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Male Self Concept and Small Penis Syndrome

Allan Schwartz, LCSW, Ph.D.

 During June of 2007 I posted an article entitled, "An Anxiety Disorder, Small Penis Syndrome."

There has been an outpouring of comments about the article especially from men who complain that they suffer from small genitals.

This is an extremely difficult issue to discuss because it involves very real feelings of pain and suffering on the part of those males who believe their genitals are too small to satisfy a woman. This is an issue that strikes deep into the heart of male virility and sense of masculinity. That is the reason why, with respect to these men, it is important to look at some of the evidence from medicine about this issue.

A review of the literature on the topic of men and penile size and length reveals the fact that it is normal for men to under estimate the size of their genitals. This is so much so, that some medical experts believe that it is not psychologically abnormal for a male to believe that they have a small penis. Only when that belief becomes an obsession and interferes with performance will the Medical Experts consider this abnormal.

There are a variety of reasons for men to be think that they have small sexual equipment:

For one, young boys, viewing their adult male role models, naturally are impressed by what they see and doubt that they can ever become "so big."

Secondly, adolescent boys in the gym locker room in either High School or Middle school, may make negative comparisons between them selves and their classmates. In this, they lack knowledge that teenagers grow and mature at different rates. Just like the variety of heights, facial hair, and other features, teenage boys do not have identical bodies, especially at a time when the growth rate from one boy to the next is so variable.

Thirdly, there is the influence of pornography on what males come to think and believe about their bodies. Pornographic material exaggerates penis size into something totally unrealistic.

Fourth, there is a lot of misunderstanding about sexuality, sexual function and male-female sexual relationships. For example, the size of the penis when it is flaccid and erect are totally different. The flaccid or "limp penis" look very different and this is something that many males fail to understand.

Fifth, men, peering down at their genitals, do not have an accurate view of their genitals, causing them to under estimate their size.

Sixth, there is a steady stream of advertisements in magazines and on the Internet about enhancing the size of the male sex organ. These advertisements play upon the fears and anxieties of those men who retain the fear and anxiety that they are too small. This is another form of exploitation.

Finally, studies show that women approve of and report satisfaction with the genitalia of their partners. However, the very same men in these studies report just the opposite of what their women report.

Body Dysmorphic Disorder

In many ways, this stark difference between what men and women report about male bodies parallels female dissatisfaction with their bodies.

Over years of private practice, it has been amazing to me to hear extremely attractive women state how unhappy they are with their appearance.

It has been suggested that the distorted opinion men have about their appearance is a form of Body Dysmorphic Disorder (BDD).

Medical Evidence:

Urological studies done around the world, among every nationality, ethnic and racial group, indicates that there is no such thing as a male having a "small penis." There are cases in which males are born with severe medical disorders, such as the penis being stored up and inside of the body. By the way, this is quite different from those males born with undescended testicles, a condition that often corrects itself before puberty and has nothing to do with penile size.

In the studies mentioned above, when the men in the studies were offered free surgery to enlarge their genitalia, the offer was rejected. There seems to be a sense among these men that their view of themselves is inaccurate.

In fact, one study of men who suffer from the false notion that they are too small, sex education was provided about penile structure and function. The results of the study were encouraging in that most of the men came to realize that they were quite normal.

Comments to the article:

I found it really interesting that one of the women who commented on the article about "small penis syndrome," reported that she was pregnant even though her partner believes that he is too small to satisfy her. She added that she feels quite satisfied. It seems that some men are almost delusional about how they think of their equipment.

Some of the men who commented about the article not only reported that they are small, but that they experienced a girl friend criticizing them their appearance. Of course, such a criticism reinforces this false self perception.

Why would a woman make a critical comment about the size of their partner's genitalia?

The answer to the question is that there are always people who are insensitive, sadistic or cruel and uncaring about the feelings of others. In the same way, I have heard many women complain that a husband or boyfriend was critical about their breast size, weight or sexual appeal.

In these types of circumstances in which a boy or girl friend levels this type of criticism, I would suggest finding a new partner who is not mean and sadistic.

Male Circumcision:

I have not seen one shred of evidence that male circumcision causes any type of sexual dysfunciton. Male circumcision, whereby the foreskin is removed from the penis, most often during infancy, is practiced all over the world by diverse cultural groups. In some cases it is practiced for religiou reasons and in others for health reasons.

As to whether or not there are health benefits or not to male circumcision is a matter of debate. There are those researchers who report that it prevents cancer of the penis later in life. There are also those who state that it helps prevent cervical cancer in women. The debate continues unabated with ther result that some families practice because they believe in the health benefits of circumcision while others do so for their continuing religious reason.

Suggestions:

1. I want to encourage any male who believes that there is something wrong with their genitalia to visit a urologist to get a medical evaluation and solid medical evidence as to whether there really is or is not something wrong. If someone's genitalia are immature, there usually is medical treatment available.

2. I want to encourage those of you who are interested, whether male or female, to do a search on Google Scholar and read the many abstracts available at no cost on this topic. An Internet search can also be done.

3. If you have taken these steps: done the reading that is suggested and visited an MD and get clearance from the doctor that all is well, that you go for psychotherapy to help with the deep seated feelings of low self esteem, fear and anxiety.

Cautionary Note:

It really makes no difference whether a man's penis is really small or he believes so. Being convinced that your sexual organs are in some way inadequate is horribly painful and humiliating whether you are a male or female. Even if an MD is likely to report to a man, after a full examination of his genitalia, that everything is normal and healthy, in no way means that the man will believe this to be true. That is why I am encouraging both medical examination, follwed by psychotherapy over this extremely painful and sensitive issue.

Your comments are welcome

Editor's Note: August 3rd, 2009: Several days ago, after watching a disturbing trend of angry comments start to bloom into outright advocacy of aggression (something we could not allow), we decided to turn off comments on our series of Small Penis Syndrome (SPS) articles. We regret that it has come to this as we have become amply aware that it is important that people have a place to go on the Internet where they can talk about this powerful anxiety and the shame that surrounds it. Today, we are restoring read-access to the older comments, but are not going to accept any new comments on the essays themselves.