in trying to serve the client and the state simultaneously. Increasingly, he said, therapists appeared to be less committed to helping the client’s rehabilitation through psychological work and more concerned with security and containment, in response to political pressures.

He spoke of a “treatment paradox”, a sort of no-win situation, or Catch 22: “…in order to successfully complete sex-specific treatment, clients are required to disclose all the details of their sexual history, offenses, and fantasies; often…under the duress of compulsory polygraphs. The dilemma is that the more details that clients reveal, the more they tend to disclose possible risk factors and reinforce the grounds for their own confinement.” Thus clients who cooperate with the system are damned along with those who do not.

In making these points, Brandt quoted from the academic literature in the field, specifically a recent paper by Theresa Gannon and Tony Ward. The good news here is that papers criticising the system are indeed being published, and these critiques are clearly being discussed by such leading figures in the profession as David Prescott. Even Steven Sawyer, defending his colleagues, made no attempt to defend injustices perpetrated from above, by the courts and politicians.

Another good sign recently is to be seen in a new ATSA position paper on its website opposing the horrors of residency restrictions for sex offenders. We have all heard about these oppressive rules, especially in the US, where sex offenders can find themselves living under road bridges because all the local housing is deemed too close to a school, and thus – so it is claimed – presenting a danger to the kids who go there.

Nor was ATSA’s opposition to these unjust rules hidden under a bushel. Not many people will read their website, but the association has also been trumpeting its thinking to the media.

The New York Times had reported last month that “Dozens of sex offenders who have satisfied their sentences in New York State are being held in prison beyond their release dates because of a new interpretation of a state law that governs where they can live.” Since 2005, sex offenders in the state cannot live within 1,000 feet of a school, and a February ruling from the state’s Department of Corrections and Community Supervision extended that restriction to homeless shelters. As the onus is on sex offenders to find approved housing before they are released, the prisons have been keeping them locked up when they have been unable to do so.

ATSA head Maia Christopher leapt into the fray. She sent her organization’s policy paper to New York magazine online (not to be confused with New York Times Magazine but the NYT was doubtless sent a copy too) even before it was up on ATSA’s website. And the message could not have been more clear and robust: the association “does not support the use of residence restrictions as a feasible strategy for sex offender management” because of a lack of evidence they do any good.

Rather than increasing public safety, registry restrictions tended to decrease it, because the “unintended consequences of residence restrictions include transience, homelessness, instability, and other obstacles to community re-entry.” Since “unemployment, unstable housing, and lack of support are associated with increased criminal recidivism,” and housing restrictions lead to all three, they are a bad idea, ATSA argues.

Now, I am sure there will be some heretics here who will be reading all this with a growing sense of incredulity. How can ATSA, the dark force for decades behind regimes of coercive, confrontational cognitive behavioural therapy (CBT), suddenly emerge as radical agents of humane and enlightened policies? Does Not Compute!

Well, all you sceptics, you are not alone in going through a confusing dose of Cognitive Dissonance on this, with new facts bashing up against old experience. I feel it myself, even though another of those new facts is ATSA’s openness to at least be thinking about radical non-CBT therapy – as evidenced by its acceptance of my own recent article proposing a deeper and more humane approach. A corrective against being over-optimistically carried away has been fightback385’s comments in response to Why I am talking to the terrorists.

“Fightback” has usefully pointed out that “ATSA is still ignorant of the research on child sexuality (e.g., Floyd Martinson) and refers to children who behave sexually with each other in developmentally appropriate ways that scare Americans as ‘children with sexual behavior problems’ (CSBP), advocating the use of drastic treatments that teach them their sexual feelings (and by implication, they themselves) are wrong and dangerous.”

In further comments that I would urge everyone to read, Fightback sets out a very persuasive parallel between sex offender therapy and religious authoritarianism. The really important point underlying his thesis, I suggest, is that this authoritarian thinking has not suddenly disappeared. Especially in the US, religion is still very strong. Authoritarian politicians often invoke religious rhetoric in their thunderous denunciations of “evil doers”; and it may be that in ATSA’s other stronghold countries its members include a substantial proportion of those for whom zeal against sex “offending”, even when non-violent, non-coercive and utterly harmless, has become a secular substitute for religion.

These authoritarians have a mindset in which evidence-based policy does not figure strongly: they are content to enforce their received ideas with unquestioning vigour. Their conservative morality is accordingly unlikely to be greatly influenced by progressive forces within their own ranks: even ATSA leaders as senior as David Prescott and Maia Christopher, and researchers as prestigious as Theresa Gannon and Tony Ward, are unlikely to trump the “prophets of old” in their minds, such as Gene Abel, who pioneered CBT. And for the true believers among them, of course, there is no trumping God Himself!

Bearing in mind the continuing existence of this conservative rank-and-file, can ATSA ever be expected to make substantial progress? Even more importantly, can it contribute to changing not just itself and its therapeutic practices but also wider society?

Jesse Singal, author of the New York magazine report cited above, felt that even the relatively modest change involved in getting rid of residency restrictions was no more than a pipe dream. After all, he said, what politician wants to stand up and say, “You know what? I think sex offenders should be able to live closer to children”?

His scepticism makes sense except for the fact that civil society is not led by politicians alone; indeed they tend to follow opinion rather than lead it in our age of opinion polls and focus groups. Leadership these days has passed in many cases to the judges, especially in Europe, where human rights law has racked up many major achievements over the last several decades, including the ending of the death penalty across the continent. The US, too, has enjoyed its great moments of judicial leadership, not least in terms of its increasingly radical interpretation in the 20th century of the First Amendment: it was not the early politicians, the Founding Fathers, but Supreme Court judges such as Oliver Wendell Holmes and Louis Brandeis who most advanced freedom of expression as a vital civil liberty, less than a century ago.

The Supreme Court itself, as opposed to the influential minority opinions of its best judges, has by contrast often been disappointing, not least in terms of rejecting challenges to civil commitment. But that may not last. Crime in general has been falling rapidly in the US for years now, including sex offences against children. Despite all the hype over internet grooming and pornography, the worst of the panic there may be passing (unlike in the UK where historic celebrity and street grooming scandals continue to fuel the flames). Whereas almost the entire civic establishment would once have backed harsher penalties for sex offenders in the US, there is now a growing realisation – including within the judiciary – that unthinking harshness has gone too far. In these circumstances, a reform-minded ATSA may be surprised to find itself pushing against an open door where the judiciary is concerned. The class-action lawsuit against Minnesota’s civil commitment program may not be the hopeless cause that some might suppose.

Heretic TOC hopes that ATSA will accordingly find ways to give this lawsuit their energetic support, whether through the media or within the courtroom or both.

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