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Psychologic Implications of Scrotal Sac and Testes for the Male Child

Clinical Professor of Psychiatry, Georgetown University School of Medicine, Washington, D.C.

The uncontrollable retractability of the testes during cold, fear, anger, sexual arousal, and defecation is the basis for castration anxiety and fear of object loss including body parts. The scrotum is associated with the anal area, which is considered "dirty," leading to the concept that sex is "dirty." Because of the fear that a testicle can fall off, boys tend to achieve bowel training later and with more difficulty than girls. Hor monal changes in prepuberty and puberty, which cause increased size and sensitivity, also increase the masturbatory urge. Feeling guilty about masturbation, a boy may think that he has damaged his sac and testes when he perceives that the left testicle hangs lower than the right, a normal state. In cases of cryptorchidism, both sterility and homosexual problems play an im portant role: physically, if bilateral, sterility and feminizing of the male ensue; psychologically, he develops a depression about his procreative inability and fears homosexual attack. Such attacks are more likely to happen to the cryptor chid boy.

The pediatrician is urged to regularly examine the boy in various positions, particu larly before age six. We must caution the pediatrician that his tendency to make a cursory examination may be caused by fears of being accused of making homosexual overtures.

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