Advice Column Response

Dear How to Do It,

I’m a 59-year-old gay man who had a prostatectomy last year. Lately, I’ve been getting some pretty aggressive flirtation from nice guys who seem keen on a casual hookup. But I feel like I owe them a heads-up.

Honestly, I really want to say yes (with some precautions), but when should I tell them that I can’t get hard? I’m passionate and like a lot of things, and I can still experience intense, dry orgasms. But rejecting oral sex might come across as me rejecting the person. On top of that, bringing up my prostate cancer can kill the vibe for a casual fling. It’s awkward when we start making out and I can’t get hard—I’m into it, but it feels personal. I’ve got a BiMix prescription, which isn’t easy to carry around, so I often find myself excusing myself awkwardly. What kind of explanation am I obligated to provide, and when? If my situation is a dealbreaker, I don’t want to waste their time. Not many seem to understand the emotional impact of this surgery.

—From Top to Bottom But Still Alive

Dear From Top to Bottom But Still Alive,

First off, I can relate to your situation; the effects of a prostatectomy are generally under-discussed, notably in relation to gay sex. It sounds like you’re managing things well, though. I’m not sure if your sign-off completely reflects your current sexual practices and interests, but if it does, that’s impressive. You’re navigating an unfair landscape effectively.

If you identify as a bottom, it’s totally reasonable to communicate that your dick is off-limits from the get-go, particularly during casual encounters. Many bottoms don’t focus on getting hard, and while it might be disappointing for some versatile or top guys, that shouldn’t deter everyone. The negative responses you’ve received are likely not the norm; perhaps you just encountered a less-than-ideal group. Being nearly 60, it’s common for guys to experience erectile difficulties. You don’t owe anyone an explanation or have to detail your surgery. They can take it or leave it. Sure, that might lead to some rejection, but the same could happen if you identified as a total top and met another total top. Not every person will suit you, and that’s okay, even if being pursued is exhilarating.

As for hookups, I’d suggest that you don’t owe them much explanation. You’re doing what you enjoy, and the hard part just isn’t involved. If you start seeing someone regularly, that’s when you might want to share something about your situation, probably when things become less anonymous. By then, they should already appreciate what you bring to the table and hopefully be fine as things are.

Getting familiar with the BiMix injection process might ease the awkwardness, too. Try to rethink how you feel about that medication. Although it’s not perfect, think about the strides medical technology has made! If someone is enthusiastic about being with you, they’ll likely be accepting of whatever method you use to achieve an erection. Relying on medication can feel humbling, but try to approach it practically—it’s nothing to be embarrassed about.

—Rich

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My wife and I have been married for almost 11 years and have been together for 15. I’ve tried to have discussions about sex, but they rarely lead anywhere productive. I’ve gone through various strategies to improve our sexual frequency, like scheduling times or asking her what excites her, but those suggestions are often dismissed. She prefers spontaneity or feels she needs to be in the right mood. While I respect her feelings, it doesn’t help me figure out how to improve things. Over the past year, I know she’s made an effort to be more open to my needs, which I truly appreciate, but there’s a catch.