(105) EXPANDING THE UNDERSTANDING OF ORGASM: VALIDATION OF PENILE AND NON-PENILE INDUCTION
Authors: Bole R , Adler A , Fascelli M , Bajic P , Lundy S 
Published: December 2024

Abstract

Introduction
There is no singular and widely agreed-upon definition of an orgasm. Descriptions of orgasms for people assigned male at birth (AMAB) are limited in number and comprehensiveness surrounding the different types of orgasm. The classical definition consists of a penile-induced orgasm whereas a prostate-induced orgasm is rarely represented in the peer-reviewed medical literature despite patient experiences to the contrary. This discrepancy in a shared definition of orgasm type disproportionately affects our understanding of mechanism, natural history, pathology, iatrogenic outcomes related to orgasms arising outside the classical definition. Specifically, patients AMAB currently lack widely accepted medical terminology to describe their sexual function or dysfunction related to non-penile induced orgasm.

Objective
To perform a qualitative study of the real-world experience of orgasm in patients AMAB using data from a publicly-available anonymous online forum.

Methods
Reddit web posts under 10 subreddits were searched and data extracted by RedditExtractorR, an R package using Reddit’s API (application programming interface). Posts and comment threads were analyzed using inductive reasoning principles by two reviewers. The top two subreddits r/AskGayMen and r/ProstatePlay were manually reviewed to generate open codes related to orgasm experience. Following joint review, axial codes were then created to consolidate similar codes into subcategories. Open and axial codes were updated until no further codes or themes were found and thematic saturation had been reached. Selective codes were then used to unify the axial codes into themes, one of which related to orgasm type. Fig. 1 shows the axial and selective code frequency. The qualitative analysis program QualCoder (Version 3.5) was used to apply codes to the entire dataset and descriptive analysis of the extracted counts was done using R. Comments were analyzed to calculate the frequency of each code. Upvotes or downvotes of a comment were included in the analysis.

Results
The top subreddit r/AskGayMen was fully analyzed. The posts covered from 6/30/2015 to 3/3/2024. Analysis included a total of 16 209 comments from 4196 different individuals/usernames. The theme of orgasm type was mentioned 674 times. The most frequently mentioned orgasm types were penile (46.7%), prostate (38%), anal (13.1%), and non-genital orgasm (2.2%). Outside of orgasm type, the most frequently mentioned themes were relationships and partners (51.6%) and health and healthcare (16.2%). The most frequently mentioned topics within these were sexual orientation (64.1%) and society dynamics (17%). Frequently mentioned terms included partners (1284), details of foreplay (130), sex toys (2275), doctors or physicians (470)].

Conclusions
Without shared language to describe different types of orgasm, our ability to study sexual function is limited as is our ability to communicate accurately and effectively with patients. This study is the first to propose broadening the medical classification of orgasm to validate lived experience of individuals AMAB as recorded on an online forum. We found that there were 4 distinct classifications of orgasm induction including penile, prostate, anal and non-genital orgasm. Common themes surrounding orgasm experience also included discussion of partnered intercourse and healthcare. Our findings highlight the ongoing need to include real-world patient experience in the study of sexual medicine.

Disclosure
No.