Emotional Consequences

Boys and men with hypospadias develop a variety of emotional responses related to the condition.

For the vast majority of men affected, the experience of hypospadias is generally kept as an intimate “secret”. This secrecy occurs firstly because penis size and shape are subjects rarely approached sensibly in our society, and secondly because this birth difference has been barely discussed in the press or other media.

This means that men affected by hypospadias have very little access to basic information which might be useful for them– for example, most are not aware that is a relatively common condition.

Obviously a penis with hypospadias differs from what is generally thought of as “the normal”, though even normal penises have a wide variety of shapes and sizes!

That said, a boy or man with the condition may feel different or even abnormal when he compares himself with other boys or men, or when he compares his penis with a “normal” penis. What makes this worse is not understanding what hypospadias actually is, and being unable to discover anything about it.

The outcome is that many young boys, adolescents, and adult men grow up with no understanding of why the most important physical feature of their maleness – their penis – is “different”.

As boys, they begin to compare themselves with other boys and discover that they are “different” and therefore perhaps “deformed”, or somehow less of a man. If these quite understandable feelings are not discussed with them as young boys, they may grow up with feelings of inadequacy and/or have a negative body image.

They may begin to avoid situations that are part of everyday life, such as using a public urinal. They may avoid sexual intimacy with another person, and this can produce a negative emotional cascade. And so a boy or man with hypospadias may feel that he will never be able to perform as well as other men do.

This feeling of being “different” and “inferior” can generate a range of negative emotions such as depression, anxiety, insecurity, frustration, anger, confusion, humiliation, shame and powerlessness. With time, the experience of these negative emotions can profoundly impair the psychological, social and sexual functioning of the young boy and the man he becomes.

Furthermore, it may significantly impair his academic and professional achievement. Some boys or men are so distressed that they do not see solutions to this problem and become prone to depression and suicidal thoughts. Some have been driven to self-harming themselves.

Not all boys and men with hypospadias have these kinds of emotional experiences. Either because they grew up in a supportive family or because they benefited from the presence of a supportive friend or partner, some men have never faced such emotional challenges, or they have managed to resolve them.

Indeed, many boys and men in this situation adapt very well to their “difference”. Their positive acceptance of themselves means that hypospadias does not affect or control their lives, and they experience happiness and pleasure in all areas.

What Types Of Support Are Useful?

Various types of support maybe very useful for boys and men with hypospadias and their families. Connecting with others who are living with the same issue or with other affected parents through the internet can be highly effective, providing a source of information and knowledge which can help overcome difficulties and challenges related to the condition.

Local, regional or national support groups can be another way to lessen the negative effects of hypospadias. Meeting other men in person is one of the most powerful experiences men with penile difference can have, helping them to break down the loneliness that some men have experienced in keeping their hypospadias a secret all their lives.

Another real source of help is support or discussion groups where you can share experiences and express your feelings and emotions about hypospadias. You can also get emotional support and discuss different ways in which you can cope with hypospadias, and find practical information on how to live positively with hypospadias.

What Do We Know About The Long Term Effects?

Fatherhood: men with hypospadias have just as much chance of becoming a father as any other man, so long as the opening of their penis is not located at the base of the penis, when it may be difficult to ejaculate semen directly into their partner’s vagina.

There is a slightly greater chance, compared with other men, that men with hypospadias will pass the condition on to their sons.

Urinary infections: these do appear to be more common with men with hypospadias. These infections may be related to a narrowing of the urine tube (a stricture) so that the urine does not completely empty from the bladder, or they may be the result of surgery where a skin graft bearing hair was used in the operation. Surgery disrupts the body’s normal protective arrangements and that can lead to higher susceptibility to an infection.

Sexual functioning: some men with hypospadias complain that they dribble semen instead of spurting it out when they have an orgasm.

It’s possible this has nothing to do with the penile structure, since the ability to ejaculate forcefully is mostly related to the power of the muscles around the sexual organs rather than the location or size of the urethral opening.

Chordee: some men with prominent chordee may experience discomfort during sexual intercourse in certain positions. However, other men say that chordee actually enhances their sexual pleasure – and that of their partner also.

Sexual orientation: some men dealing with this issue have expressed a concern that they are gay or bisexual. While a man with hypospadias may be gay, we believe that many men with hypospadias think they are gay or bisexual because they have an interest — sometimes a very keen interest — in the appearance of other men’s penises.

This may lead to actual physical contact with other men, sexual or otherwise, but this desire to look at or experience “normal”penises does not necessarily mean a man is either gay or bisexual.

Information about hypospadias for men, boys and parents from the UK Hypospadias Trust