A look at “‘Not enough’ vs. ‘never perfect’: a qualitative analysis of penile enlargement surgery intentions in heterosexual and homosexual men” by Boqiang Zhang, Tie Li and Bin Lei (2026)
We hear a lot about body image pressures on women, and increasingly on gay men’s bodies more broadly: gym culture, dating apps and the endless scroll of perfect torsos. But one area rarely discussed in public is genital body image. This study from China asked men who had considered or undergone penis enlargement surgery what drove them, and found that straight and gay men often had quite different reasons.
What they found
The researchers interviewed 24 cisgender men, 12 heterosexual and 12 gay, who had either had penis enlargement surgery or recently consulted about it. Using a “push-pull” framework, they separated internal pressures pushing men towards surgery from external factors pulling them back or complicating the decision.
Shared hesitations (the “pull” factors). Both groups worried about physical safety, meaning risks and complications, and about social exposure: the fear of others finding out.
Different drivers (the “push” factors).
- Heterosexual men described a logic of “not enough”. Pressures centred on their partner: sexual performance anxiety, worries about being “man enough”, and comparisons they imagined their partner making.
- Gay men described a logic of “never perfect”. Pressures centred on the community: body image anxiety, a culture of constant self-improvement and enhancement, and comparison with peers, for example on dating apps.
The authors call these two logics “relational adequacy” versus “visual optimisation”, and argue that psychological screening and counselling before surgery should take these different motivations into account.
A grain of glitter ✨
This study opens up an important, rarely discussed topic, and its comparison across sexual orientation is genuinely illuminating. But it’s small and specific: 24 urban, educated men in China, recruited online. Bisexual and trans men weren’t included, and the paper uses the dated term “homosexual”. The authors are based in a hospital setting, so they approach the topic from a surgical angle. The study doesn’t assess whether participants might be experiencing body dysmorphia, an important consideration with any cosmetic surgery. It also looks only at intentions, not at how men felt afterwards.
The two neat categories, while memorable, may oversimplify. Many men will recognise elements of both.
Why this matters
If you’re a gay, bi or queer man and feel you’re never quite good enough, in the mirror, on the apps or in the bedroom, you’re not alone, and the pressure often comes from the culture around you rather than any real flaw. The same goes for straight men worried about measuring up. Before considering any cosmetic procedure, it can really help to talk things through with a therapist who understands body image and male sexuality. Sometimes the most transformative change happens in how we see ourselves.
Every unicorn’s horn is exactly the right size for its magic. Promise.