Medical Schools, Critics Clash Over Using Porn Films in Doctor Training

Lusty sex scenes flicker across screens in darkened rooms at medical schools nationwide each year, allowing doctors of tomorrow to overdose on a prescription of carnal knowledge.

Sexually explicit films made for educational use like “Who’s Doing It?” and “Playmates” are shown with the kind of pornographic films seen on 42nd Street in New York, such as an erotic animated version of Snow White and the Seven Dwarfs.

Students have been watching the films as part of sex education programs for more than a decade, attracting little public attention. But the practice has recently sparked fierce criticism that the material denigrates women.

Medical schools defend the programs, saying the films can be an effective tool to teach future physicians about sex and make them comfortable with the sensitive subject.

Citing illnesses like acquired immunization deficiency syndrome, educators say sexual dysfunction and sex-related maladies are a common problem and doctors must overcome prejudices so they can help their patients.

The films are usually shown as part of human sexuality courses, accompanied by workshops, discussions and lectures and are frequently coupled with segments dealing with sexual abuse and sexism.

One part of the program known at some schools as “desensitization” is aimed at helping students overcome inhibitions so they can discuss their patients’ problems without being easily aroused or embarrassed.

The programs vary, but at some schools students are bombarded with films in the hope they will become inured to the subject. One school has students watch nine explicit pornographic films simultaneously.

Critics, however, say the material is offensive, and question whether desensitization is necessary or desirable.

“They say it desensitizes people to sex. We say it desensitizes people to the abuse of women,” said Catharine A. MacKinnon, a visiting law professor at Stanford University and an outspoken critic of pornography.

“What I’m saying is if they are using pornography . . . then what they are teaching doctors is not simply sensitivity to sexual variance. What they are teaching doctors is to be numb to abuse when it is done through sex,” she said.

MacKinnon, who co-wrote a controversial proposal that would subject pornographers to civil lawsuits by equating their product with sexual discrimination, said there are better ways to teach doctors to be open-minded.

“I think the doctors should be sensitive to the way in which people express themselves sexually,” she said. “But this is the difference between the doctors being open and caring and responsive to people’s problems and the doctors being numb.”

Most medical schools created sex education programs during the 1970s. But a back-to-basics trend mixed with increasingly sophisticated students prompted many schools to cut back the courses in the last five years. Most schools, however, still have at least remnants of the courses while many have intensive programs.

“The emphasis throughout is tolerance,” said Dr. Richard J. Cross of the University of Medicine and Dentistry of New Jersey-Rutgers Medical School. “There are people who believe that masturbation is a sin. They are entitled to their opinions. But they shouldn’t let it interfere with how they treat their patients.”

Rutgers has one of the most extensive programs, a week devoted entirely to the subject, dubbed Sex Week by students. Pupils watch a series of films and hear lectures on topics including sterility, orgasm and homosexuality, then participate in workshops and discussions.

Most of the films used are made specifically for educational use and have, in fact, won praise and awards from educational groups.

“I think that if you went to a local video store and rented one of our films I think you’d be disappointed,” said Mark Schoen of Multi-Focus Inc., the largest distributor of the educational films.

“There is no film that is denigrating to either sex. Many of them are sexually explicit. Sexism is in the eye of the beholder. To some people, if there is a man on top, that’s sexist. The large majority of our population viewing our films would not consider them sexist,” he said.

The company’s catalogue describes “Sweet Dreams” as a “sensuous, sexually explicit” 13-minute film that “combines erotic fantasy with one woman’s masturbation pattern.” In “Playmates” a couple “obviously sensitive to each other’s desires” use “a variety of sexual techniques.”

“A Film About Sharon” is a 19-minute “mixture of documentary and erotically explicit sexuality” about “an attractive, educated and well-spoken woman who has achieved commercial success” as a pornographic actress.

Some films deal with teen-age pregnancy while others demonstrate the sexual practices of homosexuals, the elderly and invalids. Many are clinical, such as the 20-minute “Diagnosing Erectile Problems” and the 16-minute “Diagnostic Methods of Male Impotence.”

Feminists say they are more concerned with the use of commercial pornography than with films like Schoen’s.

“They tend to be, except in places where women have revised the material, your regular, rotten commercial pornography,” said Andrea Dworkin, a radical feminist writer who co-wrote the anti-smut ordinance with MacKinnon.

Cross, who retired last year after directing the Rutgers program for 18 years, said he used samples of commercial pornography only as part of an optional seminar dealing specifically with the subject.

“I have one (film) that deals with rape, but it makes me uncomfortable every time I see it and makes the people I show it to uncomfortable also,” he said. “That’s the point.

“We are strong believers of an egalitarian approach. We don’t believe at all in force and pressure. We spend a half-day on rape and other forms of coercive sex, and I think the students get it very clearly where we stand.”

Tufts University School of Medicine in Boston eliminated its desensitization program about five years ago--not because of any complaints but because it was not effective.

“We didn’t disagree with the premise. We want doctors to recognize they have their own feelings about human sexuality, and if they recognize that, they’re less likely to let that get in the way while counseling patients,” said Dr. Robert Kennison, associate chairman of the Tufts department of gynecology.

‘Sort of Matter-of-Fact’

“The theory is that it may be titillating to observe these films at first, but with repetition it becomes sort of matter-of-fact,” he said. “The theory does hold up, but for our purposes we didn’t feel it was the most beneficial use of time.”

Studies found that after viewing the films, about one-third of the students surveyed were less anxious about the topic, one-third were unaffected and one-third were more anxious, he said. But Kennison defended the practice.

“If it’s used in a proper educational setting, it can have a value,” he said. “We’re trying to educate people who have to deal with these issues. Sexual dysfunction is extremely common in the United States. If they (doctors) are not willing to ask the patients questions because they’re too apprehensive about their own feelings, then they’re not going to do their jobs.”

But Dworkin said much of the material is offensive, especially for the increasing numbers of female students.

“We’ve always had a very big problem of misogyny in medical schools,” she said. “They’re including some feminist stuff and think it counterbalances it, and it doesn’t. The point about pornography is that it changes men. It increases their aggression toward women. It changes their responses, and nobody knows what it takes to undo what pornography does.”

Dworkin also said she wondered whether some of the films made specifically for educational purposes contained material as offensive as that found in commercial porn.

“One of the things that was always surprising to me is that what people tell you they show is very different when they show it to you,” she said.

Pornography and Violence

The question of whether pornography causes violence against women has frequently been the focus of debate.

Dr. John Money, a professor of medical psychology who taught a sex course at Johns Hopkins Medical School in Baltimore, disputes contentions that doctors viewing pornography have any ill effects.

“Don’t you think doctors should know something about pornography?” asked Money, who included films dealing with sadism and masochism in his course.

“If you want to show how a lot of working-class women are treated by their husbands, you couldn’t do much better than that,” he said. “If you want them to know what sadism and masochism is, you expose them to it. But you do it in a moral setting. It has nothing to do with condoning it. When you show them pictures of someone operating on brain cancer, are you condoning brain cancer? No. You’re showing them how to treat it.”

Dr. Vernon Mark, a Harvard Medical School surgery professor who wrote a book with his wife criticizing the sexual revolution, said the use of explicit films in medical schools degrades men and women.

“The desensitization is demeaning and counterproductive,” he said. “If you’re going to help people with their problems, you have to help them as human beings.”

Mark said students should learn about sex, but sexually explicit films are unnecessary.

“Do you think medical students are so stupid they don’t understand the English language?” he asked. Harvard has no human sexuality courses.

But Sharon Satterfield, whose University of Minnesota program includes an intensive weekend in which students watch six hours of explicit films, said there is more degradation of women in mainstream media than in her courses.

“We very purposefully position the pornography we use with other films,” she said. “The whole aim of the discussion is to see the difference.”