This article is to coach you (and your partner) in the truth about healthy, pleasurable, satisfying sex—not hype or promises that only lead to disappointment and “is that all there is?” We coach you in the scientific and medical facts, the reality of real men who have real jobs and real stresses, living real life with real women, with real failures as well as successes. We wrote this article to coach you with integrity, openness, candor, frankness, and details that you can apply to your life. We wrote this article because we believe there is too much BS out there about men and sex. We wrote this so that you can avoid the myriad of mistakes we have seen in our clinical practices, mistakes made out of ignorance, misinformation, unrealistic expectations, anxiety, shame, and following hyped-up promises—“Use this cream and your ‘dick’ will grow two inches.” We’ve seen too many lies told to men. We want to give you the facts! So, we have written this article with the promise—to ourselves and to you—that this is an article with integrity. We’ve counseled and coached thousands of men (and their partners) how to develop positive male sexual health, address sexual problems, and overcome worries, misunderstandings, and other barriers to sexual satisfaction. We have heard legions of men individually, in educational workshops, in couples therapy, and in men’s group therapy express hidden thoughts and conflicts about sex. These men are scientists, construction workers, college students, professional football players, Fortune 500 CEOs, politicians, government employees, computer geeks, police officers, invest- ment bankers, bakers, hockey stars, medical doctors, waste management truck drivers, pilots, prisoners, clergymen, chefs, military personnel, lawyers, factory workers, diplomats, teachers. You name the occupation, and we’ve heard from them over the years of our clinical work. They are young, middle-aged, older, single, married, divorced, sexually active, celibate, in good health, in poor health. Like their jobs and status in life, men are different emotionally and sexually. We are not stereotypes but have incredible diversity and ranges of thoughts, feelings, experiences, and sexual preferences. Some of us are saintly, some are villainous, while most of us are in the broad expanse in between. While we are different from each other in many ways, we all seek sexual health. Here are principles and facts that are common to all of us when it comes to sexual health. Men’s sexual health is grounded on psychological and physical facts and truths.
Fact #1: Healthy Men Are Proud of Their Sexuality
Feeling good about your body and sexuality is essential to being sexually healthy. The truth about great sex is that every man deserves to feel proud and confident of his masculinity. Okay, there are jokes that sexual health for men is impossible or an oxymoron—that men are sexual idiots or “only think with their penis.” These are simplistic stereotypes. Trash talk!
Each man can feel proud of his masculinity. Sex is a good part of a man’s (and a woman’s) life, not something to feel ashamed or embarrassed about.
Feeling proud of your body, unashamed of your powerful sex drive and sexual desires, buoyed by your sexual function, and clear with yourself
of the importance of feeling pleased and satisfied with sex are important principles of men’s sexual health. This confidence is based in physical, psychological, and relationship principles that accept masculinity with pride and self-respect.
Fact #2: Sexually Healthy Men Are Confident and Strong
What is men’s sexual health? How do I get a solid grip on it? How do I determine if I am a sexually healthy man? These are not simple ques- tions with simple answers. Sexual health is a lifelong process, with subtly different dimensions at each stage. For example, sexual health of a boy is part of the lifelong process but is different from that for a teen or young adult and different from a middle years and older adult. However, at each stage of life, common elements characterize sexual health. Here is the description of sexual health from the United Nations’ World Health Organization (WHO, 1975):
Sexual Health may be defined as a dynamic and harmonious state involving erotic and reproductive experiences and fulfillment, within a broader physical, emotional, interpersonal, social, and spiritual sense of well-being, in a culturally informed, freely and responsibly chosen, and ethical framework; not merely the absence of sexual disorders.
A translation may be helpful. Sexual health is the integration of your psychological, biological, and interpersonal sexual energies in a comfortable, meaningful, and satisfying way. In short, you feel confident and strong about yourself as a sexual man and know that others feel comfortable with you as well. Sex is a physiological, natural function, and sex is part of sexuality. Sexuality is a learned, psychosocial function. Sexuality is an integral part of every man’s personality and is expressed in all that we do. In the broadest sense, sexuality is the psychic energy that finds physical and emotional expression in the desire for contact, warmth, tenderness, eroticism, and love. This energy is part of a man’s balanced self-confidence and strength.
Fact #3: Men Have a Wide Range of Sexual Concerns
Every man (and woman) has concerns about what is sexually normal. There is a wide range of concerns about what is normal physically (like penis size); how your sexual body functions (erections, ejaculation); what thoughts or fantasies are normal (e.g., being sexually aggressive, group sex, attracted to a coworker, sex with animals); how to make love (how to “turn a woman on”); and what are appropriate sexual feelings (e.g., “horny”), sexual interest (e.g., “Am I addicted to strip bars?”), or behaviors (“Is my use of porn okay?”). We hear real men say things like:
- “Am I normal?”
- “Is my partner normal?”
- “I love sex; it’s great. But I am not like men in the movies or TV. Is
- there something wrong with me?”
- “My testicles hang differently. Is there something wrong with me?”
- “I don’t want to get older, 55 or 75, because sex surely must decline and end.”
- “I’m embarrassed that I don’t know how to be a super lover.”
- “I had really great sex with her, but is that all there is?”
- “I feel so dumb! Nobody talked to me about what healthy sex is.
- I don’t trust all the braggadocio I hear from male friends in the locker room or sports bar.”
- “Sex with a long-term partner gets boring.”
- “I use pornography regularly because it is my guarantee for vari- ety. It ensures that I can get aroused and erect. Is that healthy?”
- “I feel inadequate; I doubt my ability to perform and satisf y my partner.”
- “Penis size seems so important to women. I worry, am I big enough?”
- “Sex is supposed to be natural, but I have difficulty letting go.”
- “My sexuality as a man seems more complex than what other men say, TV or movies show, or what the Internet says. Am I peculiar or inadequate?”
- “There are times that I feel very ashamed of my honest sexual desires, that they are ‘bad.’”
- “I often doubt my ability to perform, to sexually satisfy my partner.”
- “Are my fantasies, my body, my lovemaking style normal?”
- “I’m afraid she’s judging me, my sexual skills and performance;
- this makes me anxious.”
- “I have some weird thoughts and desires. How do I know if I’m deviant?”
These and other thoughts and feelings represent common concerns men have about their masculinity and sexual performance. If you are a man who wants to be honest with yourself and not live in the world of beer commercials, simplistic promises of Viagra ads, and sexual hype, you’ll find yourself in this article. You can learn to feel proud of your masculinity and sexuality. This is an article for honest, strong, thoughtful men. We will explore common anxieties that many of us experience. Most men have little opportunity to learn from other men about healthy sexuality. We will confront common barriers to growing and developing an adult, healthy, and satisfying male sexuality.
This article takes men’s sexuality seriously. Rather than trivializing men and sex, we consider complexity. This is an article for real men, not politically correct men. We will give you essential facts and discuss how sexual health can confirm your masculinity and promote life satisfaction.
Fact #4: What Is Good for Your Body Is Good for Your Sex Life. What Is Good for Your Sex Life Is Good for Your Body
The interrelationship between your physical body and sexual function is crucial to sexual health. Good lifestyle habits and choices—such as proper sleep, regular exercise for physical conditioning, healthy diet, moderation in your use of alcohol—provide the foundation for easy sexual function. Taking good care of your physical body is a prerequisite for satisfying sex. Positive, realistic expectations and cooperation with your partner are good for your sexual function. This interrelationship makes sense in the context of physiological sexual response and the importance of relaxation and comfort with your partner.
Fact #5: Satisfying Sex Is Important to Your General Health
When men feel sexually healthy and satisfied, men walk tall. Our sexual feelings, emotional well-being, confidence in the world, and even our physical health are essentially intertwined. On the other hand, a man who is troubled with his sexuality is at risk for low self-esteem, irritability, anxiety, and even physical illness. This interrelationship is an important reason that sexual dysfunction is considered both a psychological and a medical concern. The mind–body connection is valid.
Fact #6: Satisfying Sex Involves Lovemaking Skills
Good sex is more than performing as a “stud.” Healthy physical conditioning, realistic psychological thinking, emotional health, and interpersonal cooperation for mutual pleasure are all part of good psychosexual (love-making) skills. While procreation may be biologically natural, satisfying lovemaking skills are not automatic but are developed through healthy attitudes, behaviors, and emotional intimacy. You can develop comfort and confidence with psychosexual skills and strengthen your desire, arousal, and orgasm response.
Fact #7: Knowledge Is Power
Accurate and realistic knowledge about men’s bodies and male sexuality is crucial. Sexual health for men involves understanding physical, psychological, and relationship factors. Being realistic and thinking accurately about your body and your sexual function is a crucial component of sexual health.
This is essential because the public presentation of sex has nearly no relationship to the truth. The media, marketing, and public discourse is about getting your attention more than teaching you the truth about sex in real people’s lives. This is a major problem and one of the most important motivations for our writing this article.
You also need a good understanding of your emotional life. It is important to understand the differences between your sex drive (“feeling horny”) and positive and negative emotions like anxiety, loneliness, enjoyment, or pride in a job success. All energy in the body is not sexual energy, although there is a tendency for men to interpret a variety of emotions as sexual and try to manage their emotions by sexualizing them. For example, most men have masturbated to relieve anxiety or stress.
You also need to understand what healthy sexual behaviors are. Men care about sexual performance. Sexual function (performance) for men is fundamental, and to dismiss this important component of male sexuality is self-defeating. We’ll coach you how to put sexual function into perspective; otherwise, it becomes a huge barrier to sexual pleasure, sexual acceptance, and relationship intimacy.
Fact #8: Sexual Health Is a Lifelong Developmental Process
Your health as a sexual man is a lifelong process. Sex can be a positive, integral part of your life at every stage. You are sexual from the day you are born to the day you die. Realize that your sexuality is a lifelong, progressive, and developmental process. It changes as you go through your life—from boyhood, adolescence, young adulthood, middle age, and older. Your sexuality as a 15-, 25-, 45-, 65-, or 85-year-old has both underlying similarities and also differences. We can be sexually healthy at each stage of our lives.
“To be what we are, and to become what we are capable of becoming, is the only end of life.”—Robert Louis Stevenson.
The best research indicates that the quality of sex—like fine wine—improves with age. If you take good care of your psychological, physical, and relationship health, lifelong sexual satisfaction is a realistic expectation.
Fact #9: There Are Many Barriers to Healthy Sex
Detrimental messages, stereotypes, and erroneous beliefs about men and sex can set you up for sexual self-doubts, dysfunction, and dissatisfaction. The quiz you took earlier presented common myths. Some incorrect stereotypes include “Good women really don’t like sex” or it’s antithesis, “Hot women expect perfect sex performance”; others, “Great sex is what you see in porn videos” or “Marital sex is inevitably boring and mediocre.”
Do not be duped by such damaging messages—recognize where they come from. Don’t get faked out! Pay attention to positive sexuality. The following sources can undermine your sexual health.
Negative Messages About Men and Sex in the Media.
Product marketing: It is important to realize that we live in a commercial culture and that media is a primary source for selling products. Sex sells. Because of its natural power, sex is used to get our attention and even to create a need by associating sexualized women to attract us to a product—whether a car, shaving lotion, beer, or athletic club. Be aware that marketing typically trivializes men and sexuality.
News and entertainment: Male sexuality attracts attention—often associated with shame. For example, news reports often and sadly focus on rape, lust killings, child sexual abuse, arrests of men making or dis- tributing child porn, sexual abuse by clergymen, and voyeurism. Men are frequently portrayed as sexually troubled and even dangerous, addicted to Internet pornography, sex harassers, or sex offenders. Some TV shows engage in male-bashing. Men who try to be sexually healthy may unfortunately take on by osmosis subtle collective shame, feeling that as a man he is somehow implicated, suspect, bad.
Avoidance (“Silence”) About Honest Male Sexual Feelings.
Men’s cautiousness about expressing honest sexual feelings is a significant barrier to sexual health. This silence in expressing honest sexual feelings subverts feeling proud of masculinity and sexuality. Men (and women) get faked out, believing that male sexuality is simplistic, one-dimensional (e.g., intercourse), impersonal, and about perfect performance and proving masculinity. This may fit an adolescent emerging from childhood to manhood, but men seeking lifelong sexual health do not live in such a one-dimensional world of sex.
Male “Bravado”: Bragging and Trivializing.
Seldom do men honestly talk with other men about sex in a personal way. Locker-room teasing, joking about another man, and exaggerating sexual escapades are accepted as normal male interaction. Sex is simple, no questions, automatic; it is about how often one “scores” (gets “laid”). This competitive bantering is the usual public discourse for men. When that is the only level on which men communicate with each other about sex, it reinforces a lack of understanding and acceptance and sets up self-defeating sexual expectations.
Typical male language can also be a barrier—language that is object focused (third person) rather than an expression of personal thoughts or feelings. Objectifying language depersonalizes and trivializes sexual- ity. For example, when a man says to his partner “Your body is hot” he may actually mean “I’m lonely and want to feel special and close to you”; “You’ve got great tits” may mean “When you invite me to enjoy you and get close to you I feel special”; or “You don’t want sex? What’s wrong with you?” may mean “I’m confused. When you flat out just say ‘no,’ I think you don’t love me. I feel rejected and controlled.”
Unrealistic Sex Expectations.
Sex as presented in our society has virtually nothing to do with what we know of realistic sex according to the best scientific research. The public impression and discussion of sex in Amer- ica is almost silly. When accurate information is undermined by myths, political distortions, and hype, people do not learn and accept facts about men’s bodies, women’s bodies, and how people function sexually. Without accurate information, we are susceptible to myths, “Hollywood” or pornographic notions of what is supposed to be “real” sex. You will not find men’s sexual health portrayed in a porn movie because pornography is purely about sexual fantasy.
Fantasy is “what you don’t have and can’t reasonably have in real life with a real woman.” That doesn’t make it “bad”—just fantasy. Porno- graphic fantasy has the message that sexual drive does not need to be regu lated, that anything goes. Major unrealistic expectations are encouraged. There is an absence of positive societal messages that teach boys (and men) to regulate their sex drive. Instead, the cultural message about sex drive is negative and shaming (such as in radical feminist philosophy, anti-porn zealots, or negative religious messages of sin). Paradoxically, this shame serves to powerfully contribute to sexual impulsivity and impede men’s sexual health.
Fact #10: You Need a Model for Your Sexuality as a Man
So, what is your model for male sexuality? Who is your role model for a sexually healthy man? How can you think positively about the multiple dimensions of your masculinity? How can you create your standard for healthy sexuality? Your model defines what—for you—is sexual health. It includes your assumptions about what is good sex and what causes sexual problems. This framework determines your understanding of the nature and purposes of sex, your attitude toward your body and your partner’s body, your feelings, the value of fantasies, sexual growth and maturity, your expectations about sex, your relationship expectations, what a sexual dysfunction is, your attitudes toward friendships with men and women, your philosophy of life, the relationship between spirituality and sex, and your definition of sexual satisfaction.
Your sexual model will have a valence; sex is either fundamentally positive or negative—sex is good or sex is bad. Your model needs to focus on you as an individual and on your sexual relationship. Focus your model on accurate knowledge, feelings (satisfaction), and behavior (sexual function). You want to avoid being simplistic or one-dimensional. Ensure that your model of sexuality is inclusive, multidimensional, and well integrated with your body and mind. As much as we all wish important things in life could be simple, the fact is that life is complex, and so is sexuality.
Exercise 1.2: Creating Your Model of Male Sexual Health
Consider the following questions about your thoughts, beliefs, and values about male sexuality:
- Do you think that you can be in poor physical condition and still have a good quality sex life?
- How do you understand your body to be “programmed”? What is it sexually designed to do?
- For you, what are the most important purposes for sex?
- If you feel that you are ugly or have a small penis, can you find sexual satisfaction?
- What do you think is the relationship between your physical and sexual health?
- Could you be happy as a celibate man? What are your specific sexual needs?
- What is the interaction between your sexual thoughts, feelings, and actions?
- Do you think sex is the one area of your life where you should be free and not need to regulate feelings or behavior?
- Is your sexuality your own, or is sex meant to be shared with a loving partner?
- Do you believe that sex is serious or playful?
- Where does your sex drive come from? Body? Emotions? Relationship? Do you think playfulness during sex is valuable for your relationship? Can you sexually disappoint your partner and still have satisfying sex and feel good about yourself?
- How important is a good sex life to an intimate, long-term relationship?
- Do you think sex should rely more on physical desire than emotional closeness?
- How much do you value intimacy? How much eroticism? Can these be integrated into your relationship?
Reflection: There are no simple responses, no correct or incorrect responses to these considerations. Ask yourself:
What thoughts stand out as you reflect on these questions? What do you learn about yourself? Your values? Your model of male sexual health?
Fact #11: Men’s Sexuality Is Complex
An honest model for men’s sexual health grapples with its complexity. We are not the simple, testosterone-driven, google-eyed, lap dogs for women portrayed in beer commercials. Men who model their sex on a Bud Light commercial (think wet T-shirt contest and female mud wrestling) may have fun in college, but this will restrict your adult sexual growth and health.
We propose a new psycho-biosocial, integrative model, that can be valuable for the man (and his partner) from his 20s to his 80s. We label our model the “Good-Enough Sex” model. What is different about our integrative psycho-biosocial model is that it includes multidimensional aspects of each component (mind, body, relationship) plus positive, realistic expectations based on accurate, scientific information and personally relevant guidelines. For example, the psychological dimension appreciates that we have important sexual thoughts (cognitions), feelings (emotions), and actions (behaviors) that need to be integrated. We want you to see the complexity of male sexuality, not trivialize it; to feel confident; to respect your manliness; to understand how to build your sexual satisfaction individually and in a relationship. These features vary and develop throughout your life. Sexuality is not set in stone, immutable, but rather evolving and contributing to the distinctive man that you are at each age.
Fact #12: Male Sexuality Has Multiple Dimensions
Men’s sexual health involves multiple dimensions that help understand and integrate the physical, psychological, relational, cultural, and psycho- sexual lovemaking skills. These five factors are illustrated in Figure 1.1. The 5 Components of Integrative Sexual Health. Each dimension is indispensable and warrants attention to ensure sexual health throughout life.
The biological factors are the physiologic dimensions of sexual function—sexual drive, getting and keeping erections, ejaculation and orgasm, and physiological sexual satisfaction. The physical systems are the vascular, neurologic, hormonal, and behavioral health habits. Good physical condition and healthy habits are the foundation for your biological sexual health.
The psychological dimensions (CBE) are your cognitions, behaviors, and emotions. You can understand and ensure healthy sexual cognitions or thoughts (C); actions or behaviors (B); and your feelings or emotions (E).

The relationship dimension, includes the identity you and your partner share as a couple (e.g., couple expectations such as balancing autonomy and cohesion); your style of cooperation and interactions such as mutual conflict resolution; and emotional intimacy—especially empathy with your partner.
Societal norms refers to the social and cultural environment within which sexuality is understood, moderated, and regulated. This dimension includes prevailing societal attitudes, scientific understanding of sexuality, the laws regulating sexual behavior, as well as religious, moral, and ethical principles. Integrating your sexuality within the social norms and freedoms as well as restrictions of your culture are important aspects of healthy male sexuality.
The psychosexual skills for lovemaking include the cognitive, behavioral, emotional, and interpersonal factors in sexual response. These are important aspects for facilitating your sexual comfort and confidence.
This approach is worth your investment because when you understand how things work and what’s involved, it makes sense, and you can integrate it into your cognitions, behaviors, and emotions. This allows you to feel more comfortable and natural. What you understand, you can do. What you can do well, you feel good about!
Fact #13: Pornography May Be Fine Fantasy but Healthy Sex Is Reality Based
Fantasy for both men and women is a natural part of sexuality. Its role in sexual health depends on its function. Like any other area of life, it needs to fit your realistic lifestyle. A soldier’s use of a group sex fantasy may bring relief through masturbatory arousal. For a married man who avoids his spouse sexually, pornography may serve an anti-intimate role. For the couple who mutually integrate erotic materials into their sexual relationship it may serve to freshen their lovemaking. The debates about the appropriate use of pornography in men’s sexual lives should be about situation-appropriate sexual arousal. In a sexual relationship, pornography use should be about the comfort of both partners as an intimate team.
Fact #14: Ultimately Sex Is About Relationship Intimacy and Satisfaction
From the psycho-biosocial and developmental perspective, the ultimate function for a long-term sexual bond is relationship satisfaction. Consider that over the course of your life, there is a developmental flow from the biological and physiological development and growth of youth, the psychological and sexual development of young adulthood, and the integration of biological, psychological, and relationship dimensions of sexuality in adulthood and older age. It would be unusual for a teen- ager to achieve the level of relationship intimacy that is developmentally possible for middle years and older adults. At the same time, among older adults, it would not be reasonable to expect the biological intensity of adolescence. This perspective can enrich the quality of lifelong sexuality.
Fact #15: Long-Term, Satisfying Sexuality Varies in Quality
One of the most important facts is that the quality of lovemaking is naturally variable. It is a perfectionistic myth to believe that lovemaking will always be exceptional. The best research clearly indicates that while love- making may vary in quality, satisfaction can still be high. In short, the major criterion for sexual satisfaction is not performance but acceptance and pleasure.
The Truth About Great Sex
The truth is that if you think healthy and act healthy, you’ll feel healthy sexually. Thinking well about male sexuality involves taking good care of your body, your partner’s body, realistic expectations of sex, and adopting the Good-Enough Sex model. This approach is focused on being an “intimate team;” on pleasure-oriented sexual function rather than falling into the perfect performance trap; understanding the multiple purposes for sex, the three basic arousal styles and how to use them in partner sex, and maintaining positive, realistic sexual expectations.
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