LGBTQIA+: Homosexual Males and Sexual Dysfunction

Sexual dysfunction is something that affects all males- regardless of their sexual orientation. The difference for homosexual males is that the topic is rarely discussed within the community, or with medical professionals. Due to this disparity in healthcare and discussion, the topic is most often left avoided, and the male is left to decipher their own issues, alone, and hope for a solution.

Homosexuality shows itself through varied and complex behaviors that are shared by many in the community. These behaviors are attitudes, preferences, lifestyle choices, values, and concerns profoundly affect each individual- much like heterosexuality does for others.

Some of the issues that commonly affect homosexual males are:

  • Loss of libido & desire. There are many reasons a person can face the loss of libido, or desire, for intimacy and sex. Depression and anxiety are two of the most common triggers for this, followed closely by medical issues like cancer, illness, surgical intervention, and even gender reassignment surgeries and treatment. Facing this crisis can leave a person feeling alone, undesirable and unable to connect with others on any intimate level. It is important to address this issue quickly and with a therapist who is comfortable working with those in the community.
  • Performance anxiety. Stress about sex and intimacy can cause performance anxiety. When a person does not feel adequate, or that they can fulfill their partners’ or their own personal sex need, this can cause anxiety that thusly prevents intimate activity from happening in a mental, or a physical manner. Performance anxiety typically results from negative feelings such as:
    • Body image
    • Penis size
    • Perceptions of virility
    • Ideas about gender roles and definitions
    • Relationship troubles
    • The use of internet porn
    • Financial concerns
    • Family issues
    • Stress at work

These issues can be addressed and dealt with by having open communication with yourself, your partner, or a therapist who understands the demands and lifestyle choices of the male.

  • Erectile Dysfunction. Erectile dysfunction is a disorder that prevents a male from having an erection that is hard enough for penetrative intercourse. For some, this means that might not be able to achieve the “hardness” they did in younger years. Other males may not be able to achieve any erection, and others will be able to achieve a partial erection, but not have the firmness to insert or “play” with the unit. Many times in life, a male might experience temporary erectile dysfunction due to stress, physical issues, mental instability or discomfort. There are many things that can cause long-term erectile dysfunction. Some of these are:
  • cardiovascular disease
    • diabetes
    • cancer
    • chronic illness
    • autoimmune diseases
    • hypertension, or high blood pressure
    • high cholesterol
    • obesity
    • low testosterone levels or other hormone imbalances
    • kidney disease
    • increased age
    • stress
    • anxiety
    • depression
    • relationship problems
    • certain prescription medications, such as those used to treat high blood pressure or depression
    • sleep disorders
    • drug use
    • consuming too much alcohol
    • using tobacco products
    • certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS)
    • damage to the pelvic area through injury or surgery
    • Peyronie’s disease, which causes scar tissue to develop in the penis

Thankfully, there are ways to help your body function for intimacy and sex that do not require medications or harsh therapies. There are many holistic options, as well as therapeutic aids, designed to help reclaim and reintroduce intimacy when erectile dysfunction makes it feel next to impossible.

  • Hypoactive sexual desire disorder. This disorder, HSDD, is common among all humans, and means that the person does not have thoughts, fantasies, or a need for sex. These individuals do not pick up on their partners’ sexual cues or suggestions, and often lose interest in the actual act of sex- sometimes as it is happening. Thankfully this is a recognized disorder, and there are certain “treatments” and medications that might work for you. Some of the treatments might include:
    • Kegel exercise
    • Talking openly with your partner about sexual likes and dislikes
    • Exploring porn that brings you feelings of wonder or pleasure
    • Masturbating, self-exploration and using therapeutic devices designed for pleasure
    • Reducing stress
    • Limiting alcohol and stopping smoking tobacco or street drugs
    • Exercise regularly
    • Meeting with a counselor or therapist to find the root of the issue

If you feel that you are experiencing Hypoactive Sexual Desire Disorder, reach out to your trusted medical care professionals to help get you back on track to reclaim your intimacy.

  • Ejaculation disorders. These disorders can occur in various ways, and change frequently depending on the scenario, stress level, and even mood. For some, ejaculation issues do not cause any detriment within their life or relationship. For others, it greatly affects performance and mental feelings of inadequacy. The most common forms of ejaculation disorders are early ejaculation, delayed ejaculation, and absent ejaculation.
    • Delayed ejaculation. The psychological definition of delayed ejaculation refers to the inability to have an ejaculation during sexual intercourse. However, this can also be a problem in masturbatory events as well. While there are not many studies done on the “whys” and “hows” of delayed ejaculation, many of the same issues that cause ED are also marked with delayed ejaculation. Medications and high stress are often at the top of the list.
    • Early ejaculation. This condition was once called, “pre-mature ejaculation,” but medical professionals agreed that the change was necessary for a more adult approach. Early ejaculation is defined as an ejaculation that occurs before it is desired. Typically, the ejaculation has become inevitable either during foreplay or in the first moments following penetration. In spite of their best efforts, the male experiences a sense of helplessness in controlling their ejaculation. A significant amount of distress from the male or their partner almost always accompanies an early ejaculation. The partner feels equally unsatisfied and frustrated.
    • Absent ejaculation. Most bodily functions change with age, and sex is no exception. Males who stay healthy can expect to retain erectile function, and even fertility, throughout life — but they can also expect a gradual reduction in libido, penile rigidity, the volume of the ejaculate, the number and activity of sperm, and the intensity of orgasm. Diseases of the spinal cord, surgeries, cancer and some medications are often responsible for absent ejaculation. Although many males who have had radical prostatectomies for prostate cancer can have orgasms, although none can ejaculate because the necessary structures have been removed.

Ejaculatory problems can leave the male feeling the mental (low self-esteem) and physical toll (being unable to feel sated or please their partner), which is why seeking help is vital to healing and forward progression. Not all medical professionals understand this issue or will take the time to get to the root cause.

There are also more holistic ways to help with ejaculation problems like desensitizing creams, support sleeve, masturbation devices, and therapies designed to help the user get to know their bodies in a new, better defined way.

  • Anodyspareunia. Anodyspareunia is a condition affecting males who have anal intercourse that is accompanied by severe bouts of pain and discomfort during receptive anal sex. In some cases, this pain can be linked to having inadequate amounts of lubrication, uncomfortable positioning, or mental factors. Other notes factors for males was penetration depth, force of the thrust, or lack of social comfort with their partner. Anxiety was also at the top of most study lists, although in some rare cases, actual physical issues, deformities or abnormalities were cited to blame. If you are experiencing this sort of pain with receptive anal sex, consult your medical care professionals or reach out to a LGBTQIA+ organization that can direct you to a safe, open professional that can help guide you and help you to work through the issue, if mental.

If you find yourself struggling with sexual dysfunction, do not hesitate to reach out to your urologist, or sexual wellness expert for guidance. There are also numerous LGBTQIA organizations that can help to direct you to a medical professional that understands the needs and lifestyle of homosexual men.

Resources Used:

Reclaiming Intimacy


Harvard Health

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