What is a micropenis and how do you live with it? Gareth May interviewed Jon, who wasn’t diagnosed until age 28, and discusses the mental health impact of late diagnosis.
Over the years I’ve interviewed men in all kinds of sexual circumstances, from octogenarians with active sex lives, to the founder of the NoFap community, to disabled sexual rights activists. The spectrum of male sexuality is vast and eclectic. And yet none have struck as hard as an interview I conducted with Jon (name changed) a 30-something man from America, who has a clinically-confirmed micropenis.
For those who don’t know, a [micropenis](https://www.healthline.com/health/micropenis) (also known as microphallus), is a medical condition that affects approximately 0.5% of men. The term describes penises that are shorter than 2.5 inches when stretched, and 3.5 inches when erect. It’s caused by the male foetus’s penis failing to elongate after the first trimester of pregnancy, typically due to testosterone deficiency, genetic mutations, or, as some [research suggests, dioxins and other environmental chemicals](https://pubmed.ncbi.nlm.nih.gov/15758562/) as well.
Far from the laughing matter of ‘small dick’ insults from the gross-out movie canon, a micropenis can seriously impact both a man’s sexual wellbeing and mental health. And the hormonal causation is often paired with other physiological ailments such as [Fryns syndrome](https://rarediseases.info.nih.gov/diseases/3699/fryns-syndrome), [Kallmann syndrome](https://ghr.nlm.nih.gov/condition/kallmann-syndrome), [Laron syndrome](https://rarediseases.info.nih.gov/diseases/6859/laron-syndrome), and testicular dysgenesis that can lead to poor semen quantity and cancer. So how to live with a micropenis? I asked Jon for his story.
## Getting personal about penis size
Jon first knew something was off was when he saw his dad getting out of the shower in his early teens. The smoking gun was the fact that his father’s penis was ‘dangling’. Surely his would grow as he got older? It didn’t.
As his sexually formative years came and went, his confidence vanished. He never took showers in high school and when he tried out condoms they never stayed on. As such, his sexual life became a fantasy rather than something that he could reach out and experience. It was only at college that he was brave enough to build a relationship; one which ended the minute she put his hands down his pants, ‘almost laughed’, and dumped him two days later.
Jon’s sexuality drifted into voyeurism, pornography and cam services; sometimes he masturbated online with other men with a similar penis size. Jon describes this period as one of great loneliness and depression; and even though mutual masturbation with men was exciting, he had no sexual interest in men. He was just desperate for ‘some sort of human connection’.
Whenever he involved himself in other communities to open up he was laughed at, told he’d always be a virgin, and in some cases issued with death threats. “When you are anonymous, the real monsters come out,” he told me.
He found solace by masturbating online with women who were compassionate to his situation and eventually had another sexual experience at 28 and lost his virginity just before his 30th birthday. An online relationship followed and marriage shortly thereafter.
## The psychological ‘baggage’ of micropenis
Jon describes his marriage as the result of two ‘sexually damaged people’ finding each other on the internet. But ‘sexual damage’ for people with micropenis isn’t a given. It can often be avoided with early diagnosis and psychiatric counselling and social services (for patient and parents) to help a child deal with both the physiological impact and the societal stigma of a micropenis. Even if diagnosed early, though, Jon’s experience is commonplace among male subjects, with fear of sexual rejection, sexual inadequacy, poor body image, and a reduced quality of life all familiar complaints. It’s just one example of how society’s obsession with ‘perfect’ bodies – including penises – can have a devastating impact on people who don’t fit the ideal.
Positively, if treated properly, [particularly from paediatric nurses](https://www.jpedhc.org/article/S0891-5245(09)00140-0/fulltext#bib16), and with long-term follow-up, some patients have shown that there are no major alterations in male sexual activity or identity. Indeed, the work of Dr. Douglas A. Husmann* has found that while psychological issues surrounding a microphallus range from behavioural issues to suicidal thoughts, recent long-term studies of micropenis sufferers have found that even if the penis remains small, the condition does not seem to affect most boys’ level of sexual activity, sexual identity or erectile function. They also enjoy sex, though PIV (penis in vagina) sexual activity may be less fulfilling.
Physiologically, recent developments have shown some success in [corrective surgery](https://pubmed.ncbi.nlm.nih.gov/11458075/) using skin from the forearm, while hormone therapy is also having success with infants (when the patient is injected with testosterone three times a month). When the penis grows over a three month-trial of testosterone, the outlook is a standard adult penis size and function.
### So how do you live with a micropenis?
Jon was clinically diagnosed much later in life compared to other, more positive case studies. He only learned of the term micropenis when he was 28. The years of emotional turmoil have led to weight gain he is unhappy with, and a secret life (none of his friends know of the condition). He is undergoing therapy to reconcile his anger towards the world. Only in recent times, with the help of a ‘loving wife’, has he ‘started to see a future’.
No longer having the rampant libido of a teen or 20-something has helped too; the reduction of sexual desire as his body chemistry changes with age is a part of coming to terms with his condition. Regardless of this, Jon doubts he will ever accept his body.
Ultimately though, he say he’s still full of regret and has some sage insight for those born with a micropenis. “Don’t let having the fear of ‘What if she laughs?’ ruin potential intimate encounters,’ he told me. “I kept telling myself, ‘This time I’ll ask her out’ and never did because of my fear. Now all of a sudden I am middle-aged and the game is over. Did I lose out on so much? I’ll never know and there is nothing worse than that feeling of regret.”
For more info on diagnosis and how to live with a micropenis, check out this resource:
[Stanford Children’s Hospital’s info about micropenis in children](https://www.stanfordchildrens.org/en/topic/default?id=micropenis-90-P03096)
* *Unfortunately the research is *not* sex positive or queer/trans-inclusive and for this reason we haven’t linked to it, but as there is so little research available on this condition, we felt it was important to mention it.*
