My recent street reasoning on self-pleasure generated significant interest on my social media pages. Some of the responses were comical, some cynical and others very critical.

One recurring question was why, as minister of health and wellness, I would spend time discussing masturbation when there are so many other important health issues requiring attention.

The reaction doesn’t surprise me. But neither does it persuade me that we shouldn’t have the conversation.

Health is not only about hospitals, doctors, medication and treating people when they become sick. Health starts in our homes and communities. It is influenced by how we live, our relationships, our environment and the choices and behaviours that affect our physical, mental and social well-being. Sexual health is part of that.

I understand that in a predominantly Christian society, like Jamaica, masturbation is a sensitive subject. For some, it goes against deeply held religious or moral principles. For others, it is simply something that should remain private.

Let’s not limit discussions to comfortable topics

I respect those views. But public health cannot be limited to the subjects we are comfortable discussing. If a behaviour is taking place in our homes and communities and has implications for people’s health and well-being, then there is a legitimate public-health interest in understanding it and providing accurate information.

That was the purpose of going into Ocho Rios recently and asking Jamaicans what they thought about self-pleasure. And what a conversation it turned out to be.

One woman was quite open about owning several sex toys — in several colours — she was quick to add. Another said self-pleasure “doesn’t talk back” and, in her view, gets the job done. Some of the men had equally colourful responses.

There was laughter, embarrassment and no shortage of Jamaican humour. But beneath the humour were some interesting perspectives.

Some felt people were turning to self-pleasure because relationships had become more difficult.

Others mentioned money. Some saw it as a way of satisfying sexual needs without having a partner. And some rejected it completely on moral or religious grounds.

Ocho Rios Square is clearly not a scientific sample of Jamaica and I would never present it as one. We do not have national data that tells us how widespread masturbation is among Jamaicans.

International research, however, gives us some indication of how common the practice is. In Britain’s large National Survey of Sexual Attitudes and Lifestyles, more than three-quarters of men and four in 10 women aged 16 to 44 reported masturbating within the previous month. A national study in the United States similarly found that about six in 10 men and more than one in three women had masturbated within the previous month.

We cannot assume the Jamaican numbers are the same. What we can say is that masturbation is not an unusual behaviour, and our own vox pop showed that Jamaicans certainly have views and experiences to share about it. So, what do we know about the health effects?

From a clinical perspective, masturbation is generally considered a normal sexual behaviour. It occurs among men and women, among single people and among people who are in relationships.

Solo masturbation cannot result in pregnancy and, where there is no exchange of bodily fluids or sharing of sex toys, it does not carry the sexually transmitted infection risks associated with sexual contact with another person.

If sex toys are being used, however, hygiene matters. They should be properly cleaned, and sharing them without appropriate cleaning or protection can expose users to infection.

There are reported benefits

Research into why people masturbate frequently identifies pleasure, relaxation and stress relief among the reasons. Understanding your own sexual responses can also be useful in addressing certain sexual difficulties, and directed masturbation has been used as one approach in the treatment of some orgasmic difficulties.

Some people also report that orgasm helps them to relax and sleep, although the research on its effect on sleep is mixed.

There are also many myths surrounding masturbation. There is no credible evidence that masturbation causes infertility, erectile dysfunction, reduced sperm count or shrinking of the genitals. That does not mean there can never be downsides.

Overly vigorous or frequent masturbation over a short period can cause temporary soreness, chafing, irritation or reduced sensitivity. These effects are generally temporary.

Frequency by itself is also not necessarily an indication that something is wrong. Some people masturbate frequently, others occasionally, and some never do it at all.

The more important question is whether the behaviour is affecting your life.

If it becomes difficult to control and begins interfering with work, relationships, responsibilities or other important areas of life, that is a different matter and may warrant professional attention.

There can also be an emotional dimension. If masturbation conflicts with someone’s religious, cultural or personal beliefs, it may result in feelings of guilt or emotional discomfort. Clinical information cannot resolve that conflict for an individual.

It’s not a promotion of the subject

And this is where I think an important distinction needs to be made. Talking about masturbation is not promoting masturbation.

My responsibility as minister of health and wellness is to put credible health information into the public domain so people can make informed decisions. Sometimes those discussions will be comfortable. Sometimes they will not.

We talk about contraception because people have sex. We talk about sexually transmitted infections because people have sex. We talk about alcohol, substance use, mental health, intimate relationships and other behaviours because they exist and because they can affect people’s health.

Self-pleasure should not somehow become exempt from factual discussion simply because the subject makes us uncomfortable.

In fact, the Ocho Rios exercise reminded me of something I have seen repeatedly in these street conversations. Jamaicans will talk about almost anything once you create the space for them to do so.
Sometimes we laugh first. Sometimes we disagree. Sometimes we condemn. And sometimes we are surprisingly candid. But we talk.

And I would much rather have Jamaicans talking and asking questions than making health decisions based on myths, embarrassment or misinformation.

Be guided by your own principles

If masturbation results in persistent pain or injury, becomes difficult to control, or begins affecting your relationships, responsibilities or emotional well-being, speak with a healthcare professional.

Beyond that, whether you choose to engage in self-pleasure is ultimately up to you, guided by your own philosophical and/or religious principles.

My job, as I see it, is not to make that choice for you. It is to broaden the conversation, put credible health information on the table, and encourage better understanding towards a healthier community.

Dr Chris Tufton is Jamaica’s minister of health and wellness. E-mail: cctufton@gmail.com