Archives of Sexual Behavior

, Volume 46, Issue 7, pp 2123–2130 | Cite as

Characterization of Genital Dissatisfaction in a National Sample of U.S. Men

  • Thomas W. GaitherEmail author
  • Isabel E. Allen
  • E. Charles Osterberg
  • Amjad Alwal
  • Catherine R. Harris
  • Benjamin N. Breyer
Original Paper


Male genital satisfaction is an important aspect of psychosocial and sexual health. The Index of Male Genital Image (IMGI) is a new scale that measures perceptions of male genitalia. We aim to characterize genital satisfaction using the IMGI and correlate dissatisfaction with sexual activity. We conducted a nationally representative survey of non-institutionalized adults aged 18–65 years residing in the U.S. In total, 4198 men completed the survey and 3996 (95.2 %) completed the IMGI. Men reported highest satisfaction with the shape of their glans (64 %), lowest satisfaction with the length of their flaccid penis size (27 %), and neutrality with the scent of their genitals (44 %). No demographic characteristics (age, race, sexual orientation, education, location, and income) were significantly associated with genital dissatisfaction. Men who were dissatisfied with their genitals were less likely to report being sexually active (73.5 %) than those who were satisfied (86.3 %). Penetrative vaginal sex (85.2 vs. 89.5 %) and receptive oral intercourse (61.0 vs. 66.2 %) were reported less by dissatisfied men. Overall, most U.S. men were satisfied with their genitals; however, a subset (14 %) report low genital satisfaction, which included men of all ages, races, and socioeconomic groups. Low genital satisfaction is associated with a decrease in sexual activity. These results provide clinicians and health educators a baseline of genital satisfaction to provide education and reassurance.


Genital satisfaction Sexual activity Oral sex Penis size Index of Male Genital Image 


Compliance with Ethical Standards

Conflict of interest

No competing financial interests exist.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures were in accordance with the ethical standards of the institutional review board at the University of California, San Francisco.


  1. Bland, J. M., & Altman, D. G. (1997). Statistics notes: Cronbach’s alpha. British Medical Journal, 314, 572.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Brody, S., & Costa, R. M. (2009). Satisfaction (sexual, life, relationship, and mental health) is associated directly with penile-vaginal intercourse, but inversely with other sexual behavior frequencies. Journal of Sexual Medicine, 6, 1947–1954.CrossRefPubMedGoogle Scholar
  3. Chambers, W. C. (2007). Oral sex: Varied behaviors and perceptions in a college population. Journal of Sex Research, 44, 28–42.CrossRefPubMedGoogle Scholar
  4. Dalke, K. A., Fein, L., Jenkins, L. C., Caso, J. R., & Salgado, C. J. (2013). Complications of genital piercings. Anaplastology, 2, 1–5.Google Scholar
  5. Davis, S. N., Binik, Y. M., Amsel, R., & Carrier, S. (2013). The Index of Male Genital Image: A new scale to assess male genital satisfaction. Journal of Urology, 190, 1335–1339. doi: 10.1016/j.juro.2013.03.121.CrossRefPubMedGoogle Scholar
  6. Davis, S. N., Paterson, L. Q., & Binik, Y. M. (2012). Male genital image: Measurement and implications for medical conditions and surgical practice. Sexologies, 21, 43–47.CrossRefGoogle Scholar
  7. Gaither, T. W., Truesdale, M., Harris, C. R., Alwaal, A., Shindel, A. W., Allen, I. E., & Breyer, B. N. (2015). The influence of sexual orientation and sexual role on male grooming-related injuries and infections. Journal of Sexual Medicine, 12, 631–640.CrossRefPubMedGoogle Scholar
  8. Glickman, M. E., Rao, S. R., & Schultz, M. R. (2014). False discovery rate control is a recommended alternative to Bonferroni-type adjustments in health studies. Journal of Clinical Epidemiology, 67, 850–857.CrossRefPubMedGoogle Scholar
  9. Grov, C., Parsons, J. T., & Bimbi, D. S. (2010). The association between penis size and sexual health among men who have sex with men. Archives of Sexual Behavior, 39, 788–797.CrossRefPubMedGoogle Scholar
  10. Herbenick, D., Reece, M., Schick, V., Sanders, S. A., Dodge, B., & Fortenberry, J. D. (2010). Sexual behavior in the United States: Results from a national probability sample of men and women ages 14–94. Journal of Sexual Medicine, 7, 255–265.CrossRefPubMedGoogle Scholar
  11. Herbenick, D., Schick, V., Reece, M., Sanders, S., Dodge, B., & Fortenberry, J. D. (2011). The Female Genital Self-Image Scale (FGSIS): Results from a nationally representative probability sample of women in the United States. Journal of Sexual Medicine, 8, 158–166. doi: 10.1111/j.1743-6109.2010.02071.x.CrossRefPubMedGoogle Scholar
  12. Herbenick, D., Schick, V., Reece, M., Sanders, S. A., & Fortenberry, J. D. (2013). The development and validation of the Male Genital Self-Image Scale: Results from a nationally representative probability sample of men in the United States. Journal of Sexual Medicine, 10, 1516–1525. doi: 10.1111/jsm.12124.CrossRefPubMedGoogle Scholar
  13. Hudak, S. J., McGeady, J., Shindel, A. W., & Breyer, B. N. (2012). Subcutaneous penile insertion of domino fragments by incarcerated males in southwest United States prisons: A report of three cases. Journal of Sexual Medicine, 9, 632–634. doi: 10.1111/j.1743-6109.2011.02551.x.CrossRefPubMedGoogle Scholar
  14. Karraker, A., DeLamater, J., & Schwartz, C. R. (2011). Sexual frequency decline from midlife to later life. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 66, 502–512.CrossRefGoogle Scholar
  15. Khan, S., Somani, B., Lam, W., & Donat, R. (2012). Establishing a reference range for penile length in Caucasian British men: A prospective study of 609 men. British Journal of Urology International, 109, 740–744. doi: 10.1111/j.1464-410X.2011.10338.x.CrossRefGoogle Scholar
  16. Knowledge Panel Design Summary. (2013). Retrieved October 28, 2014, from
  17. Leichliter, J. S., Chandra, A., Liddon, N., Fenton, K. A., & Aral, S. O. (2007). Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States. Journal of Infectious Diseases, 196, 1852–1859.CrossRefPubMedGoogle Scholar
  18. Lever, J., Frederick, D. A., & Peplau, L. A. (2006). Does size matter? Men’s and women’s views on penis size across the lifespan. Psychology of Men and Masculinity, 7, 129–143.CrossRefGoogle Scholar
  19. Mondaini, N., Ponchietti, R., Gontero, P., Muir, G., Natali, A., Caldarera, E., & Rizzo, M. (2002). Penile length is normal in most men seeking penile lengthening procedures. International Journal of Impotence Research, 14, 283–286.CrossRefPubMedGoogle Scholar
  20. Mureau, M. A. M., Slijper, F. M. E., Slob, A. K., Verhulst, F. C., & Nijman, R. J. M. (1996). Satisfaction with penile appearance after hypospadias surgery: The patient and surgeon view. Journal of Urology, 155, 703–706. doi: 10.1016/s0022-5347(01)66504-2.CrossRefPubMedGoogle Scholar
  21. Reiner, W. G., Gearhart, J. P., & Jeffs, R. (1999). Psychosexual dysfunction in males with genital anomalies: Late adolescence, Tanner stages IV to VI. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 865–872. doi: 10.1097/00004583-199907000-00017.CrossRefPubMedGoogle Scholar
  22. Silberstein, J., Downs, T., & Goldstein, I. (2008). Penile injection with silicone: Case report and review of the literature. Journal of Sexual Medicine, 5, 2231–2237. doi: 10.1111/j.1743-6109.2008.00911.x.CrossRefPubMedGoogle Scholar
  23. Vardi, Y., Har-Shai, Y., Gil, T., & Gruenwald, I. (2008). A critical analysis of penile enhancement procedures for patients with normal penile size: Surgical techniques, success, and complications. European Urology, 54, 1042–1050. doi: 10.1016/j.eururo.2008.07.080.CrossRefPubMedGoogle Scholar
  24. Veale, D., Eshkevari, E., Read, J., Miles, S., Troglia, A., Phillips, R., & Muir, G. (2014). Beliefs about penis size: Validation of a scale for men ashamed about their penis size. Journal of Sexual Medicine, 11, 84–92. doi: 10.1111/jsm.12294.CrossRefPubMedGoogle Scholar
  25. Veale, D., Miles, S., Read, J., Troglia, A., Carmona, L., Fiorito, C., & Muir, G. (2015a). Penile dysmorphic disorder: Development of a screening scale. Archives of Sexual Behavior, 44, 2311–2321.CrossRefPubMedGoogle Scholar
  26. Veale, D., Miles, S., Read, J., Troglia, A., Wylie, K., & Muir, G. (2015b). Sexual functioning and behavior of men with body dysmorphic disorder concerning penis size compared with men anxious about penis size and with controls: A cohort study. Sexual Medicine, 3, 147–155.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Wilcox, S. L., Redmond, S., & Davis, T. L. (2015). Genital image, sexual anxiety, and erectile dysfunction among young male military personnel. Journal of Sexual Medicine, 12, 1389–1397. doi: 10.1111/jsm.12880.CrossRefPubMedGoogle Scholar
  28. Wylie, K. R., & Eardley, I. (2007). Penile size and the ‘small penis syndrome’. British Journal of Urology International, 99, 1449–1455. doi: 10.1111/j.1464-410X.2007.06806.x.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Thomas W. Gaither
    • 1
    Email author
  • Isabel E. Allen
    • 2
  • E. Charles Osterberg
    • 1
  • Amjad Alwal
    • 1
  • Catherine R. Harris
    • 1
  • Benjamin N. Breyer
    • 1
    • 2
  1. 1.Department of UrologyUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA

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