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Abstract

The media equate a man's penis size with his power and masculinity. Views about penis size were assessed in an Internet survey of 52,031 heterosexual men and women. Most men (66%) rated their penis as average, 22% as large, and 12% as small. Self-reported penis size was correlated positively with height and negatively with body fat level. Whereas 85% of women were satisfied with their partner's penis size, only 55% of men were satisfied with their penis size, 45% wanted to be larger, and 0.2% wanted to be smaller. Satisfaction did not vary across age groups from 18 to 65. Men reporting a larger-than-average penis rated their appearance most favorably, suggesting a possible confidence effect of perceived large penis size. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Does Size Matter? Men’s and Women’s Views on Penis Size
Across the Lifespan
Janet Lever
California State University, Los Angeles
David A. Frederick and
Letitia Anne Peplau
University of California, Los Angeles
The media equate a man’s penis size with his power and masculinity. Views about
penis size were assessed in an Internet survey of 52,031 heterosexual men and women.
Most men (66%) rated their penis as average, 22% as large, and 12% as small.
Self-reported penis size was correlated positively with height and negatively with body
fat level. Whereas 85% of women were satisfied with their partner’s penis size, only
55% of men were satisfied with their penis size, 45% wanted to be larger, and 0.2%
wanted to be smaller. Satisfaction did not vary across age groups from 18 to 65. Men
reporting a larger-than-average penis rated their appearance most favorably, suggesting
a possible confidence effect of perceived large penis size.
Keywords: body image, body mass index, age, penis size satisfaction, penis size
Urologists and psychotherapists often en-
counter patients who complain about the length
of their penis, but these patients are usually well
within the typical range for penis size. Many
patients also worry that their romantic partner
may not be satisfied with their penis size (Alter,
1995; van Driel, Weijmar Schultz, van De Wiel,
& Mensink, 1998), perhaps because men con-
sider the size of their penis to be an important
feature of their sexual prowess (Francken, van
de Wiel, van Driel, & Weijmar Schultz, 2002).
Men’s concerns about penis size are fueled by
cultural messages equating penis size with mas-
culinity. Kilmartin (2000, pp. 215–216) ob-
served, “‘Real men are . . . described as having
huge penises....Infact, the penis is sometimes
described as ‘his manhood.’”
Popular media, especially TV and men’s
magazines, frequently emphasize the connec-
tion between penis size and masculinity (Leh-
man, 1993). Pornographic movies, magazines,
and Web sites featuring men with very large
penises also reinforce the cultural message as-
sociating large penis size and masculinity.
Women’s exaggerated sexual responses to
overly endowed men in these pornographic im-
ages may also convince men that women have
strong preferences for large penises. Most men
are aware that the penises in these pornographic
images are atypically large, but persistent expo-
sure to these images may cause men to overes-
timate the average penis size and underestimate
the size of their own penis.
Men’s worries about their personal inadequa-
cies have created a large market for penis en-
largement products and procedures. A recent
issue of For Him Magazine featured separate
Janet Lever, Department of Sociology, California State
University at Los Angeles (CSULA); David A. Frederick
and Letitia Anne Peplau, Department of Psychology, Uni-
versity of California, Los Angeles (UCLA).
Those interested in a parallel paper on breast satisfac-
tion among women in this sample (Frederick, Peplau, &
Lever, 2005a) and in additional papers on body image
from this and other projects should contact David Fred-
erick. We thank Elle magazine for access to the data from
the Elle.com/MSNBC.com Sex and Body Image Survey.
We are grateful to the UCLA Graduate Division; the
Center for Culture, Brain, and Development; the Depart-
ment of Psychology; and the Communication Studies
Program for providing financial support for David Fred-
erick. We would also like to thank Sheila Allameh, Anna
Berezovskaya, Monica Birnbaum, Iva Boteva, Lesley
Bulechek, Lisa Burklund, Jeremy Casey, David Creswell,
Erika Forster, Martie Haselton, Johanna Jarcho, Kathleen
Lambert, Henry Madrid, Traci Mann, Tara Mulrenan, Leila
Sadeghi-Azar, Janet Tomiyama, Andrew Ward, and Erika
Westling for their assistance with this database and the manu-
script of this article. We are grateful to Carol Edwards, who
helped to create the database.
Correspondence concerning this article should be ad-
dressed to David A. Frederick, Department of Psychology,
University of California, 1285 Franz Hall, Los Angeles, CA
90095-1563. E-mail: enderflies1@aol.com
Psychology of Men & Masculinity Copyright 2006 by the American Psychological Association
2006, Vol. 7, No. 3, 129–143 1524-9220/06/$12.00 DOI: 10.1037/1524-9220.7.3.129
129
full-page ads for three different penis enlarge-
ment pills: Argionic Desire (2005), Magna-RX
(2005), and ProPlus (2005). These advertise-
ments promised an increase in penis size of up
to 5 in. over a 60-day period. The ads also
included testimonials that reinforce men’s be-
lief that women are more sexually satisfied by
larger penises: “I’m [now] 8 in. and much
thicker. My girlfriend wants it all the time”
(ProPlus, 2005, p. 131).
Instead of taking pills, some men purchase
weight systems, stretching devices, vacuum
pumps, or even silicone injections in an attempt
to lengthen their penis (Templer, 2002). Some
men who seek more dramatic results undergo
penile enlargement surgery. Advertisements for
surgical enlargement of the penis are featured in
the sports sections of major newspapers such as
the Los Angeles Times and include captions like
“Size Matters” (Beverly Hills Surgical, 2005)
and “Bigger is Better” (Total Life Enhance-
ment, 2005a). These ads promise men great
benefits to pursuing surgery, such as increased
confidence and desirability to women. Adver-
tisers’ Web sites feature before-and-after sur-
gery photos and testimonials, including some
from women. Illustrative is the letter from
“D.T.,” who wrote,
I was satisfied with our lovemaking ....However, my
husband did not like the size of his penis ....Since his
surgery, he has more confidence. And, to my surprise,
I have been overwhelmed with the difference in our
sex life. His increased length, and especially his added
thickness have satisfied me more than I ever dreamed
possible. (Total Life Enhancement, 2005b)
The flourishing penis enlargement industry
indicates that at least some men worry enough
about penis size to spend money on costly prod-
ucts and on potentially risky surgery to boost
their self-confidence. However, little is known
about how many men have such concerns and
whether women do attach importance to penis
size.
Research on Actual Penis Size and Other
Physical Characteristics
Available research on penis size has typi-
cally focused on determining human variation
in actual penis length. Summarizing results
from 25 sources, Templer (2002) concluded
that the typical penis was approximately 3.5
in. (8.9 cm) long when flaccid and 6 in. (15.2
cm) long when erect. Measurements made by
sex researchers, however, tend to be signifi-
cantly smaller than self-reports by male re-
spondents. In two carefully controlled studies,
penis size was measured by researchers after
men self-stimulated themselves and/or in-
gested pharmaceutical drugs to induce erec-
tions (Senegezer et al., 2002; Wessells, Lue,
& McAninch, 1996). Combining the means
and standard deviations reported by these re-
searchers, we calculated that the mean erect
penis length was 5.3 in. (13.5 cm), with 68%
of men measuring between 4.6 and 6.0 in.
(11.7 cm and 15.2 cm), 13.5% between 3.8
and 4.5 in. (9.7 cm and 11.4 cm), and 13.5%
between 6.1 and 6.8 in. (15.5 cm and 17.3
cm); only about 2.5% of men possessed a
penis over 6.9 in. (17.5 cm) long, and 2.5%
were under 3.7 in. (9.4 cm) long.
Folk beliefs suggest that penis size is related
to other physical traits, such as foot size, hand
size, height, and weight (Paley, 1999). Past re-
search with sizable samples has found penis size
to be correlated positively with height (Ed-
wards, 1998; Ponchietti et al., 2001) and nega-
tively with weight (Ponchietti et al., 2001), but
in one small-scale study (Schneider et al., 2001)
it was found to be unrelated to age.
Research on Men’s Attitudes Toward
Penis Size
From a psychological perspective, however,
the crucial issue may not be actual penis size but
rather a man’s perception of the size of his penis
relative to other men’s. Very few empirical
studies have assessed the association between
men’s beliefs about their penis size and satis-
faction with their penis or psychological well-
being. A small survey (Lee, 1996) of 112 col-
lege men found that most men viewed their
penises as average (69%), but the rest of the
men were more likely to believe they were
smaller (26%) rather than larger than average
(5%). A similar pattern of results was found in
a small survey of 123 young men in the Korean
military (Son, Lee, Huh, Kim, & Paick, 2003),
suggesting that in contrast to the normal distri-
bution of actual penis size discussed above,
some young men underestimate the size of their
penis.
There have been a few studies attempting to
relate penis size to satisfaction. A study by
130 LEVER, FREDERICK, AND PEPLAU
Edwards (1998) found that only 10% of men
who rated their penis as “modest” were content
with their penis size, compared with 40% of the
average-sized men and 70% of the “endowed”
men. However, these findings were based on the
responses of men (mean age 30 years) who
chose to participate in a survey posted on Ed-
wards’s www.sizesurvey.com Web site, and
thus may reflect only the views of men partic-
ularly interested in the question of penis size. A
recent study of undergraduate Canadian men
examined men’s concerns with their erect, flac-
cid, and overall penis size (Morrison, Bearden,
Ellis, & Harriman, 2005). This study found that
most men were more likely to be satisfied with
their erect penis size (83%) and overall penis
size (71%) than with their flaccid penis size
(51%). However, the majority of participants
completed the survey in a mass testing situation,
which may have created social desirability pres-
sures against reporting dissatisfaction with pe-
nis size. Interestingly, the authors also found
that men’s global satisfaction with their genitals
(e.g., size, shape, coloration, testicles) was
linked to increased body satisfaction (Morrison
et al., 2005).
Research on Women’s Attitudes About
Penis Size
With all this emphasis on the importance of
penis size to men, the voices of women have
been neglected. One study (Fisher, Brans-
combe, & Lemery, 1983) found that self-re-
ported sexual arousal did not differ among col-
lege women who read a vignette about sexual
activity with a man whose penis was described
as being 3, 5, or 8 in. long. Needless to say,
however, textual descriptions likely have less
influence on arousal than visual images or real-
life encounters. In another study (Franken, van
de Wiel, van Driel, & Weijmar Schultz, 2002,
174) women (mean age 30 years) were asked
about the importance of two aspects of penis
size: length and girth. Only 21% rated length as
important, whereas 33% rated girth as impor-
tant. Absent from past research is information
about how women perceive their partner’s penis
size and whether they are satisfied with the size
of their partner’s penis. If the vast majority of
women are satisfied with their partner’s penis
size, then many men may be worrying need-
lessly about the size of their penis.
Goals of Present Study
A recent large-scale survey about body image
among more than 50,000 heterosexual men and
women, ages 18 –65, provided an opportunity
to examine men’s perceptions of their own pe-
nis as well as women’s perceptions of their
partner’s penis. Our analyses had four main
goals.
1. Self-reported penis size and penis size
satisfaction. The first goal of this study was to
assess how men view their penis size in a larger
and diverse sample of adults. Second, we ex-
amined how self-reported penis size relates to
penis size satisfaction. We predicted that men
who rate their penis as small would be less
satisfied with their penis size than men reporting
an average penis, and that men who reported an
average penis would be less satisfied than those
reporting a large penis. We also investigated
how three other physical attributes— height,
body fat level, and age—related to men’s be-
liefs about their penis size. Consistent with past
research, we hypothesized that taller and thinner
men would be more likely to report a larger
penis size, but that there would be no age dif-
ferences in reported penis size.
2. Men’s attitudes toward penis size and body
exposure concerns. A second goal was to in-
vestigate how negative attitudes about penis
size might relate to self-consciousness during
sexual activity. Do men’s concerns with penis
size relate to their comfort with exposing their
bodies to a romantic partner? We hypothesized
that men who reported a small penis and men
who were not satisfied with their penis size
would be less willing to undress in front of their
partners and more likely hide their penis from
their partners during sexual activity.
3. Penis size and overall body satisfaction. If
men believe that a large penis is the cultural
ideal, self-perceived penis size may relate to
men’s perception of their general physical at-
tractiveness. Men with a larger-than-average
penis may experience a confidence effect that
might lead them to rate their body more posi-
tively, not only on general measures of body
image but also on attributes such as facial at-
tractiveness that are seemingly unrelated to pe-
nis size. Conversely, men with a small penis
may experience an insecurity effect that might
lead them to rate their body and face less favor-
ably. Thus, we predicted that men reporting a
131PENIS SIZE SATISFACTION
larger-than-average penis size would rate them-
selves most positively on body image and facial
attractiveness.
4. Women’s satisfaction with their partner’s
penis size. A final goal was to provide a care-
ful examination of women’s perceptions of their
partner’s penis size among a large sample of
women of differing ages. In addition, past re-
search has not examined how women’s assess-
ment of their partner’s penis size is related to
their satisfaction with their partner’s penis size.
Consistent with prior research, we predicted
that women would report being satisfied with
their partner’s penis size whether they consid-
ered it to be average or larger than average;
however, in contrast to the vignette study find-
ing that men with small penises were as arous-
ing as men with average or large penises (Fisher
et al., 1983), we predicted that women who
consider their partner to be smaller than average
would be dissatisfied with their partner’s penis
size.
Method
A brief 27-item survey was posted on the
MSNBC.com and Elle.com Web sites in Feb-
ruary 2003. Participants were visitors who vol-
unteered for a Sex and Body Image Survey. To
prevent 1 individual from responding to the
survey multiple times, a computer program pre-
vented multiple responses from any given com-
puter. Basic findings from the survey were re-
ported in Elle magazine (Lever, 2003), which
commissioned the study. The present study is
based on secondary and more detailed analyses
of this large dataset.
Participants
Most respondents (98%) were from the
MSNBC.com Web site; only 2% were from the
Elle.com Web site. Because this analysis of the
Elle.com and MSNBC.com data focused on
men’s attitudes toward their own penises and
women’s attitudes toward their male partner’s
penis, we excluded from our analyses hetero-
sexual individuals who did not answer ques-
tions relating to penis size (0.8% of total sam-
ple). We also excluded lesbian participants
(1.2% of total sample) for whom penis ques-
tions were not applicable and gay male partici-
pants (2.8% of total sample) because the word-
ing of the penis size question precluded us from
determining whether gay men were indicating
their attitudes about their own penis size or
about their partner’s penis size. The analyzed
sample consisted of 25,594 heterosexual men
and 26,437 heterosexual women between the
ages of 18 to 65, weighing 90 to 295 pounds,
with body mass index scores ranging from 14.5
to 40.5 and heights ranging from 63 in. to 74 in.
(152.4 cm to 188 cm) for women and 62 in.
to 78 in. (157.5 cm to 198.1 cm) for men.
Individuals outside of these ranges were ex-
cluded because of small sample sizes. For more
details regarding the sample, refer to Frederick,
Peplau, and Lever (2005b).
Physical Characteristics
Age. The mean age of participants was 33.5
years (SD 10.9) for women and 36.9 years
(SD 11.8) for men. Women and men were
fairly well represented across the age spectrum,
and for some analyses, five age groups were
created: 18 –25, 26 –35, 36 – 45, 46 –55, and 56 –
65. The percentages of men and women in each
category were, respectively, 18 –25, 20% and
29%; 26 –35, 30% and 32%; 36– 45, 24% and
22%; 46 –55, 18% and 14%; and 56– 65, 8%
and 3%.
Height. The mean self-reported height in
inches was 65.1 in. (165.3 cm; SD 2.7 in. [6.9
cm]) for women and 70.7 in. (179.6 cm;
SD 2.8 in. [7.1 cm]) for men. The men and
women in this sample were about an inch taller
than the national data provided by the National
Center for Health Statistics (2004). This differ-
ence may reflect actual differences in height
between the samples, or it may reflect the fact
that some participants in our sample may have
exaggerated slightly when self-reporting their
own height. Height groups were created for
men. These groups were very short (62 in.– 64
in. [157.5 cm–162.6 cm]), short (65 in.– 68 in.
[165.1 cm–172.7 cm), average (69 in.–71 in.
[175.3 cm–180.3 cm]), tall (72 in.–75 in. [182.9
cm–190.5 cm]), and very tall (76 in.–78 in.
[193.0 cm–198.1 cm]). These categories were
chosen to facilitate data presentation related to
height while still maintaining a relatively nor-
mal distribution across the five groups. The
percentage of men in each category was as
follows: very short, 1%; short, 20%; average,
39%; tall, 36%; and very tall, 4%.
132 LEVER, FREDERICK, AND PEPLAU
Body mass index (BMI). BMI is a standard
measure used to estimate an individual’s level
of body fat. It is calculated by dividing a per-
son’s weight in kilograms by his or her squared
height in meters (National Health & Nutrition
Examination Survey, 2000). A BMI score was
computed for each respondent. The mean BMI
of participants was 26.6 (SD 4.0) for men
and 24.2 (SD 4.8) for women. The men in our
sample had BMI scores comparable to those
from a large-scale study by the National Center
for Health Statistics (2004). Women in our sam-
ple were thinner than the average U.S. woman
(BMI of 24.2 vs. 26.5). Standard BMI levels
described in the National Health and Nutrition
Examination Survey (2000) were used to create
four categories: underweight (BMI of 14.5–
18.49), healthy weight (18.5–24.99), over-
weight (25–29.99), and obese (30 –40.5).
Psychological Measures
Penis size. Self-perceived penis size was
assessed with the item “Do you consider the
size of your own penis OR that of your partner’s
to be. . .” with the answer choices being small
(“smaller than average”), average (“average”),
or large (“larger than average”).
Satisfaction with penis size. Satisfaction
with penis size was assessed with the item “Are
you satisfied with the size of your own penis OR
that of your partner’s” with the response options
being smaller (“no, I wish it were smaller”),
satisfied (“yes, very satisfied”), or larger (“no, I
wish it were bigger”).
Body exposure concerns. Respondents
were asked about their possible concerns with
showing their body to a romantic partner. Indi-
viduals without a partner were instructed to
answer the questions thinking about the last
partner they had. One question asked, “Do you
undress in front of your partner?” with the re-
sponse options being yes or no. Most men
(92%) reported undressing in front of their part-
ner. Another question asked, “Do you ever try
to hide a least favorite physical feature during
sex? Select all that apply.” One of the six re-
sponse options was “yes, my genitals.” This
response was selected by 3.5% of men.
Body image: Self-rated attractiveness. As a
general measure of perceived attractiveness,
one item asked, “How do you feel about your
body?” The four response options were “I have
a great body” (4), “I have a good body” (3),
“My body is just okay” (2), and “I find my body
unattractive” (1). The percentage of men re-
sponding in each category was as follows: great,
7%; good, 47%; okay, 36%; and unattractive,
11%. This one-item measure of body image was
strongly correlated ( ps.05) with the widely
used seven-item Appearance Evaluation scale
(Cash, 2000) for both men (r.75) and women
(r.75) in a sample of 153 college men and
313 college women (Frederick, Peplau, & Le-
ver, 2005b). These strong correlations provided
confidence in this item as a measure of body
satisfaction.
Body image: Comfort in a swimsuit. Body
image satisfaction was also assessed with the
item “How do you think you look in a swim-
suit?” Response options were “Good; I’m proud
/not at all embarrassed to be seen in a swimsuit”
(3), “Okay; I don’t flaunt it but my self-con-
sciousness doesn’t keep me from wearing a
swimsuit” (2), and “So uncomfortable that I
avoid wearing one in public” (1). The percent-
age of men responding in each category was as
follows: good, 25%; okay, 59%; and uncom-
fortable, 17%. The correlation between the Ap-
pearance Evaluation scale in Frederick, Peplau,
and Lever (2005b) was .62 for men and .58 for
women, providing confidence in this item as a
measure of body satisfaction ( ps.05).
Face satisfaction. Respondents’ satisfac-
tion with their face was assessed with the item
“How do you feel about your face?” Response
options were “My face is very attractive” (4),
“My face is nice/pleasant” (3), “My face is
plain” (2), and “My face is unattractive” (1).
The percentages of men responding in each
category were as follows: very attractive, 14%;
nice/pleasant, 65%; plain, 19%; and unattrac-
tive, 3%.
Results
We begin by presenting men’s self-reported
penis size, men’s satisfaction with their penis
size, and the correlates of these reports. Next,
we consider how penis size and satisfaction
were associated with comfort with exposing
one’s body to a sexual partner and, more
broadly, with self-ratings of physical attractive-
ness. Finally, we present findings about wom-
en’s satisfaction with their partner’s penis size.
Because our large sample size provided the
133PENIS SIZE SATISFACTION
power to detect even miniscule effects, we set
p.001 as the criteria for determining if a
finding was statistically significant, and we paid
close attention to the actual pattern of means
regardless of statistical significance. Further-
more, we report effect sizes for comparisons of
interest.
Correlates of Self-Reported Penis Size
and Penis Size Satisfaction
How did men in our sample assess the size of
their penis? As shown in Table 1, the majority
of men (66%) characterized their own penis size
as average. This is similar to the findings re-
ported by Lee (1996) for American college men
and by Son et al. (2003) for young Korean
adults. In our sample, only 12% of men viewed
their penises as small and 22% viewed them as
large. This finding departs from the two earlier
studies, which found a greater proportion of
men reporting small rather than large penises.
Table 2 presents data on men’s satisfaction
with their penis size. Overall, 55% of men re-
ported being very satisfied with their penis size,
but a substantial minority were dissatisfied. For
many men, being average wasn’t good enough.
Among men who rated their penis size as aver-
age, 46% wanted to be larger. This desire was
widespread among men who rated their penises
as small (91%) and uncommon among men who
rated their penises as large (14%). Fully 86% of
men who rated themselves as large were satis-
fied with their penis size, compared with only
54% of men who rated themselves as average
and 8% of men who rated themselves as small.
Height. We predicted that taller men would
be more likely to report a large penis size than
shorter men, a pattern that is shown in Table 1.
Self-reported penis size and height were signif-
icantly correlated. This correlation was small,
however, possibly because most men rated their
penis as average in size and there was consid-
erable variability in height among this average-
size group. As shown in Table 1, the taller
groups of men (tall and very tall) were two to
three times more likely to report having a large
penis than were the shorter groups of men (short
and very short). To examine this pattern further,
the percentage of men reporting a large penis
was calculated for every height from 62 in.
to 78 in. The same was also done for the per-
centage reporting a small penis. As shown in
Figure 1, the percentage of men who reported a
large penis size increased steadily as height
increased, while the opposite was true for men
reporting a small penis size. This suggests that
although the overall correlation between height
and penis size was low, height is a good pre-
Table 1
Association of Men’s Physical Characteristics to Self-Reported Penis Size
Physical characteristic
Penis size
% small % average % large r
Overall 12 66 22
Height .15
62 in.–64 in. (very short) 22 66 12
65 in.–68 in. (short) 16 69 15
69 in.–71 in. (average) 12 68 20
72 in.–75 in. (tall) 10 64 26
76 in.–78 in. (very tall) 7 57 36
Body mass index .11
14.5–18.5 (underweight) 11 68 21
18.5–24.9 (healthy) 9 67 24
25.0–29.9 (overweight) 11 67 22
30.0–40.5 (obese) 19 65 16
Age .08
18–25 11 65 24
26–35 11 64 26
36–45 11 67 22
46–55 13 68 19
56–65 16 70 14
134 LEVER, FREDERICK, AND PEPLAU
dictor of whether a man believes that his penis
is large versus small.
We predicted that satisfaction with penis size
would also be related to height. Data in Table 2
support this prediction. Shorter men were less
likely to be satisfied with their penis size than
taller men, perhaps because shorter men were
more likely to view their penis as smaller than
average.
Body fat level. Men with high BMI scores
may be more likely to report a small penis
because additional fat in the pubic region re-
duces the percentage of the penis that extends
outside of the body. We predicted that thinner
individuals would be more likely to report a
large penis than heavier individuals. The corre-
lation between BMI and self-reported penis size
was statistically significant but small. As shown
in Table 1, obese men were nearly twice as
likely to report a small penis as other groups of
men. Interestingly, men in the healthy weight
range were most likely to report a large penis
size and least likely to report a small penis size.
To examine this pattern further, the percentages
of men reporting a large, average, or small penis
were calculated for every BMI score from 15
to 40. Figure 2 shows that with minor excep-
tions among the extreme weight groups, the
percentage of men who reported a large penis
decreased steadily as body fat level increased,
whereas the percentage of men reporting a small
penis increased with body fat level. The per-
centage of men reporting an average-size penis
showed less variability across body fat levels.
This suggests that although the overall correla-
tion between body fat level and penis size was
low, body fat level is a good predictor of when
a man rates his penis as small versus large.
We predicted that satisfaction with penis size
would also be related to body fat level. As
shown in Table 2, heavier men were less likely
to be satisfied with their penis size than thinner
men, perhaps because heavier men were more
likely to view their penises as smaller than
average.
Age. We examined whether age was related
to self-reported penis size or to satisfaction with
penis size. Self-reported penis size was signifi-
cantly correlated with age, but the association
was very small. As shown in Table 1, older men
Table 2
Association of Men’s Physical Characteristics to Satisfaction With Their
Penis Size
Physical characteristic
Penis size satisfaction
% very satisfied % desire larger % desire smaller
Overall 55 45 0.2
Penis size
Large 86 14 0.6
Average 54 46 0.1
Small 8 91 0.3
Height
62 in.–64 in. (very short) 52 48 0.3
65 in.–68 in. (short) 52 48 0.3
69 in.–71 in. (average) 54 46 0.2
72 in.–75 in. (tall) 58 42 0.3
76 in.–78 in. (very tall) 62 38 0.3
Body mass index
14.5–18.5 (underweight) 62 37 1.0
18.5–24.9 (healthy) 60 40 0.3
25.0–29.9 (overweight) 55 44 0.2
30.0–40.5 (obese) 45 55 0.1
Age
18–25 54 46 0.2
26–35 55 45 0.3
36–45 55 45 0.4
46–55 58 42 0.1
56–65 57 43 0.1
135PENIS SIZE SATISFACTION
were more likely than younger men to report
that their penis size was average or small and
less likely to report that their penis size was
large. Penis size satisfaction, however, did not
vary as a function of age. The percentage of
men reporting satisfaction with their penis size
(54%–58%) and the percentage who desired a
larger penis (42%– 46%) were similar across
age groups. Thus, older men were no different
from younger men in their desire to have a
larger penis.
Men’s Attitudes Toward Penis Size and
Body Exposure Concerns
We predicted that men who rated their penis
as small would be less willing to expose their
body to a romantic partner. Survey items asked
about undressing in front of one’s partner and
hiding a body part during sex. Men reporting a
small penis size were less likely to undress in
front of their partner (15%) than were men
reporting an average (8%) or large penis size
(6%). Furthermore, men who reported a small
penis size were more likely to hide their penis
during sex (15%) than men reporting an average
(2%) or large penis size (1%).
We also predicted that dissatisfaction with
penis size would be associated with greater con-
cerns about body exposure. As expected, hiding
one’s penis during sexual activity was associ-
ated with penis size satisfaction. Only 1% of
men who were satisfied with their penis size
reported hiding their penis during sex, com-
pared with 11% of men desiring a smaller penis
and 7% of men desiring a larger penis. In con-
trast, however, penis size satisfaction was not
associated with willingness to undress in front
of a partner. Only 7% of men satisfied with their
penis size were unwilling to undress in front of
their partner, and only 11% of men who desired
a smaller penis and 11% of men who desired a
larger penis reported this behavior.
0
10
20
30
40
50
60
70
80
62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78
Height in Inche s
Percent Selecting Each Penis Size
% Average Penis % Large Penis % Small Penis
Figure 1. Association of men’s self-reported penis size to height.
136 LEVER, FREDERICK, AND PEPLAU
Penis Size and Overall Body Image
Satisfaction
We predicted that there would be an associ-
ation between men’s self-reported penis size
and their general assessment of their physical
attractiveness. We predicted that men who re-
ported a large penis would have a more favor-
able overall body image than men who reported
a small penis. Two survey items assessed body
satisfaction by asking men to rate the attractive-
ness of their body and their comfort wearing a
swimsuit in public. To compare the body image
of men differing in self-reported penis size, we
conducted two one-way analyses of variance
(ANOVAs) with self-rated attractiveness and
comfort in a swimsuit as the dependent vari-
ables. Because age, BMI, and height had small
but statistically significant correlations with
self-reported penis size, they were introduced as
covariates in the ANOVAs. The marginal
means are summarized in Figure 3. As ex-
pected, there was a significant main effect of
penis size on self-rated body attractiveness, F(2,
25588) 684.98, p.001, and on comfort in
a swimsuit, F(2, 25588) 384.80, p.001.
The standard errors for each level of the inde-
pendent variable were small, ranging from .005
to .013, indicating that the means were close
approximations of the estimated population
means.
Pairwise comparisons were conducted to de-
termine if men who reported a large penis had
the most favorable body image and if men who
reported a small penis had the worst body im-
age. All pairwise comparisons for both mea-
sures of body image were significant at the p
.001 level. Cohen’s (1988) dscores were calcu-
lated to measure the size of the effects. Cohen
recommends the following interpretations of ef-
fect sizes: d.20 is small, d.50 is moderate,
and d.80 is large. As predicted, compared
with men reporting an average-sized penis, men
who reported a large penis had higher self-
ratings on body attractiveness (d.34) and
comfort in a swimsuit (d.24). Men who
reported a small penis had the worst body im-
age, reporting lower self-ratings of attractive-
ness (d.85) and swimsuit comfort (d.63)
0
10
20
30
40
50
60
70
80
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
Body Mass Index
Percent Selecting Each Penis Size
% Average Penis % Large Penis % Small Penis
Figure 2. Association of men’s self-reported penis size to body mass index.
137PENIS SIZE SATISFACTION
than men who reporting a large penis. Men who
reported a small penis also reported lower self-
ratings of attractiveness (d.53) and swimsuit
comfort (d.36) than men reporting an aver-
age-sized penis.
To examine if the association of penis size
and body attractiveness persisted across differ-
ent levels of body fat, we conducted a 3 4
between-subjects ANOVA with penis size
(small, average, or large) and body fat level
(underweight, healthy, overweight, or obese) as
the independent variables and self-rated attrac-
tiveness as the dependent variable. Height and
age were entered as covariates. The means are
summarized in Figure 4. There were significant
main effects of both penis size, F(2, 25580)
88.45, p.001, and body fat level F(2,
25580) 836.75, p.001. A significant in-
teraction, F(2, 25580) 4.15, p.001, was
also found. The standard errors for each level of
each independent variable ranged from .009 to
.054. Across all levels of body fat, men report-
ing a small penis had poorer body image than
other men and men reporting a large penis had
more favorable body image. However, an ex-
ception to this pattern was found among under-
weight men, with men who reported an average
penis having the most positive body image.
Satisfaction with one’s face. Is penis size
associated with traits that are seemingly unre-
lated to penis size, such as greater satisfaction
with one’s facial appearance? To compare the
face satisfaction of men differing in self-re-
ported penis size (small, average, or large), we
conducted a one-way ANOVA with height and
age entered as covariates. The marginal means
are summarized in Figure 3. There was a sig-
nificant main effect of penis size, F(2, 25775)
436.02, p.001. The standard errors for each
level of the independent variable ranged from
.005 to .012. Pairwise comparisons were con-
ducted to determine if men who reported a large
penis reported the most satisfaction with their
faces and if men who reported a small penis
reported the least satisfaction with their faces.
All pairwise comparisons were significant at the
p.001 level. As shown in Figure 3, larger
self-reported penis size was associated with
higher levels of satisfaction with one’s face. As
predicted, compared with men reporting an av-
erage-sized penis, men who reported a large
penis had higher face satisfaction (d.28).
Men who reported a small penis had the worst
face satisfaction, reporting less satisfaction than
men who reported a large penis (d.64). Men
who reported a small penis also reported less
1
1.5
2
2.5
3
3.5
4
Attractiveness Swimsuit Face
Satisfaction Ratings
Small Penis
Average Penis
Large Penis
Figure 3. Association of men’s self-reported penis size to ratings of body and face satis-
faction. Higher numbers represent greater satisfaction.
138 LEVER, FREDERICK, AND PEPLAU
face satisfaction than men reporting an average-
sized penis (d.37).
In summary, men who rated their penis as
large had significantly more positive views
about their body and the attractiveness of their
face than did other men. In contrast, men who
rated their penis as small had the least favorable
views about their body and face.
Women’s Satisfaction With Their
Partner’s Penis Size
How do women view their partner’s penis
size? As shown in Table 3, most women rated
their partner’s penis size as average (67%),
some women viewed their partner’s penis size
as large (27%), and few women perceived their
partner’s penis size as small (6%). Turning to
satisfaction, most women (84%) were satisfied
with their partner’s penis size, only 14% wanted
their partner to be larger, and 2% wanted their
partner to be smaller. A much higher percentage
of women were satisfied with their partner’s
penis size than the percentage of men who were
satisfied with their own penis size (84% vs.
55%). For women as for men, there was an
association between ratings of penis size and
satisfaction with penis size. The vast majority of
women who reported that their partner was av-
erage or large were very satisfied with their
partner’s penis size (86% and 94%, respec-
tively). In contrast, the majority of women
(68%) who rated their partner as small wished
1
1.5
2
2.5
3
3.5
4
Underweight Normal Overweight Obese
Self-rated Attractiveness
Small Penis
Average Penis
Large Penis
Figure 4. Association of men’s self-reported penis size to ratings of self-rated attractiveness
across body fat levels. Higher numbers represent greater satisfaction.
Table 3
Women’s Attitudes Toward Their Partner’s
Penis Size
Report of partner’s penis size
% small % average % large
Overall 6 67 27
Satisfaction with partner’s penis size
% very
satisfied
% desire
larger
% desire
smaller
Overall 84 14 2
Penis size
Large 94 1 5.0
Average 86 14 0.5
Small 32 68 0.4
Age
18–25 86 12 2
26–35 85 13 2
36–45 84 15 1
46–55 82 16 2
56–65 80 18 2
139PENIS SIZE SATISFACTION
their partner had a larger penis. Fortunately for
men, however, only 6% of women rated their
partner as smaller than average.
Discussion
Popular lore might suggest that men are uni-
versally worried about their penis size. How-
ever, in our large and diverse sample, most men
viewed their penis as average or large. Only 1
man in 10 rated his penis as small. These find-
ings contrast with the results of two small stud-
ies in which a larger percentage of men rated
their penis as small. In our sample, most men
were satisfied with their penis size. Not surpris-
ingly, satisfaction with penis size was typical of
men who viewed their penis as large, common
among men who viewed their penis as average,
and uncommon among men who viewed their
penis as small.
This study provided an opportunity to exam-
ine heterosexual women’s attitudes about part-
ner’s penis size. Most women rated their part-
ner’s penis as average or large. Almost all
women who viewed their partner as average or
large were satisfied with his penis size. The
majority of women who judged their partner’s
penis as small, however, were not satisfied.
Men’s reports of their penis size were asso-
ciated with other physical attributes. In line with
past research (e.g., Ponchietti et al., 2001), men
who were taller and men who were thinner were
more likely to report a large penis than were
men who were shorter or heavier. Similar re-
sults were found for satisfaction with penis size:
Taller men and thinner men were more likely to
report satisfaction with their penis size than
were shorter men and heavier men. Older men
were also less likely to a report a large penis
size than younger individuals, but this associa-
tion was small.
Our study found that many men (45% of the
total sample) desired a larger penis, especially
those who believed their penis is smaller than
average (91%) or average sized (46%). To put
this prevalence of dissatisfaction in perspective,
this exceeds the percentage of men in our sam-
ple who were dissatisfied with their height
(38%) or their weight (41%). Our data suggest
that dissatisfaction with penis size diminishes
only slightly as men age, indicating that the
symbolism of having a large penis holds its
value across the life span.
As we have demonstrated, men’s dissatisfac-
tion with their penises is associated with
broader patterns of body image discontent. Men
who reported having a large penis also reported
greater satisfaction with their body and face and
less concern about exposing their body during
sexual activity. In contrast, men who reported a
small penis reported less satisfaction with their
body and face and greater concern about expos-
ing their body to a partner during sexual inter-
course. One plausible interpretation of these
findings is that penis size affects men’s more
general views of themselves, creating a confi-
dence effect for men who consider their penis to
be large and an insecurity effect for men who
consider their penis to be small. However, as
these data are correlational in nature, the direc-
tion of causality is unclear. It is also possible
that men’s more general body image influences
their estimates of their penis size. Alternatively,
a third variable such as self-esteem may be
operating (Baumeister & Tice, 2001). Men who
have generally positive views of themselves
may be more likely to have favorable attitudes
about their body and face and also to report a
large penis size; conversely, low self-esteem
may lead to unfavorable self-ratings of penis,
face, and body.
The correlation between penis size and body
image found in this study parallels the findings
by Morrison et al. (2005), who reported that
penis size satisfaction was associated with body
satisfaction. These findings suggest that body
image researchers, who have not typically ad-
dressed the role of penis size as a component of
overall body satisfaction, should consider in-
cluding it and exploring the direction of causal-
ity. For example, if poor global body image is
caused by penis dissatisfaction or perceived
small penis size, then interventions addressing
men’s concerns with penis size might enhance
global body image.
Strengths and Limitations
Limitations of the study must be mentioned.
Our findings are based entirely on self-reports
of penis size and other physical characteristics.
To increase participation rates, the survey was
necessarily short and relied on single-item mea-
sures of key variables. Furthermore, our mea-
sure of penis satisfaction measured only con-
cern with overall size, whereas some past re-
140 LEVER, FREDERICK, AND PEPLAU
search has indicated that men’s concerns with
their flaccid penis size differ from their con-
cerns with their erect penis size (Morrison et al.,
2005). This survey also did not allow for the
examination of men’s concerns with other as-
pects of their genitalia. Insofar as this survey
did not include separate measures for girth and
length, we assume that women’s satisfaction or
dissatisfaction was based on a combination of
both aspects of penis size.
In addition, although our sample was large, it
was not nationally representative. For example,
people with higher socioeconomic status tend to
be somewhat overrepresented in Internet re-
search, although the distributions are reasonably
bell-shaped and include participants from a
broad range of backgrounds and geographic lo-
cations (Gosling, Vazire, Srivastava, & John,
2004). Furthermore, differences between the
demographics of Internet users and non-Internet
users have been diminishing over time as Inter-
net use becomes more common, and the per-
centage of women, minorities, and older indi-
viduals using the Internet has increased (Pew
Internet & American Life Project, 2005). One
limitation of our study is that the survey did not
include items pertaining to ethnicity. Given ra-
cial stereotypes about ethnic differences in pe-
nis size, such data may be important (e.g., Ed-
wards, 1998). For example, how satisfied a per-
son is with his penis size may be influenced by
his perception of what is typical for his ethnic
group.
Several strengths of the current research are
noteworthy. Our sample was substantially
larger and more diverse than previous studies,
which have often relied on small convenience or
college student samples. The breadth of our
sample provided an opportunity for detailed
comparisons of women and men across the age
spectrum from 18 to 65. We were also able to
compare respondents who differed substantially
in height and weight. Our methods provided
considerable protection of anonymity and al-
lowed individuals to participate from the pri-
vacy of their home or workplace. The ease of
participation may have further reduced some of
the bias introduced when volunteers must travel
to a research setting to participate. In addition,
this study obtained both men’s and women’s
views about penis size. Whereas past studies
have assessed women’s abstract conception of
the importance of penis size (e.g., Francken et
al., 2002), this research asked women about
their satisfaction with their actual partner’s pe-
nis size. Finally, it should be emphasized that
this is the first large-scale study of the associa-
tions among men’s self-reported penis size, pe-
nis size satisfaction, personal characteristics,
and body image.
Concluding Comments
As Kilmartin (2000, p. 219) observed, “As
long as men continue to equate penis size with
masculinity, they will continue to feel unneces-
sary sexual anxiety.” Kilmartin’s view is sup-
ported by the fact that men’s desire for a larger
penis continues to be experienced later in life, in
spite of achievements or other experiences that
one would expect to have put “manhood” into
broader perspective. Addressing the problem of
male dissatisfaction with penis size is particu-
larly important in the modern technological age
where alteration of the body through cosmetic
surgery has become a widespread phenomenon.
A strong limiting factor against augmentation
phalloplasty to date has been the high risk and
ineffectiveness in substantial enlargement of the
penis. Both the American Urological Associa-
tion and the Society for Esthetic Plastic Surgery
have issued policy statements expressing con-
cerns about the safety and efficacy of this pro-
cedure. However, advances in surgical tech-
niques are making penis enlargement safer and
more effective. For example, a new augmenta-
tion phalloplasty procedure performed on 39
patients successfully produced notable average
increases in both the length (1.6 cm) and width
(1.3 cm) of the erect penis. Most men who had
this new procedure reported high levels of sat-
isfaction 9 months after the procedure and ex-
perienced few complications (Austoni, Guar-
neri, & Cazzaniga, 2002).
As the day approaches when larger numbers
of men may elect to have augmentation phallo-
plasty, it becomes increasingly important to un-
derstand the factors that contribute to penis dis-
satisfaction and the possible consequences of
this discontent. An intriguing finding was the
substantial discrepancy between the percentage
of men versus women who reported satisfaction
with their own or their partner’s penis. Only
15% of women said they were not satisfied with
their partner’s penis size, compared with 45%
141PENIS SIZE SATISFACTION
of men who were not satisfied with their penis
size.
Why are so many men dissatisfied with their
penis size when the vast majority of women are
satisfied with their partner’s penis size? Past
research has suggested that one reason men
overestimate the importance of a trait to women
is that media marketed to men give greater
emphasis to the importance of this trait than do
media marketed to women (Frederick, Fessler,
& Haselton, 2005). For example, media mar-
keted to men (pornography, popular magazines)
may emphasize the importance of supersized
penises, whereas media marketed to women
may not. If individuals use media as a source of
information about what physical features are
important, than gender-differentiated media
may mislead men about women’s actual prefer-
ences. Future research should examine in
greater detail the degree to which men overes-
timate the importance of penis size to women
and the reasons for this misperception.
Even if a man recognizes that his partner
finds his penis to be adequate, however, he may
still want to be larger as a way to feel more
masculine. This insecurity may stem from how
he feels his flaccid penis size and his erect penis
size compare with those of other men. The only
place in real life where most heterosexual men
view another man’s penis is in its flaccid form
in locker rooms, which may cause flaccid penis
size to become an important component of their
perceptions of how masculine they are. Men’s
perceptions of their erect penis size relative to
other men’s may also be shaped during verbal
competitions where men boast about their size
when erect. We encourage future researchers to
pose questions that probe this aspect of male
culture.
Pleck (1981, 1995) put these concerns within
the context of what he termed gender role
strain. One specific form of gender role strain,
termed discrepancy strain, results when one
fails to live up to one’s concept of manhood.
This perspective suggested two ways to reduce
men’s dissatisfaction with penis size. First, men
can be encouraged to reject the cultural mes-
sages associating penis size with masculinity
(e.g., Richmond & Levant, 2003). Using popu-
lar newspapers and magazines to publicize the
finding that penis size is less important to
women than men think will help male readers
allay at least this source of anxiety.
Second, researchers have an obligation to dis-
seminate findings within the medical and psy-
chotherapy communities, for example, by pub-
lishing research notes in journals for urologists,
so that their members can challenge patients’
beliefs that they need penis enlargement proce-
dures to be acceptable as sexual partners. Let-
ters to the editor of journals for clinical thera-
pists, for another example, can urge the spon-
soring association to issue policy statements
that discourage surgery as an individual solu-
tion to a cultural problem. It would be useful to
urge media outlets to stop promulgating the
bigger-is-better association of penis size with
masculinity, too. Reaching creators of mass me-
dia messages is more difficult than reaching the
health care community, but encouraging image
shapers to take greater social responsibility
should not be abandoned as an impossibility.
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Accepted February 7, 2006
143PENIS SIZE SATISFACTION
... In sum, available studies suggest that as many as one third of all women and up to almost half of all men may be dissatisfied with the appearance and/or size of their genitals, 5,27 but less is known about how many individuals that present with more severe dissatisfaction in the population. Other aspects that need further investigation are whether actual genital size, the consumption of SEM or other factors affect people's genital selfimage as well as the association between avoidance and safety seeking behaviors and degree of genital dissatisfaction. ...
... Our finding that over one third of the sample to some degree explicitly report being dissatisfied with the appearance of their labia minora or penis is in line with previous research. 5,27 Furthermore, 3.6% of females and 5.5% of males in our sample were classified as having severe genital dissatisfaction. On the other hand, roughly one in seven individuals also reported that they would consider undergoing cosmetic genital surgery. ...
Article
Background Dissatisfaction with the appearance and size of one's genitalia is a common issue, and the use of cosmetic genital surgery is increasing among people with normal genitalia. Aim This cross-sectional study aimed to investigate the distribution of genital self-image in a large sample of males and females, and whether selected factors could predict genital self-image. Methods Three thousand five hundred three anonymous participants completed online questionnaires. Multiple linear regressions were used to identify the association between genital self-image and genital size (length of penis or protrusion of labia minora), consumption of sexually explicit material (SEM), sexual activity, avoidance and safety seeking behaviors, openness toward genital cosmetic surgery and age. Outcomes Total scores on the Female and Male Genital Self Image Scale were used as the main outcome measures. Results Overall, 3.6% of females and 5.5% of males had a severely low genital self-image (defined as 2 SD below the mean) and 33.8% of all individuals reported dissatisfaction with the appearance of their genitalia, with 13.7% of females and 11.3% of males considering undergoing cosmetic genital surgery. Mean protrusion of labia minora and stretched flaccid penis length in the population was estimated to 0.76 cm (95% CI 0.63–0.89 cm) and 12.5 cm (95% CI 12.33–12.76 cm), respectively. A higher genital self-image score was predicted by having a larger penis or less protruding labia minora, but not by the degree of SEM consumption, although 93.6% of males and 57.5% of females had consumed SEM in the past three months. The degree of avoidance and safety seeking behaviors, sexual activity, and openness toward genital cosmetic surgery predicted a low genital self-image. Being older was associated with a better genital self-image in females. Clinical Implications The results show that a psychological intervention may be needed as an alternative to cosmetic genital surgery for people who are dissatisfied with the appearance of their genitals. Strengths and Limitations This is one of few available studies investigating the association between actual genital size and genital dissatisfaction. The vast sample size and high response rate are also strengths. Limitations include the cross-sectional design, and possible bias in the study sample due to self-selection. Conclusion Overall, a low genital self-image and dissatisfaction with one's genitalia is relatively common and is influenced not only by genital size, but also behaviors performed to alleviate worry about one's genitals. Hustad IB, Malmqvist K, Ivanova E, et al. Does Size Matter? Genital Self-Image, Genital Size, Pornography Use and Openness Toward Cosmetic Genital Surgery in 3503 Swedish Men and Women. J Sex Med 2022;XX:XXX–XXX.
... The reason behind the spread of penis enlargement practices over time is indeed rooted in the virility that the appearance of the genitals can give a man, as well as an altered perception of his own body. A large study of 25,594 healthy men found that 45% desired a larger penis [3]. Sometimes behind the request for penis enlargement, that is the increase of penile circumference, is hidden the desire to give more pleasure to the partner, although men generally view penis size as more important than women do [4]. ...
... Up to 66% and 12% of men in the general population perceive their penis size as average and smaller than average respectively and the desire to have a bigger penis was present in 46% of men who rated their penis as average and 91% of men who rated their penis as smaller than average [3]. The negative perception of the size of one's own penis could underlie a somatoform disorder called Penile Dysmorphic Disorder (PDD) which is classified according to DMS-5, within Body Dysmorphic Disorders (BDD) [8]. ...
Article
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The reason behind the spread of penis enlargement practices over time is rooted in the virility that the appearance of the genitals can give a man, as well as an altered perception of his own body. The approach should be to modulate the interventions on the real needs of patients, carefully evaluating the history, the psychological picture, and possible surgical advantages. The aim of this study was to shed light on cosmetic surgery of male genitalia through minimally invasive and more radical techniques, with the purpose of laying the foundation for possible indications and recommendations for the future. A non-systematic literature review using the PubMed and Scopus databases was conducted to retrieve papers written in English on cosmetic surgery of the penis published over the past 15 years. Papers discussing cosmetic surgery in patients with concomitant pathologies associated with sexual dysfunction were excluded. The main outcomes recorded were change in penile dimensions in term of length and girth and surgical complications.
... Genital improvement is mainly required to improve self-esteem and oneself in the eyes of others rather than to increase the sexual satisfaction of the partner. In a study published by the American Psychological Association (APA), only 55% of men were satisfied with their penis size, although 85% of women were satisfied with the size of their partners' genitals; 45% of men wanted a bigger penis, and only 0.2% wanted smaller genitals [39]. The greatest concern to patients is usually the length of the penis in a flaccid state, up to sometimes configuring the "Locker room syndrome" [40,41]. ...
Article
Since ancient times, men have tried to change the size and shape of their genitals. Bites from insects or poisonous snakes and weights were among the first methods used for this purpose. In the first half of the 1900s, the scientific push regarding male genital aesthetic surgery began. Scrotoplasty, penile suspensory ligament release, injection of hyaluronic acid as filler, use of several types of grafts, lipofilling, and liposuction are techniques currently used. The Penuma® implant has recently been described with promising results. We are living in the era of tailored surgery and regenerative medicine. Shortly the surgeons will have to know several surgical techniques and adapt them to the patient. New fillers with ideal characteristics, innovative prosthetic devices, and stem cells will probably be the protagonists of future aesthetic surgery. The main effort of the scientific community should be directed towards the design of new randomized controlled trials to increase the evidence on the efficacy and safety of the topic, with the ultimate aim of allowing clear recommendations from scientific societies.
... In the body areas attractiveness ranking, the abdomen, chest, and genital area were also frequently rated among the most unattractive body areas of one's own and/or the peer's body. These findings likewise correspond to previous studies indicating that men often perceive the abdomen and the chest as unattractive body areas (Tanck et al., 2019) and are frequently dissatisfied with aspects of the genital area (e.g., one's own penis size) (e.g., Lever et al., 2006). In turn, the body areas most frequently rated as among the most attractive body areas of one's own and/or the peer's body included the forearms, the upper arms, the hands, and the thighs, which also corresponds to the findings by Tanck et al., (2019). ...
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Background Body-related attentional biases are assumed to contribute to the development and maintenance of body-related concerns or specific mental disorders such as eating disorders. However, while studies have indicated gender-specific differences in body-related concerns, less is known about gender-specific differences in body-related attention allocation. Methods An eye-tracking paradigm was used to assess women’s (n = 41) and men’s (n = 42) attention patterns towards their own and a peer’s body. Additionally, state body satisfaction and affect were examined. Results While both women and men showed higher state positive and negative affect after viewing one’s own body than after viewing a peer’s body, only women displayed worse state body satisfaction after viewing one’s own body than after viewing a peer’s body. Conversely, both genders showed a similar deficit-oriented attention pattern, irrespective of the presented body type. Conclusions The findings provide evidence of gender-specific differences in state body satisfaction after viewing one’s own and a peer’s body. However, these differences do not seem to be reflected by gender differences in body-related attention allocation. As both women and men showed a deficit-oriented attentional bias, they might benefit from interventions which aim to establish a functional or self-serving way of looking at one’s own body.
... Over the past 20 years, most national studies in the United States focusing on affective body image have relied on one-item measures of key constructs (Frederick & Essayli, 2016;Frederick et al., 2006;Frederick et al., 2008;Frederick, Garcia, et al., 2020;Krueger et al., 2008;Lever et al., 2006;Lever, Frederick, Laird & Sadeghi-Azar, 2007;Peplau et al., 2009;Swami et al., 2015). This provided useful information, but body image is a multidimensional construct consisting of cognitive, behavioral, affective, and perceptual factors (Banfield & McCabe, 2002). ...
Article
We examined how gender, body mass, race, age, and sexual orientation were linked to appearance evaluation, overweight preoccupation, and body image-related quality of life among 11,620 adults recruited via Mechanical Turk. Men were less likely than women to report low appearance evaluation, high overweight preoccupation, negative effects of body image on their quality of life, being on a weight-loss diet, and trying to lose weight with crash diets/fasting. Racial differences were generally small, but greater appearance evaluation was reported by Black men versus other groups and Black women versus White women. Across all measures, gay and bisexual men reported poorer body image than heterosexual men, with only small effect sizes observed for sexual orientation differences among women. Body mass, but not age, was strongly associated with body image. The prevalence of poor body image highlights the need for interventions. On the positive side, half of men and women reported high appearance evaluation. Examination of this group could identify factors promoting positive body image.
... Signifiers of gender/sex, including femaleness and maleness seem to vary in significance by context, too. For example, large penises or breasts seem to be a prominent feature of mainstream porn compared to in-person sexuality and fantasy (Hesse & Pedersen, 2017;Joyal et al., 2015;Lever et al., 2006). ...
Article
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Sexual orientation describes sexual interests, approaches, arousals, and attractions. People experience these interests and attractions in a number of contexts, including in-person sexuality, fantasy, and porn use, among others. The extent to which sexual orientation is divergent (branched) and/or overlapping (coincident) across these, however, is unclear. In the present study, a gender/sex and sexually diverse sample (N = 30; 15 gender/sex/ual minorities and 15 majorities) manipulated digital circles representing porn use, in-person sexuality, and fantasy on a tablet during in-person interviews. Participants used circle overlap to represent the degree of shared sexual interests across contexts and circle size to indicate the strength and/or number of sexual interests within contexts. Across multiple dimensions of sexual orientation (gender/sex, partner number, and action/behavior), we found evidence that sexual interests were both branched and coincident. These findings contribute to new understandings about the multifaceted nature of sexual orientations across contexts and provide a novel way to measure, conceptualize, and understand sexual orientation in context.
Article
Introduction: Across many cultures, penis size has been associated with virility, and concerns about penile length are commonplace. Peyronie's disease (PD) is a known acquired cause of penile shortening. Objectives: This paper describes the psychosocial impacts of penile length on men and their partners, both generally and in men with PD, and evaluates the effect of PD treatments (eg, collagenase clostridium histolyticum , surgery, mechanical therapy) on this outcome measure. Methods: A PubMed database search was performed for English language articles through July 2021. Main outcome measures were association of penile length with emotional well-being, selfesteem, and relationship satisfaction in men with PD, and change from baseline penile length after treatment. Results: Shortened penile length caused by PD can negatively impact patient and partner quality of life, including effects on body image, emotional well-being, sexual function, and interpersonal relationships. In men with PD, studies have demonstrated an association between loss of penile length and emotional problems, reduced satisfaction with sexual performance, poor self-esteem, depression, and relationship difficulties. Loss of penile length can frequently occur after surgery for PD (including plication, plaque incision/excision with grafting, and penile implant). Advanced surgical techniques may preserve/increase penile length, but the increased risks associated with these complex procedures must be carefully considered. Treatment with collagenase clostridium histolyticum does not appear to negatively impact penile length, and 5-year follow-up data suggest potential longterm posttreatment improvements in this outcome measure. Penile traction therapy, either alone or as adjunctive therapy, may increase penile length in men with PD, but nonadherence may limit improvement. Conclusion: Changes in penile length are important to many men, particularly those with PD, and should be considered during PD treatment selection. Penile length should be measured objectively before and after treatment for PD and should be included as an outcome measure in future studies on treatment effectiveness. Goldstein I, Gelbard MK, Lipshultz LI. Clinical Significance of Shortened Penile Length and Alterations in Penile Length Following Treatment for Peyronie's Disease. Sex Med Rev 2022;10:409-420.
Article
Body image is a critical component of an individual’s sexual experiences. This makes it critical to identify demographic and sociocultural correlates of sexuality-related body image: the subjective feelings, cognitions, and evaluations related to one’s body in the context of sexual experience. We examined how sexuality-related body image differed by gender, sexual orientation, race, age, and BMI. Four items assessing sexuality-related body image were completed by 11,620 U.S. adults: self-perceived sex appeal of their body, nude appearance satisfaction, and the extent to which they believed that body image positively or negatively affected their sexual enjoyment and feelings of sexual acceptability as a partner. Men reported slightly less nude appearance dissatisfaction and fewer negative effects of body image on sexual enjoyment and sexual acceptability than women, but did not differ in reported sex appeal. Poorer sexuality-related body image was reported by people with higher BMIs, not in relationships, who had sex less frequently, among White compared to Black women and men, and among gay compared to heterosexual men. Data also revealed a subgroup of respondents who reported that their body image had a positive impact on their sex lives. The findings highlight a need for interventions addressing sexuality-related body image.
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present an overview of the . . . debate about male gender role strain in the research and theoretical literatures of the last dozen years / distinguish the 3 major arguments inherent in the gender role strain model and describe how they have faired in recent research / develop the construct of masculinity ideology as a central "co-factor" in male gender role strain / analyze and respond to the criticisms on the gender role strain model made by a more recent theoretical perspective on masculinity, social constructionism / consider the recent revival of "male identityism" (the older dominant theory of masculinity) and reflect on the broader cultural contention between the strain and identity models of masculinity (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
An expanded, updated version of Peter Lehman's classic text that became the leading source for the study of masculinity, the male body, and sexuality in film.
Article
This research sought to examine psychologically mediated effects of differential penis size. To investigate this issue, we asked male and female undergraduates (N = 284) to read erotic passages that differed only in the length of the penis that was ascribed to the male protagonist—3 in. long (small), 5 in. long (medium), 8 in. long (large), or no mention made of penis size (control condition). Arousal and attributional responses to these portrayals were then assessed. In addition, subjects' erotophobia‐erotophilia (their disposition to respond to erotic stimuli with negative to positive emotions) and their level of prior sexual experience were assessed. Results showed that the erotic passages were significantly arousing and that the manipulation of perceptions of penis size was highly effective. Despite the effectiveness of the manipulation, however, subjects did not report differential arousal or (for the most part) attributional responses to depictions of small, medium, or large penises. Correlational analyses revealed that erotophilic (versus erotophobic) persons may be more aroused by depictions of a large penis, and more sexually experienced males seemed to be more aroused by depictions of medium than by small or large penises. In all cases, however, the observed correlations were modest. Overall, the findings suggest that, for most individuals, penis size may be as unimportant on a psychological level as it appears to be on a physical level.
Article
Genital aesthetic and penile enlargement surgeries are relatively new. Most results are anecdotal, but some surgeons are trying to generate meaningful data. Follow-up data are often difficult to obtain because many patients travel long distances for the surgery. Dermal-fat grafts have been successful, although some patients resist the operation primarily because of the large donor scar(s). Gluteal crease donor scars are less noticeable than groin scars. Physicians performing fat injections promise small scars and minimal morbidity but emphasize the frequent necessity for re-injections. Dermal-fat grafts do not need re-operations and appear to have good long-term results. A reasonable aesthetic proportion between the shaft and the glans should be maintained. Some men with massive fat injections, however, appreciate the greatly enlarged shaft despite the “grotesque” appearance resulting from the disproportion between the shaft and the glans. The limited size of the dermal-fat grafts does not allow for massive thickening of the shaft because circumference increase of 1 to 2 inches is reasonable even with a relatively small glans. No effective procedure for enlargement of the glans is known. Penile lengthening operations in the normal patient remain a major question. There is no satisfactory incision for skin advancement onto the penis, but a Z-plasty or double Z-plasty may be acceptable. Z-plasty is preferable owing to the high incidence of hypertrophic scars, wound disruption, and dorsal humps with V-Y advancement flaps. Moreover, exaggerated length claims of many physicians are unrealistic; a gain of 1 inch is considered a success. The patient with the 3-inch gain may be deformed with an extended escutcheon and a low-hanging penis, while achieving minimal or no real length gain. Malpractice is a major consideration in penis enlargement surgery. Most malpractice carriers will not insure penile fat injections. Depending on the physician and the insurance carrier, dermal-fat grafts may be covered. Liability largely depends on adequate informed consent. Patients should be advised that these operations are investigational and require an extensive consent form to be signed. They must understand that penis enhancement techniques are evolving and that results are still being compiled. Extensive physician consultation before surgery is imperative, and a “factory” approach is unethical. No two patients are anatomically alike, and thus, a “standard” approach to penile enhancement surgery is not in the best interest of the patient. Many referred patients present with persistent pain, bizarre-appearing V flaps, penile shortening, and massive fat injections with lumps. Some men have become emotional cripples, physically and psychologically unable to perform sexually. Obviously, a man seeking penile enlargement surgery has self-esteem issues, and therefore, a disastrous result may leave him further devastated. Dissatisfied male aesthetic patients have a greater propensity towards violence, so the physician must carefully screen these patients and perform good work for the protection of both the patient and himself. The male with the concealed penis definitely benefits from a suprapubic lipectomy, release of the suspensory ligament, and a possible Z-plasty of the penoscrotal junction. Such reconstructive cases to restore normal sexual functioning may be covered by insurance. The necessity for understanding plastic surgical principles to achieve satisfactory results cannot be overemphasized. Knowledge of the principles of flap design and surgical technique is necessary to prevent flap necrosis, wound disruption, “dog-ear” formation, unsightly genital distortion, and poor scar formation. Urologists should study these principles and techniques before performing such operations. Meticulous, time-consuming surgery will help prevent major problems and patient dissatisfaction. Penis enlargement surgery is effective with low morbidity and high patient satisfaction. As new techniques evolve, demand will continue to increase.
Article
Young men often complain about problems with condom use, but very little information exists about the influence of men's age on penile dimensions and therefore on possible problems in the use of the most important means of contraception in the young. We performed a prospective measurement of penile dimensions in 111 men,18 to 19 years old (group A), and in 32 men, 40 to 68 years old (group B). We measured penile length and width in the flaccid state and after visual and manual self-stimulation in group A and after intracavernous injection of prostaglandin E(1) in group B. The mean flaccid length in group A (8.60 cm) and group B (9.22 cm) was significantly different. The mean erect length in group A (14.48 cm) and group B (14.18 cm) was not significantly different. The mean flaccid width at the base was significantly different between group A (3.08 cm) and group B (2.87cm), but the mean flaccid width at the glans was not (group A, 3.02 cm; group B, 3.01 cm). The mean erect width at the base (group A, 3.95 cm; group B, 3.50 cm) and the erect width of the glans (group A, 3.49 cm; group B, 3.32 cm) were significantly different. Our assumption that the problems young men experience with condom use may be because of smaller penises could not be proved. To address the problems in condom use in younger men, a larger variety of condom sizes and better information about condom use may be useful.
Article
The knowledge of normal variations in the size of male external genitalia is of considerable interest to several disciplines. We carried out an extensive study in young Italian males to provide estimates of normal variations of penile dimensions. The penile length in flaccid and stretched states and the penile circumference were measured in a random group of 3,300 young men aged 17-19 years and free from endocrine disorders and from congenital or acquired abnormalities of the penis. In a random sample of 325 subjects of the same set of people, penile length and circumference were also correlated with weight and height. Statistical analysis was performed with the Sperman test, because our data were not normally distributed as tested by the Kolmogorov-Smirnov test (p < 0.01). The median values of penile dimensions recorded in the present study are flaccid length 9.0 cm, flaccid circumference, at the middle of the shaft, 10.0 cm, and stretched length 12.5 cm. We also observed that the penile dimensions are highly correlated with height and weight. Since penile length and circumference correlate with anthropometric parameters such as weight and height, we suggest to consider themselves as two bodily measures which display a wide extent of normal variability along the general population.
Article
There are only a few reports that investigate the measurement of functional penile length and compare the methods used for this purpose. The aim of this study was to determine the correlation between the measurement techniques and to determine an appropriate method that correlates the erect state most closely. Measurements of penile length in 200 healthy men were made during three different states--flaccid, erect, and stretched--of the penis. The results were evaluated using descriptive statistics, paired t-test, correlation coefficients, and regression equations. The correlation between the flaccid and the erect lengths was 71.2%, and it was 80.2% between the stretched and the erect lengths (p < 0.01). Using regression equations, the degree of accuracy in estimating the erect length by using the stretched length was 65.3% (R2 = determination coefficient; p < 0.01) and was 50.8% by using the flaccid length (p < 0.01). When both the flaccid and the stretched lengths were considered together, the predictability of erect length was R2 = 65.5%. The results obtained using different statistical methods showed that the most accurate results can be obtained by considering stretched penile length, whereas flaccid length had little importance in determining erect penile length. In conclusion, the stretched penile length measurement technique is highly recommended for the accurate prediction of the erect penile length.
Article
Penile augmentation surgery is a highly controversial issue due to the low level of standardisation of surgical techniques. The aim of the study is to illustrate a new technique to solve the problem of enlarging the penis by means of additive surgery on the albuginea of the corpora cavernosa, guaranteeing a real increase in size of the erect penis. Between 1995 and 1997, 39 patients who requested an increase in the diameter of their penises underwent augmentation phalloplasty with bilateral saphena grafts. The patients considered eligible for surgery were patients with either hypoplasia of the penis or functional penile dysmorphophobia. All the patients included in our study presented normal erection at screening. The average penis diameter in a flaccid state and during erection was found to be 2.1cm (1.6-2.7 cm) and 2.9 cm (2.2-3.7 cm), respectively. Before surgery the patients were informed of the experimental nature of the surgical procedure. The increase in volume of the corpora cavernosa was achieved by applying saphena grafts to longitudinal openings made bilaterally in the albuginea along the whole length of the penis. No major complications and specifically no losses of sensitivity of the penis or erection deficiencies occurred during the post-operative follow-up period. All the patients resumed their sexual activity in 4 months. A measurement of the penile dimensions was carried out 9 months after surgery. No clinical meaningful increases in the diameter of the flaccid penis were documented. The average penis diameter during erection was found to be 4.2 cm (3.4-4.9) with post-surgery increases in diameter varying from 1.1 to 2.1cm (p<0.01). The penile enlargement phalloplasty technique with albuginea surgery suggested by the authors definitely is indicated for increasing the volume of the corpora cavernosa during erection. Albuginea surgery with saphena grafts has been found to be free from aesthetic and functional complications with excellent patient satisfaction.
Article
To investigate the flaccid and stretched penile sizes of young Korean men and their complexes or pride about their penile size. After an explanation and agreement to the purpose and methods of this study, 123 Korean men in their early 20's visiting the Jinhae Military General Hospital were included in the study. The flaccid penile length, flaccid mid-shaft circumference, stretched length and pre-pubic bone fat pad depth were measured in a warm comfortable environment. The accuracy the subjects assessed their penile size was investigated by asking them to rate their penile size, as 'very small', 'small', 'normal', 'large'or 'very large', All subjects were asked to complete the Minnesota multiphasic personality inventory (MMPI) test. The mean flaccid length, flaccid circumference, stretched length and fat pad depth of the 123 subjects were (6.9+/-0.8) cm, (8.5+/-1.1) cm, (9.6 +/-0.8) cm and (1.1 +/-0.4) cm, respectively. The answer distribution on penile size was 1 (0.8 %) 'very small', 29 (23.6 %) 'small', 86 (69.9 %) 'normal', 6 (4.9 %) 'large' and 1 (0.8%) 'very large'. Subjects who underestimated their penile size showed significantly higher scores on the hypochondriasis (Hs), depression (D) and psychasthenia (Pt) subscales of the MMPI than those in the Unbiased Group (P<0.05). In consultation, with a patient requesting penile augmentation, the urologist should consider the psychologic attitude of the patient to his penile size.