“Penile Dysmorphic Disorder” and Obsessions with Penis Size

Tori Rodriguez, a writer for MensHealth.com, recently interviewed me for a piece prompted by a recent article in the British Journal of Urology reporting that most men electing penis enlargement surgery are in fact normally endowed.  Thanks to Ms Rodriguez and to the editors of MensHealth.com for permission to publish the original interview that led to the article:

TR: How common is Body Dysmorphic Disorder involving the penis – or as some have called it, “Penile Dysmorphic Disorder”?

Dr.Snyder: I don’t know of any statistics on this. Anxiety or insecurity about penis size is extremely common in men. It would be difficult to determine how frequently the more serious condition of penis-focused BDD — or “penile dysmorphic disorder” occurs. But it’s undoubtedly much rarer.

TR: Do you see many men with this condition?

Dr.Snyder: People with BDD tend to avoid mental health specialists.  Which is not surprising, since part of the psychology of BDD is the conviction that one has an actual physical problem.  It’s much more likely I think that a man with “penile dysmorphic disorder” will purchase penis enlargement equipment or consult a surgeon than consult someone like me.

TR: Why would a man have “penile dysmorphic disorder,” even when he doesn’t actually have a small penis?

Dr.Snyder: Good question.  The answer, as one of my urology colleagues puts it, has more to do with the “big brain” in a man’s head than with the “little brain” between his legs.  There is an extraordinary diversity of human minds.

TR: What kind of a man would be prone to “penile dysmorphic disorder” ?

Dr.Snyder: Some people seem to have an innate tendency for obsessive thinking.  Why some of these people develop BDD, and others OCD or Anorexia Nervosa is unknown.   Many of these obsessive thinkers also have behaviors (such as compulsions and avoidance behaviors) intended to reduce the distress associated with obsessive thinking.  Unfortunately, over time these behaviors seem to make obsessive thinking worse.

TR: For example?

Dr.Snyder: A man who begins to obsess about the size of his penis may begin to compulsively and repeatedly measure his erections, and to avoid dating because he’s convinced he’ll be humiliated.  Then the whole thing can spiral out of control, until ultimately he’s online studying penis enlargement techniques.

TR: The penis itself doesn’t tolerate all this obsessive self-scrutiny very well, right?

Dr.Snyder: The more obsessively a man worries about his penis, the more likely he’ll develop a sexual dysfunction.  If a man finds himself obsessing about his penis or any aspect of his sexual function, he should get help before he causes himself psychological or physical harm.

TR: How do partners react when a man gets obsessed about the size of his penis?

Dr.Snyder: When a married man comes to see me worried about his penis or his erections, I usually ask to see his wife too. Often her chief concern is that he’s so obsessively preoccupied with his problem that he’s become a stranger to her in bed.  Women experience such preoccupation as selfish – which in a way it is.

TR: What practical advice would you give to a man who’s gotten obsessed about the size of his penis?

Dr.Snyder: Step back and notice your compulsion and avoidance behaviors.  Notice how often you compulsively masturbate in order to reassure yourself you’re OK.  Or compulsively measure your erection.  Or compulsively surf the net for penis enlargement advice.   Or avoid dating because of fear of humiliation.  See if you can drastically reduce compulsive and avoidance behaviors.

TR: And if a man can’t manage to do this?

Dr.Snyder: Get professional help. Be forewarned, though.  Most mental health professionals don’t know much about sexual issues — or about “penile dysmorphic disorder.” To find one who does, go online to www.sstarnet.org or www.aasect.org.


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