Two situations need more aggressive action. The first is if you decide, for whatever reason, that you will live with your partner. Families tend to view this with contempt (although they accept that younger people do this quite often). Government authorities also tend to be censorious, even demanding access to your joint home to see if you share the same bed and, if you do, to reduce both your pensions. Older people should rebel against this invasion of their privacy. Neither your family, nor the state, nor the neighbours have any right to insist that you marry. It is your life, enjoy it – and ignore them!

The second problem is even more damaging. Many old people need to live in institutions because of increasing disability or because of poverty. Institutions and their managements are particularly censorious about sexuality. Not only are men and women segregated but, in some, husbands and wives are separated. This is inhumane. Any couple, whether married or not, who wish to share their lives and their bed should be encouraged to do so rather than being obstructed. By sharing their lives fully, they will enhance their sexuality, and increase the sense of their own value and their value to others. There is medical evidence that in institutions which allow their guests to live in this way, there is less depression, less need for drugs, less disability, and more happiness than in repressive, segregated homes. Although you may have to live in an institution, this does not make you less human, you have the same human rights as others outside. You have the same right to establish a relationship. You have the same right to privacy. You have the same right to dignity. You have the same right to be treated as a responsible adult.

Treatment to ‘cure’ homosexuality is ineffectual, whether prolonged deep psychoanalysis or aversion therapy is used. Aversion therapy is particularly offensive. In this form of behavioural modification, the homosexual is attached to a machine which gives him an electric shock. He is then exposed to erotic pictures; when a male is shown, the shock is given, when the picture shows a female, the shock is withheld. The theory is that the ‘patient’ will learn to associate male erotic pictures with pain and will change his erotic preference as a consequence. Treatment rarely produces a complete conversion of an adult from exclusive homosexuality to satisfactory heterosexuality. Although enthusiastic psychoanalytic and aversion therapists report high percentages of success, most report soon after treatment, on selected patients, who are usually under the age of 25 and often bisexual. The committed homosexual rarely changes permanently, and the longer the follow-up, the less effective is treatment shown to be.

The gonococcus is a very fragile organism and dies very rapidly if it is not within the warm human body. Small falls in temperature kill it, and even if the infected discharge from a man’s urethra contaminates clothes or other articles, those articles are rarely infectious, as drying quickly kills the gonococcus. For this reason the myth that you can get gonorrhoea from an infected towel, a lavatory seat, or infected clothing should be remembered for what it is – a myth!

You will know if you have been infected between 3 and 5 days after sexual intercourse. The first thing you notice is that you have developed discomfort or tingling in your urethra. Very quickly a discharge appears which is creamy, thick, and purulent, and which drips from your penis. You will also find that it is uncomfortable to pass urine and, when you do, you get a burning feeling in your urethra. The area around the eye of your penis is usually reddened, but you feel quite well apart from these symptoms. If you do not seek treatment, the infection spreads upwards along your urethra and, in to to 14 days, the part of the urethra nearest to your bladder becomes inflamed. When this happens, the burning and pain on passing urine increase, and you may feel unwell, with headaches or fever, due to absorption into your blood of toxic products from the infection.

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In Dr Masters’s clinic the first four days are arranged so that the couple can learn about their sexual anatomy and sexual function. They talk to each other about sexual matters. They learn to touch each other and to pleasure each other. Only when these preliminaries have been completed does the specific therapy for the specific problem begin. During the preliminary phase, the time given to ’sensate focus’ exploration is especially important. In the later stages of this period, the woman is encouraged to find out which form of genital stimulation the man most appreciates. He may prefer her to caress his penis with her fingers, or with her mouth, or to place his penis between her breasts. If this stimulation leads to ejaculation it does not matter, for the couple are exploring each other’s bodies and minds. At this stage, the man is instructed to be selfish and pay no attention to the woman’s sexual needs. Instead, he must concentrate exclusively on the pleasurable erotic sensations coming from his stimulated penis. He shuts his eyes, he keeps his hands still, and he concentrates on his erotic fantasies and on what he is feeling. In this way, the threat to his sexuality is reduced, as he knows that the woman is happily helping him to overcome his sexual problem, which will in turn help her to obtain greater sexual joy.

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Neither the man nor his wife must have any idea who the donor is: they must never meet him knowing that he provided the semen. Nor may the donor have any idea who has received his semen.

The reason for the security is that confidentiality is essential as the child of the artificial insemination is the ‘natural’ child, in law, of the couple. It might be argued that by some chance the child might later have a child by its half-sister or half-brother and that this could lead to some genetic defect. This result is so unlikely (about a million to one chance of a genetic defect occurring) that it can be ignored. The couple need have no anxiety about this.

For legal protection both husband and wife must sign a document confirming that they understand and agree without coercion to the artificial insemination by the unknown donor. In some countries the legal status of a child produced by artificial insemination using a donor’s semen is unclear, but changes are occurring and A.I.D. has enabled a large and increasing number of infertile couples to enjoy raising a child of their own.

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