Can't bottom for medical reasons & depressed about it

[ant811]

I'm 24 and I've never had a boyfriend of had any type of anal sex before. I've never even made out with anyone to be honest, although I did receive oral sex from a random guy I met on Grindr about a year and a half ago when I was 23 (go figure. I basically just pressured myself into doing it because I felt like a loser for having no sexual encounters at age 23).

I've always struggled with my sexuality, and I suffer from bad OCD, depression and anxiety which I guess has sort of hindered my social life and has prevented me from getting out there and meeting people. It started in high school, and I ended up becoming physically ill and was diagnosed with Ulcerative Colitis at age 15. After medications failed to work, I had to have 2 surgeries when I was 16 to have most of my colon removed. It's known as "j-pouch surgery", where the small intestine is used to create a "new colon".

However, I wondered if this would affect my ability to be a bottom in my future gay sex life. I always imagined being the bottom, being a top never really appealed to me much. I decided to contact my surgeon in September 2013, and I sent him an e-mail asking about it. This was his reply:

Anthony,

I do remember you, and I am really glad that you have done well from your surgery. Please do not be embarrassed by your question – it is a quite common one. Unfortunately, my answer is that any anal penetration following the surgery that you had is not advisable, either for you or for your partner. For you, there could be damage to the connection between the pouch and the bottom, as well as to the underlying sphincter muscles, and could potentially even ultimately lead to the need for a permanent ileostomy. I advise all of my patients not even to allow any physician to do a rectal exam, unless the physician is an expert in the type of surgery that you had (either a GI or a surgeon who does this). And for any partner, there is the potential for penile injury, as there are staples in the area, which could potentially scratch, cut or otherwise injure the penis. My advice is that you try your best to limit your sexual activities to those which do not involve you as an anal receptive partner.

I hope that this is a helpful (if not the desired) answer to your question. Please feel free to call me or to come and see me any time.

Best,

MH

This has made me very depressed, as I feel my sex life is over before it's even really started. I know there are other things I can do, but it's hard enough finding a suitable partner as it is. People will just say "just be a top", but it's not that easy for me.

Not sure how to cope with this and just accept it. I mean, I am glad I was able to have the surgery and am now in good health, but I wish I had at least experienced bottoming a little before having such a life-changing surgery. I didn't know this issue before I had the operation, and I wish I had, although I hadn't really come to terms with my sexuality at the time anyway, and I'm sure my doctors/surgeon didn't think anything of it either.

 

[dpnice]

Firstly I find it incredible that your surgeon was so straight forward with his reply. I personally would have been relieved at having such a professional and caring reply allowing me to establish my own sexual limits.

Secondly, there is a certain fantasy about anal sex but it is not, by any means, the only method to have a worthwhile and fulfilled sex life.

Thirdly, it is obvious that there are other problems that we here at JUB are not really competent to answer. We can give sympathy and recount our own experiences but it is down to you to go out and get professional help. I personally think that the fact that anal sex is something prohibited for you really is the least of your problems. Your mental health, social problems and self image seem to require the input from a specialist.

Hope things get better and take care.

 

[kallipolis]

I suffer from bad OCD, depression and anxiety which I guess has sort of hindered my social life and has prevented me from getting out there and meeting people

This should be your priority...

 

[Seasoned]

It's almost always traumatic when choices are taken away and I'm empathetic to your problem and understand your grief. That being said, human beings are, thankfully, adaptable once acceptance takes over. That is where I suggest you place your focus.

I'm sorry this happened to you at a young age before you've had a lot of experience. Missing out before you had a chance to decide if you liked it can take over your thought process, but keep working on that acceptance piece. I've been with my husband for almost 32 years and we've been mostly oral. The thing with sex is that with a caring partner there are countless ways to stimulate one another. Obviously, there will be disappointed people, but it's just one more variant in finding a compatible person.

While it's not a substitute for someone hell bent on anal sex, thigh fucking gives the sensation of two people in the same physical contact positions.

I've no doubt you'll get though this as long as you grieve it properly, own it and be matter of fact about it. In the end, I'm betting anything that you'll end up with a sweeter guy than you might have had you not had this problem.

 

[KaraBulut]

It's an unfortunate situation. However, the issue is not that you can't get fucked. The issue is that you're not working toward having any sort of social or sexual relationship with another man.

Ask yourself this: if you were able to bottom, would that change your situation? Would you be meeting guys? Would you be dating? Would you be having sex?

The key to resolving this is probably going to require working with a therapist on social skills. Work on focusing on the kinds of relationships that you can have instead of allowing your limitations on a single sexual act become the barrier that prevents you from enjoying any relationship with a man.

 

[xboxfan34]

What's wrong with topping?

 

[nyrival]

I agree with the advice of others here and I think that you should seek counselling regarding your anxiety and depression first as mental health should take priority over sexual health.

Having said that, your sex life isn't over. I would recommend some experimentation in an effort to redefine what sex means to you. It shouldn't just be about anal penetration. There's so much more to it then just that and the more experience you gain the easier it will be to reframe your thinking and replace your negative thoughts over not being able to bottom with positive thoughts about sexual activities you still can enjoy. There are also things you can do by yourself and with a partner to stimulate your prostate externally. Most would probably agree that prostate stimulation is the best part of anal sex anyway and you're in luck because now you get to enjoy it without having to plan ahead and douche before every sexual encounter! Try using two fingers and apply slight pressure to the outside of your perineum. You may need to feel around a bit but once you find your prostate the response from your penis will likely indicate your success. Next, try purchasing a small vibrating toy to place on the end of your index finger or for use by a partner and use that to massage the same area you located with your fingers. While it may never be the same as anal penetration I think you will still find it quite pleasurable and these techniques will likely be a suitable substitution for you and your doctor as they do not require any actual penetration.

 

[ant811]

It's an unfortunate situation. However, the issue is not that you can't get fucked. The issue is that you're not working toward having any sort of social or sexual relationship with another man.

Ask yourself this: if you were able to bottom, would that change your situation? Would you be meeting guys? Would you be dating? Would you be having sex?

The key to resolving this is probably going to require working with a therapist on social skills. Work on focusing on the kinds of relationships that you can have instead of allowing your limitations on a single sexual act become the barrier that prevents you from enjoying any relationship with a man.

I've seen a regular therapist on and off for 10 years and it hasn't helped much. I've also seen a few psychiatrists, and we've tried medications to treat my OCD/depression but not much luck in that department either.

Just a couple of weeks ago, I finally started seeing a therapist who specializes in OCD and he is doing Cognitive-Behavioral Therapy (CBT) with me. I'm hoping this works, and I'm also working on finding a doctor who knows what they're talking about in regards to medication and OCD. It's not an easy thing to cope with, and has prevented me from doing a lot and living my life to the fullest. It's something I struggle with every day.

I guess obsessing over not being able to be a bottom ties into my OCD. I know it would probably be hard on any gay guy, but it's especially hard on me because my OCD causes to harp on negative issues in my live obsessively. Hopefully once I get this all straightened out and feel better about myself, I can actually get out there and have a normal social life.

 

[KaraBulut]

I've seen a regular therapist on and off for 10 years and it hasn't helped much. I've also seen a few psychiatrists, and we've tried medications to treat my OCD/depression but not much luck in that department either.

Just a couple of weeks ago, I finally started seeing a therapist who specializes in OCD and he is doing Cognitive-Behavioral Therapy (CBT) with me.

If after 10 years, you haven't had much luck with a therapist, it's time to fire them. It sounds like you have already taken the step that I would recommend- finding a new therapist who is experienced in CBT.

I'm hoping this works, and I'm also working on finding a doctor who knows what they're talking about in regards to medication and OCD.

Psych meds are an imprecise science, so it often takes several trials and adjustments before the right combination is found.

You might want to seek out a neuropsychiatrist. That specialty is more adept at finding creating medication solutions (or correcting a misdiagnosis) when others have failed.

 

[88Jockstraps]

I have what you have. I have mostly anxiety as my number one problem, then mild depression (I don't know how heavy your depression is), and OCD.

My OCD plays itself out like this. I sometimes tap my laptop two times before I feel 'fulfilled'. Or I will close the refrigerator door then tap it three times lightly to make sure that it is closed 'completely'. Does any of this feel familiar to you?

I do take medication but my anxiety has decreased as I grew older every year. I'm sure I will always suffer from it though.

 

[88Jockstraps]

With OCD I just lay the problem aside rather than get rid of it. It's a part of you, but you can decrease it a billion times.

With OCD, if I think about it in a way of as getting rid of it forever, the OCD comes back. Same thing with other thoughts. But if I have the realization that all thoughts and obsessions are related to each other (past, present, and future) the OCD gets less intense.

Also, once you finish a thought, just realize that a new one will form. Your mind is forever thinking and moving forward. But realize that imperfection and un-evenness is a part of life and reality.

I think OCD may also be a sign of intelligence. It's because you noticed and notice details others don't and scenarios that others don't.

These are only my ideas and not from a therapist or a professional so I'd warn you to decide for you if these ideas will help you or not. They worked for me, but they may not work for you. Also, I hope they don't make your OCD worse, so be careful, that's why I'm warning you.

 

[Irish Queer]

I'm 24 and I've never had a boyfriend of had any type of anal sex before. I've never even made out with anyone to be honest, although I did receive oral sex from a random guy I met on Grindr about a year and a half ago when I was 23 (go figure. I basically just pressured myself into doing it because I felt like a loser for having no sexual encounters at age 23).

I've always struggled with my sexuality, and I suffer from bad OCD, depression and anxiety which I guess has sort of hindered my social life and has prevented me from getting out there and meeting people. It started in high school, and I ended up becoming physically ill and was diagnosed with Ulcerative Colitis at age 15. After medications failed to work, I had to have 2 surgeries when I was 16 to have most of my colon removed. It's known as "j-pouch surgery", where the small intestine is used to create a "new colon".

However, I wondered if this would affect my ability to be a bottom in my future gay sex life. I always imagined being the bottom, being a top never really appealed to me much. I decided to contact my surgeon in September 2013, and I sent him an e-mail asking about it. This was his reply:

Anthony,

I do remember you, and I am really glad that you have done well from your surgery. Please do not be embarrassed by your question – it is a quite common one. Unfortunately, my answer is that any anal penetration following the surgery that you had is not advisable, either for you or for your partner. For you, there could be damage to the connection between the pouch and the bottom, as well as to the underlying sphincter muscles, and could potentially even ultimately lead to the need for a permanent ileostomy. I advise all of my patients not even to allow any physician to do a rectal exam, unless the physician is an expert in the type of surgery that you had (either a GI or a surgeon who does this). And for any partner, there is the potential for penile injury, as there are staples in the area, which could potentially scratch, cut or otherwise injure the penis. My advice is that you try your best to limit your sexual activities to those which do not involve you as an anal receptive partner.

I hope that this is a helpful (if not the desired) answer to your question. Please feel free to call me or to come and see me any time.

Best,

MH

This has made me very depressed, as I feel my sex life is over before it's even really started. I know there are other things I can do, but it's hard enough finding a suitable partner as it is. People will just say "just be a top", but it's not that easy for me.

Not sure how to cope with this and just accept it. I mean, I am glad I was able to have the surgery and am now in good health, but I wish I had at least experienced bottoming a little before having such a life-changing surgery. I didn't know this issue before I had the operation, and I wish I had, although I hadn't really come to terms with my sexuality at the time anyway, and I'm sure my doctors/surgeon didn't think anything of it either.

You have no idea the respect I have for you right this second for being so brave to discuss this, only wish I was brave enough to post concerning issues I have.

 

[bankside]

I'm sorry the issues with your mental health are making this harder on you, and I think it's smart to pursue effective help for that, either with the professionals you've seen already or with a new doctor.

But I want to come back to the main issue: I'm sorry you can't bottom. Even though you know you can't spiral down about it, that genuinely sucks. I don't want everyone telling you to just have a can-do attitude and shake it off while trying something else in bed, when bottoming is a choice that many gay men make, and that many of them like.

Being depressed and having OCD are real concerns that can make it harder to deal with this kind of situation, but in my opinion dealing with it also requires admitting that not being able to get fucked when you want to is a legitimately sad thing. It's okay to be sad about it and mourn for something you would have wanted to try. If you go to any therapist, I hope they will not brush off that sadness, but help you to deal with how to mourn something sad, instead of trying to just get you to change the subject in your everyday life. OCD people are allowed to actually be unhappy about something and think about it a lot. It isn't "all just OCD."

One thing about relationships though:
This will make it harder to have a fling with some random guy who is looking for a quick-and-easy, no complications fuck. You are not in the best position to give that kind of guy what he is looking for, and maybe a few of those guys are attractive to you and you would have wanted to hook up with them. I don't think it is going to work.

But I'm going to suggest they would also not make the best partners for you, and also that it's ultimately no big loss.

You need someone with a bit more patience, who has a heart, and some compassion and understanding, and who won't get freaked out by ocd, or depression, or no bottoming, and who proves he is trustworthy enough to explain all this to over time. Plus you need to be turned on by the guy. Plus you need to have a few ideas about how to turn him on.

Don't go looking for hook-ups because that is probably not how you'll find a guy like that. Over time though, meet lots of people for friendship and just keep an eye out. The right guy will come along.

Physically I have a suggestion too: getting fucked makes me feel totally intimate with my guy, and like I can let go and relax with him. I get the same feeling though, even if he does not have his dick in me but he's lubed up and stroking it against my hole, or if he's doing the same thing with his finger, and never penetrating. At times like that, he gets me twitching and squirming and totally relaxed without ever getting inside me. From what your doctor says, penetration is the issue. Being able to open up and let him bring you to that kind of feeling, letting him touch you gently on the outside, was not forbidden by your doctor.

You need to know there are plenty of guys who will be very horny doing that, who will enjoy it and be very fulfilled by it, and who will not be disappointed at all by moving on to do something else with you after you enjoy that part of it. For some guys that will be more ideal than actual penetration. Lots of guys are not going to need you to just flip over and top every time either, they'll be glad to top you "from the outside." Part of this issue is about what you want, but I'm sure you are also thinking about what you have to give a guy that would turn him on. I'm saying the way your body works now is not going to be a problem for lots of guys. Give yourself a plan and a chance to find him.

 

[fallinlove]

I've had a few guys approach me on dating websites, saying right away that they don't do anal sex. I don't really ask them why because I figured it was either because they just don't like it or maybe a medical issue. But just the fact that there are guys out there like that are OK without anal should be a relief for you because it means you can find someone who also won't do anal (FYI - you can always top which is awesome). If you need anal stimulation, the above posts talked about it a bit. Or maybe even have a partner use a safe Dildo that would stimulate you. That would be great. And someone can rim you too, which is fantastic. And rub his cock on your ass with lub.

Also, oral sex is awesome and many couples have a great sex life without anal sex.

 

[innocentbychoice]

Even if you can't top, there are a lot of guys who are comfortable with foreplay only. Masturbation, oral sex, etc...can be just as or even more rewarding than penetration for some people. You'll be fine! Don't worry about it

I think your main concern right now should be your anxiety and personality issues that are preventing you to meet guys.

 

[Styles]

You're not the only one. I was diagnosed with my UC at 13 and had my colondectomy/pouch surgery at age 16 about 10 years ago, life does go on though. The fact that I can't bottom hasn't stopped me from having relationships and a healthy sex life. I'm now married to the man of my dreams who wholeheartedly understands what I'm going through and all the depression I went through as a teen in the hospital dealing with UC has all but vanished. Give yourself time and go out and meet people.