Hot* Take Alert!

*Terrible

Hi (No) Wonder-ers,

Ever since numerous abstracts and presentations during the American Urological Association (AUA) 2022 Annual Meeting highlighted social media misinformation as a key issue, I have tried to follow the AUA's call to address misinformation and offer evidence-based information specifically about sexuality education - an area where our collective knowledge ranges from abysmal to nonexistent. I firmly believe that many of us, and our partners, suffer unnecessarily because information about our identities, sexualities, and relationships is withheld from us on a systemic, religious, and cultural level. I know I could have suffered less and enjoyed my life and relationships more had I learned sex-positivity earlier in life, as opposed to learning and then having to unlearn sex-negativity. So I've made it my mission, both in and out of the exam room, to help folks accept who they are and how they live and love. This brought me to Mastodon, Threads, and Bluesky... where I've been fortunate to meet some of you. Engaging with you and other benevolent, intelligent, accepting humans has been a highlight during dark times.

Notwithstanding the warmth many of you brought to my social media feed, social media as a whole has become a net negative for my mental health. Not to put too fine a point on it, but our timeline is as irredeemably stupid as it is unnecessarily cruel - and the social media zeitgeist reflects every bit of this. I understand and share the desire to be well-informed on current affairs, even (especially) the very depressing ones; however, my tenuous mental health can handle only so many wildly ignorant, tone-deaf takes from smug milquetoasts who fancy themselves "independent thinkers" and "pundits" or whatever. The next intelligent thing I hear from Ross Douthat or Matt Yglesias will be the first. And for every bad-take artist I blocked, two new ones popped up, like a goddamn hydra. The bad-take arms race completely drowned out the positivity, informativeness, or usefulness.

It all became an unpleasant distraction from my IRL family and professional obligations. It became too much. Hence why some of the more astute among you may have noticed my absence.

Shortly after I scrubbed my Bluesky account, I logged into the Journal of Sexual Medicine (J Sex Med) hoping for a reprieve from our timeline's unnecessary cruelty and stupidity. In classic frying-pan-to-fire fashion, I encountered a real humdinger of a take - the kind of wildly problematic take I'd been trying to avoid.

Yes, you read that right: These dipshits are trying to blame erectile dysfunction on the partner's age.

Not the patient's age. The partner's age.

I'll get into the specifics of why this take, and its appearance in a reputable peer-reviewed medical journal, is problematic. But first, something important.

Fuck the investigators who pitched this idea and saw it through to publication. Fuck whoever provided funding for this project. Fuck the IRB that approved it. And fuck the editor who allowed this to get published in the Journal of Sexual Medicine.

I see the authors are Italian, so also... VAFFANCULO A TUTTI.

Now that we've got that out of the way, here's why their take sucks hard enough to be worthy of our collective disdain.

-People with older partners tend to be older, themselves. Someone's ED is much more likely to be caused by their own age-related medical and psychiatric comorbidities than their partner's age. Thus there may be a correlation between ED and partner age, but correlation isn't causation - and everyone who mistakes correlation with causation ends up dying.

-Erectile dysfunction already causes enough relationship discord without introducing more under a false veneer of medical legitimacy. Because we are not encouraged to discuss erectile function, nor its multifactorial biopsychosocial causes, that creates a knowledge gap when a patient experiences erectile dysfunction. The knowledge gap leaves room for all kinds of cognitive distortions that adversely affect the relationship dynamic: The ED patient worries that they are broken or "less of a man." The partner wonders if the ED patient still finds them attractive. The ED patient insists that yes honey, I still find you attractive. The partner isn't sure. Having the medical establishment go out and say "ED occurs because the partner is too old" doesn't help them work through this productively, but it amounts to sabotage as ED patients and their partners work through their sexual and relationship scripts.

-It will discourage cis, het men from taking responsibility for addressing their erectile dysfunction. It's a hell of a lot easier for men to blame someone else and abdicate responsibility for their ED, than it is for them to talk vulnerably about it at a urology visit. This odious article gives a convenient out for anyone looking to blame other people for their ED, rather than taking responsibility for their own health.

-It will encourage sexual shame among already-shame-prone women. Did these fuckwits seriously look at how society treats aging women and unironically decide "no, we don't shame women enough for aging normally"...?

-Focusing on things we can't control, like another person's aging, is unhelpful. Seriously, what the hell are these bozos expecting ED patients to do about their partner's age? Leave their partner for a younger partner? Did Leonardo DiCaprio fund this study?

So yeah. This article sucks. It turns out ignorant rage-bait isn't just for social media anymore, but also for peer-reviewed scientific journals.

We're cooked,

Merrit