Dr. Buehler Goes to IndiaIt’s exotic, India: spices and incense, jungle foliage, and temples, both massive and small, built to honor the pantheon of Hindu gods. It’s also grounded: a crush of cars and people, grand hotels beside tiny shelters, and daily grand movement from home to work and back again.

In a hotel in Nagpur, located smack in the middle of India, 250 physicians, sex therapists, and sex educators–plus one international delegate from the US (me)–to discuss the vagaries of human sexual behavior. What were the problems they addressed? Here’s a sample list:

  • The effects of infertility on sexuality, and vice versa.
  • Whether testosterone should be prescribed to women.
  • The latest treatment for erectile dysfunction.
  • Problems sex educators face in the community.
  • How relationship therapy can help save a couples’ marriage.

Surprise! It doesn’t look much different from a list from a conference in the States! What I learned is, sexual struggles are the same across cultures.

There are some notable differences, however. I learned that men in India obsess over penis size, the way that men where I practice obsess over their brokerage accounts.

They also suffer from dhat, a syndrome that causes a man to have premature ejaculation or erectile dysfunction and a belief that their semen is going into their urine. Because semen is seen as a man’s essence, this belief causes exhaustion, anxiety, and depression. Indian clinicians spend a lot of their time educating men and their partners about sexual anatomy.

I also learned that having a baby is critical for happiness, and that women, especially, will go to the ends of the earth to seek treatment for infertility. Without a child, they may be, or feel they are, barred from sharing in adult life in their community. Thus, it is preferable to seek assisted reproductive technology (ART), which seems a sure thing compared to getting help for a spouse’s sexual difficulties.

I also learned that the media distorts the truth in India. Shocking, I know—but I somehow expected journalistic ethics to be different. Instead, a talk I gave on treating out of control sexual behavior honed in on one sentence I stated, about the fact that we don’t know the effects that looking at pornography has on young children. This turned into a headline, “Dr. Buller (sic) states pornography is bad for children.” The rest of my talk ended up, metaphorically, on the cutting room floor.

Speaking of children, sex education in India isn’t any more or less advanced than sex education in the States. The Indian educators were aghast that we have many states that require zero sex education. Even in states where it is offered, it is suboptimal, with a focus on anatomy, reproduction, and prevention of pregnancy and STIs. Those who sought wisdom from me on how to create a program were likely disappointed. The one thing I could share is that the important job of sex education shouldn’t be left to the schools. It needs to happen at home, and with the context of values. Parents should know what to expect in terms of childhood and teen curiosity, and be prepared to answer questions truthfully.

Finally, many Indians still participate in arranged marriage. The statistics for this form of mating show that there is higher marital satisfaction for these couples than for those who choose their mate. Makes sense. Most 20-somethings are clueless about themselves, let alone knowing how to choose a partner. Two incomplete people look to one another for completion, and end up frustrated. In an arranged marriage, at least four people (two sets of parents) have given some thought and consideration to the chances of creating a fruitful partnership, with the benefit of some real adult wisdom.