Erwin J. Haeberle
This invited lecture, together with a live demonstration of the author's own e-learning courses, was given in Beijing's Great Hall of the People on Oct.16, 2004. The occasion was the 10th anniversary of the China Sexology Association.
As Prof. Wu Jieping told us in Hong Kong, the subject of sexual health had already been dear to the heart of the late Chou Enlai who, time and again, had advocated nation-wide sex education in the People's Republic of China. Today, thanks also to the work of the China Sexology Association, this goal is within reach.
Please, allow me at this time to add some personal remarks: At the invitation of Prof. Liu Dalin, I first came to Shanghai 15 years ago in order to help with the first nation-wide sexual survey in China. Since then I have been able to return several times and to witness the breathtaking speed of the current reforms together with their impressive results. I feel greatly honored to have been invited to this momentous forum.
Since I am now living in Berlin, this visit has for me an additional significance. As you may know, modern Western sexology originated in Berlin in the early 20th century. Berlin was the birthplace of the first sexological journals, organizations, congresses and, indeed, the first Institute for Sexology. The blossoming of this new science was the work of many men, but the most important of these was the Berlin physician Magnus Hirschfeld.
One lifetime ago - in 1930 - Hirschfeld embarked on a lecture tour around the world, introducing his new science to many countries from Germany to the USA, East Asia, India, the Near East, and back to mediterranean Europe. In the summer of 1931, this 2-year journey also took him to China, where he lectured to great acclaim at all Chinese National Universities. Indeed, an old photo shows him at the Central National University here in Beijing. This photo is an important historical document for a special reason: It also shows Hirschfeld's last disciple and heir - Li Shiu Tong, a young medical student from Hong Kong.
This Chinese student traveled with his German teacher for the rest of the lecture tour to India, Egypt, Palestine, Greece, Austria and Switzerland. Indeed, he was still with him in 1935, when Hirschfeld died suddenly and unexpectedly in France. Since his teacher died childless and in exile, Li Shiu Tong became Hirschfeld's heir in every sense of the word: He inherited his material possessions, and he also became his spiritual heir, trying to continue to work in the new science to which he had been introduced.
Unfortunately, at the time of Hirschfeld's death, his fate had already taken a tragic turn. As just mentioned, he had become an exile, because, in the meantime, the Nazi movement in Germany had become very strong. Hitler and the Nazis fanatically opposed all liberal sexual policies advocated by Hirschfeld and the other sexologists - sex education, gender equality, law reform, legal contraception and abortion, and anything else that stood in the way of their repressive and racist political aims. In fact, since Hirschfeld was both a socialist and a Jew, the Nazis had long chosen him as their special target, and, by the time he arrived in Europe, it had become too dangerous for him to return home. This put his Chinese student in an unexpected, puzzling and embarrasing situation which he cannot possibly have fully understood. Instead of beginning his intended regular studies at Hirschfeld's world-famous institute in Berlin, Li Shiu Tong now found himself in the company of an outcast, living in hotels, traveling from one European country to another, always hoping that the Nazi menace would pass, and never daring to enter Germany. Finally, in May 1933, both teacher and student were forced to abandon all hope: In a Paris movie theater they saw a newsreel showing how the Nazis, now in control of the German government, plundered Hirschfeld's institute and publicly burned his library.
When Hirschfeld died two years later in Nice, his Chinese student and heir was left with little more than some suitcases and a few books. As the general political situation in Europe deteriorated, Li Shiu Tong thought it wise to move to Switzerland, where he contined his medical studies at the University of Zurich. During the Second World War, he even moved to the USA and studied at Harvard for a few years, but, after the war, returned to Zurich. At that time, he could have claimed the remaining inheritance in Berlin, but refused to do so. Instead, he eventually went home to Hong Kong, where later researchers lost his trail.
In 1990, on the occasion of the Hong Kong "Conference on Sexuality in Asia", both Prof. Ng Man Lun and I tried to find Li Shiu Tong, because we suspected that he might still be alive. We even brought my exhibition about the "Birth of Sexology" from the University of Zurich to Hong Kong (1). This exhibition also contained his photos, but all our efforts to find him were in vain. Only a few months ago this year did we learn from other sources that he had indeed still been alive at the time. He had emigrated to Canada and died in Vancouver in 1993 at the age of 86. He never knew that, for many years, both Chinese and German scholars had been looking for him as the most important link to our common sexological past. He could have told us much that we still would like to know, but now will never find out.
This first promising start of Chinese-German cooperation came to nothing because of the Nazi dictatorship and the world war it started. However, in the meantime, we have begun a second attempt at working together, and, thanks to the latest electronic technology, we now have a better chance than ever to succeeed far beyond anything Hirschfeld and Li could have imagined. Indeed, the global future of sexology looks very bright, and if we only dare to seize the opportunities now opening up before us, we can lead a world-wide revolution in sexual health education.
Many people believe that the electronic revolution will also mean a revolution in human sexual behavior. They hope or fear that the internet will drastically alter sexual relationships and that it will mean the end of courtship, marriage, and the family as we know them. However, I do not share this view, and I believe that most of my colleagues who know the history of human sexuality will agree with me.
After all, the sexual side of human nature is the result of a very long and gradual process of evolution, and, as illustrated by ancient stone carvings and cave paintings in China, Africa, and Europe, the sexual behavior in the earliest days of the human race was, in fact, not very different from that of today. Of course, the social organization of sexual behavior, just as that of any other human behavior, has changed a great deal in the course of time. However, this does not mean that the behavior itself has changed. While there may still be some doubt about the exact meaning of prehistoric stone carvings, there is none about the first literary records. As long as man has recorded his life, he has also recorded his sexual life, either directly or indirectly, and it has proved to be the same at all times and all over the world. However, slowly and painfully, man has, over thousands of years, also learned that some ways of organizing his life are more intelligent than others. Thus, he has, time and again, broken taboos, abandoned previous assumptions and changed traditional laws and customs. Some such breaks with tradition may indeed become necessary in our new age of global communication. These breaks will not change human sexual behavior as such, but they will help us in facing the challenges of the future.
One major change is easy to predict: There will be more equality between women and men. In other words, the demands of the Beijing International Women's Conference of 1995 will gradually be met. This will not happen in all countries at the same time or at the same speed, but the general trend seems to me irreversible.Allow me to give you a few additional examples:
Last month, Turkey passed a thorough reform of its criminal law. Originally, this included a new law making adultery a crime. However, since Turkey is now also applying for membership in the European Union, it was told by its current members that no admission was possible as long as Turkey had such a law. The Turkish legislature therefore dropped its adultery law from its reform package. Needless to say, neither a new law nor its absence will change the incidence of adultery in Turkey. The experience of the other European countries simply forced the Turks to understand that it is unwise to send adulterous husbands and wives to prison. This would have created more problems that it could possibly have solved.
Another example is the decriminalization of homosexual behavior in many Western countries. Again, experience has shown that making such behavior a crime forced many people to hide and lie, and that such lies were a serious obstacle to AIDS prevention. They made it nearly impossible for epidemiologists to obtain reliable data. Therefore, public health officials in most countries now argue for an end to all discrimination of homosexuals. Indeed, many politicians in the USA and Europe now openly acknowledge that they are "gay", and this has in no way harmed their careers. On the contrary, large cities like Paris, Hamburg, and my own hometown of Berlin now have popularly elected homosexual mayors. In the case of the city states Hamburg and Berlin, they are, in addition, also state governors.
Still another example is the decriminalization of prostitution in most European countries. Prostitution has often been called "the world's oldest profession", and indeed it has always existed in all parts of the world. Attempts to suppress it through criminal sanctions are now more and more proving to be counterproductive. However, since prostitution has so many different facets and implications, Europe has not yet found a common approach to it. Sweden and the Netherlands, for example, are taking very different tacks. The Netherlands try to make prostitution a regular job with health insurance and pension plan, Sweden tries to suppress it altogether by punishing the prostitutes' customers. However, in the long run, some common policy will have to evolve. After all, the fight against the present epidemics of AIDS and other sexually transmitted diseases can be won only if both the prostitutes and their clients cooperate with the health authorities. Such cooperation cannot be obtained, however, if the whole sexual transaction remains hidden in the dark of illegality.
In short: Human sexual behavior has long proved resistant to change in spite of all past and present revolutions. Only the way societies deal with them changes and is is likely to change a great deal more. We will all be forced to become more rational about sex. Being rational here means being able to learn from experience. We will have to avoid adding unnecessary problems to the many problems we already have. However, at the same time we must realize that, whether legal or illegal, sexual behavior will develop some new forms and will provoke new social reactions.
For example, many formerly stigmatized sexual minorities will become more respectable and accepted by society, because the internet allows them to present their case to the public and educate it about their problems and aspirations.These efforts are already bearing fruit in many countries where doctors have now learned to be both more sensible and more sensitive in treating intersexes and transsexuals. Indeed, in the meantime, many governments haven passed laws allowing transsexuals to change their personal identity papers according to a new gender identity. As for homosexuals, there is a growing trend to allow same-sex couples to enter legally binding partnerships or even to marry. In the USA, this is still a controversial issue, but in several European countries same-sex marriages are already a fact, and, after its recent change of government, Spain is about to give them full legal recognition as well. Does this mean a change in European sexual behavior? Not at all. However, it does mean a change in the way we react to it. For some, it even means revolutionary change, especially for certain religious traditionalists. Still, in an increasingly interconnected world, such changes are unlikely to remain isolated incidents. In any case, I am not arguing that all possible and likely changes are going to be beneficial. I am saying only that there will not be any great changes in human sexual behavior as such. This is, at the same time, a reassuring and a sobering thought. After all, not all sexual behavior was, is, or will be good. Much of it has always been and will remain destructive, and we still have the obligation to do something about it. And here I am able to introduce a hopeful note: The electronic revolution will enable us to act preventively and promote sexual health better and more widely than ever before.
In 1975, the first modern definition of sexual health appeared in an official document of the World Health Organization (WHO), which also made some recommendations for its protection (2). Since then, several additional definitions have been provided by the WHO and other sources (3), and there is now general agreement that the promotion of sexual health should be considered a priority in every country. This insight has been growing for many reasons, but one of the most important is the current AIDS pandemic which threatens the economic and political stability in several regions of the world. Since, so far, there is neither a vaccine nor a cure for AIDS, global sexual health education is the only promising option left.
On the present occasion, I do not want to go into the details of sexual health definitions, WHO recommendations or suggested AIDS prevention measures. Instead of talking about problems, I would like to call your attention to possible solutions, i.e. to the enormous potential of the new electronic media for providing sexual health education around the globe.
Indeed, the internet has now made it possible to make scientific knowledge available to everyone. Especially in regions without adequate schools, colleges, universities, and libraries, the new electronic technology can help us to reach hundreds of millions of highly intelligent and highly motivated young people who, until now, never had a chance to learn. In other words: We are standing at the threshold of a true revolution that will transform the traditional ways of teaching and learning, and that will reach very large, formerly disenfranchised segments of the world population. However, this revolution can be successful only if the present guardians of knowledge - the scholars, researchers, teachers, assistants, librarians, archivists, and university administrators - understand its true implications and act accordingly.
Today, I would like to mention just a few aspects of the electronic revolution. First, I will point to some of the new general principles of transmitting knowledge and then try to apply them to the specific case of sexology.
Saying that the internet is a global medium is stating the obvious, but many people still do not see the obvious or understand what it means. Countless university web sites all around the world are still nothing more than extended electronic business cards. They just provide their own addresses, explain their organizational structures, list their tuition costs, fees, and teaching schedules, and all of this in only one language - that of their own country. Sometimes they add a few photos of the campus or of important faculty members, but that is all. It never occurs to them to supply the world with useful scientific information and to do so simultaneously in several languages. They simply do not consider it their responsibility to offer free access to the knowledge they themselves possess. On the contrary, they consider it their own intellectual property which must be hoarded and then sold to their own student customers at a price.
However, in the meantime, the internet already offers an enormous amount of free scientific information. Not only are most religious, literary, political, and scientific "classics" freely accessible, but also many current scientific journals, governmental and non-governmental reports, directories, dictionaries, and encyclopedias. Great international organizations like the UN and the WHO, national services like the American CDC, and countless private foundations, organizations, and interest groups provide position papers, research findings, and scientific news. And, needless to say, many important newspapers also have free internet editions. In short, there is already an enormous wealth of information freely available. Indeed, we can be confident that the future will offer still more. A fast growing world-wide movement is now demanding "open access" to all scientific information, including that which is still being kept inaccessible today.
The demand for "open access" is increasingly finding support among scientists and even among politicians who, in several countries and even at the international level, are preparing new legislation that would take this demand into account (4). How far these legal reforms will eventually go, remains to be seen, but one thing is already clear: More and more academic authors today publish directly in the internet without expecting any royalties. They'd rather have more readers than more income and, in any case, much traditional academic publishing never provided any income to begin with. At the same time, financially starved libraries are reducing their book purchases and canceling expensive journal subscriptions. Not only that: Many libraries have started to digitalize their own holdings in order to make them available in the internet. In some cases, only their own students are permitted to read them, in other cases world-wide unrestricted use is the ultimate goal. Indeed, the Massachusetts Institute of Technology (MIT), with the financial support of two American foundations, is already offering the materials of 500 of its courses freely in the internet (5). As the MIT president put it: "We hope that...we will inspire other institutions to openly share their course materials, creating a world-wide web of knowledge that will benefit mankind." Interestingly enough, the MIT is now being joined in this endeavour by CORE, a consortium of Chinese colleges and universities that, over the course of the next five years, will translate all of the MIT courses into Chinese and also offer open and free access to materials from Chinese educators (6). Again, I do not want to go into further details about this current global trend. Let me just say that it provides all of us with new opportunities that were unthinkable even a few years ago.
Among many other things, the internet is also revolutionizing distance education. Electronic learning - the so-called e-learning - has created entirely new opportunities for both students and teachers (7). There are already a number of online universities without a campus, lecture halls, dormitories, libraries, or other physical facilities except an office building and a large electronic server. Faculty and staff can reside anywhere, since they communicate with their students only online. These students, in turn, may also live anywhere, even in very distant foreign countries. In return for their tuition and fees, they are put in touch with their professors and fellow students, read their course materials, send in their assignments, take their examinations and receive their degrees - and all that by simply sitting in front of their PCs at home. So far, the subjects taught range from mathematics, engineering, economics, business administration, accounting, politics, law and criminology to psychology, nursing, and health administration. Even some traditional universities are now discovering this market and offer their first distance learning programs online, for example in sexual health education. The way they are going about it may still be half-hearted, shortsighted, inconsistent, and self-limiting, but they are setting a precedent that deserves a closer look.
Three years ago, in 2001, the World Health Organization (WHO) together with the Pan-American Health Organization (PAHO) and the World Association for Sexology (WAS), issued "Recommendations for Action" designed to promote world-wide sexual health. Two of their stated goals were "comprehensive sexuality education for the population at large" and "education, training and support for professinals working in sexual health and related fields". Toward this end, the recommendations spell out both the requirements of such education and the means to fulfill them. Indeed, the document proposes specific basic curricula which only have to be copied by interested institutions and organizations. Needless to say, they are also freely available in the internet (8).
This has opened up a great future for sexology. After all, our work has always been interdisciplinary and international. We are standing ready to heed the call, and we do not have to "re-invent the wheel". The general principles have been laid down, the standards have been established. All we have to do is combine our individual efforts, follow the blueprint offered by the WHO, and the internet will provide us with a global audience.
However, in order to reach this audience, any serious effort must observe two basic rules:
The first of these rules is all too often violated by incomprehending university administrations in the erroneous belief that only restricted access to "authorized" users can guarantee the necessary income. The second rule is usually violated by uninformed content providers who simply buy anything offered to them by profit-oriented designers and software suppliers. The fact is, however, that most additional technical gimmicks are unnecessary and, in any case, shut out most of the very students one is trying to reach.
In contrast, a future-oriented, truly global e-learning program would offer freely accessible content, a simple design, and an easily understandable structure. Only this way can one reach the many millions of potential students in remote, poor, or underdeveloped countries. And it is precisely this enormous, steadily growing number of people that needs the courses most. On the other hand, once they have been reached, they can make a decisive difference in the state of world-wide sexual health, because this difference will be felt in many countries at the same time.
The vision of free global health education will, of course, raise an interesting question in many people's minds: Who will pay for the cost? To this question, there are two answers.
1. The first answer is provided by several current examples. I have already mentioned the foundation-supported pioneering role of the Massachusetts Institute of Technology (MIT). Another project is closer to our own area of interest: For the last several years, the Harvard Medical School has been providing free information in the internet about all aspects of illness and health, including sexual health (9). This information is so accurate, so well presented, and so comprehensive that Harvard has pre-empted all possible competitors and now maintains an unchallenged position as the Nr. 1 source of information about any possible health problem, from the common cold to cancer. This free service is being supported by a powerful sponsor - a major life and casualty insurance company. The sponsor does not try to influence the web site content and is, in fact, beyond suspicion in this regard. Indeed, the whole project can serve as a model for others. Still, the free information from Harvard is available only in English, and it is not designed to be used in any formal training. So far, no major sponsor has supported free regular online courses, perhaps because no university has yet developed them to a point where they deserve world-wide suppport.
2. The second answer to the question of financing is simple and obvious, although it runs counter to all conventional thinking: Universities should invest in the development of free courses and then reap the financial rewards as they attract paying distance students from every corner of the globe. It's really very simple: The internet may eventually make all scientific information freely available, but only universities can award academic degrees. In other words: Once potential students have seen the courses and begin to appreciate their quality, they may want to study them as part of a regular Bachelor's, Master's, and even doctoral program. Distance students who then want to enroll in such a program will have to meet certain requirements, register, and pay tuition and fees for a certain number of semesters. The university, for its part, can add its own materials to the courses as well as an interactive element for mutual communication. Since the number of potential students is so great, the tuition can be kept so low that it remains affordable even in poor countries. Even so, the income derived from these new distance students may be much higher than anything that can now be earned on campus.
The whole procedure is similar to one used successfully for many years by the Wen Hui Daily Newspaper in Shanghai. It produced printed materials and sent them out in installments to interested teachers who wanted to be trained in sex education. They gladly paid for the materials, studied them and finally took a central examination. Those who passed, were given a diploma. This system may still be workable to an extent, but the difference today is the global reach and enormous speed of electronic communication. More students can be trained faster than ever before.
To be sure, the great number of potential electronic students presents a challenge to the traditional way of doing things. However, now is the time to start thinking about how to meet this challenge. If we are serious about our cause of promoting sexual health world-wide, we must find ways to deal with a possible avalanche of serious student applicants not only from our own countries, but from many other countries. Should they all be turned down, simply because we are still unprepared?
Obviously, since the same free courses may form the basis of different programs in different countries, there is bound to be some competiton between universities trying to attract the best or the largest number of students. Here, a number of factors will come into play - the university's name and reputation, the academic record of its professors, the price of tuition, the duration of the program, the quality of its interactive components, the individual attention given to each student, etc. Given the right combination of factors, formerly unknown small colleges may, in certain disciplines, rise to positions of international prominence, and schools that are now world-famous may fall behind. In any case, those universities that insist on developing their own restricted programs, must know that they nevertheless remain in competition with the freely available courses. After all, they will be freely available to their own paying students as well. These will compare all internet offers and continue to pay tuition only if their restricted courses are better than the others.
In addition to colleges and universities, professional organizations will increasingly use e-learning programs for the continuing education of their members. Many of these organizations will offer certificates or diplomas for completing their courses and thus, at a certain level, will compete with regular academic programs. In some ways, this has already been true for some time, but the internet will increase the options on all sides and sharpen the competition.
In the meantime, we should understand another consequence of the electronic revolution: Every professor, whether he knows it or not, has now been put in direct competiton with the best in his field. In a sense, of course, this has always been true. Traditional libraries have always made international comparisons possible and allowed students to find out whether their teachers met international standards and were up-to-date. However, the internet has made such comparisons much easier: They cover much wider areas and can be made instantly. In the future, professors will find themselves lecturing before students who can quickly check every statement they hear against a great number of authoritative sources in the internet. Many will do just that and simply leave the class if it does not measure up to the higher standards they have found elsewhere.
The electronic revolution has also called the traditional concept of marketing intellectual property into question. For example, I believe that all attempts to sell scientific information in the internet are doomed to failure for two reasons:
In the internet, no information monopoly is possible, and no scientific knowledge can remain restricted to a few privileged individuals. Therefore, new ways must be found to protect the interests of authors and to reward their efforts. Musicians, film makers, and other artists have been struggling with the problem of "electronic piracy" for several years now, and eventually they may find a satisfying solution. I will here make only a few suggestions with regard to sexology.
Large sex research projects have always been funded by governments or foundations, and thus had usually been paid for at the time of their publication. True, in some cases, some sex surveys became bestsellers and made money for publishers and authors, but these cases have always been rare. As a rule, sex research has been, and still is, published in scientific journals, and no author ever receives any payment at all. The conclusion is logical: In the future, authors will either publish their work themselves in the internet, or they will, together with other authors, found freely accessible electronic journals (10). They still won't make any money, but they will have many more readers than before. Such journals cost very little to produce and are easily funded by the membership fees of sexological organizations, just as many printed journals are today.
In the same spirit, the great international federations - the Latin-American, European, and Asian Federations of Sexology - should consider working together on some global projects like world-wide directories, specialized curricula, bibliographies, special dictionaries and encyclopedias. Good models of such projects exist, but they need to be updated and expanded, and, in the long run, this can be assured only by continuously cooperating teams (11). Exceptionally large projects could also be initiated and coordinated by the World Association for Sexology (WAS).
Any of this is, of course, possible only if universities, government agencies, and foundations are prepared to modernize some of their administrative structures. For example, once researchers become their own electronic publishers, they need programmers and designers, and these new positions need to be created. Traditional university publishing houses - the university presses - can be helpful, provided they themselves "open a second, electronic front". After all, it is much easier and much cheaper to update and amend electronic texts than anything printed on paper. Authors can now instantly correct anything they have written. If they have a large, world-wide readership, the can be rewarded with higher pay. Professors with many distance students can get corresponding salary increases. As for funding these new ventures, I have already mentioned sponsorships and income from distance learning. However, even "open access" courses and publications can have commercially viable "spin-offs", and this possiblity deserves to be explored. Depending on the case, one could even accept some discreet advertising as long as there is no conflict of interest or a suspicion of undue influence. Finally, both national and international agencies are called upon to support world-wide electronic education, if for no other reason than that is cheaper and more efficient than any alternative.
The fact that, thanks to the interent, free health information can now be sent to the farthest regions of the globe has some far-reaching implications that are not immediately apparent, but must be spelled out. For example: E-learning courses can be copied on CDs and distributed to people who have a computer, but no internet access. Indeed, properly designed courses can be printed out page by page and thus provide a free textbook which, in turn, can be multiplied with the help of a simple copying machine. More importantly: In the future, the courses can appear on the screens of mobile phones which are already in the process of acquiring more and more functions of our present personal computers. Again, if we are at all serious about promoting world-wide sexual health, we must prepare for this future now. There has never been a similar opportunity to reach so many people so easily and so quickly. Especially young people deserve scientifically sound information about all aspects of sexual health, including the STDs and their prevention. We can provide this information, and we now have a moral obligation to do so.
At the same time, we must realize that, once the information is "out there", we no longer have any control over it. In the case of e-learning, we must get used to the idea that anyone anywhere can teach our courses. Teachers in many countries may, without any preparation, and without telling us about it, project our courses on a classroom wall and then, per simple mouse click, move their students through the content. No more textbooks, no more writing on blackboards, no more slides, no more transparencies - it's already all there on the screen. The students, in turn, no longer need to take lecture notes, but can repeat the lessons at home as often as they wish. If they should miss a class, they can find it and repeat it on their PC.
This raises the question whether certain classes should even be taught any longer in traditional classroom settings. It is perhaps better to convert all basic and introductory classes into an e-learning format and to reserve all face-toface interaction between teachers and students for seminars or even advanced seminars. Certainly, excessively large classes in huge auditoriums are no longer justified. Since they do not allow for any interaction anyway, they are better taught in the internet, where students can study them at their leisure.
No matter how universities handle the new challenges, we as scholars and scientists should stay focussed on the ultimate goal of all knowledge gathering and knowledge transfer - the betterment of the human condition. Here, the internet means a giant leap forward for mankind. Sexologists everywhere should, wherever possible, cooperate with globally active organizations like the UN and WHO. For example, we can prepare whole online libraries on sexual health to be used free of charge in developing countries. Or we can offer needed translations of texts and courses that are already freely available in the internet. Such translations can be made by sexological students as part of their assignments and thus do not have to cost our universities anything. In other words, taking advantage of the internet, we do not always have to wait for funding to start internationally useful projects. Instead, we can make them part of our academic routine.
Our Archive for Sexology in Berlin has been doing just this for the last 10 years, and we would welcome any cooperation that any of you can offer (12). In fact, in producing our own free e-learning courses, we have already successfully cooperated with an American sexological organization, a German and a Hungarian foundation, and the Hong Kong Department of Health (13). Thus, even this modest example indicates the direction in which we can and should move. The electronic revolution has made geographical boundaries and barriers irrelevant. Thanks to the internet, everyone can now easily cooperate with everyone else, and together we can instantly reach a global audience.
Only two barriers remain: Language and intellectual comprehension. We should therefore make every effort to provide sexual health information in as many languages as possible and to provide it for different educational levels from kindergarten to graduate school - work enough for all of us!
I realize that, by implication, I am arguing here for a "communism of knowledge": "To each according to his needs, from each according to his abilities" - and all this without first thinking of profit! There are many who consider this hopelessly utopian. However, we should remember that even capitalism can sometimes produce almost socialist results, and that it has always worked in both direct and indirect ways. It has always rewarded innovation, and all innovations have eventually become affordable to more and more buyers. Prices drop as both demand and supply increase. As a result, the market expands, and the next cycle of innovation can start on a broader economic base.
Thus, over the last 500 years, education, once the privilege of the few, has more and more become the right of the many. From a few large, hand-written and hand-illustrated, leather-bound parchment volumes in inaccessible libraries to printed books and their mass-produced popular softcover editions, the transfer of knowledge has become both cheaper and more democratic. In this sense, the internet is simply the latest in a long line of technical innovations that have reached ever larger segments of the population. From the private tutoring of princes to free public schooling, education has developed into the "great leveller" of societies. The goal of providing knowledge "to each according to his needs" may still elude us, but we are now closer to reaching it than ever before in human history.
Like it or not, we are finding ourselves in the midst of an irreversible and accelerating process of globalization. In the economic sphere, this has produced both winners and losers, but in the sphere of education this need not be so. On the contrary, I see at least us sexologists in a win-win situation. The present globalization of knowledge is bound to benefit especially those who were formerly excluded from any participation in the world's intellectual life. Thanks to the internet, we can now communicate with them, give them the latest scientific information, and thus turn millions of losers into winners. The cost of doing so should be considered an investment that will eventually pay all of us enormous dividends. Our immediate profit is mostly an indirect one: Increased knowledge can lead to an improvement of living conditions. Increased sexual knowledge can certainly improve sexual health.
Still, there is reason to worry: Many formerly localized sexual health problems are now also acquiring global dimensions. Actually, one might say that our increasing educational opportunities are arriving just in time to adress the simultaneously increasing threats to the world's sexual health. Indeed, both the problem and its solution are merely two sides of the same coin. For example, the new epidemics of sexually transmitted diseases in various parts of the world, and especially the AIDS pandemic which now threatens the social stability of whole continents, are fed by the same globalization that is giving us the means to fight them. Business travel, tourism and migration on a scale never seen before in human history help spread the diseases all over the world with the speed of modern ships, buses, trucks, trains and airplanes. With our fast internet connections, we do have the means to catch up, even to gain on them und pass them, but the outcome of the race is by no means certain. Ultimately, it will be depend on our adaptability. Will we learn quickly enough how to use our new electronic tools? Will we be able to modernize obsolete academic structures in time?
As for myself, I am optimistic. Standing here before you as a visitor to a country on the move, a country that itself exudes optimism, I believe that China can and will play a pioneering role in the promotion of sexual health. Here, more than in Europe and the USA, the evidence of rapid progress is all around us. Within the next decade, China will have more people using the internet than any other country and therefore can take the lead in its practical application.
In the early 1930's, it took Magnus Hirschfeld two years to introduce his new science to the world, and in order to deliver his lectures he had to travel by boat once around the globe. Today any of us can achieve the same goal in a few minutes by simply hitting a few buttons on a computer keyboard. Hirschfeld had a single Chinese student, whose efforts were eventually frustrated by one dictatorship in one country that destroyed the new science he wanted to study. Today, this science has taken root in many countries, and Chinese students interested in sexology can now stay home and study it in e-learning courses. The early sexological books could be burned; the internet is available everywhere and therefore indestructible.
Hirschfeld had summarized his ambition, the guiding principle of his entire life, in the motto: "Per scientiam ad justitiam - Through science to justice!" At the time of his death, he seemed to have failed, and his student must have felt utterly discouraged. Today, we stand ready to try again, remembering the ancient admonition of Confucius "The love of justice without the love of learning will lead to harshness and abuse." Let us soften such harshness and stop such abuse! Let us honor the memory of the two sages: Let us help all those who would love to learn and whose access to knowledge is still unjustly being denied!
1. Erwin J. Haeberle "The Birth of Sexology 1908-1933"
2. World Health Organization (WHO), "Education and Treatment in Human Sexuality: The Training of Health Professionals", Technical Report Series Nr. 572, 1975
3. Sexual Health:
4. Open Access:
7. Implications of the electronic revolution:
9. Harvard University Medical School (Intelihealth),
10. Examples of free electronic journals:
11. For examples see "Global Projects" at
13. "E-Learning Courses in Sexual Health",