There may be multiple reasons why you or someone you know may be afraid of anal sex. This could be due to numerous reasons some include: the physical pain, being self-consciousness or anxiety about hygiene, medical issues or injury, shame or stigma around the bottom role or STD/HIV transmission. In this multiple series of blogs, we will touch on these topics. It is important to note however, that you can distinguish between being afraid and not wanting to or are not interested in anal sex, if it is the latter then there is no shame in this, just because you identify as a gay male does not automatically mean you HAVE to engage in anal sex. Now, if it is the former and you are afraid then here we will discuss one of the common factors.

Fear of Physical Pain 

For many gay men, bisexual men or men who have sex with men the fear of physical pain can be a deterrent but, we first need to differentiate between actual pain you may experience, and the pain you don’t actually have, but are afraid you will. The latter is called “anticipatory anxiety”, which is fearing something that hasn’t happened yet. The short answer to anticipatory anxiety is to “try it and see how it goes.”  Simple right? Well actually part of sexual self-empowerment is learning to say no, or slow down or change position, can we take a break, if you are uncomfortable. Learning to tolerate bottoming comfortably and enjoyably, can be a gradual process, not something that happens over night. Even the practical elements like finding the right lubricant, can really help, or gradually increase the ability to be penetrated comfortably, by using various gradation sizes of toys, because the sphincter muscle has to be trained to relax and expand, just like any other muscle in the body.

However, if the fear of bottoming is because you have already experienced pain, here it is important to determine the cause of the pain. Is it something physical, such as a fissure, haemorrhoid, or another medical condition? Here is where a medical doctor could be sought.

Or it the pain due to psychological factors such as:

Social or religious guilt about gay sex, particularly being the bottom in gay sex? 

Feeling guilty because you are breaking a monogamy agreement?

If you are a survivor of sexual abuse?

If you’re bottoming because you were persuaded to, or feel that you’re obligated to?

If the psychological factors are some of the triggers than Cognitive Behavioural Therapy can help. Finding comfort in anal penetration is a topic that both a physician and a therapist might help you with, like many topics that involve the medical/physical and the emotional/psychological understanding where your fear comes from and how and when to seek help is always the best way when tackling such issues. 

If you think that you can benefit from professional support on this issue you can reach out here.


Stef Gafa’ is a counsellor with Willingness who has a particular interest in trauma, attachment, domestic violence and the LGBT community.