A recent study published in The Aging Male journal has revealed that as men’s self-perception of their genitals deteriorates, their susceptibility to depression and anxiety increases. The findings suggest that men who view their genital appearance negatively may experience significant mental health challenges, which in turn can affect their sexual function and overall quality of life.
Body image plays a important role in an individual’s mental and emotional well-being, influencing their self-esteem, social interactions, and sexual satisfaction. For many men, the size and appearance of their penis are intimately tied to their self-confidence and perceived sexual adequacy. Although extensive research has explored various aspects of body image and sexual satisfaction, the specific issue of genital self-perception in men remains under-examined.
Previous studies have highlighted the relationship between body image and mental health, showing that a negative perception of one’s body can lead to issues such as depression, anxiety, and sexual dysfunction. However, there has been limited research focusing specifically on how men’s perceptions of their genitalia might relate to these mental health outcomes. The researcher behind this study — Adil Emrah Sonbahar, a board certified urologist and sexologist at the Izmir Katip Çelebi University Atatürk Training and Research Hospital — sought to fill that gap by exploring the correlation between male genital self-perception, sexual functioning, and the prevalence of depression and anxiety.
“My special interest is sexual medicine, which led me to plan this study. In today’s changing world, people have begun to think about self-image and sexual performance more than before. When considering these issues, personal perception—how individuals view themselves—is very important,” explained Sonbahar.
The study was conducted at the Andrology outpatient clinic of Izmir Katip Çelebi University, where researchers recruited 75 male participants between March and June 2022. Participants were men who visited the clinic for various reasons, but those with a history of pelvic surgery, previous penis enlargement surgeries, known psychiatric disorders, or those who refused to participate were excluded from the study.
The average age of the participants was approximately 47 years old, with a body mass index (BMI) of around 28 kg/m². Most participants were married, and a significant portion were smokers. To measure genital self-perception, Sonbahar used the Male Genital Self Image Scale (MGSIS), a validated questionnaire that assesses how men perceive their genitalia. The scale consists of seven statements (e.g. “I am satisfied with the size of my genitals”) scored on a four-point Likert scale, with higher scores indicating a more positive genital self-image.
In addition to the MGSIS, Sonbahar used several other measures. Sexual function was assessed using the International Index of Erectile Function (IIEF), a 15-item questionnaire that evaluates different aspects of male sexual health. Mental health was assessed using the BECK Depression Inventory, a 21-item questionnaire that measures the severity of depression, and the State-Trait Anxiety Inventory, which assesses anxiety levels.
The researchers also conducted physical measurements of the participants’ penis size. A single urologist measured both the flaccid and stretched penis lengths, as well as the penile circumference, under standardized conditions to ensure accuracy.
There was a positive correlation between penis size (both flaccid and stretched) and genital self-image scores. Men with larger penis sizes tended to have a more positive perception of their genitals. Conversely, men with smaller penis sizes were more likely to report a poor genital self-image.
The study found that men with a more negative genital self-image also reported poorer sexual functioning. Specifically, these men had lower scores in erectile function, sexual satisfaction, and overall sexual satisfaction. The findings suggest that men who are dissatisfied with their genitalia may experience more significant challenges in their sexual lives, including difficulty achieving and maintaining erections and lower overall satisfaction with sexual activity.
Perhaps most notably, the study uncovered a strong relationship between poor genital self-image and increased levels of depression and anxiety. Men who had lower genital self-image scores were more likely to score higher on both the Beck Depression Inventory and the State-Trait Anxiety Inventory. This suggests that dissatisfaction with one’s genitalia is not just a superficial concern but is deeply tied to broader issues of mental health.
“I was wondering about the rate of depression in those with a negative sexual perception, but the findings were more than expected,” Sonbahar told PsyPost. “The average person should understand that ‘it is first of all in mind,’” he added, highlighting the crucial impact of subjective self-appraisals.
While this study provides valuable insights into the relationship between male genital self-perception, mental health, and sexual function, there are several limitations that should be considered. One of the primary limitations is the relatively small sample size of 75 participants. Although the researchers ensured that the sample was sufficient to detect significant correlations, larger studies are needed to confirm and expand upon these findings. Additionally, the study only included heterosexual men, which limits the generalizability of the results.
“There should be more prospective studies about sexual perception not only in heterosexual men but also in all types of sexual orientations,” Sonbahar said. “Nowadays, there are a lot of genital plastic surgeries being done. Moreover, we are not sure that all the surgeries are necessarily beneficial as well. So I think while planning these kind of surgeries, a serious investigation must be scheduled not only for the success of surgeries but also for the happiness of the patients after the procedures.”
The study, “The impact of male genital self-image on depression, anxiety and sexual functions,” was published online on June 10, 2024.
