Cover image for The ins and outs of gay sex : a medical handbook for men
The ins and outs of gay sex : a medical handbook for men
Goldstone, Stephen E.
Personal Author:
Publication Information:
New York : Dell Pub., 1999.
Physical Description:
xii, 276 pages ; 21 cm
Format :


Call Number
Material Type
Home Location
Item Holds
RA777.8 .G65 1999 Adult Non-Fiction Central Closed Stacks
RA777.8 .G65 1999 Adult Non-Fiction Central Closed Stacks

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Finally--the book for every gay man's bedside table.

At last! Answers to the questions you're too embarrassed to ask--but always wanted to know!

Why does it hurt down there?nbsp;nbsp;Is it really safe to do that?nbsp;nbsp;nbsp;nbsp;What does it mean when something looks like this--and how do I make it go away?

Chances are you never learned anything about gay intimacy from your parents, your school, or your family physician.nbsp;nbsp;Here, at last, is reliable, comprehensive information on a wide spectrum of gay medical concerns, written by an eminent surgeon and recognized authority on gay health issues.

With up-to-date facts, interviews, and case studies from the author's practice, The Ins and Outs of Gay Sex goes far beyond HIV concerns, combining a complete education about the safe and pleasurable practices of male-male sexuality with a comprehensive medical volume.

Here are the facts about what you need to know to keep your sex life hot and healthy, including:

The rules of safe anorectal stimulation.

Symptoms to send you running to the doctor.

Foreplay, sex toys, and other accessories.

Viral and nonviral STDs-don't wake up with an unpleasant surprise!

Treatments for impotence and other sexual dysfunctions.

Diseases that can be spread without penetration.

Drugs...relationships...doctors (how to find the right one for you), and much more.

Author Notes

Dr. Stephen E. Goldstone has a busy surgical practice in the New York metropolitan area. He is a fellow of the American College of Surgeons, is on the teaching faculty of the Mount Sinai School of Medicine, and holds appointments at two New York City hospitals, Mount Sinai Medical Center and Cabrini Medical Center.

Reviews 1

Publisher's Weekly Review

For almost two decades, many have viewed the AIDS epidemic as paramount among gay men's health concerns. While never ignoring its centrality, Goldstone reminds his readers that there are myriad other considerations not only for self-identified gay men but for all "men who have sex with men." Among the wide range of sexual practices and concerns Goldstone covers are anal intercourse, sexually transmitted viral and bacterial infections, impotence, oral sex and HIV transmission, as well as recreational and prescription drug use and abuse. He also discusses ancillary cultural issues such as how being monogamous, living in an open relationship or having numerous sexual partners can affect safe sex practices. Goldstone's medical information is up-to-date and accurate; although, as he points out, treatments for AIDS change almost monthly. While the book covers the safety and health aspects of body piercing, its lack of information about the health implications of the wide range of sadomasochistic practices prevalent in the gay male community is a drawback. On the other hand, Goldstone has a positive, nonjudgmental attitude toward sex. This openness, combined with a chatty style (replete with bad jokes and not very subtle innuendo, reminiscent of David Reuben's Everything You Ever Wanted to Know About Sex but without the moralizing), makes Goldstone's book unusually reader-friendly. Includes charts and illustrations. (May) (c) Copyright PWxyz, LLC. All rights reserved



CHAPTER 1   Anal Sex--   OR SO WHAT IF IT'S NOT A VAGINA?   I shook my head. I still could not find anything wrong. Alex rolled over on the table. Even with the new mustache he still looked like the surfer boy he'd been.   "What's wrong with me?" he asked.   I rested my hand on his shoulder. "Nothing as far as I can see. You're not too tight."   "I must be. Richard's not that big. I did everything you said and I still can't take him."   "You're tensing up," I said. He tried to argue, but I stopped him. "Not willfully. It's beyond your control. Maybe anal sex isn't for you. There are plenty of other ways to satisfy Richard."   He looked away. "You don't understand. This is important. If I don't do this ..." His voice trailed off. "Can't you put me to sleep or something? Make it wider?"   "It's wide enough." I gently directed him to look at me. "There is nothing wrong down there. What else is bothering you?"   He didn't answer for several minutes, but I waited. Some things can't be rushed.   Whether we call it anal sex, anal intercourse, or just plain fucking, this type of sex is an integral part of sexual relations for many men who have sex with men. But the practice is in no way limited to gay men; many women enjoy it too. In a recent survey of 100,000 women, Redbook Magazine found that 42 percent of women had tried it once, and, for 2 percent, anal sex was an important part of their sexual relationships. We are not alone! Many men enjoy anal sex; the experience is pleasurable and vital to their sex life.   I remember standing in horror as a physician I worked with berated a gay man he treated with a terse "Your asshole is for shitting, not fucking!" Well, this is not the case. Anal sex can be both pleasurable and safe if practiced properly. Unfortunately, homophobia has clouded the issue. Ignorance and rumor often magnify our fears about possible injury. Many gay men refuse to discuss anal sex with their physicians, and most physicians know little if anything about it--other than that it transmits HIV.   Many women view vaginal intercourse as the major step in their sexual evolution, giving considerable thought to who will be their first. Men joke about losing their virginity after their first anal sex experience and minimize its significance. True, we don't have a hymen to rupture, but anal sex is not an insignificant step, emotionally or physically. Many men view anal sex as the final step on their path to gayness. (Once you've done it you must be gay.) For some it's a sign of their first true love. Others view anal sex as an assault on their masculinity. Unfortunately, some men recall their first episode of anal sex as the horror of sexual abuse, and they may never recover. In any case, you shouldn't bend over for anyone until you're ready.   Physiologically, anal sex must not be taken lightly. Sure, you can't get pregnant, but there are a million other things you can get instead. Anal sex is probably the highest-risk sexual act performed by men who have sex with men--and not just because of HIV. Most sexually transmitted diseases (STDs) pass between partners during anal sex--even without ejaculation. And a condom may not be protection enough. In this era of sexual freedom, it is almost impossible to have a healthy sex life and avoid an STD. Before you let that guy inside you, make sure he's clean and you're protected.   If you have anal sex regularly, use these pages as a guide; they may protect you from injury and STDs. And for those of you who aren't ready for anal sex, read on. Someday a relationship might arise when it becomes something that you both desire.   Anatomy   Anal intercourse differs from vaginal intercourse in several significant ways. First and foremost, a hole is not just a hole, and a woman's vagina is anatomically very different from your anus. The colon's purpose, as we all know, is to transport digestive waste from your small intestine to your anal opening where it's excreted. As part of this task, the colon's lining, or mucosa, is specially equipped to absorb water from the liquid waste of your small intestines and turn it into solid feces. When your colonic mucosa doesn't work properly, diarrhea results. Your colon's heightened absorption capability makes it a particularly susceptible entryway for many infections; HIV, of course, is one of the most deadly.   Your colon is approximately six feet long, and unless your partner is something of a "giant" among men, anal intercourse affects only the last few inches. This area includes your anus and rectum; although they both are regions of your colon, they are, in actuality, two very distinct anatomic sites. Your anus is lined by squamous cells, which are closely related to skin. Your rectum resembles the rest of your colon. Importantly, your anus has nerve endings capable of experiencing pain while your rectum does not.   The muscles that control bowel movements, or sphincters, as they are commonly called, are concentrated in your anus and lower rectum. These muscles can be divided into an external sphincter and internal sphincter. (See Figure 1.1.) Your external sphincter, the outermost band of muscle, is under your direct control. You can willfully tighten it to keep gas or feces from leaking out, and you can relax it for defecation. Your internal sphincter muscle abuts your colon wall. It is an involuntary muscle, and as such you cannot willfully cause it to relax or contract. When feces enter your lower rectum, the internal sphincter involuntarily relaxes for defecation. If you're miles from a bathroom or in the middle of some speech, you depend on your external sphincter to contract and prevent an embarrassing situation from occurring. The rectal wall also contains nerve fibers that tell you the difference between feces and gas.   Just as your internal sphincter muscle involuntarily relaxes when feces enter your rectum, it involuntarily contracts when a penis or other object attempts to enter from the outside. As the word "involuntarily" implies, this sphincter contraction is beyond your ability to control, no matter how relaxed or sexually aroused you are. The relaxation and contraction of the internal sphincter allows you to pass large bowel movements painlessly, yet a penis of equal or smaller size can hurt during insertion. An anal tear can occur during the initial phase of anal sex precisely because your partner pushes his penis through your closed sphincter. Think of his penis as a battering ram, one for which your internal sphincter is no match.   Excerpted from The Ins and Outs of Gay Sex by Stephen E. Goldstone All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.