Sex and Gender


The following is not intended to be a scientific treatise nor an anthropological study, but rather the observations and anecdotal information compiled during more than 50 years as a physician, treating and studying individuals and families.  It has been my pleasure to have recently attended a course in elementary anthropology.  I had often thought that my training in psychiatry would have benefited from exposure to that discipline and had as a matter of fact suggested such a course be added to the curriculum when I was a member of the faculty at OSU.  I felt that our study of human behavior, which was largely kept within the confines of our own culture, limited our ability to resolve the conflict over the nature-nurture controversy that was raging at the time.  It was a time when neuro-scientists were challenging much psychoanalytic theory, and were learning more about alterations in brain morphology and functions that seemed to be associated with some mental illnesses.   An example of how anthropology had contributed to resolution was the observations of anthropologists in the field that the prevalence of schizophrenia was similar in all cultures studied lending evidence that at least in that disorder the cause was likely biological rather than due to a failure in nurturing as had been postulated by the Freudian school.

The section on “sex and gender” were of particular interest to me as I had devoted much of my career to dealing with families.  I found it interesting to learn more about spousal relationships in other cultures, and was more impressed with the similarities than the differences, for as in our culture male domination oftentimes coupled with physical abuse was ubiquitous.   I have witnessed the destructive effects of abusive behaviors on families and individuals.  I have seen these behaviors passed from one generation to the next as the victims of abuse grew up to be abusers.  It appears to me that the incidence of abusive behaviors has increased during my years of practice; although accurate data is difficult to obtain since abuse is likely under reported.  The police department in our town of twenty five thousand people responded to two hundred sixteen cases of domestic violence in the past year, and I am confident that this represents a very small portion of the total number of occurrences.  In recent years there has been much more attention paid to the care and protection of the abused; however very few resources devoted to the root causes of abuse.  In my opinion, one factor which has been largely ignored is the physiology of the sex act.  I believe the underlying anxiety concerning male inadequacy has much to do with his need to dominate with whatever means are available to him.  I also believe the rapidly changing roles for women in our culture is a contributing factor to male insecurity.


Not surprisingly, the vast majority of abuse cases involve male on female assaults, both physical and verbal. It is true that the males of mammalian species generally exhibit more aggressive behavior than the females.  This is even more evident in species that live in herds where the strongest and presumably the most virile male dominates.  These animals are likely to become even more aggressive when the harem becomes receptive.  Of course much can be explained by the high levels of androgen in males, and that generally the male is larger and stronger than the female.  In the human this difference is much more evident in that the male is almost always possessed of a great deal more upper body strength; consequently the female is usually no match for her spouse in physical altercations.  None of these factors; however answer the question of why men beat and verbally abuse their spouses unless one is willing to accept the idea that they do it only because they can.

It does appear from what I learned in the course that such behaviors are not unique to our culture, and I was particularly struck by the number of cultures in which females were not valued other than for vaginal masturbation, the production of male offspring, or as a commodity to be bartered.  It was surprising to me that the idea of romantic love, which permeates our culture is not necessarily the norm throughout the world.   One thing which does seem ubiquitous in all the cultures we studied was the importance to most men of their self image: their need to be seen as “macho.”  Most Freudians would likely ascribe this to men’s fear of latent homosexuality; however I feel there is a different mechanism at work. I have seen evidence of insecurity in nearly all of these men who are abusers and I believe this insecurity is due in large part to the fact that they are saddled with the total responsibility for the completion of the sex act combined with the inability to conceal failure due to biological design.  Abusive men are typically quite jealous and very controlling, often attempting to isolate their wives from friends and family.  Sometimes their jealousy rises to the level of paranoia.  They may seek validation from their partner of their sexual prowess, and episodes of these behaviors may in some cases only occur when under the influence of disinhibiting drugs such as alcohol that unmasks previously suppressed feelings.  Such observations about the male human and his frequently observed insecurity are well documented. Since this insecurity is not limited to our culture, it leads one to the tentative conclusion that it is likely biologically related.

I am of the impression that during my years of practice, the frequency of marital discord with spouse abuse has increased; although I am aware that such calculations may be skewed as women may now be more likely to come forward with their complaints.  I do know that in my day, the macho thing to do was to be a defender of females, and that those who abused or even were disrespectful of women were labeled as cowardly.  We were operating with some Victorian values still intact, and to be seen striking a female would have been considered unmanly.  Fathers would instruct their sons that they must never under any circumstances strike a woman.  On the other hand young women were taught to be “lady like”, a euphemism for docility and therefore non-threatening.  It occurs to me this might be an example of how cultural norms developed in order to keep male insecurity in check.  In earlier times, society developed certain prescriptions in an attempt to contain men’s aggressive nature, and encourage female subservience. For example, the idiom “rule of thumb” is said to be derived from a law that stated a man couldn’t beat his wife with a switch thicker than his thumb. Other laws dictated the time of day that the beating of one’s wife was prohibited. Indeed, the tradition of the female assuming her husband’s last name is derived from the fact that society viewed a female as the property of her father who then “gave her” to another man to be his property.  The Salem witches were all female, there were multiple biblical injunctions for women to be submissive to their spouses.  In some Christian religions Eve was blamed for causing mankind to be saddled with “original sin” (notice the use of the male gender to describe the world’s population).  My Daughter, the feminist, reminds me that although all men are created equal, nowhere in the constitution is the word woman or any reference to the female gender to be found.  For several hundred years British common law prescribed the principle of coverture for all married women which meant that a woman became the property of her husband, and gave up most of her rights upon marriage. It appears from what I have learned that this attitude toward women is common with most if not all cultures which have been studied.

While it may have been considered cowardly and disrespectful to strike the weaker gender in the context of how I was reared in the 40s and 50s, abuse still occurred.  Victims were threatened with dire consequences if they should report being beaten.  They were intimidated, usually had no resources, and eventually their self esteem diminished until they became hopeless and helpless, sometimes even blaming themselves for the abusive situation.  Family matters were considered private so that even when abuse was obvious, society was reluctant to intervene.  Courts were generally unsympathetic, but even if granted a divorce many abused women felt there was no way they could make it on their own, especially if there were children involved.  In general, relying on family support was often problematic. When the victim would ask for help from her family, she would often be told “you made your bed now you can lie in it.”   Some families did intervene if the woman was not too ashamed or frightened to report the abuse.  I recall my satisfaction when the brother of one of my patients appeared at her house with the simple message to her husband, “If you ever hit my sister again I will kill you.” She lived an unhappy but peaceful life thereafter and when last seen had decided to stay in the marriage until her children were grown.

Family structure had not changed much as our society moved toward the middle of the last century.  Indeed it seemed to have much in common with most cultures we studied in our anthropology course.  The father was undisputed “head of the household” in charge of discipline, and providing for the material needs of the family.  The mother was charged with nurturing and maintenance of the living quarters.  Although she was nominally in charge of running the household, usually the father was in charge of her and she would make no major decisions without his approval.  A frequently heard mantra was “a woman’s place is in the home,” and for her to spend too much time away from home risked her being labeled as neglectful.  There were some professions open to women.  Nurses had proven themselves capable during the Civil War and the job seemed to fit the female role of nurturer.  Female school teachers were common, but there seemed to be a preponderance of spinsters among them.  I suspect this was because they were less likely to need maternity leave, and I wonder if some did not feel that to get married put their job at risk.  Unmarried women were also deemed suitable for secretarial jobs, telephone switchboard operators, and of course various types of domestic positions as housekeepers and nannies.

Although women earned the right to vote in 1920 with the passage of the 19th amendment, they still faced many discriminatory practices, all of which seemed designed to keep them in their place, helpless, dependent, and non-threatening.  Most churches prohibited women from involvement in leadership positions and female pastors were unheard of.  The legal system was almost exclusively run by men and divorces, although rare, usually did not favor the woman unless she could prove infidelity, and even then a divorcee was often looked on with disfavor.  In the case of infidelity, people would silently wonder what she had done to drive her husband into the arms of another woman.   As a divorcee, she would always be suspect and often shunned.

One particular legal issue that shocked me was to learn that if a wife sues for redress following a disabling injury, the husband may join the suit and demand payment for “loss of conjugal rights.”  I wonder how they determine the value.  Perhaps they could have a prostitute testify as to the going rate.  I have never heard of a woman who sued for loss of her conjugal rights, but I suspect even now she would be laughed out of court.

It is said that most cases of rape went unreported in the past, as a woman was likely to be accused of causing if not actually inviting the rape.  Some women have reported that the court room experience was almost as terrifying as the rape itself.  Though our tendency to blame the victim does not result in the extreme punishments as carried out in other cultures, the principle is the same and the results psychologically devastating.  It has given me pause in encouraging the reporting of some rapes by these women; although there has been much improvement in recent years in the procedures for dealing with rape victims in most cases.  However recent publicity concerning the number of unpunished sexual assaults in the armed forces is compelling evidence that the problem has not been completely remedied, nor is it surprising it continues, since the male of our species is subconsciously reacting to a loss of power as the culture advances to a society that doesn’t require male-dominated traits, such as physical strength. Sexual assault of women is not limited to the United States: the World Health Organization reports that one third of all women worldwide will be the victims of violence during their lifetime.

For at least 150 years, women of our culture have lobbied for equal rights.  The suffragette movement was the first milestone in their efforts; however I believe that World War II marked the beginning of changes leading to their quest for more independence.  There had been a few heroines, Amelia Earhart comes to mind, who had invaded some professions formerly the exclusive province of males, but they were rare enough to be newsworthy.*  WW II however; resulted in a manpower shortage caused by the millions of men drafted into the military, and a massive increase in manufacturing for the war effort.   The country was gripped in a patriotic fervor and posters of “Rosie the riveter” wearing dungarees working in an airplane factory were everywhere.   For the first time other than for nurses, women were inducted into the army and navy as support in non-combatant roles. Some were even trained as aviators to be used for delivering airplanes to the troops.  As a result, Susie homemaker would never be the same.

When “Johnnie came marching home,” many women decided they preferred a career in a man’s world to the traditional role of full-time housewife.  There continued to be a mass exodus from the hinterlands to the cities: for to paraphrase George M. Cohan’s lyrics, you can’t “keep them down on the farm after they’ve seen Paree.”  Children were not an asset for city dwellers, and more effective birth control methods were developed.  New technologies were providing efficiencies for the average housewife and it was a time of relative prosperity.  It was also a time of unprecedented consumerism.  The wartime propagandists turned their skills toward selling stuff, and were wildly successful.  Many women wanted more for themselves and their families, but were also bored and missed working outside the home. Additionally, there were now more opportunities for women to further their educations and many were interested in careers other than the ones previously labeled as suitable for women.   Thousands of veterans took advantage of the G.I. bill, and many married couples invaded college campuses during the late 40s, my own brother was among them.  The discipline and maturity veterans had developed in the armed services served them well in the classroom, and many professors reported these guys were excellent students despite in many cases dealing with what was termed battle fatigue (now called post traumatic stress disorder, and known in World War I as shell shock).

The post war euphoria of the 1940s was dimmed by the onset of the Korean War in 1950, and most WWII vets managed to avoid that one.  I was in undergraduate school at the time and along with thousands of other students was given an academic deferment.  That conflict did not result in the all out response which characterized what would come to be known as the “Big One.” The veterans of the Big One (WWII) were now graduating from college and contributing to the baby boom.  Many appeared to be living the American dream with a house in the suburbs, a couple of kids and a shaggy dog.  These children of the Great Depression were rapidly ascending the socioeconomic ladder to become members of a great new middle class.  Centers of learning flourished, a huge new population of eager consumers fueled demand for products as manufacturing facilities built to produce the materials of war were converted to satisfy that demand, and which soon expanded to include most of the world.  In short, we prospered while much of the world lay in ruins.  What an irony that the unspeakable horror of such a war could be followed by such a period of growth and prosperity in our history.   Opportunities abounded, families frequently moved to take advantage of them, and the traditional cohesiveness of the extended family often suffered.

Technology continued to grow at warp speed, and in particular, the miracle of television took over many a household.  I recall overhearing a conversation between my father and his friend during which my father was telling his friend about an invention that was a radio in which you could not only hear, but see the people.  The friend responded that was the craziest thing he had ever heard, and suggested my father stop reading science fiction. In the 60s, space exploration dominated our need to be the biggest and best, and science fiction had become reality. It seemed as if anything was possible.

But the 1960s were not only a time of great scientific exploration, but also of massive social upheaval, not the least of which was a questioning and exploration of our sexual behaviors.  There had been some cracks in the dam but it burst with a roar in the late 50s and 60s as our puritanical sexual inhibitions were challenged.  I could barely remember the gasps of the audience when Clark  Gable delivered that famous line  to Vivien Leah, “Frankly my dear, I don’t give a damn” in the classic movie Gone With  The Wind.  The movies continued to be self censored probably until well into the 60s.  There was never any profanity permitted let alone nudity.  Bedroom scenes were always filmed showing the couple in twin beds.  There may have been hints of sexual activity, but never directly expressed.

Prior to the war discussions about sex or even use of the word sex in mixed company were considered to be in poor taste.  Men were expected to enjoy sex and women to tolerate it.   Parents were embarrassed and dreaded the conversation with their children about the birds and the bees.   For women, chastity was valued above all else, and an intact hymen was treasured so that her husband could be reassured that she had not been “ruined.”  The most information many girls got in the way of sex education was to be told that sex must be avoided at all costs, and should not even be discussed.  The idea of sex education in the schools was unheard of, and still today some groups violently oppose it, convinced that ignorance of the subject will prevent promiscuity.   On the other hand, the potential husband could be expected and even desired to be “experienced.”  It was not clear how he could accomplish this without having consorted with “wanton” women.

Boys sought their sex education through their peers or older brothers; consequently there were many myths promoted by self-anointed experts in the field.   As testosterone levels climbed, tales of sexual exploits more often imagined than real dominated conversation between boys both young and old.  In truth, we remained woefully ignorant.  I remember an incident in my adolescence when a friend and I were reviewing a purloined marriage manual.  While reviewing an illustration of a copulating couple, my friend said in disgust, “My mom and dad would never do anything like that.” The fact that we, the most intelligent organisms on the planet, were the only species to need such instruction suggests that societal influences have been sufficiently powerful to suppress mankind’s most basic instinct. My own formal sex education consisted of a brief lecture in high school by Mr. Shamp, the gym teacher, concerning the dangers of venereal disease.  He was frequently interrupted by the snickers of his audience.  As the migration of society to urban areas continued, most children were no longer exposed to the reproductive activities of farm animals, and they were even more ignorant of sexual matters.

By the late 50s, I had begun my medical career, and considering the environment in which they had grown up, it is not surprising that many of my female patients were confused about sex. Many were woefully ignorant about anything sexual, in addition to being very inhibited.  Some considered it dirty and the act itself abhorrent.  As I mentioned previously it seemed that the inability to achieve climax was much more common than it is today; although it could be that some felt it unbecoming to admit they enjoyed sex.  Societal constraints on sexual activity were loosening.    Playboy magazine had wide distribution, and its publisher saw himself as the originator of the so called sexual revolution.  Boys treasured their pilfered copies especially the centerfold nude photos.  Mothers frowned and fathers smiled.  To top that bit of journalistic excellence, Hustler magazine soon followed, and topped their predecessor in the semi porn business by displaying the genitalia of their nude models, thus providing little Johnny with a more comprehensive anatomy lesson than was available in his mother’s lingerie catalogs.   There were stirrings of discontent amongst some feminists who were now beginning to organize and flex their political muscles.  There was a sense that such publications exploited women, and Barbara Walters gained her entry onto the big stage by infiltrating a playboy club as a playboy bunny and giving witness to how she felt those girls were denigrated.

Much has been made of the societal upheaval of the 60s.  It was a time of demonstrations and protests, the most notable of which were for civil rights and against the Vietnam War, but it was an opportunity for oppressed groups to join in the struggle.  There was also much questioning of traditional gender roles and sexual mores.  The subject of sex was out of the closet and now a favorite topic of everyday conversation.  The F word (I still have trouble writing it even though it has become a mainstay in my limited vocabulary), the absolutely taboo word that should never ever cross the lips of any female, was used with impunity.  The so called sexual revolution was in full swing.  Masters and Johnson were doing in depth studies of sexual activity in their laboratories.  The concept of “free love” was resurrected, along with open marriage, communal living, shacking up, and wife swapping**.  Trial marriages were recommended by some, and the decade ended with Woodstock which some observers described as a “giant orgy with music” (I once had a patient who told me she had it on good authority that she had been conceived at Woodstock).  In 1965, the venerable and conservative magazine Cosmopolitan, for nearly 100 years a bastion of advice for the traditional homemaker, shocked many of its subscribers by suddenly focusing in very explicit terms on methods for becoming sexually fulfilled.   The idea that women should expect and seek enjoyment via sexual relationships was in itself revolutionary.  With the development of “the pill”, fear of pregnancy was no longer an inhibitor of sexlual activity.   Many clergy felt that Sodom and Gomorrah had arrived, but in spite of all the hubbub the vast majority still held on to their old beliefs and moral codes.

At about this time, a group of women formed the National Organization for Women (NOW) to join the quest for equality.  Their stated mission was for equal rights in general, but specifically to escape the confines of male dominance, and attain equal status in all areas of life.  They became a political force as membership and fellow travelers grew in number and they realized that they did not have to vote as instructed by their husbands or boyfriends.  They had appeared to capture some of the revolutionary zeal of their predecessors of the suffragette era.  Not surprisingly this “women’s liberation movement” was not met with a great deal of enthusiasm on the part of the male population and the women involved were frequently labeled “castrating bitches,” a term very telling in itself and provides evidence to support the theory to be presented shortly.

The female quest for equality has been successful in many ways; although remnants of the old biases persist.  I am amazed at the changes which have occurred during my lifetime.  There were three women out of a class of 150 in my medical school class, and now I am told that women students outnumber the men, and usually outperform them.  I recall when there were practically no females actively involved in government but have witnessed a string of female heads of state beginning with Golda Meir, Margaret Thatcher, Angela Merkel and more recently a woman seriously campaigning for president of the United States.  Some women’s groups complain that there are too few CEOs of major companies as if the fact that there are any is miraculous compared to what was.  The other day I even saw with my own eyes a woman riding her own motorcycle, and expect to soon see one with a man mounted behind.  With the speed at which these changes are happening, I may live to see a female NFL football coach.

Now for those of you who have managed to endure this preamble there must be questions as to how it all relates to the subject of male on female abuse.  It is my premise that the relationship problems that lead to violent behavior originate from the fact that the male bears full responsibility for completing the act of sexual intercourse.   Throughout the animal kingdom it is generally the responsibility of the female to attract the male and he must then be the aggressor.   She may be actively involved, but is able to be totally passive and can fake orgasm if she so chooses.  This is especially true if the couple copulate in the so called missionary position.  Consequently, there is no performance pressure on her, while her partner must undergo a series of complex autonomic nervous system functions which are not under his conscious control.   In other words he is powerless if an erection does not occur and his failure cannot be masked.  Since women are not under such pressure to perform, and do not have a refractory period following intercourse their ability to perform is only limited by desire.  Men on the other hand require that a period of time elapse between episodes.  In contrast to other mammals female humans may be receptive to a mate at any time since they are not limited to a period of estrus, thus requiring an insecure jealous male to be constantly on guard.

These factors combined to place women in a position of power, which could only be overcome by physical domination.  As societies became more complex and “civilized” more subtle methods of control needed to be developed thus men were able to develop cultural institutions designed to perpetuate the myth of female inferiority thereby justifying the necessity of masculine control.    Since their sexual superiority was the only source of power left to the women, it is little wonder that they learned to use their “feminine wiles” in order to be relevant.  A bit of seductive behavior to attract attention followed by the massage of a fragile ego with a few flattering comments about his masculinity would often produce the desired results.

There is ample evidence that throughout history women have frequently been the “power behind the throne”, so I suspect this form of interaction is not a modern invention.   Awareness of the male’s vulnerability has also been used as an offensive weapon.  Passive aggressive measures involving sexuality are sometimes used as a mechanism to express hostility toward men.  In those cases the woman exhibits some suggestive seductive behavior, but when the man responds she appears to be insulted that he is “hitting” on her, and he feels foolish or angry that he has been duped.  Even more devastating are comments suggesting that his performance in bed is less than perfect, or that his performance leaves her unsatisfied. There is nothing new about these observations: but I find it interesting that we men often describe these behaviors and many times other expressions of hostility as “castrating.”  Use of this term denoting a violent removal of one’s source of masculinity provides further evidence of the male’s sense of vulnerability, which may on occasion lead to a violent response.

The female’s weapons, although effective in many situations, are no match for an adversary twice her size and strength who is bent on inflicting pain.  During the years I have listened to literally hundreds of accounts from my patients describing their feelings of horror during some of these assaults.  Contrary to what some cynics and/or chauvinists may report, I have never seen any evidence that any one of them enjoyed or deliberately provoked the attacks.  On the contrary they reported that they were constantly in fear of saying or doing something which might “set him off.”  Reports of loaded guns held to their head, or a knife to their throat were not rare.  Many have been told that if they should ever leave or report the assaults that they would be killed.  The worst of the abusers were the ones who threatened harm or even death to their own children as the ultimate weapon of control.  For some their rants and rages expanded to include the children.  Teachers or pediatricians would hear all kinds of implausible stories as to the cause of their injuries.  A mother would be caught in the worst kind of dilemma: if she reported the abuse she felt certain there would be violent repercussions while no action almost guaranteed the terror would continue.  Most cowered, begged and directed most of their energies toward placating the monster in her home.

There were exceptions, and some of the persecuted chose to react in kind.  There were many thwarted attempts to fight back with whatever weapon was available usually a kitchen knife, but I recall one instance in which a baseball bat was used effectively.  There were many instances in which the oldest son in the family would take it upon himself to be the protector, and when sufficiently mature would contain the abuse by abusing the abuser.  There was one instance where rage overcame fear, and my patient shot and killed her husband.  I was asked to see her the next day and shall never forget her reaction, for she ran over, embraced me and said, “Oh Dr. Smith I didn’t know I was so sick.”   She was so overcome with remorse that she hung herself that same night.  In another case I was subpoenaed to testify for the defense in a case in which my patient had been shot and killed with his own hunting rifle while he slept.  His wife who admitted to the act alleged a prolonged pattern of physical abuse, intimidation and threats if she left him.  The jury was apparently not very sympathetic for she was sent to prison.  These examples although extreme are meant to show that the issue of domestic violence is not a trivial one.  I have occasionally given lectures to groups of law enforcement officers, and am told that they believe the most dangerous part of their jobs is responding to domestic violence situations.

The terrible physical trauma inflicted on these families, may not be as destructive in the long term as the verbal and emotional abuse which was usually a component of the physical abuser’s armamentarium. Verbal assaults could also be very effective by themselves, and had the advantage that they left no tell tale bruises.  Some were able to achieve their goal of absolute domination simply with words. Many of the most damaged patients I have seen grew up hearing a litany of criticism, and derogatory, humiliating comments.     These verbal abuse victims often grow up lacking confidence, self- worth, and with a very poor self- image.  They not only feel unloved but also unlovable.  Personal relationships are difficult, for their self-loathing leaves them convinced that no one could ever like them.  They tend to distance themselves from others, and are chronically depressed.  One can only imagine how many lives have been ruined in this way.  It is generally accepted as fact that the abused often grow up to be abusers, and I believe that abused female children frequently grow up to be abused, thus becoming unwitting participants in the cycle of violence.  I have always been amazed at how many of these women grow up to find themselves in an abusive relationship reminiscent of that which they had experienced in childhood.  One would not expect this to be an area where the repetition compulsion would be operant, but many go from one abusive relationship to the next.  The only plausible explanation I have come up with is that perhaps they feel unworthy of the respect which would be due an undamaged person.

Not all victims of childhood abuse grow up to satisfy the stereotypes I have just presented.  I have known some male survivors who were passive and avoidant of confrontation, usually suffering from treatment resistant depression.  One such family comes to mind, four members of whom I had seen off and on over a period of 30 years.  Although they were reluctant to talk of it, I was aware that both their father and grandfather had been abusive (one of the advantages of practicing psychiatry in a small town).  Father had died at a young age presumably from the effects of chronic alcoholism, and the children were all very protective of their mother who suffered from crippling rheumatoid arthritis.  She lived with one of the daughters, but they all were involved in her care.  It seemed the siblings had a close relationship, which is not common in such cases for usually the kids escape as soon as they are able, vowing never to return, and the family scatters.  My impression was that the abuse in this case created a common bond, which was reinforced by their need to protect their mother.  One of the men suffered from a seizure disorder (I suspect as a result of paternal abuse).  His brother could never seem to hold a job, was barely literate, and never was able to recover from abandonment by his wife.  All four had failed marriages, one sister had been treated for drug addiction and the two brothers eventually committed suicide.  One of the suicides left me with a good deal of self- recriminations for the last time I saw him he paused at the door as he was leaving to thank me “for all you have done for my family.”  Long before societal programs to prevent suicide were developed, I was giving lectures to my students, other physicians and anyone else who would listen about using a third ear to detect subliminal messages which might indicate a person might be contemplating suicide.  Joe (not his real name) was obviously saying goodbye, and I had missed it.  Later in the day as I was recording the session, the light came on and I attempted to contact him, but it was too late.   Some might insist that these good gentle people were the victims of bad DNA, which may well be true; however I am certain early life experience played its part.

Up until now I have said little about rape for I feel it deserves special treatment as the most destructive of all the abuses one can suffer for it involves a violation which affects the total being.  I have interviewed many rape victims and they have difficulty putting into words how they feel, but you can see in their eyes a hollowness too vacant for tears.  Violated is the word I most often heard from these women, but later would come the fear and then the anger.  Rare is the rape victim who can go on through life without it having a profound effect on future relationships.  It appears that no one is immune for it is ridiculously common among all ages and socioeconomic classes in our culture. I am not privy to any information about the prevalence of rape in other societies; however would expect that in those who undervalue females even more than we, many cases would receive little attention.  As a matter of fact in some cultures a rape victim is typically blamed for having been raped and may be murdered by her own family as a so called “honor killing.”

In this country it is estimated that at least twenty percent of women will experience a sexual assault of some kind during their lifetime.  It has been said that rape has little to do with sex, that its main goal is domination. With rape that domination is complete for by denying her control over her own body, she is denied the last vestige of power, and is totally devalued.   Married women are not immune, and husbands who force themselves on their wives are not as rare as you might think.  We are told that date rape has become common on college campuses, and that the drug, ecstasy, has been used to facilitate unwanted sex.  There seems to be little shame associated with these behaviors and some rapes, even gang rapes have been proudly displayed on social media.  It is little wonder that the term gentleman is used less frequently these days, for the quality of gentleness in a man no longer seems to be as highly prized as it once was.  I find it interesting that gay men who are not faced with the same challenges as heterosexual men appear to be much less violent, and even gentle.

It may seem inconsistent that I began this paper with anecdotal observations suggesting that the incidence of spousal abuse had increased over the past 50 or so years, and proceed to indicate that women’s power had increased dramatically over the same period of time.  I contend that it is precisely due to this empowerment coupled with the inevitable loss of customs which had conspired to limit female power that were seen as a threat to many men.  Men had always been insecure about their ability to act on the most basic of instincts (reproduction), but now that the insecurity increased they often projected blame on their wives for their own deficiencies.  The language of exclusively male habitations make frequent use of sexual colloquialisms.   For example a powerful man or outstanding athlete was called a stud, a man who was felt to be submissive to a woman was dubbed as “pussy whipped”, and “ballsy” was synonymous with gutsy while cowards were said to lack gonads as in “grow a pair.”  Women who were felt to be aggressive were called “ball busters” or “nut bashers” or as mentioned previously among the more sophisticated as “castrating.”   Of course it has been noted by many that women in positions of authority are often referred to as bitches for exhibiting behaviors which would be admired in men.   Sometimes idioms are very revealing.

In spite of all these problems, there has been considerable progress made in the protection of women from domestic violence.   The establishment of shelters for battered women and their children, advocacy groups, rape counselors, and in some states laws requiring the reporting of cases of suspected abuse.  Ohio laws now allow police to file domestic violence charge on their own in order that accusers can no longer yield to pressure to withdraw their charges.   Most emergency rooms now have so called rape kits available which allow them to gather evidence in a timely fashion.  Although these efforts are laudable, they do little to get at the root causes.  Our culture has changed dramatically in a very short period of time, and the end is not in sight.  The cave man approach to dealing with women is no longer appropriate or acceptable, although punishment of the perpetrators does little to solve the problem.   It is clear to me that there is need to focus more on the abusers for feelings are rarely changed by fiat.  Men may feel they have little control over their family, but cling to the thought they are responsible as titular head.  Finding oneself in a position of responsibility without power guarantees anxiety and frustration which often leads to anger.

Families continue to be in a state of flux for the changes I have enumerated have resulted in changes in family structure and function.  Stay at home moms are no longer the norm, support is usually unavailable from extended family, the neighborhood or village.  Scheduling of the family dinner is increasingly difficult due to outside activities.  Back when I was director of the Family Study Unit at OSU, we felt the traditional family dinner was the most important activity for developing family cohesion.  It was a time of sharing, learning, listening, and perhaps most important belonging.  Those who work with juvenile gangs tell us that these organizations are often a substitute for a functioning family.  I wonder how many have been present at a family dinner on a regular basis.

Family structure now exists in many forms.   There are families with same sex parents, others where mom brings home the bacon, and dad fries it.  There are many single parent families and also large numbers of blended families.  In recent years I have seen many families where grandparents are rearing the children after parents have abandoned or abused them.  I have even seen one happily married couple who professed their love for each other and seemed to have been successful parents in spite of the husband being transgender.  Unfortunately the variety can be confusing since the instruction books from previous generations no longer apply, and folks must improvise.

Those of you who have labored through this writing must feel you deserve to hear a solution to the problem.  I am sorry to disappoint for I only have suggestions as to how it might be minimized.  From what I learned in anthropology, it seems that cultures eventually create customs to deal with change.  It appears to me that tradition like morality develops in the service of social expediency.  Tradition development takes time and the changes in our culture are occurring much more rapidly than ever before.  As I mentioned before, prior attempts at social engineering while discarding previously held values resulted in unintended consequences.  If the premise that male on female violence originates from the male’s fear of the female’s power is correct, then convincing men that nice is a more effective weapon than nasty might be effective.   This seems unlikely since cultural mechanisms to deal with the problem in the past have apparently met with limited success.  Men’s need to dominate is well documented throughout recorded history and is not likely to go away easily.

To me the future for gender relationships in this country does not look promising.  Women continue to consolidate power in politics, religion, and education.  It has been said that the woman vote elected our current president.  The equal rights amendment which had languished for nearly one hundred years may finally get a hearing.  The hue and cry of equal pay for equal work is getting louder.  A woman was recently promoted to general in the army.  Some catholic women are agitating for female priests to be ordained.  The myth that females cannot excel in mathematics, physics and engineering has been dispelled.  Although these are some of the factors which are predictive of a power shift, I am also convinced that as our manufacturing processes change, women will be more in demand than men. It is predicted that robots will soon be doing all the heavy work in manufacturing, and that when robots are able to manufacture more robots there will be little demand for so called brute force. The jobs left would be those requiring more digital dexterity at which women have been shown to be more efficient and capable.  Could we then have a culture in which stay at home dads predominate, and the mythical Amazon society comes into being?  I doubt that we men with our fragile egos could cope.  Although I say all this with tongue in cheek, it does beg the question of how we will cope with gender equality which seems now to be almost inevitable.  It might even come to pass that those who have been dominated for thousands of years may come to dominate their opposite sex.  If either case should occur, the fallout would be earth shattering, and the question is will our culture find ways to adapt.

*My daughter points out the irony of my example of Amelia Earhardt as a female heroine in that she is known for her failed flight around the world.

** My daughter finds it interesting that the term is “wife swapping” and not “husband swapping” or spouse swapping, denoting ownership of the wife as is rooted in the custom of matrimony.


Today I learned that congress now has introduced a bill designed to deal with the apparent epidemic of sexual assaults on college campuses.  I recall an incident when I was a freshman in undergraduate school in which a male student was permanently expelled after he was seen leaving a female dorm in the early morning hours.  A mere thirty years later, we checked my son into a co-ed dorm, and we were told that colleges were no longer in the parenting business, and they were not interested in monitoring students’ sexual behaviors.  It does bring up the question as to whether sexual permissiveness may contribute to sexual assaults; although of course in no way does it excuse them.  For my part, I don’t believe that most young men need stimulation to stoke their testosterone levels, and l wonder if lust is the primary motivator in some of these cases.  Binge drinking which can be very disinhibiting and adversely affect judgment may also be a factor.  As in the past, there is little interest expressed in looking at causation and possible prevention.  I recently returned from a trip to Vanderbilt’s castle in Ashville North Carolina, and found it interesting that unmarried female guests were housed in a separate wing of the house as far away as possible from the men.   Photos of people at the indoor swimming pool showed as little of the anatomy as possible.  Apparently, this was a cultural attempt to tamp down overt sexual stimulation, or perhaps simply to promote chastity.  Since we have no reliable records of the incidence of sexual assaults from that era, we will never know if these measures had any preventive effect.  I suspect they did, and suggest that a look at college campus subcultures might be revealing.

Darell J. Smith MD

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