The burden of toxic masculinity on men's health

The first time he couldn’t get it up, I was devastated. The chemistry was strong, we were sober and enjoying the moment—what could possibly go wrong? I asked myself what many women do in this situation: Am I the problem?

He assured me I had nothing to worry about and hesitated before sharing what was up. He had just received a poor annual performance review at work, and the stress had been consuming him.

We were casually dating, and I appreciated his vulnerability. Talking about this isn’t easy. 

Over the next couple of months, we kept running into the same problem, so I asked him to seek professional advice. He didn’t want to, claiming all he needed was Viagra. I realized just how much shame he felt in searching for help. And he’s not alone. 

Since Viagra’s debut 25 years ago, a surprising number of men as young as 19 years old have started taking the blue pill. In 2018, when Viagra’s over-the-counter version hit the UK market, an estimated 67% of customers were between the ages of 25-54.

“25-30 million men globally take Viagra. Many are young, and they do so because they don’t want to seek help and are scared of losing an erection,” said Brazilian sexologist Ana Canosa in a recent podcast interview. “Not everyone that takes the medication actually gets hard, because they get too worried about losing it, so the stress overwhelms the physical function.”

Sex-focused therapist Mike Rosen confirms, “Many men seek quick solutions through Viagra prescriptions, but those prescriptions don’t actually help them do the deeper, longer-lasting work on their anxiety and mental health.”

But why do men struggle with doing the deeper work? And how can we address this unhealthy dynamic?

Historical significance: the penis as a symbol of power

For thousands of years across civilizations, the penis has carried an extraordinary amount of symbolic weight. Ancient Egyptians believed the universe was born from creator God Atum’s ejaculation through masturbation. In Ancient Rome, phallic stone carvings symbolized spiritual protection, which is why many have been found in military sites.

Rectangular pillars with erect penises were placed at entrances and land boundaries to ward off danger in Ancient Greece. Nunneries in India have phallic representations symbolizing divine worship and strength. There were even phallic saints across medieval European, Scandinavian, and Celtic cultures!

It’s fascinating just how universal the symbol of the penis as protection, power, and fertility is. That’s a whole lot of pressure for a bodily organ if you ask me.

Cultural perspectives on penis size

If you’ve ever looked at Ancient Greek sculptures and wondered why they seem to have such small penises relative to massive bodies, you are not alone. Art historians found that large penises were considered vulgar at the time. Throughout art, comedy, and mythology, they were attributed to fools, enemies, and mythological creatures part-man, part-animal who lacked restraint in hedonistic pursuits.

A smaller penis represented self-control and intelligence, while potency “came from the intellect needed to power man’s responsibility to father children, prolong the family line and the oikos [the family unit or household], and sustain the polis [the city-state],” writes historian Paul Chrystal in his book In Bed with the Ancient Greeks.

While this social construct wasn’t shared in every culture, our notion of the “ideal” size has grown over time. A study analyzed penis size depictions throughout three different art periods: the Renaissance (15-16th Centuries), Baroque-Rocco, and Impressionism (17th-19th Centuries), and Contemporary Art (20th-21st Centuries). It found that the size of the penis in nude males gradually increased over the last seven centuries, and especially throughout the 1900s.

Today we equate a larger size with masculinity, strength, and social status. And this construct has come with detrimental consequences to men’s health.

The impact of pornography

From the 1970s onwards, modern porn has generally portrayed sex aggressively and unrealistically. Penises are unusually large and perpetually hard. Sex is about going longer, faster, stronger.

The problem is that while it was originally made for entertainment purposes, it has turned into an educational source. A whopping 32% of Americans say most of their sexual education comes from porn, according to a study done by health company Hims and Hers.

“Half of men (53%) say porn has changed their perception of how they should last and how erect their penis should be, and an equal 53% say porn has changed their perception of sex altogether,” cites the study. This has also distorted women’s perception of male pleasure.

Over the last few years, urologists have seen more interest in penile enlargement surgeries. “We realized that this increased demand is mainly due to the increased consumption of porn, especially during the pandemic period. Many young men compare their penis size with that of porn stars and consider their penises to be small, although their sizes are within the normal range,” said Ege Can Serefoglu, a professor of urology at the Biruni University School of Medicine who conducted a study on the matter.

“They are having a great amount of anxiety regarding the inability to satisfy their partners, although it has been demonstrated that penis size does not have a significant impact on partner satisfaction,” Serefoglu continued. “This phenomenon is called ‘penile dysmorphophobia,’ which is nowadays considered a part of body dysmorphic disorder.”

Other research also suggests a correlation between compulsive porn consumption and erectile dysfunction, aka porn-induced erectile dysfunction (PIED).

The evolution of modern masculinity

If symbolism, size, and porn aren’t enough, men also face an added layer of emotional complexity.

The strong male body as a symbol of health, strength, and morality was at the core of modern masculinity when it arose in the late 1750s, according to renowned historian George Mosse in his book The Image of Man.

By the First World War, masculinity became militarized. It symbolized patriotism, aggression, sacrifice, and honor. More than 100 years later, these ideals still prevail.

Men are brought up to be stoic, to endure pain and hardship without showing their feelings. They are expected to be financially successful, physically strong, and have high libidos. This has dire consequences on their own health and relationships.

Filmmaker Justin Baldoni shared the undue weight of masculinity in a recent episode of his podcast We Are Man Enough:

“We have been conditioned to not let anything out…we don’t know how we’re even feeling and we’re taught to shut ourselves off for self-preservation. And the reason I believe that we say, ‘Oh, I’m fine,’ is because underneath that ‘I’m fine’ is an ocean of frustration and disappointment and anger and sadness and shame…and if the dam breaks just a little bit, we don’t believe we are worthy enough of love…

We are told conditionally through socialization that the last thing you’re [women] going to want in a man is for me to be weak and there’s nothing more weak that a man is told than opening up and whining or complaining and sharing his feelings.

So you won’t have sex with me if I share all of this with you, if I share all of the things that I’m feeling, so I have to shut down…men are damned if we do and damned if we don’t because we don’t have the tools, nobody’s taught us these things at a young age and we’re supposed to figure out how to be in relationship and how to open up when we’re told that if we do open up we’re punished for it and then of course our love language then just becomes sex.”

And he’s right, it is a catch-22. Men struggle with masculinity ideals, and women are conditioned to uphold them.

Emotional complexity

Studies have shown that men who make less money than their wives are more likely to cheat and more likely to have diabetes and high blood pressure. As writer Liz Plank says, “researchers have found that not being able to meet society’s definition of masculinity is literally making men sick.”

Research has also found that women who have a higher income than their partners are twice as likely to fake orgasms and to have lower rates of sexual satisfaction. Moreover, women who believe their partner has a high level of fragile masculinity (known as insecurity) are less likely to talk about their sexual needs.

“If we’re learning about sex from porn, we’re definitely not learning how to please women, which means we’re already insecure because we’re comparing ourselves to whatever we’re seeing. 

So I’m imagining there is no space for the fragile male ego to hear that they’re not being pleased. It’s so ironic that the bigger, stronger, more alpha the guy tends to be, the more fragile the ego is,” said Baldoni.

These feelings of inadequacy can be harmful, translating into anger, abuse, emotional unavailability, and gaslighting. Sex can also be used as a substitute for intimacy. It’s a lose-lose situation for everyone involved.

Practical steps towards a healthier masculinity

Not everyone has the means to do therapy, but everyone has the means of practicing self-awareness. Take the time for regular reflections on how you’re feeling, what is triggering your insecurities, and what steps you can take to overcome them. That can look like a support network of trusted friends and family members, or having regular conversations with your partner to share how you’re feeling, and how they can help.

If you’re dealing with a sexual dysfunction, seek a urologist to run tests on any possible physiological issues. And depending on the results, invest in a sex therapist or coach to work through it.

If you’re experiencing low libido and unsure where to look for help, check out our online course The Art of Sexual Desire. It offers scientifically-backed methods to boost libido and intimacy with exercises that you can do from the comfort and privacy of your home.

Remember: building strong communication and self-awareness are key to having healthy relationships both in and out of bed. If you have a partner, including them in the healing process is a constructive way to overcome the narrow ideas of masculinity that no longer serve you. Understand that it takes patience, commitment, and compassion.