Sex worship has been practised in many ancient cultures and religious and one can easily understand the reason for it. Sex creates and maintains the continuity of life. The sexual instinct is considered to be the evidence of the vast creative power which sustains the universe. According to the Puranas, the sacred writing of ancient India, the Supreme Being, when creating human beings, split himself into two, thus becoming male and female. The phallus is the symbol of life and creativity and in many ancient and modern temples all over India lingam (phallus) worship is freely and reverently practiced. The idol is made in the shape of a low pillar supported in a round shallow base, depiciting the divine male and female organs in union.

There is nothing indecent or crude about phallic worship and no promiscuity or sexual activity is attached to the ceremony. The lingam worshippers are a pure and pious Hindu sect. Sexual symbolism in devotion is not, howeverm peculiar to the Hindu. The Songs of Solomon in the Bible abound in sexual symbolism and graces of the beloved's neck, breasts and thighs. Christ is considered the Divine Bridegroom and the Church is bride. The mystics of Islam, the Sufis, display the same preoccupa- tion with sex in their devotional concepts.

Several schools of Hindu thought believe that an erotic sentiment is a necessary part of devotional worship. Lord Krishna, one of the most powerful deities of the Hindu pantheon is known as the God of Love. Some of the most memorable incidents about him tell of his escapades with the gopis. Women found him totally irresistible. He is described as a very habdsome person with a strong and beautiful body. Lord Krishna taught his followers that a well lived worldly life is more noble than renunciation and asceticism. The present western interest in the Krishna cult is significant.

Sex has played a glorious and turbulent role in human affairs and will continue to do so. Some sincerely believe that the forbidden fruit of life was sex. Our age and time has not discovered anything new. In fact, we are going back to many practices which were used thousands of years back and were abandoned because they did not promote human happiness and welfare. The relationship of man and woman is complicated by the extreme intensity of their sex instinct. If the quality and complexity of human sexuality is understood better, we are better able to manage and enjoy it.

I have another reason for getting the kids to color these drawings. It helps them to remember the names of these organs. If you just look at the drawings, the names of the parts may not stick in your mind. If you spend time coloring the parts, you have to pay attention. You're more likely to remember their names. These are important parts of the body. It's worth a little effort to learn their names. While everyone is coloring, we talk about slang words. People don't alwats use the medical names for these body parts. They sometimes use slang words.

The boys in the back row of my very first puberty class were walking dictionaries of slang. Whenever I said penis'' or vagina'' out loud, their brains would buzz and hum with dozens of slang words. It was too much for them to keep to themselves. Leaning out of their seats, they flapped their arms, playfully punching each other. Gleefully, they whispered these bad'' words out loud proved into fits of wild giggling. Some of them were actually rolling around on the floor. Soon, the entire class was totally out of countrol. Maybe,'' I thought, I'm not cut out for this line of work.''

I might have given up teaching puberty classes then and there, but I had a sudden brainstorm. I turned to the blackboard and started to list all the slang words that were flying around the classroom. I encouraged the whole class to add to the list. Soon the blackboard was covered with slang words, and the clas was calm enough for us to go on. I'm not exactly sure why this works, but over the years, I've learned that it does. The best way to keep these words from disrupting the class is to bring them right out in the open. So while we're coloring, kids call out slang words and I list them on the blackboard. Here are some of them:

Some Slang Words for the Penis and Testicles

Penis :

cock peter tool
dick dong frankfurter
prick dingus thing
schlong dork pecker
wee-wee meat dinky
wanger pisser penie

Testicles :

balls cujones
nuts things
eggs bangers
rocks hangers
jewels stones
cubes seeds
After we've listed them on the board, the class talks about these slang words. We discuss which words we'd use with a friend, with a doctor, or with our moms. We also talk about people's reactions to slang words. Some prople object to these words. They may get upset if they hear you using them. You may or may not care about upsetting people in this way. But you should at least be aware that many people find slang words offensive.

The homosexual isindeed a pathetic figure. His awareness and appreciation of the beauty and magic of the opposite sex and his ability to participate in the act of procreating life is lost. The wonder and joy of the opposite sex is denied to him. In their frustrations and inadequacy, homosexuals turn upon their own kind seeking an unnatural outlet for the sexual instinct. The perversions and tyranny of the instinct of sex are frightening and degrading. Sex is perhaps the greatest provacator of human emotions. When this powerful instinct is warped it causes the most awful abberations in human nature.

There are some basic facts that we need to understand about sex. The instinct is exceedingly powerful and begins to make its presence felt very early in life. Science has not yet been able to identify the exact age of the awakening of this instinct, but all indications point to the fact that sexual awareness comes almost at birth. By four the instinct is sufficiently pronounced and by the age of puberty it is well developed. The problems and pressures of sex are very complex and disturbing during the adolescent period and guidance and help available at this time is usually insufficient understanding and control to guide the instinct. They usually face these bewildering days alone. Many mistakes are made during this period which may seriously curtail its fullest enjoyment.

Sex is generally associated with youth and most people believe that between 14 to 24 years one experiences the most intense passion. But actual studies disprove this simple belief. It has been found that human beings have a lifelong capacity to enjoy sex and it is most satisfying during the years 23 to 55. With skill, technique and proper control the enjoyment of sex can even be anhanced during the later years of life. Sexual practices which interfere with the reproductive process are biologically unsound and harmful. Monks, nuns, spinsters, bachelors, and permanent homosexuals are all, in a reproductive sense, aberrrant. Society has bred them, but they have failed to return the compliment. A study of the celibate population in France showed that their mortality rate was nearly double that for married people. There were twice as many in asylums and hospitals as patients. Celibacy evidently creates problems, both for the individual and the state.

In our times there seems to be an unseemly interest in sex. It has become the hottest selling product. Sex-charged literature and pornographic material find the best market. A wild, promiscuous wave seems to be sweeping the world and all are secretly enjoying this new freedom and titilation. In a way it is right, for too long sex has been shrouded in mystery and sin. A young person speaking enthusiastically on the subject said that sexual freedom is a very unique achievement of modern times. For the first time man has been able to overthrow sexual inhibitions and is free to enjoy and indulge his greatest and most powerful urge.

This generation would be naive to believe that it has discovered something new and wonderful about sex, unknown and untried by all the generations before. The freedom, abandon, promiscuousness, lasciviousness and perversions of sex in all possible forms have all been practised before. Out generation cannot claim any frame or originality in this matter. The blatant exploitation of sex in the balmy days of teh mighty Roman empire are too well-known. The orgies of sex, its enjoyment and exploitation reached giddy heights during the days of the Roman empire. People still remember with wry amusement the sexual abandonment of the people of Sodom and Gammorah and the story in the book of Joshua of how, when the two angels visited the city, the people lusted after them. Poor Lot offered his beautiful virgin daughters to the crowd so that they may spare the angels.

In Greece the beauty, grace and worship of the perfect body reached its zenith. Greek sculptures of the human body are still unsurpassed in their beauty and perfection. The theme of sex and its appreciation and enjoyment attained an all time high in ancient India. The carvings in the temples of Bhubaneshwar, Puri and Khajuraho are breathtaking in their boldness, zest and abandon. The sheer beauty, grace and variety of sexual poses and modes of intercourse in life size figures is shocking and exciting in its daring display. And yet there is a beauty and dignity in all these daring poses which leaves one profoundly impressed.

The enjoyment and bold participation in sex which ancient India achievfed as depicted in his temple sculpture of some thousands of years cannot be easily surpassed. Sex play and love-making became a highly developed art. Ancient India literature such as the Kama Sutra, Kokshastra, Kama Kalpa and Ananga Rana are recognised the world over as the most exhaustive literature on sex. These writings study the subject of sex with a thoroughness and scientific detachment which the Western sexologist has not yet displayed.

The popular modern western literature on sex often over-emphasises the mechanics of the sexual act. The Hindu literature and sculpture on love and sex is exceedingly rich and wide. Vatsyayana, the great Hindu mystic and author of the famous Kama Sutra, the treatise on sex, maintained that sex is an essential as food for the happiness and well-being of man and woman. He considered sex the greatest gift of God and gave detailed instructions and guidance for its full and proper use.

Once everyone has copies and colored pencils, I hold up the picture of the male sex organs. I tell the class that the sex organs on the outside of a man's body are the penis and the scrotum. The kids in my class still giggle like mad or fall off their chairs in ambarrassment, but I don't pay much attention. Using my vest kindergarten Lady voice, I say, The penis itself has two parts: the shaft and the glans. Find the shaft of the penis and color it with blue and red stripes.'' Now everybody gets very intent on the coloring. Some are still giggling, but they do start coloring. Why don't you color the shaft in, too? (Unless, of course, this book belongs to someone else or to a library. One of the people we most admire is a librarian. We would be in very got water if labrarian thought we were telling people to color library books.)

Next I ask the class to find the small slit at the tip of the penis and circle it in red. This is the urinary opening. It is the opening through which urine leaves the body. There's usually less giggling by now. The urinary opening is small. The class has to pay more attention to the coloring. Then we color in the glans itself. I usually suggest blue, but color it any way you want. Red and blue polka dots for the scrotum,'' I tell my class next. The scrotum is a loose bag of skin that lies beneath the penis. Scrotal sac is another name for the scrotum. Inside the scrotum are two egg-shaped organs called testes, or testicles. Then, I explain that the curly hairs on the sex organs are public hairs. I have the class color them as well.

Finally, we come to the anus. This is the opening through which feces (bowel movements) leave our bodies. The anus isn't a reproductive organ. But it's nearby, so you might as well color it, too. By the time the class has colored in the different parts, I've said the word penis'' out loud about twenty-eight times. Everyone is used to my saying this and other words that aren't usually said out loud in classrooms. My students no longer have to go crazy each time I use these words. Besides, the pictures look funny. Everyone is laughing. Laughter makes it easier to deal with embarrassed or nervous feelings.

Circumcision

Circumcision is an operation that removes the foreskin of the penis. The foreskin is part of the special skin covering of the penis. The operation is usually done when a baby is only a few days old. Most males in this country have been circumcised. But there are also many that still have their foreskins. If a boy has not been circumcised, his foreskin covers most or all of the glans. When a male baby is born, the foreskin and glans are usually attached. sooner or later, the foreskin works itself free. By the time a boy becomes an adult, if not sooner, he can retract the foreskin. This means he can pull it back over the glans and down the shaft of the penis. You may be wondering why people have their sons circumcised. Maybe you have other questions about the operation. If so, you'll find more information about circumcision in further articles.

The two basic most powerful instincts of all forms of life are self-preservation and reproduction. We are all well aware of the intense and all-powerful urge for life. Man will undergo any suffering or sacrifice in order to continue to live. Even the very old and feeble hold on to life desperately. The other instinct, the instinct of reproduction, is not always so frankly and honestly acknowledged. The belief in sex as a mysterious, dynamic and all-pervading force of life has its protagonists as well as opponents. Some deny or denounce it completely. Some religious, cultures and self styled moralists' have tried to belittle sex and make men and women feel ashamed about teh sexual side of life. In modern India, for example, the word sex is not considered a respectable word and is not mentioned in plite society. Any display, mention or reference to sex in mixed company is considered vulgar and is frowned upon.

From a strictly biological point of view sexual intercourse is nature's method for the continuance of life. It is necessary in life is to continue. Sexual reporduction is an advanced step in the evolutionary scale. The simplest forms of life reproduce through the fission method, where the object grows and divides itself into two and continues to multiply endlessly in this manner. Without the sexual act all forms of higher life could not be reproduced and would abruptly come to an end. To ensure reproduction nature has made sexual intercourse the most exciting and pleasurable experience of life.

Sexual Instinct Dominates Life :

The influence, dominance and constant pressure of the sexual instinct on our daily life is all-pervading. Man's preoccupation with woman is almost total. All advertising and display designed to attract attention chiefly employ the female figure for appeal. We are constantly aware and responsive to the opposite sex. The greatest single determining factor in human life is sex. Our actions from infancy to old age are dominated and motivated by it. Those who attempt to ignore teh sexual side of life when dealing with the subject of life as a whole cannot be honest. It would be an attempt to bypass the most vital force affecting and influencing life, simply because it is a difficult and delicate subject. Sex is not only the most initimate and vital aspect of human life, it can be equated with life itself. Sex is the source of life.

Sexual attraction is the healthy urge which a member of one sex feels for a normal, healthy member of the opposite sex. The act of reproduction can take place between any two normal members of the opposite sex. Nature has done a perfect job in making the sexes alive, aware and ever conscious of each other. The magic of the sexes is strong, exciting and irresistible. There is no bliss greater than the all-powerful union between man and woman. There is no pleasure so eagerly sought after by man as union with a beautiful, loving woman.

In CARC Calling of Jan-March, 1990, Dr. Indira Kapoor the then Director, Government of India, Family Welfare and Research Centre in Bombay, presented a very useful outline ragarding education and counselling for AIDS prevention. Four major target groups were identified and modules were proposed for each group separately. These are not only informative but extremely useful in the present context. Therefore, they are reproduced in Tables A, B, C, D, E and F Hereunder.

TABLE A

GROUP 1 : PROFESSIONAL GROUPS

TABLE B

Group 2.1 : GENERAL POPULATION

The word sex itself is confusing. Even though its a small word, sex has a lot of meanings. In its most basic meaning, sex simply refers to the different bodies males and females have. There are lots of differences between male and female bodies. The most obvious is that males have a penis and a scrotum, and females have a vulva and a vagina. These body parts, or organs, are called sex organs. People have either male or female sex organs and belong to either the male or female sex. The word sex is also used in other ways. We may say that two people are having sex.

The word sex is also used in other ways. We may say that two people are having sex. This usually means they are having sexual intercourse. As we'll explain later in this chapter, sexual intercourse involves the joining together of two people's sex organs. Intercourse between male and a female is also how babies are made. We may say that two people are 'being sexual with each other'. This means they are having sexual intercourse or are holding, touching, or caressing each other's sex organs. We may say that we are feeling sexual. This means that we are having feelings or thoughts about being sexual with another person.

Our sex organs are private parts of our bodies. We usually keep them covered. We don't talk about them in public very often. Having sexual feelings and being sexual with someone aren't usually classroom ropics either. If I had half a brain in my head, I would have thought about all this before my first class. I would have realized that coming into a class room and talking about sex, penises, and vaginas was going to cause a big commotion. After that first class, I caught on real quick. I decided that, if we were going to get all silly and giggly, we might as well get really silly and giggly. Now I start my classes and workshops. I also give everyone red - and blue - coloured pencils.

The sex organs on the outside of the body in a grown man and a grown woman you can see in the image. These sex organs are also called the genital, or reproductive organs. We have sex organs on both the inside and outside of our bodies. They change as we go through puberty.

Some birth control counsellors ignore the condom and advise the use of the pessary, but the pessary is secondary to the condom as a contraceptive. The pessary should be used only as a last resort. The pessary is a metal ring covered with a film of rubber far thicker than the condom rubber. Yet, it does not affect the sex feeling because it merely covers the cervix.

How to Insert Pessary :

(1) Press the rim of the pessary to an oblong shape with the thumb and bend middle finger and hold a stretched index finger along the length of the rubber part so that the finger tip is set against the metal rim. It may difficult as the beginning to place the index finger within the rim but this can be achieved with practice.

(2) Place one foot on a low stool (left foot for righthanded person) and lean slightly forward. Sprea the vulva wide open with the left hand, insert the Pessary (with rubber face against vagina's upper wall) until the thumb prevents further insertion, then twist the hand so that the palm faces up. At the same time, press the rubber face flat against the vagina's front wall and push as far in as possible.

(3) Release the thumb and push the pessary in deeper in the direction of the arrow (toward anus), while firmly holding the rim with the tin of the index finger and pressing the finger against the vagina's rear wall.

(4) Stretch out the middle, ring and little fingers in a way to cover the anus with them, and while still holding the index finger's tip against the ring and pressing the finger against the vagina's rear wall, push the pessary further in toward the anus. Now, most of the pessary is in the vagina. Any part of it remaining outside may be pushed in by pinching that part with thumb and index finger and pushing it in while turning the rings. Finally, using the index finger, while pushing the outermost part of the rim inward, push it up (in the direction of the arrow) and hook it onto the inside of the pelvic bone (depression in vagina's front wall)
Insert the index finger once more into the vagina to check whether the pessary is properly placed on the cervix. Also move the index finger over the rim of the pessary to see whether it is evenly inserted. If not raise or lower the rim to straighten it.

Precaution in Insertion :

When to Insert - It is not advisable to insert the pessary immediately prior to intercourse as it destroys the mood. A wife should predict intercourse and insert it in advance.

Use Jelly :

Both the inside and outside of the pessary and the rim should be coated with jelly before insertion. After its removal the pessary should be washed up with soap in lukewarm water, wiped dry, powdered liberally and stored for future use. The pessary should be used only after consultation with a physician and after receiving a physical examination. Repeated use of the pessary and jelly may result in vaginal inflammation.

In general terms, law is expected to ensure social justice to protect society while ensuring order, support for fundamental human rights and, at the same time, preserve and protect the public good. Ethics on the other hand is a series of guidelines derived for a specific group to ensure their correct and good behaviour in respect of their professions or workplace. It is related to colleagues and other persons that they come in contact with during the performance of their

It might seem that overall, 'medical ethics' conveys that it is the power conferred to cure and control. It is desirable to replace the word 'power' with the word 'knowledge'. All medical, paramedical, technical, nursing and other staff providing health care are called health care workers (HCWs). According to Dr. Eustace J.de Souza, Executive Director, F.I.A.M.C.,
Bio-medical Ethics Centre, Bombay, every HCW should follow three primary ethics.
* The ethics of LOVE
* The ethics of TRUTH
* The ethics of DO NO HARM.

To heal the sick, alleviate suffering, promote health and prevent the spread of the disease are components of the first. HCWs should maintain strict confidentiality regarding patients illnesses and informa- tion imparted in confidence during consultancy. At the same time, they should respect patients rights and give the correct information about their health status. The 'do no harm' ethic is obviously important. It should also include taking all sensible safety precautions to prevent the spread of infection.

A basic concept is developed in HIV prevention, that is called 'universal precaution.' It is neither practical nor ethical to test every single patient for HIV. Blood and sexual fluids are the major vehicles carrying the virus. Therefore, the best policy for HCWs is to handle every single blood specimen (sexual fluids if handled) with care and precautions as if it were infectious. This means that a habit needs to be inculcated so as to control the spread of the virus.

Patients rights were mentioned earlier. They also have obliga-tions. A very important ethic for them is 'do no harm'. They should not perform any negligent act that can spread HIV/AIDS to others. In fact, Section 269 of the Indian Penal Code has a provision for negligent act likely to spread infection of disease dangerous to life.

This is punishable with imprison- ment extending to six months, a fine or both. This Section was provided during the British rule to protect against plague, cholera, etc. It is understood that this was also implemented. There is also a Section 270 which mentions 'malignant act likely to spread infection of disease dangerous to life' with imprisonment of two years or a fine or with both. The three basic tenets of ethics should also be applicable to patients spouses, family members, community and society. There is a need for provision for anti-discrimination. No person should be discriminated in education, employment, housing, travel or any community services or benefits on the ground of his or her HIV positive status. Here too, dissemination of information and imparting correct knowledge may be more beneficial than a legislative measure alone which is implemented infrequently.

The one legislative measure urgently needing enforcement concerns mandatory screening of all blood donors of HIV and hepatitis B virus, irrespective of whether they belong to the category of professional/paid or voluntary donors. This intro- duces an ethical issue regarding 'informed consent' of these donors. It should not be difficult to ensure that every donor is made aware that HIV screening will be done routinely before the blood can be accepted for transfusion. The condition for compulsory testing should be incorporated while giving licences to all blood banks including the vast number of small, private ones.

There should be appropriate and, if necessary, separate legislation regard- ing manufacture of blood products including mandatory testing of their paid donors. At the same time, techni- cal recommendations made by the national authority should be scientifi- cally and technically sound and equiva- lent to the international standards. There is also a need to encourage and support manufacture of indigenous products of good standard quality. Many of these are required continuously for the survival of patients suffering from blood disorders, such as haemophilia and thalassaemia.

Dilemmas arise in blood banks and hospital services. In blood banks, the ethics regarding disclosure of HIV status to the respective blood donors is, as a rule, not followed. The reason is that a single ELISA reactive blood unit is descarded without confirmation. In views of this somewhat incomplete testing (with the main objective of safety of recipients in mind) no donor is informed for the fear that the result might be 'false positive' and may create unnecessary panic in a truly uninfected individual. If, however, the person is in fact infected, but is not informed, he/she may continue unsafe sexual practices and may add to the chain of transmission. 'To tell or not to tell' is indeed a dilemma. If a patient refuses to inform his/her spouse of his/her HIV-seropositive status, should the doctor do so, thus breaking 'confidentiality' or, should he remain silent and thus place the other partner at risk?

Yet another dilemma in hospital emergency services confront doctors. After large-scale accidents or due to emergency requirements to treat severe bleeding (during delivery or some surgery), unexpectedly large number of blood units may be required. A situation may arise leaving no time for screening of blood donors. Should a doctor give unscreened blood with a potential danger to the recipent, or should he play safe and refrain from transfusion of unscreened blood? What order of priority should he/she allot between requirements of those who are HIV-infected and those who are not? This and many such dilemmas will increasingly face our doctors who will have to play God.

Puberty (PEW-bur-tee). You say puberty with the most emphasis on the first part of the word, PEW. Puberty is the time in your life when your body is changing from a child's body into an adult's body.

Female Puberty Changes : A girls go through puberty, their breasts develop, and they begin to grow public hair, as well as hair on their underarms. They also get taller, and fat tissue begins to grow around their hips, thighs, and buttocks, giving their bodies a curvier shape. Our bodies change quite a bit as we go through puberty. We grow taller. Of course, we grow taller all throughout childhood. But, during puberty, a girl goes through a growth spurt. She grows taller, at a faster rate, than she evel will again.

There are a number of words in this book that we think you may not have heard before. When we first use these words, you'll find a pronunciation key at the bottom of the page. We will always use capital letter to indicate which part of the word to empgasize when you say it out loud. And we use uh'' in the pronunciation guide to indicate the vowel sound that rhymes with the uh'' in huh''. See, for example, vulva,;; testicles,'' and urethra''. Remember that you don't pronounce the h'' in uh''. We also use ih'' to indicate the vowel sound that rhymes with the e'' in edit''.

During puberty the shape of our bodies changes. Our breasts begin to swell and to blossom out from our chests. Our hips and thighs get wider. We take on a more rounded, curvy shape. Soft nests of hair begin to grwo between our legs and under our arms. Our skin begins to make new oils, which change the very feel and smell of us. While these changes are happening on the outside of our bodies, other changes are happening on the inside.

For some girls, puberty seems to take forever. For others, these changes happen so fast they seem to take place overnight. They don't really happen that quickly, though. Puberty happens slowly and gradually, over a period of many months and years. The first changes may start when a girl is quite young, or may not begin until her teen years. No matter when puberty starts for you, we bet you'll have lots of questions about what's happening to your body. We hope this book will answer those questions.

We'' are my daughter, Area, and I. The two of us worked together to write this book. We talked to doctors and read medical books. And we talked to many women and girls, too. They told us what happened to them during puberty, how they felt, and what questions they had. I teach classes in puberty, and together Area and I do workshops on puberty for kids and their parents. The kids in my classes and the mothers and daughters in our workshops alwats have lots of questions. They also have lots to say about puberty. Their quotes appear throughout these pages,* so, in a sense, they helped write this book.
* To protect their privacy, we changed the names of the girls and women who were kind enough to let us quote them.

I first began teaching puberty and sexuality classes back in the days when dinosaurs still roamed the Earth (well, nearly that long ago). Back then, sex education wasn't taught in very many schools. I had to invent my lesson plans from scratch. I decided to start off my very first class by explaining how babies are made. This seemed like a good place to begin. After all, during puberty, your body is getting ready for a time in your life when you may decide to have a baby.

I didn't think I'd have any problems teaching that first class. Nothing to it,'' I told myself. I'll just go in there and start by talking to the kids about how babies are made. No problem.'' Bou, was I wrong! id hardly opened my mouth before the class went crazy. Kids were giggling, nudging each other, and getting red in the face. One boy even fell off his chair. The class was acting weird because to talk about how babies are made, I had to talk about sex. Sex, as you may have noticed, is a very big deal. People often act embarrassed. giggly, or strange when the topic of sex comes up.