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Sex Therapist Ian Kerner Explains All Things Anal in This Excerpt From His New Book

"Yes, penises extend from the body, but there are pleasures to be found by turning inward—into the unknown, the unexplored, into the anorectal system."

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Much often gets written about the differences between male and female sexuality, but I think we often ignore the similarities. For example, the biological sex of a fetus isn’t determined until around week seven of gestation; up until that point we’re all working with same embryonic material and waiting to be sexually differentiated. Even when that differentiation happens, male and female genitals are essentially homologous (the same structure and origin), with the penis growing outward and the clitoris growing inward.

In their outwardness, penises are sexual imperialists: conquering, colonizing, and reshaping the world around their penetrative experience of pleasure. In keeping the clitoris out of sight and out of mind, the penis is left to render and re-render its own sexual reality in which the male heteronormative narrative is central, and everything else—queer sexualities, trans sexualities, female/femme, the fluid, the nonconforming, the gay, the bi, the non-binary—are pushed beyond the scrim to a misty hinterland. But, even so, at times a heterosexual male will intuit the narcissism of his sexual existence, the monotony of the treadmill his libido is consigned to run. In these moments, he will feel a beckoning of something different, something beyond the curtain of his implicit sexual solipsism. There must be more. Yes, penises extend from the body, but there are pleasures to be found by turning inward—into the unknown, the unexplored, into the anorectal system.

When I talk to gay men about receiving anal pleasure, many love the experience of being penetrated, of feeling another person’s body in their own; they love submitting, and they love the intense physical pleasure of anal play, which is often accompanied and amplified by stimulation of the penis. Writes author Woody Miller, “Bottoming isn’t just about the physical sensation of being penetrated. It’s the emotional high of accepting someone else’s presence in your body. It’s the psychological thrill of being momentarily ‘owned,’ of submitting yourself to the strength of another man.” Or, conversely, I propose, submitting oneself to the strength of another woman if you’re a heterosexual man and want this experience too!

Sex therapist Joe Kort says he jokingly reminds straight men who are insecure about enjoying anal play that the human anus has no sexual orientation. So let’s discuss anal pleasure for all.

Pushing Through

Sphincter muscles. Inside the anus are two muscle groups that control its opening and closing, for example during bowel movements. Closest to the anus is the external sphincter, which is controlled voluntarily. Remember a time you really had to go but there wasn’t a bathroom nearby? Chances are you were giving your external sphincter a pretty rigorous workout. Beyond the external sphincter is a second group of muscles known as the internal sphincter. These are under the authority of your autonomic nervous system and react reflexively, i.e., relaxing when you’re about to poop. Though controlled separately, the two sphincters often work together.

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By learning to better control your external sphincter, you may be able to influence your internal sphincter. Kegel exercises are a great way of exercising your control and relaxation of the pelvic floor, including the sphincter. (Next time you’re peeing, stop the flow of urine mid-pee and you’re Kegeling.) While Kegeling focus on the feeling of “drawing into” the anus. Practice Kegels in combination with rhythmic breathing and erotic fantasy/imagery (you want to be relaxed and aroused), and then try to insert a lubed finger or small butt plug just beyond the anus and sphincter muscles. By small, I mean a butt plug that’s not much bigger or wider than a pinkie or index finger and has a flared top that allows it to be removed easily, and safely, without getting stuck inside the anus. Just as with Kegeling, focus on drawing in the plug. Receiving into the anus isn’t just about being penetrated, it’s about inviting and taking in.

Because the anus doesn’t self-lubricate, whenever it is being penetrated it’s best to have an artificial lube on hand. Lots of it. As we’ve discussed, water-based lubes are great but tend to dry out, silicone lubes don’t work well with silicone toys because they cause the toy’s membrane to degrade, and many oil-based lubes are incompatible with toys and condoms, so there’s a lot to consider in picking a lube. Many great lubes are also designed for anal sex. Just watch out, as desensitizing/numbing products are sometimes sold as lubricants— avoid these! (Usually the active ingredient is lidocaine or prilocaine.) After all, pain is the body’s way of alerting you that something is not right, and if you can’t feel “the ouch,” you might go too far, damaging delicate tissues. However, there’s not enough lube in the world to compensate for a lack of being warmed up. But with a little practice (Kegels, breathing, and erotic fantasy) and some lube, the insertee will be able to painlessly and pleasurably draw in whatever is being used to penetrate the anus past the sphincter muscles.

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The rectum is the last stop of the large intestine. It is about twelve centimeters long and made of soft tissues that can expand to accommodate something larger—a bowel movement, a finger, a penis, a toy—and then contract to its original state. Unlike the vagina, the rectum isn’t straight—there’s a bend in your rectum called the “anorectal angle.” Initially, it tilts in toward the front of the body, then an inch or two in the rectum shifts in the other direction. A few inches later it goes toward the front of the body again. It’s a bit like an “S” shape (also called a sigmoid shape). So while you can enter the anus and venture an inch or so through the anal canal to reach the prostate, you’ll need to take a bit of a right turn to continue into the rectum. So go slowly. Also, take note: in a standing position the anorectal angle is about 90 degrees (not the best for a straight path), whereas in a sitting position it relaxes to 100 degrees, and in a squatting position the S-curve will straighten to 126 degrees3 (a perfect straight line is 180 degrees), making a squat the position of choice for entry into the rectum.

Much of the potential pain of anal sex for the receiver is the result of not being relaxed enough to accommodate a penis or sex toy and not being able to flex the rectum to more fully accommodate whatever is doing the penetrating. Relaxing, lubrication, and taking it slowly will help the anorectal angle to straighten and provide less resistance. This is important for the penetrator to know as well—when you encounter resistance, stop, slow down, and let them receive.

Pegging

Continuing our journey inward, “pegging” is a term that sex columnist and activist Dan Savage coined to describe anal sex in male- female couples, in which the guy is on the receiving end and the female partner is generally wearing a strap-on dildo.4 Although the term tends to be used for male-female couples, pegging is enjoyed as well by lesbian, trans, and gender-queer couples too. While much of the appeal of pegging has to do with the prostate pleasure we discussed earlier, the psychological pleasures of pegging rival, and possibly transcend, the physical ones: the switching and subversion of gender roles; the playing with power; the novelty of a woman wear- ing a penis, the newness of the physical sensations for each partner; the trust, bonding, and intimacy that go into this delicate act, and the empathy that comes with seeing something familiar (sex) through a different lens. Sex educator Charlie Glickman says that he’s spoken with a number of men who have said that pegging has given them a better understanding of how their female partners feel—needing more foreplay, not being in the mood for intercourse, experiencing pain, or being easily influenced by outside stressors. Likewise, he notes that women who peg discover the amount of work, responsibility, and power that can go into penetrating someone.

Let’s talk briefly about pegging equipment. As with almost all sex toys, harnesses come in myriad designs and can be made of anything from fabric to rubber. No matter what the material, harnesses have a hole or an O-ring for a dildo to slip through as well as some form of straps to anchor it to the body. In terms of the dildo, flexible materials like silicone or rubber work best as strap-ons, and they’ll give the wearer a better sense of having an actual penis. Be sure that your dildo has a flared base and flat bottom so it will work with a harness. The dildo should fit right over the pubic bone. Some realistic-looking dildos have “balls.” While this may or may not appeal to your specific fantasies, many women like the clitoral stimulation of having the balls rub against their vulva while pegging their partner.

When pegging for the first time, I recommend that the partner doing the penetrating gets a good sense of what it feels like wear- ing the harness, and how this new attachment responds. This might be plenty for starters. Sometimes simply seeing his partner with her “penis” and the novel combination of male and female physical characteristics is enough to excite a guy. And if either of you finds you’re not into it, or aren’t ready to go further, you can stop here. If you have chosen to use the harness, chances are you’ve used toys to stimulate his anus before, but this is a different experience, both mentally and physically, and it’s important to go slowly and listen to your bodies and each other. When you’re both ready, use plenty of artificial lubricant. Keep in mind you won’t have the same indicator that things have gotten dry as you do when penetrating him with your fingers, so reapply frequently.

Enter slowly and use your hands as a guide. Give him time to get used to the dildo bit by bit. Once you’re inside, take a minute for both of you to adjust. And don’t forget to check in often and ask how he’s feeling and whether he’s comfortable and enjoying himself. For many women, thrusting is a completely new experience. It can take time to grasp the concept and find a rhythm. The beauty of the strap-on is that it frees up your hands, so don’t forget to use them. Rub his balls or thighs; keep edging his penis toward the point of no-return/ ejaculatory inevitability. Most of the same configurations that work for penile-anal penetration can be used for strap-on play.

Pegging and anal sex aren’t for everyone, and it’s probably not an everyday experience. It may turn out that prostate play, anal play, and even edging aren’t regular parts of your sex script, but they can be part of your sexual toolkit. Just beyond your sexual comfort zone, an expanding horizon of physical and psychogenic stimulation potentially awaits.


Excerpted from the book: So Tell Me About the Last Time You Had Sex: Laying Bare and Learning to Repair Our Love Lives by Ian Kerner, PhD, LMFT. Copyright © 2021 by Ian Kerner, PhD, LMFT. Reprinted with permission of Grand Central Publishing. All rights reserved.

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