Society reserves few spaces for men to air their insecurities. Opportunities to do so become even scarcer when it comes to matters of sex and intimacy. There is one place where men commonly reveal their truth. The professionals you’ll find there are bound by oath to perform a service for those who come to see them. It’s a judgment-free zone where privacy is guaranteed. It’s called the urologist’s office.
Dr. Abraham Morgentaler understands this. He opened his first clinic in 1999 and today he is the director of Men’s Health Boston and is an associate clinical professor of urology at Harvard Medical School. When men come in to have their equipment inspected, they talk about how it’s used and how it performs. The discussion touches on all matters of sex and intimacy. And, according to Morgentaler, much of the information that flies around the four walls of the exam room stands to shatter long-standing beliefs regarding performance and the way men experience pleasure. His book, The Truth About Men and Sex: Intimate Secrets From the Doctor’s Office, explores the science of male sexuality and insecurity and shares stories of men who have come into his room. Fatherly spoke to Dr. Morgentaler about his new book and what society generally gets wrong about men and sex.
So really, what can a urologist tell us about male sexuality that we don’t already know?
I often joke that I think of myself as a “psycho-urologist.” The reason I say that is because after you’ve been dealing with male sexuality for as long as I have, you’ll see that there is much more to this issue than just the biology of what’s working and what isn’t. What happens behind closed doors with my patients is really so different from the stereotypes of men that appear in movies, in stories, in newspapers, et cetera. And I thought it was worth sharing that.
Of all your professional observations about male sexuality, what might surprise readers the most?
We tend to think of men as being always ready for sex, always interested and almost exclusively concerned with their own pleasure. And that may be true for some men, especially when they’re younger and haven’t really emotionally been involved in a relationship. But once a guy is in a relationship and cares about his partner, men typically care more about their partner’s pleasure than their own.
For example, I see men who have been married for some time and maybe now they have a problem because of age, or erections, or whatever. Often I hear these guys say, “I feel like I’m letting my wife down.” They’ll say sex was an important part of their relationship and they feel like they can’t contribute their part to it any longer. They feel “unmanly” because they can’t provide for their partners in that way. They feel “unmanly” because they cannot fulfill their role as a sexual provider.
How else might the drive to perform as a “sexual provider” manifest itself?
We see men routinely who may have adequate erections, but they want something for a firmer erection. That alone sort of counters the stereotypes that are out there. What one has to understand is that the sensation for a man doesn’t change much whether he’s extremely firm or a little less firm than ideal but still able to have intercourse. The orgasm is going to be the same.
So what’s the firmness about? What’s that hunger about? Why do they go to the doctor, take time out of their day, go to the pharmacy, and risk a certain amount of embarrassment to get a prescription? Why do they do that? The answer is that – in the man’s head – having a firmer erection provides more pleasure for his partner. It makes him feel like he’s performing better sexually.
What value might your book provide to male readers?
Most men don’t know what sex is like for other guys. Their only way of knowing is through porn, and that’s not real. With very rare exceptions, guys don’t talk about anything important sexually with other guys. There’s a lot of vulnerability in that. And even among friends, there’s always an element of competition. One can talk about vulnerable things, but the way guys do it still typically gives them the sense of being in control. It is exceedingly rare for a man to tell a friend about his sexual failures in any kind of detail. The value of the book is that they get a peak behind the closed doors. They get to uncover what guys really say and experience in the bedroom and in their heads.
And for female readers?
I think men and women can have a lot of trouble understanding each other. Once a guy actually cares about their partner they tend to care about their partner’s pleasure. Of course, it’s not all about orgasm. A lot of women can’t have orgasm through penetrative intercourse, so that’s not an appropriate goal. But guys want to hear from their partners that they’ve done a good job. If they have, then they feel good. If they get the sense that they didn’t, well then, the sex was probably not so good for them. A lot of guys take their cues from women.
Is there any one patient, or one predicament, that stands out to you as a medical provider?
I treated a man who became a paraplegic after a diving accident. Nothing worked from the waist down. He was married. His wife was neurologically normal. He was unable to have sex, [Viagra and Cialis] weren’t working for him. One of the alternative treatments we have for people is a medicine you can inject into the side of your penis. Within a few minutes, the medicine tells the blood vessels to create an erection. He came to see me a few weeks later and he was just thrilled. He told me he felt like a man again. Now remember, because of his injury he has no sensation below the waist. His penis is getting hard, but he’s not getting any physical pleasure out of sex. He can’t even have an orgasm. So what is it that’s making him feel “manly” again? It’s not that he’s having sex for pleasure again. It’s that he’s able to perform sexually in a way that provides what he thinks he’s supposed to provide for his wife.
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