Penis size is the ultimate taboo in the world of men’s health. But here is why you’re probably NOT as small as you think: DR MAX PEMBERTON
‘Hitler has only got one ball.’ You know the rest. That playground song has been passed down through generations of schoolchildren, a way of cutting the monster down to size by attacking his manhood.
Except that, recently, the joke took a strange turn towards reality. In a Channel 4 documentary, geneticist Professor Turi King, famous for identifying the remains of Richard III, revealed that DNA analysis of blood taken from the sofa where Hitler shot himself showed he almost certainly had Kallmann syndrome.
This is a rare genetic condition that disrupts hormonal development. Among its effects: incomplete puberty, undescended testicles, and in some cases, a micropenis. Meanwhile, court documents from Jeffrey Epstein’s trial included claims about his small anatomy.
But while the stories made gripping reading, it’s important to be clear there is no proven link between having a micropenis and being a monster.
Hitler was defined by his choices and his evil, not his hormones. Epstein was a predator because of what he did, not what he looked like undressed.
To suggest otherwise would be to stigmatise thousands of innocent men who already carry a burden of shame they don’t deserve. If anything, the men I’ve treated are more likely to retreat from the world than to seek power over it.
Yet the salacious headlines have done something valuable, opening up the conversation.
Being smaller than average is far more common, yet many men worried about their size are well within the normal range
Because having a genuinely small penis is taboo, buried under cruel jokes, and missing the compassion we extend to other physical differences.
Over the years, I’ve spoken to a number of men affected and what strikes me most is how alone each feels: they have no idea that others share their suffering, because nobody talks about it.
First, an important distinction. A micropenis is a specific medical diagnosis: for an adult man, it means a stretched or erect length of less than approximately 7cm (the average length, erect, is around 13cm).
Being smaller than average is far more common, yet many men worried about their size are well within the normal range.
Regardless of whether someone meets the clinical criteria, the psychological impact can be devastating.
The loneliness they experience can be crushing, but the fear of exposure is worse. The effect is heartbreakingly common. Research shows that men with a micropenis experience higher rates of depression, anxiety and social withdrawal.
Even thinking you’re poorly endowed can affect men’s mental wellbeing. Research by King’s College London in 2015 found that those with body dysmorphic disorder (characterised by being excessively preoccupied with perceived physical flaws which are often unnoticeable to others) that focused on their penis had reduced erectile function and less satisfaction with intercourse compared to controls, even though their anatomy was normal.
It would be remiss not to mention online pornography, which has given an entire generation of young men a deeply distorted sense of what is normal.
Porn performers are selected for their unusually large endowments, much as fashion models are selected for unusual height. Comparing oneself to them is absurd, yet countless men do so.
This is fuelling anxiety: in my NHS clinic there’s been a marked increase in young men complaining about erectile dysfunction that has no physical cause. But their minds are so consumed by performance anxiety they cannot function.
Tellingly, studies consistently show that for most women, emotional connection matters far more than measurements.
So what can be done? For parents of children diagnosed with a micropenis, the evidence supports early hormonal treatment and, crucially, open and supportive communication. Children who grow up knowing their bodies are different but that they are loved fare far better than those who absorb shame in silence.
For adult men living with a micropenis or significant anxiety about their size, psychological support can be transformative.
Cognitive behavioural therapy, used to identify negative thought patterns and develop healthier ways of responding to difficult emotions, can help (ask your GP for a referral, or self-refer to NHS Talking Therapies; private therapy is also available and the Sexual Advice Association offers support and guidance on all kinds of sexual health concerns).
Sex therapy – sessions with a qualified sex therapist – can help individuals and couples explore intimacy beyond penetrative sex (often available on the NHS via your GP or urologist; or privately via the College of Sexual and Relationship Therapists).
Another patient who came to me in his 50s after a lifetime of avoidance because of his micropenis is now, following therapy and online support, in a happy relationship.
‘I wish I’d done this 30 years ago,’ he told me. ‘All that time I wasted being afraid.’
That is the real tragedy here. Not the anatomy, but the years lost to shame. We’ve made enormous strides in discussing women’s body image and the pressure of unrealistic beauty standards. It is time we extended the same compassion to men.
And for anyone affected, the first step is always the hardest. But it is worth taking.
