DAZED AND CONFUSED

Masturbation, penis size, rough sex: What Indians ask doctors online since no one will tell them at home

Quartz india
Quartz india

Even before Saurabh Arora got his online healthcare platform off the ground, the former Facebook data scientist had an inkling of what Indians might want to ask doctors—especially if they could send questions via a smartphone app and in complete privacy.

The low-hanging fruits, as Arora described them, were mental health, women’s health, and well-being of children. But the subject that would probably provoke most curiosity, Arora felt, was sexual health.

Arora’s instincts were not off the mark. Two years after the launch of Lybrate, an online doctor database that connects physicians to patients through a mobile app, user data from the platform shows that an overwhelming number of Indians have many, many questions about sex.

Lybrate allows users to post general health queries, consult doctors in real time, search for doctors in the neighbourhood, and book appointments online. Users can choose to remain anonymous for online interactions.

Lybrate, of course, is not entirely representative of India’s patient population. But with an enrolled base of 100,000 doctors who interact with a daily patient load of 200,000 individuals, according to the company’s estimates, the user data still provides a significant insight into what health issues Indians are concerned about.

“I’m sure these discussions are not new,” Arora said, referring to the overwhelming interest in sexual health among Lybrate’s users. “Particularly in metros, the need has been there, and it has been circulating in private groups, one-to-one phone conversations, and things like that.”

Conversations around sex are still largely taboo in India. Sex education is not part of the curriculum in most schools. Few parents will openly talk about it and even doctors can be hesitant to ask patients about their sexual habits.

On the other hand, the environment that many young, smartphone-wielding Indians grow up in involves a liberal dose of pornography. Indians—and not just the men—are among the world’s most prolific consumers of online porn, with a special liking for smut involving “Indian bhabhi,” “Indian wife,” and “Indian aunty.” Obviously, all of this happens behind closed doors with little room elsewhere for serious discussion about sex.

So, in a country where over 40% of the population is under 20 years of age, people seem to be taking the discussion online. And platforms like Lybrate, which allows individuals to consult doctors without necessarily surrendering their privacy, provide a window into that exchange.

Lybrate’s data shows that across tier I, tier II, and tier III cities, the most common questions are on erectile dysfunction, premature ejaculation, menopause, and low libido.

Major categories of sexual health queries across Indian cities

Cities Male Female
Tier-I: Delhi, Mumbai, Chennai, Kolkata, etc. Masturbation, erectile dysfunction, premature ejaculation, effect of diabetes on sexual life, infertility Contraception, infertility, medical termination of pregnancy (induced abortion)
Tier-II: Bhubaneswar, Ranchi, Chandigarh, etc. Penis size, unsafe sex, right age for sex Contraception, abortion
Tier-III: Bhilai, Shimla, Aligarh, Guntur, etc. Stamina for sex, erectile dysfunction, premature ejaculation Unwanted pregnancy, forceful sex, conceiving during sex (very few queries on contraception)

The absence of an open conversation about sex and sexuality in India is an overwhelming concern for sex educators like Anju Kishinchandani who focuses on educating school-going children in Mumbai. For the lack of better options, children are turning to the internet for answers and there, pornography is often the first thing they find.

The recent smartphone boom in India, the world’s second largest smartphone market where 77% of users aged between 15 and 24 years surf the internet every day, has made matters worse.

“It’s very, very scary,” said Kishinchandani, “If they (children) are learning about sex and sexuality mostly through porn films, then they’re getting a very, very warped view because what they’re seeing there is not reality.”

The extent of misinformation can be frightening. Kishinchandani, for instance, recalls teenagers aged between the ages of 16 and 18 explaining how porn has shaped their assumptions about contraception.

“I’ve had children of that age group tell me ‘Why are you saying that we need to use contraception? Because when we watch porn films on our phones, those people don’t use contraception,’” she said.

Silence over sex

Meanwhile, parents are still unwilling or unable to broach the topic with their children. “Parents are still unfortunately clueless,” said Kishinchandani. “A lot of them want to talk to their kids but they don’t know how, so they don’t end up talking to them.”

The taboo is so overwhelming that even doctors sometimes hesitate to ask their patients about their sex lives. “They (doctors) say, ‘how can I ask? They (patients) might find the question irrelevant. They may think that I’m raising too personal a query’,” said Rajan Bhonsle, a sexologist. “This open dialogue between a parent and child, the teacher and student or a doctor and patient has to happen.”

The consequences of a lack of dialogue on sex can be serious.

“I meet people in their 40s and 50s and 60s, when they have avoided getting into relationships or getting married only out of some myths and misconceptions they carry about themselves, or about the sexual act,” explained Bhonsle, also a professor at the department of sexual medicine at Mumbai’s Seth GS Medical College and KEM Hospital.

Then, there is the possibility of individuals developing fetishes, paraphilias (abnormal sexual behaviour), and fixations related to sex, according to Bhonsle, only because they were not informed at the right time in the right manner.

The obvious risk of sexually-transmitted diseases, including HIV/AIDS, is also aggravated by the silence around sex.

Stigma and crime

Suppression of an accessible discussion on sex in India may have an even more wide-ranging manifestation: the endless wave of sexual crimes against women.

“This kind of taboo around talking about sex means people don’t understand what sexual relationships are about,” said Paromita Vohra, founder and creative director at Agents of Ishq, an online sex education project. “Because when there is a silence on a subject, then all kinds of hierarchies continuously get played out. And all of the stigma also (gets) attached to things.”

Men in India, Vohra explained, often have no idea what women’s pleasure is, what women’s consent entails, and how to negotiate that consent. So when they are rejected, it sometimes translates into violent reactions, like acid attacks or other acts of aggression.

Also, among women, who usually do not have space to speak about their own sexual desires and comfort, there is little awareness. “When you don’t ever talk about what is a healthy sexual relationship or a healthy sexual interaction, how do you learn to recognise it?” Vohra asked. “How do you learn to say, ‘No, this is not OK for me?’”

In a country where 95% rape accused are family, friends, co-workers or persons known to the victim one way or the other, this lack of information about sex—and stifled discussion on the subject—can evidently be dangerous.

And that is why the conversation that platforms like Lybrate are provoking is important. It is a fact that Arora recognises, although he is also acutely aware of its limitations.

“Tools like ours are obviously a great help but we understand that we cannot fulfil everything,” he said. “We still believe that to truly solve the problem, more and more people should know (about the subject). But more and more people should become aware at an earlier stage.”

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