“Bottoming has never been my forte, but after I met my current boyfriend of 3 months, it seemed as if that “role” was mine to play. Being a total beginner, I was quite naive when I thought: how hard could bottoming possibly be? A few days prior to my anal debut, I did some research by watching some gay YouTube stars as they discussed their approach to preparing to bottom. Their recommendations were all over the map, without clear and concise directions, and almost all lacked commentary from physicians or other medical experts. After much research, I decided to take matters into my own hands, combining all of their advice, as best as I could. To start the preparation, I used store bought fleet enemas. I found myself having to use several of them since each time I flushed out more and more stool. Even after an hour of continued applications, the water still wasn’t clear. Finally, I decided to give up and hop in the shower to freshen up the exterior. Now smelling great and ready to go, my boyfriend came over and before I even knew it, we were naked on the bed and I could sense all he wanted to do was stick it in. I was eager, too, but with all the preparation I went through, I totally spaced and forgot the lube. My hole was already wet from him rimming me and the area felt so numb from all the alcohol we drank. I let him be the aggressor and he proceeded to enter. Right from the onset, I knew it didn’t feel right. Part of me was in severe pain and knew he should stop, but the sadistic part of me wanted it even more. We both came simultaneously and I must say, I was relieved for it to be over. As I was cleaning out his fluids, I started developing excruciating pain that was accompanied with bleeding. I knew something was wrong and found myself in the emergency department of my nearest hospital. Clearly, I was incredibly embarrassed thinking no one would understand the woes of a newbie bottom. Finally, I stumbled upon Dr. Evan Goldstein through an Out Magazine “101 on Bottoming” article. Through this and making a consultation at Bespoke Surgical, I was thoroughly guided on the in’s and out’s of safe preparation, appropriate engagement – identifying correct lubricants, pre-dilation, and correct positioning – and of post-coital rituals. With all of this, my role in my relationship has been optimized with plans for longevity through prevention and expert preparation.”
Prevention focuses on minimizing injury, with proper mechanics to accomplish defecation and engage in anal intercourse, while extensively monitoring for the potential development of anal carcinoma.
If you look at any community, the patients within it not only demand a basic understanding of their values and ethics, but also tend to surround themselves with others like them. This is purely second nature, and it’s comforting. For that reason, Dr. Goldstein believes it’s essential for medical providers to understand the intricacies and nuances of gender, sex, and all aspects of sexual relationships — so that every patient feels comfortable and understood.
True acceptance allows for further discussions on risk assessment. Dr. Goldstein views “demons” as when people don’t confront the devil within. Who’s to say we can’t turn those demons into desires? The desire to explore sexually, the desire to open a relationship, or the desire to fix address a anatomical imperfection. All of these should not be viewed in a judgmental manner, but rather discussed in such a way that allows one a truly safe environment in which to approach and explore these new encounters, with the least amount of risk to oneself, others, and the community at large. That’s our philosophy at Bespoke Surgical, where creating a fully open space is paramount.
At Bespoke Surgical, some of our preventative measures focus on:
- The intricacies of anal intercourse and how to minimize injury or harm
- Yearly preventative evaluations and maintenance
- Knowledge of the myriad types of relationships and the inherent risks of each
- The best methods to approach safe sexual encounters
- Utilization and management of PrEP, along with a diverse knowledge of its appropriate use cases
- Hormone replacement therapy
A clear conception of these topics (among others) leads to a coherent and expansive discussion with patients. Dr. Goldstein understands that this is an ever evolving and changing field, so the commitment to constant re-evaluation and preventative education on all levels is imperative. By analyzing knowledge gaps and addressing the issues that cause them allows for the human side of the elevated doctor-patient relationship to develop.
We at Bespoke Surgical are leading the charge on proper sexual education and practices and are strategically using science and the newest technologies to provide our community with the essential tools required for safe and long-lasting sexual relations and better overall anal care. Stay tuned for more to come with amazing product development in this arena.
Bespoke Surgical offers the following prevention and anal care services: