How big is too big? The idea of researching the ideal girth of a penis might seem a peculiar past-time, but physician Maurice Garcia at Cedars-Sinai Medical Center, California, and his colleagues have good reason to embark on such a task. Access to female-to-male gender-affirming surgery is increasing in the United States and abroad. But when it comes to the delicate matter of choosing a penis, where do you go for advice?
Until now, there has been no evidence-based research on the optimal range or maximum size of a newly constructed penis, or 'neophallus'.
Garcia's team recently encountered four patients who asked for revision surgery to decrease the size of their new penis, due to excess girth that rendered intercourse impossible or painful.
"Based on our experience in San Francisco and London, during preoperative planning, transgender men commonly request neophallus dimensions that are larger than the average penile dimensions of natal men," says Garcia, in the paper.
To investigate what might be considered 'too big' for penetrative sex, the team decided to use the sex toy market as a proxy. They hypothesised that the upper limit for size would be reflected in the upper limit of popular sex toys on the market. "We expected people would not buy dildos whose girth was too large to insert," they said.
Using Alexa.com, an algorithm that tracks internet traffic, the team identified the top five sex toy vendors in the United States. They also collected information from Amazon.com using the search query 'realistic dildos' -- sex toys aimed at reflecting the physical characteristics, proportions and surface features of a real penis. They then measured the dimensions of the dildos reported as each market's bestsellers and for each vendor’s 3 largest-circumference bestselling dildos.
So what was the result? On average, mean circumference for bestselling dildos was 12.7 cm. This is slightly bigger than the average natural penis girth, which some research suggests is between 11.5 to 12.3 cm -- although these studies aren't terribly reliable, since most are based on self-reported measurements.
The four patients who asked for reconstructive surgery to reduce their penis size all had a girth exceeding 16 cm. The team conclude that surgeons should aim for a maximum girth of 13 to 14 cm, after the insertion of inflatable penile prosthesis cylinders, which are used to help the patient achieve an erection.
They say that a wider girth could be associated with an inability to engage in penetrative intercourse and result in pain for the patient's partner.
Journal reference: The Journal of Sexual Medicine, DOI: 10.1016/j.jsxm.2017.09.012
