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This case-control study involved infants and young children who masturbate and were referred to three pediatric neurology clinics between September 2004 and 2006 (n=13), and a similar control group. All children underwent basic laboratory investigations prior to referral. Other tests included electroencephalography (n=8) and brain neuroimaging (n=9). We measured dehydroepiandrosterone sulfate, 17-hydroxyprogesterone, free testosterone, estradiol, dehydroepiandrosterone, sex hormone-binding globulin (SHBG), and androstenedione in all participants.

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The median age at the first incident was 19.5 months (range, 4-36 months); the median masturbation frequency, 4 times/day; and the median duration of each event, 3.9 min. The subjects masturbated in both prone (n=10) and supine positions (n=3); two subjects used the knee-chest position. All subjects showed facial flushing; 6, friction between the thighs; 5, sweating; 9, sleeping after the event; and 12, disturbance on interruption. EEG was abnormal in one of eight subjects tested, and neuroimages were normal in all of nine subjects examined. The case and control groups had comparable levels of all sex hormones, except estradiol, which showed significantly lower levels in the case group ( P =.02).

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Masturbation in children seems to be associated with reduced estradiol levels, but not with other sex hormones. Further studies are needed to confirm our findings.

Childhood masturbation was reported by Still in 1909. It is characterized by self-stimulation of the genitalia frequently associated with unusual posture and movement, sweating, flushing, tachypnea, and typically begins in infancy and early childhood. Masturbation is a normal behavior in adolescence, occuring in 90% to 94% of males and 50% to 60% of females at some point in their lives; maturation of sex hormones predisposes to the activity. Previous reports on infants and early childhood masturbation are sparse with no attempts to identify the role of sex hormones in such a situation, despite the evidence that sex hormones are known to predispose to adolescentmasturbation behavior. In infants and young children, unusual postures and movements occur during masturbation and may be misdiagnosed as seizures, movement disorders, abdominal pain, colic, or other neurologic or medical problems. Extensive unwarranted investigations may be performed. To our knowledge, assessment of the levels of sex hormones as a possible predisposing factor has not been carried out before. The purpose of this study was to describe the clinical characteristics of masturbatory behaviors in 13 children referred to three different child neurology clinics in Jordan, to assess their sex hormones levels, and to compare these with that of a control group.

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This was a prospective study of all infants and young children referred to the participating pediatric neurology clinics between September 2004 and 2006, diagnosed as having gratification disorder. A data collection sheet was developed which included information on demographic characteristics, a detailed history on the features of the movements during masturbation, clinical examination, neurodevelopment assessment, as well as the levels of sex hormones (dehydroepiandrosterone sulfate (DHEAS), 17-hydroxyprogesterone [17OHP], free testosterone, estradiol, dehydroepiandrosterone (DHEA), sex hormone-binding globulin [SHBG], and androstenedione). All hormone levels were determined using commercially available kits as follows: DHEAS and 17OHP were measured by RIA, DHGA by immunoradiometric assay (Immunotech Marseille, France), free testosterone by RIA (Biosource Europe S.A., Belgium), estradiol by a microparticle enzyme immunoassay using an AXsym machine (Abbott Labs, IL, USA), SHBG by an enzyme immunoassay using a Cobas machine (Roche Diagnostics, Mannheim, Germany), and androstenedione by an enzyme immunoassay (DSL, Dallas, TX, USA). To assess the role of sex hormones in this condition, 13 age- and sex-matched controls were selected from children attending the same clinics for reasons other than masturbation. Blood samples were obtained from all controls and assessed for sex hormones using the same techniques as for the cases. The mean levels of the sex hormones were compared between cases and controls using the two-sample independent t test. Other tests performed included EEG (n=8), brain CT scan (n=8), and brain MRI (n=1). Five of the children were wrongly diagnosed as having epilepsy and were on a maintenance antiepileptic drug treatment prior to referral to our clinics. Basic blood tests included complete blood count, serum electrolytes, and liver and kidney profiles. Echocardiography was performed on all children before the referral. The ethics committees of the three institutes approved the study protocol. A verbal consent was obtained from the parents of all participants.

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Nyangatom woman

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For the most part Nyangatom are cattlemen, but a part of the tribe is agriculturist. Within their territories the tribe is divided into two categories, leading a completely different life. Those who live on the west bank of the Schutz Ionara ssXWQ
are engaged in farming, growing sorghum, maize, beans and tobacco. They also fish in the river. Apparently, this part of the tribe once lost all their livestock as a result of a natural disaster and was forced to adapt to a new reality. It’s impossible to raise cattle in the place where they live because of tsetse fly and that’s why the number of cattle they have today is very limited. The other big part of the tribe leads a semi-nomadic lifestyle, migrating with its large number of livestock in the Southwest of Ethiopia, as well as the territories of the Toposa tribe in neighboring Sudan.

Nynangatom woman

Nyangatom are divided into seven major clans and 20 sub-clans; every person belongs to the same clan as their father.

Generational change determines social organization of the Nyangatom tribe. Each generation is given its name. The earliest ancestors are called the Founders. Their sons are called Wild Dogs. They are followed by Zebras, Turtles, Mountains and so on. The oldest generation living today in a clan is called Elephants, followed by Ostriches and Antelopes. The youngest generation is called Buffalos.

Adult representatives of Nyangatom have their lower lips pierced – by ivory in men and copper in women. Nyangatom women wear skirts made of goatskins and the skirt is one of the hallmarks of the woman’s social status: its design and beadwork indicates whether a girl is married or not.

Also, Nyangatom women are easily distinguished from the other tribes of the Omo Valley by a large number of strands of beads on their necks. A girl receives her first strand as a gift from her father, then her husband gives her new strands of beads as a wedding gift (the number of strands signifies how much the bride is worth), and in the following years she receives more and more new threads as gifts from her husband. Thus, a middle-aged woman may have around 5-6 pounds of necklaces made out of beads and wood. Women never remove these ornaments, even during sleep (except when they wash them in the river), and the size of this bead collar is an indicator of their status and a symbol of their beauty.

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