The Ins and Outs of Gay Sex (23 page)

You can use your foreskin for a variety of sexual activities.
Frequently it is pierced, with little or no risk as long as infection doesn’t occur.
(See “
Piercing
.”
) Some men try to lengthen their foreskin by attaching weights or clamps to it.
Although some lengthening may result, most often this toughens the skin, dulling sensation and making it difficult to retract.
Some men with foreskins to be reckoned with enjoy “docking,” whereby their foreskin is stretched over their partner’s glans.
Their penises are aligned head to head, and any pleasure may be more psychological than physical.

The undersurface of a partner’s foreskin may harbor STDs that are easily transmitted during sex, particularly docking.
Medical studies prove that uncircumcised men with gonorrhea or HIV are much more likely to transmit infection during unprotected sex than circumcised men.
This does not mean that sex with an uncircumcised man is unsafe.
Just be careful!
Whether the guy is cut or uncut, sexual
satisfaction may not be the only thing you take away from the experience!

Jews originated ritual circumcision as a sign of their covenant with God.
The practice has since been adopted by many other groups, including Moslems and many Americans.
Most American males are circumcised for health or cosmetic reasons soon after birth, before they leave the hospital.
Circumcision is far less common in Europe, Asia, and South America.

Arguments abound both for and against routine circumcision, with personal beliefs often bordering on the fanatical.
Over the years, arguments change and so do trends.
Even the American Academy of Pediatrics has reversed its position several times.
In 1975 the academy opposed routine circumcision, stating that there was no medical benefit to the procedure.
In light of new research findings in 1989, the American Academy of Pediatrics, in an about-face, concluded that there probably was a medical benefit to newborn circumcision.

Circumcising a newborn is a very different operation from circumcising an adult—not just for the obvious size reason.
In a newborn, a special clamp is placed over the head of the penis, crushing the two sides of the foreskin together.
Excess skin is cut away—without anesthesia—leaving the crushed ends to heal together.
No stitches are needed.
Adults have a vastly increased blood supply to their penis, so the simple clamp method is inadequate.
Mature nerves necessitate anesthesia.
Although local anesthesia will suffice, most men ask for heavy sedation to ease their psychologic trauma, which may be worse than the pain.
After the penis is numbed, foreskin is cut away, but the two ends must be sewn together.
Although risks are minor, heavy bleeding can occur if sutures open.
If too much foreskin is removed, an incision can tear open, resulting in significant scarring (with decreased sensation).
Sexual abstinence for three to four weeks is a must while healing occurs.

For most of us, the decision to circumcise was made by our parents and little can be done about it.
Some men, feeling mutilated, have tried to have their foreskins surgically reconstructed from skin grafts.
(There is no such thing as a foreskin transplant.
) Results of this type of surgery are not very good—especially since it is done for cosmetic reasons only.

If you were not circumcised as a child, your option remains to have it done as an adult.
Reasons for adult circumcision fall into two main categories:
cosmetic and medical.
Some men think a “cut” penis is prettier and may refuse to date guys who are uncut.
But just as there are guys who find uncut men a turnoff, others find them a tremendous turn-on, and there are magazines, movies, and escort services that cater to guys who like foreskin.
If you’re thinking about circumcision for purely cosmetic reasons, think long and hard (yes, the pun was intended) before submitting to the knife.
Once it’s gone, it’s gone, and though the risks of surgery are minimal, there are risks nonetheless.
If your partner pressures you to get rid of your foreskin, maybe he’s the one who should see a doctor—a psychiatrist, not a urologist.
Don’t do anything precipitous just because he wants you to be circumcised.
Be patient and keep it very clean.
Try to get him to play with it when your penis is hard and your foreskin is pulled back.
Then your penis looks almost like it’s been cut.

Medically speaking, repeated infections (balanitis) and phimosis are the main reasons for undergoing adult circumcision.
Sweat, semen, urine, and skin secretions collect under the foreskin, providing an excellent environment for bacteria and fungus to grow.
The white cheesy material (commonly referred to by the appetizing name of smegma) has a strong odor and should be cleaned off each day.
To
do this, gently retract your foreskin and wash around the glans with an antibacterial soap on a wet cloth.
Let water soften any crusting before peeling it off or you might injure sensitive skin.
If you find yourself in bed with a man who looks like potatoes could grow under his foreskin—and you still want to stay—then include a thorough cleansing as part of your foreplay.
(See
Chapter 11
.
)

Dr.
Franklin Lowe, a New York City urologist, recommends three simple steps to optimal foreskin hygiene:

1. Always retract your foreskin before urinating.
   Otherwise urine collects under the foreskin, keeping it wet.
   
2. Wipe away the last drop of urine before pulling your foreskin back down.
   This also ensures dryness.
   
3. When washing, pull your foreskin back to cleanse under it.
   Dry your skin well before pulling it back down.
   

Improper hygiene (especially in diabetics) leads to infection (balanitis) with reddening and swelling of the foreskin.
I saw a patient whose foreskin looked like a beet with blisters.
When it first began my patient assumed the redness was an allergic reaction, so he tried a cortisone cream he found in his medicine cabinet—anything to avoid seeing a doctor.
His pain and swelling increased and he refused to retract his foreskin because it hurt too much.
This only worsened his problem by preventing adequate cleansing.
By the time he hobbled into the emergency room, the infection had spread onto his penile shaft and scrotum.
He needed an emergency circumcision.
Because balanitis is most often due to candida (a type of fungus), if caught early, antifungal creams (Lotrimin or Lotrisone) and cleansing solutions work well.
Antibiotics are rarely necessary.

When infection heals, scarring develops, causing shrinking and toughening of the foreskin.
At first you won’t notice
any difference, but after repeated bouts of infection, your foreskin is no longer large or pliant enough to retract over your glans.
Phimosis clearly reduces sexual sensitivity and worsens already present infection.
Circumcision is the best treatment.

Occasionally a tight foreskin retracted over your glans for sex cannot be pulled back down.
It acts like a tourniquet, trapping extra blood and fluids in your already swollen glans (paraphimosis).
Often men put off seeing a doctor because of embarrassment until the swelling and pain become intolerable.
Paraphimosis is actually an emergency, and if ignored, you are in danger of strangling the head of your penis.
(Talk about a nightmare!
) If faced with an early paraphimosis, squeeze the head of your penis between your hands for five minutes to force fluid out of it.
This maneuver usually shrinks the glans enough so that you can safely pull the foreskin back down.
(It may not sound like much fun, but it sure beats surgery.
) If you don’t succeed, you’ll need a circumcision.

Your doctor also might advise circumcision to treat condyloma or other STDs that do not respond to conventional therapy.
If you perform an STD check, don’t forget to look under your foreskin.

Proponents of circumcision cite its prevention of penile cancer, a condition not found in circumcised males.
Cancer phobia is no reason to be circumcised, though, because penile cancer is exceedingly rare.
Improper hygiene is thought to cause this cancer, so a good daily washing is a lot better than surgery—and you get to keep your foreskin.

Piercing, popular since ancient times, is practiced by all peoples of the world.
(Just flip open
National Geographic
.
) Within the gay culture, piercing became popular in the 1950s among S&M aficionados.
But piercing is no longer limited to the S&M subculture; it’s been adopted by gays and heterosexuals.
The Gauntlet, a piercing salon with locations in San Francisco, Los Angeles, and New York, estimates that more than half of the people pierced today are straight.

Piercing attracts gay men for many reasons, the most common being aesthetics (we love our jewelry) and heightened sensation.
A nipple or navel ring can look pretty and feel great, creating an entirely new range of sensations beyond what you were used to.
As one of my patients explained, “Your nipple still feels the same, but now there is another layer added to it.”
Some guys like gentle tugging during sex, while others find that clothing brushing against their ring or bar when they walk is exciting.
One man told me that he loves his Prince Albert ring because he feels it with every step he takes, which keeps him focused on his penis and the pleasure it brings.

Most piercers will pierce any area that has a flap of skin (a piece that hangs away from your body wall) but avoid going through muscle (except the tongue).
After ears, the most common piercing sites used to be the three Ns:
nipples, navels, and nostrils, but now tongues are even more common.

Piercing is serious, has risks, and requires a commitment to keep the area clean for many months while it heals.
It should not be done on impulse.
There are also areas, particularly your penis, that, once pierced, will never close just because you’ve changed your mind.
Diabetics have a high risk for infections and should consult their physicians.
HIV is not a contraindication to piercing as long as you are in good health and heal well.
Keloid formers (people prone to thick scars) should be wary of piercing because a keloid can develop in a most unwanted spot.

Piercing is not regulated by government health agencies
and most often is not performed by doctors.
(You need a license to cut hair but not to spear someone’s dick!
) If you want to be pierced, have it done by a professional.
Never try it yourself or let some friend do it.
Instruments must be sterile, or you will end up with a serious infection.

Anesthesia is not required if the piercing is done properly and quickly.
A needle passed through your skin creates a channel, and a ring or bar keeps it open during healing.
Two stages of healing can take months to complete.
During the first and most critical stage when infection can set in, your tissues are open as skin grows down the tunnel from each end.
Clear yellow fluid oozes out, dries, and crusts on jewelry and must be washed away to prevent infection.
The Gauntlet recommends cleansing with a liquid antibacterial soap twice a day.
Infection is rare and usually results from failure to follow simple hygiene guidelines.
Pulling on your ring or bar during this first stage of healing can cause bleeding and tearing.
Do not change your ring, either, because you may find it impossible to get another one in.

The second stage of healing begins once your skin has fully lined the tract but is still not strong enough to withstand injury.
Although frequent cleansing is no longer critical, you still must avoid rough play.
Larger rings and bars gradually “up-size” your tract.

In addition to decorative foreskin and scrotum piercing, skin on the shaft (frenum piercing under the frenulum) or your entire glans can be pierced.
(See
Figure 6.
2
.
)
Piercing straight through your shaft is dangerous because of potential injury to large blood vessels and erectile tissue.
Before having your penis pierced, be sure your ring or bar is properly sized to comfortably accommodate your erection and yet not too large that it slides around and damages healing.
Any experienced piercer will know how to do this.

A Prince Albert ring is the most common glans piercing.
In it a ring is passed through your urethra and out the undersurface of your shaft just beyond your frenulum.
(See
Figure 6.
2
.
) How it got its name is cause for much speculation; some say that Queen Victoria’s husband had it done to keep his foreskin retracted, as Her Majesty was offended by smegma.
(I know queens with the same problem!
) A pierced urethra means you’ll spray, so please remember to wipe the tops of your shoes after each trip to the urinal!