Genital questions from guys

Look at noses, eyes, ears and hands. No two are the same. The same is true of penises and genitals. We are all different – there is a lot of variation in size and shape.

Most guys have an idea of what ‘typical’ or ‘average’ is and try to compare. Some guys might worry and feel insecure about their shape or size. Or they might worry about what (future) partners might say, or whether they will be able to enjoy good sex.

Good sex isn’t about size or shape. When you feel good about yourself and your body, and when you know how your body works and how your partner’s body works and what they like, and when you‘re able to communicate with them. Those are the ingredients to great sex will happen.

If you worry a lot about this, this is the time to ask for help (rather than ignoring the problem and hoping it goes away.) A doctor or an expert can help you a great deal with your worries and help you get ready for intimacy and sex.

Some guys who come to this site might have some kind of hypospadias. This means that the pee hole isn’t located at the tip of the penis, but somewhere below, on the shaft or even at the base of the penis. It is actually pretty common – about 1 in 250 men have this.

Sometimes, surgery is offered as a child. And sometimes this includes surgeries to change how the genitals and scrotum look. And, when surgeries happen, other problems might come up, like leaks (also called fistulas). If this is the case, other surgeries might be offered to help with those issues.

If this is you, please check out the section on learning about your past care.

First of all, your penis and genitals are still growing. We don’t know how it will look in five years—your body is going through puberty and still may change a good bit.

It is important to ask yourself: why do you want to change your genitals? The penis plays a big part in sex and sexual pleasure (with yourself or someone else.) Every surgery done in this area has major risks, usually can lead to scars and may damage your ability to enjoy sexual pleasure.

Before deciding on anything, we recommend talking to someone trained in DSD care and who can help you think through how you are feeling and what path to take. A psychologist, social worker, nurse, or guys from a peer support group could help you think through the options, risks, benefits, and other important things to consider. Ask your doctor to refer you to someone who could help provide you psychological support as you approach this decision.

One type of surgery that doctors might suggest to change the appearance of your penis (and make it larger) is called phalloplasty. This surgery can only be done in young adulthood/adulthood because it is a very difficult surgery, usually involving multiple surgeries.

In a phalloplasty, skin with blood vessels is taken from one part of the body (such as your arms or legs), rolled into a tube and attached with the blood vessels to your existing penis. There is usually a pretty big scar on that part of your body where skin is taken from. It might take up to a year for the penis and the scar to heal. In a second surgery, the surgeon places an erectile device (usually a pump or flexible rod) in your scrotum. Without the device, it is not possible to have an erection.

Again, any genital changes are important to think through in depth with both doctors and psychologists before deciding on or scheduling anything.

First of all, scars from surgery differ from guy to guy. For some who had surgery, scars are minimal and the penis might look circumcised. For others, scars might be more severe and might affect the sensations you feel and sexual pleasure.

It can be helpful to talk with the specialist urology nurse or a psychologist if you feel concerned with any scarring. Some people go and see a sex therapist and can find this very valuable. Others of us have gotten in touch with support groups. There are many places to find the answers you are looking for and connect with others who have had similar concerns.