Historically, the size of one’s penis has been equated as symbol of power, masculinity, social status, fertility, and stamina (Bogaert & Hershberger, 1999
; Bordo, 1999
; Connell, 1987
; Drummond & Filiault, 2007
; Lehman, 1998
; Paley, 2000
; Pope et al., 2000
). To date, the penis’ connection to masculinity and virility is continually perpetuated throughout popular media (Drummond & Filiault, 2007
; Lehman, 1998
); thus, it is not surprising researchers have found many men are unsatisfied or feel shame about their penis size (Dotson, 1999
; Lever et al., 2006
; Mondaini et al., 2002
; Pope et al., 2000
). To that end, a growing body of research has intimated a link between penis size and social-sexual health outcomes (Reece et al., 2007
), though there has been surprisingly little research with MSM (Drummond & Filiault, 2007
This analysis explored four research questions, each assessing the connection between perceived penis size and sociosexual health outcomes. Though most of the men indicated their penis sizes were average, many (44%) fell outside this “norm,” either indicating a below average or above average perceived penis size. Further, perceived penis size was inversely related to penis satisfaction and positively related to lying to others about the size of one’s own penis. These data provide further evidence of the real socially-scripted cultural pressures MSM may feel about their penis size. Comparing these results with a sample of heterosexual men from the Body Image Survey (Lever et al., 2006
), fewer men in our sample classified their penises as below average (6.9% versus 12% from the Body Image Survey) or average (53.9% versus 66% from the Body Image Survey). Meanwhile, a larger portion of men from the Sex and Love Study classified their penises as above average (35.5% versus 22% from the Body Image Survey). This is not to suggest MSM may actually have larger penises than other men, but rather this may be an indication that MSM, because of the intimate nature of exposure they have had with other men’s penises via sexual encounters, have a more accurate assessment of how their penis may contrast with other men, and thus more positive feelings about its size. Nevertheless, it is not surprising that far more men rated their penis size as above average compared to below average (both in our data and in the Body Image Survey). Researchers who investigated similar effects about body image (Frederick et al., 2007
) have attributed such a bias to positive illusions (Taylor & Brown, 1988
). In contrast, this might be an indication that, as a result of increased focus on the body within mainstream gay cultures (Drummond & Filiault, 2007
), MSM may feel pressured to inflate their estimates, thus resulting in additional self-reporting of above average penis sizes. In total, these data highlight the need for a comprehensive assessment of the association between perceived penis size and satisfaction in a diverse sample of men that includes MSM and heterosexuals.
In terms of sexual health outcomes, findings were mixed. Perceived penis size was not related to frequency of partners, HIV status, or condom use (i.e., HIV risk-associated behavior). In recent years, condom manufactures have made concerted efforts to advertise a wider range of condom sizes (ranging from “Magnum” to “Snug” fits) (Herbenick & Reece, 2006
). This wider range of available sizes may be impacting condom use such that men who fall above or below the average condom size are more easily able to find condoms they believe will fit them. This may be particularly salient for our sample of men from New York City, where there exists a vast range of retail stores that sell a wide variety of condoms and are open around the clock. Future research might consider such an analysis among rural populations where access there may be reduced access to such a wide range of available condom sizes.
Nevertheless, this does not speak to the issue of condom slippage and breakage. Though our data did not capture experiences of condom slippage and breakage, other researchers have suggested this may play a significant role in the transmission of STIs, particularly for men with above or below average penis sizes (Herbenick & Reece, 2006
; Reece et al., 2007
). In the present analysis, men with above average penises reported significantly higher incidence of viral skin-to-skin STIs, specifically HSV-2 and HPV. In essence, although when compared with other men, men with above average penises reported similar rates of condom use, and statistically similar numbers of sex partners, improper condom fit (i.e., not being able to roll the condom all the way down), breakage, or irritation (caused by wearing a condom that may be too tight) may be exposing some men to skin-to-skin STIs. This is striking given that reported rates of condom use were consistent regardless of men’s reported penis size. Further, it is unsurprising that penis size was unrelated to non-skin-to-skin viral STIs, such as hepatitis B, hepatitis C, or HIV (which are spread through fluid exchange), or pubic lice/scabies (which can be spread on bedding or contact with pubic hair). Nevertheless, these postulations may not adequately explain the increased incidence of some bacterial STIs (gonorrhea/Chlamydia/urinary tract infections) among men with above average penises, and the non-significant association between syphilis (also a bacterial STI) and perceived penis size. In all, these data support previous research having associated penis size with STI transmission; however, more research is needed before definitive conclusions can be drawn.
Perceived penis size also played a role in sexual positioning, whereby men with smaller penises were more likely to identify as bottoms and men with above average penises were more likely to identify as tops. The direction of this relationship further supports notions of the ingrained social value of having a large penis and the presumed masculine penetrative role these men are socially–and sexually–scripted to enact (Drummond & Filiault, 2007
). These data beg the question, “To what extent are men with below average penises being socially-sexually-scripted into anal receptive roles?” Does their having a “smaller” penis devalue these men’s sexual potential, socially-coercing them into sexual roles they may not have otherwise assumed? Though our data cannot answer these questions, it is striking that men with below average penises fared significantly worse on three measures of psychosocial adjustment. Certainly, a variety of factors may also be playing a role in these associations (Connell, 1987
), but the strength and consistent direction of the relationships indicate a need to better understand the individual-level consequences of living in a penis-centered “size matters” society (see also Messner, 1997
As a word of caution, several limitations should be addressed. Clearly, these data do not generalize to all MSM, as this sample was limited to those who attended large-scale GLB events in New York City. Furthermore, as these analyses drew from cross-sectional data, causality between variables should not be inferred, nor do these analyses rule out the potential for confounding effects from other variables not assessed. This sample does, however, give a very comprehensive picture about the types of individuals that attend large scale GLB events, and comprise a considerable (and accessible) portion of the gay, bisexual, and MSM communities in New York City. Although efforts were taken to ensure confidentiality, there was potential for biased responses due to social desirability in the reporting of sensitive information. As with all social research, these factors must be considered when evaluating the findings.
The survey instrument used for this analysis assessed a broad range of variables related to social-psychological and sexual health. Such an instrument helps provide a general perspective about a variety of characteristics; however, it has its limitations. Consistent with the brief street-intercept survey method (Miller et al., 1997
), many of the questions on this survey were quantitative and close-ended. Additional qualitative research is necessary to better capture the full range of experiences. Although a wide range of STIs were assessed in this analysis, gonorrhea, Chlamydia, and urinary tract infections were captured using a single indicator. Our analysis found men with above average penises were more likely to report having been diagnosed with gonorrhea/Chlamydia/urinary tract infections, yet we are unable to disentangle which of the three, if any, might have been more common. Finally, in an effort to increase response rates for questions on penis size, men were not asked to report a numeric measurement (i.e., in inches), but rather select from a nuanced range of values (i.e., average, above average, etc.). Our use of a non-metric scale to capture penis size reduces some precision; however, a numeric measure (i.e., inches) is still subject to self-report biases, as not all men have actually measured their penis, and those who have may not use identical levels of precision.
Though it may not be a topic well explored in academic literature, perceptions of one’s penis size were clearly and consistently associated with a variety of psychosocial and sexual health outcomes among the men sampled for this analysis. These data highlight the need to provide comprehensive sexual health education that is inclusive of the varying physical and psychosocial needs that men with differing sized penises may require. If indeed MSM with above average penises are more likely to assume the anal insertive role, then it is important for them to wear sized-to-fit condoms and use sufficient amounts of lubricant as not to injure their partners nor increase their risk of HIV or STI transmission. Thus, it is essential to improve access to (and education about) sized-to-fit condoms. In contrast, if MSM who perceive themselves to have below average penises are more likely to assume the anal receptive role and to fare significantly worse on psychosocial measures, then it is essential to develop health education programs that dualistically address the HIV, STI, and other health risks that accompany anal receptive sex (e.g., encouraging routine checks for anal STIs), and that also focus on improving psychosocial well being. Finally, these data highlight the need to challenge the culturally ingrained notion that “bigger is better,” as the social consequences of these messages may have lasting negative psychosocial and sexual health effects on the individuals receiving them.