Why sexual health professionals must understand anatomy, stigma, and evidence-based practices surrounding anal pleasure and care.
Anal sex is widely practiced yet rarely discussed with clarity, accuracy, or compassion. Misinformation, cultural stigma, and shame have created a landscape where many people engage without guidance, avoid exploration altogether, or experience preventable pain and injury. For sexual health professionals, building a strong foundation in Anal Sex Education is essential for providing inclusive, affirming, and evidence-based care.
SHA met with Dr. Evan Goldstein, one of the most recognized experts in gay men’s intimate health and a pioneering voice in anal wellness. As the preeminent thought leader in this field, Dr. Goldstein is committed to expanding access to accurate education, dismantling stigma, and promoting whole-life sexual wellbeing. He has written extensively about the unique health issues affecting gay men, the cultural experience of being gay, and the nuance of being a gay father in today’s sociopolitical climate.
His personal journey, clinical insights, and educational mission offer invaluable guidance for every sexual health provider.
Why Anal Sex Education Matters — Clinically and Culturally
Despite its prevalence, anal play is often portrayed as taboo, dirty, or inherently dangerous. Such messages are rooted in cultural fears, religious norms, outdated gender beliefs, and deeply entrenched stigmas. For LGBTQ+ individuals, internalized homophobia can further reinforce these negative ideas.
These narratives keep people from:
Learning safe and pleasurable techniques
Feeling comfortable seeking medical help
Understanding their own anatomy
Preventing injury or long-term complications
Exploring pleasure without shame
Accessing affirming care
For sexual health professionals, Anal Sex Education is not simply about technique—it is about dismantling myths, validating pleasure, and creating safer pathways for intimate exploration.
Dr. Evan Goldstein: A Pioneer in Anal Health and Education
Dr. Goldstein’s path into this work began far from sexual health. Initially trained in cardiac surgery, he eventually realized that the field did not align with his sense of purpose—especially as he was navigating the process of coming out. As he began to explore his identity and sexuality, he encountered a problem many people face: there was no centralized, affirming, medically informed source for learning how to safely engage in anal play or manage injuries.
As he puts it, the questions were simple:
Why is this painful? How do people do this comfortably? Where can you go for help?
He discovered that no comprehensive clinical field existed, so he created one. His work centers on:
Corrective intervention
Injury prevention
Aesthetic and functional support
Holistic sexual wellness
Education for patients and providers
Today, Dr. Goldstein’s leadership continues to shape national and global conversations around anal health and sexual wellness.
Stigma, Shame, and Their Effect on Pleasure and Connection
A major insight from Dr. Goldstein’s interview is that stigma—not anatomy—is often the biggest barrier to pleasurable anal play.
Common misconceptions include:
“Anal sex is dirty.”
This belief stems from misunderstanding basic anatomy and hygiene.
“Only gay people do anal.”
All genders and orientations explore anal pleasure.
“If you take it, you’re submissive or gay.”
Penetrative and receptive roles have no inherent meaning beyond what partners assign.
“Pain means it’s not right for you.”
Pain usually reflects lack of preparation—not incompatibility.
These myths limit exploration and can cause emotional harm. Sexual Health professionals must be equipped to challenge these beliefs compassionately.
Anatomy and Physiology: The Foundation of Safe Anal Play
Comprehensive Anal Sex Education begins with clear anatomical understanding. Dr. Goldstein emphasizes that injuries often stem from not knowing how the body actually works.
Key points include:
The anus contains two sphincter muscles, which must relax for penetration.
It does not self-lubricate.
Anal tissue is delicate and prone to microtears.
Anxiety and stress directly affect sphincter tension.
A gradual, slow approach is essential.
When sexual health professionals understand and can teach these fundamentals, they empower clients to make informed, safer choices.
A Step-by-Step Framework for Safe Anal Engagement
Dr. Goldstein recommends approaching anal play through three phases: before, during, and after.
Before: Preparing the Body and Mind
Explore anatomy with intention
Use warm-up techniques or dilation
Understand bowel patterns and hygiene preferences
Select appropriate lubrication
Set realistic expectations
Approach the experience with curiosity, not pressure
During: Prioritizing Comfort and Communication
Start small
Add lubrication generously
Engage in deep, slow breathing
Emphasize foreplay
Use angles that minimize tension
Maintain open dialogue with partners
After: Supporting Healing and Long-Term Health
Allow rest and recovery
Observe any discomfort or changes
Practice gentle hygiene
Avoid overwashing, which can irritate tissue
Teaching this framework helps prevent trauma and increases the likelihood of positive, pleasurable experiences.
Reducing Shame Through Anatomy-Based Education
One of the most powerful tools clinicians have is evidence-based explanation. When people understand how the anus functions—muscularly, neurologically, and structurally—they often feel less anxious and more empowered.
For example:
Knowing that sphincters naturally resist penetration reduces fear.
Understanding that lubrication must be added for anal sex normalizes the need.
Learning that dilation builds comfort helps prevent first-time trauma.
Professionals who can explain these principles create safer, more supportive environments for patients and partners alike.
The Importance of Open Dialogue in Homes and Communities
Dr. Goldstein stresses that sexual exploration begins long before adulthood. The messages individuals receive in childhood and adolescence—about bodies, cleanliness, pleasure, and identity—shape their comfort in seeking care later.
Families, mentors, and community leaders can support healthier sexual development by:
Encouraging questions
Responding without shame
Seeking reliable resources
Using sexual health anatomical terms openly
Avoiding assumptions about identity or roles
Affirming bodily autonomy and exploration
For clinicians working with families or youth, fostering these communication patterns is essential.
The Emotional Labor of Leading This Work
Dr. Goldstein is candid about the intense responsibility of being one of the only specialists in this niche field. The community relies heavily on his expertise, and the personal and emotional demands are significant.
Yet he describes profound reward in helping individuals who have struggled—sometimes for years—regain confidence, comfort, and pleasure. His work illustrates how Anal Sex Education can change lives by providing clarity, healing, and liberation from shame.
What Sexual Health Professionals Must Take Away
From the interview, several core professional competencies emerge:
Normalize anal play as a healthy, valid form of pleasure.
Understand and teach anal anatomy accurately.
Assess and challenge stigma in yourself and others.
Provide safety guidance rooted in research, not personal bias.
Support clients across diverse identities and experiences.
Validate sexual exploration as fluid and personal.
Recognize injury signs and refer appropriately when needed.
Create affirming, shame-free spaces for discussion and disclosure.
Anal Sex Education is not a specialty for a select few providers—it is a necessary skill for anyone working in sexual health, counseling, education, or medicine.
Final Message: Exploration Without Limits
Dr. Goldstein’s closing message is simple and powerful: Explore without limitation. People often decide they dislike something after one painful or misinformed experience, or because culture taught them it was unacceptable. But sexual identity and pleasure preferences evolve. Curiosity, consent, and informed exploration are at the heart of a healthy sexual life.
For sexual health professionals, supporting that exploration means providing the education, empathy, and evidence-based knowledge that individuals need to feel safe and confident.
SHA remains dedicated to advancing this essential work—training professionals who can lead with clarity, inclusivity, and compassion in every area of sexual health, including anal pleasure and wellbeing.
Want to become an in-demand sexual health professional? Learn more about becoming certified with SHA!
