Sexual Performance Anxiety in Gay Men: Focus on Pleasure

In gay culture, there are so many unspoken expectations for how sex “should” go, or even who deserves to have sex. We absorb these expectations from everywhere: porn, media, even conversations with other gay men. They affect how we approach sex, and even how present we are during sex. Common expectations many gay men express are:

• “I have to be hard.”
• “I have to maintain my erection.”
• “I have to make my partner feel this or that.”
• “I want this to feel good because that tells me I’m a sexually desired man.”
• “My worth is in my sexual performance.”
• “Sex always includes penetration.”
• “To be gay means I have to enjoy anal.”
• “Sex always includes orgasm.”

When we can’t live up to these expectations, the result is often sexual performance anxiety.

What is sexual performance anxiety? Sexual performance anxiety is a worry about how you’ll “do” during sex — staying hard, lasting long enough, finishing, or being good enough for your partner. That worry pulls you out of your body and into your head, which is exactly what makes arousal harder.

Sexual performance anxiety can be seen as losing autonomy around your sexual presence. This anxiety is all about how someone else experiences you sexually. Dealing with it requires bringing you back to where your sexuality lives, which is within you. Given the expectations around sex for gay men, sexual performance anxiety can quickly devolve into shame, which then leads to other sexual and body image issues.

What it looks like for gay men

It doesn’t only show up as erection worries. These are the versions I hear most:

• Topping: losing your erection, size concerns, expectations around what a top should look like
• Bottoming: tensing up, fear of pain, worry about being “clean” or ready, or not being able to bottom at all
• Finishing: coming too fast (premature ejaculation), or not being able to come at all (delayed ejaculation or anorgasmia)
• Spectating: judging yourself mid-sex instead of feeling it
• Avoiding: dodging hookups or sex with a partner you love because you fear not being able to perform
• Numbing: needing poppers, alcohol, or chems to manage the anxiety
• Rejection: fear of disappointing your partner or not being desired, body image worries, or fear that if you’re not ready or in the mood, you’ll never have sex again
• Racism: worries about being fetishized or tokenized, or not being seen as desirable at all
• Trauma: past experiences (sexual, relational, or religious) that get triggered during sex and put your body on guard

My story: Don’t Have Sex

Growing up in a conservative, Christian Korean household, sex wasn’t ever something that was discussed. I don’t even remember my parents telling me about sex, other than that it was something married people did. My parents left sex education up to the school they put me in, and that wasn’t any better. The Christian school I attended taught us that good Christian men abstained from all sexual acts before marriage, and that lust was a temptation — one that, if we gave in to it, was a grave sin requiring God’s forgiveness. And if you were gay, you were going to hell. The more “liberal” church I attended in college at least said being gay was fine, but gay sex was the sin. The message to me was clear: “Harry, you’re not allowed to have sex.”

Given this background, it’s no wonder that when I started to come out, I didn’t code certain encounters, like mutual masturbation or oral sex, as “sex,” because I hadn’t been taught to.

All my education about gay sex was gleaned from gay porn. Gay sex was only for the ripped, muscular, white men with huge dicks I was seeing on the screen. If I ever saw an Asian man, he was always the bottom. Sex always ended in orgasm, and sex always lasted 20–30 minutes. I used to feel like I would never measure up. (I write more about this on my Asian American sex therapy page.)

My experience isn’t unique to Korean Americans or other cultural minorities, either. There is a massive gap in public sex education for gay and queer folx. Most sex ed focuses on cisgender bodies and penis-in-vagina sex for the purposes of procreation. We are taught that orgasm is the ultimate goal, which sets us up for a frantic “Race to Orgasm” every time we get intimate.

We aren’t taught that sex can be pleasurable, playful, and creative, and that it doesn’t always have to involve penetration. We aren’t taught to focus on our own experience of sex: our pleasure, our wants, and what feels good to us. Sex often becomes about the other person, not ourselves. This narrow view robs us of the validity of our experiences and creates a breeding ground for misinformation and shame.

On top of all that, many of us carry years of minority stress. Research links internalized homophobia and expecting rejection to more performance anxiety in gay and bi men. Our nervous systems learned to stay on guard, and they don’t clock out just because we’re in bed.

Rewrite your sex script

So what do we do with sexual performance anxiety when it shows up? Given all the factors and expectations, how do we treat it?

Here’s my approach with clients: First, undoing shame narratives through good education, and then help clients create and adopt compassionate, self-affirming narratives that unlock their full sexual potential.

Many sexual problems arise from bad or inaccurate information. Remember my story? I didn’t have all the information or an accurate view of sex, and that allowed shame and judgment to take hold. Once I started coming out and began to educate myself on what human sexuality really is, I was able to start challenging and replacing those harmful shame narratives.

Another common area of misunderstanding is the human arousal system. Many of us think it’s a light switch: either on or off. In reality, it’s more like driving a car. This idea is what we call the Dual Control Model. It’s a helpful way to understand how arousal works, and a good place to start building awareness and compassion toward yourself.

The model says arousal runs on two systems at once. The accelerator scans for turn-ons: a look, a smell, a touch on the back of your neck. The brakes scan for reasons not to: “Am I hard enough?” “Is he bored?” “What if I come too soon?” Performance anxiety is your foot slamming on the brakes. Trying harder to perform only presses down harder. Easing the brakes means turning back toward your own pleasure, and that requires rewriting the shame narrative.

So let’s talk about the shame that’s at the core of sexual performance anxiety. Shame drives unworthiness and disconnection. It’s the constant, powerful internal voice that echoes those harmful expectations and disconnects us from our bodies and our pleasure. Shame thrives in secrecy and judgment and withers in authenticity and vulnerability. Often, simply accepting that you’re feeling shame and naming your worries is enough to start the change.

Once you name it, you can explore it. Two leading relationship and sex therapy experts who guide my work with clients offer ways to think about sex that ease sexual performance anxiety. Esther Perel talks about erotic connection as holding two things at once: our own, even selfish, desire and mutual pleasure. When we realize that sex is any shared physical intimacy that centers pleasure and connection, we stop trying to live up to an unrealistic standard, start listening to our bodies, and start meeting our sexual needs more effectively.

Sex therapist Ian Kerner takes this idea a step further. In his book So Tell Me About the Last Time You Had Sex (2021), he asks clients to walk through their most recent sexual experience step by step, like a story with a beginning, middle, and end. He calls this the sex script: how sex started, how arousal built, what was included or avoided, what was said or left unsaid, and how you felt afterward. Once you can see your script, you can start to change it. As Kerner puts it, “rigidity is the enemy of arousal.”

Try it: Think back to the last time you had sex and walk through it, stage by stage. Notice where your script says “should.” That’s often where the shame and anxiety live — and where a new script can begin. Here’s how it can look:

1. How did it start?

Did you and your partner(s) talk about expectations beforehand? How was sex initiated? What role did foreplay play?

Tip: Mindfully bring your awareness to the spark: the building desire, and what got you aroused. If you didn’t talk beforehand, try it next time. Saying “I get nervous with someone new” out loud takes most of the power out of it.

2. When did the worry show up?

When did the worry creep in? Did it creep in slowly or all of a sudden? Was it something internal or something external? What were you telling yourself?

Tip: Be a spectator and notice your watching. Practice self-compassion: tell yourself that it’s OK to worry, and that the worry makes sense. Then mindfully bring yourself back to the sensations in your body. What feels good? What feels arousing? If nothing helps, it’s OK to ask for a break, a cuddle, or something different.

3. What did you skip, rush, or avoid?

Did you skip talking about what you wanted in sex? Was there a rush to penetration?

Tip: Remind yourself and your partner(s) that it’s OK to slow down. This is play, and play often requires in-the-moment renegotiation of what’s happening. Take time to discuss what everyone wants to do, and don’t be afraid to switch it up. Mutual masturbation, oral, grinding, making out — it all counts.

4. What felt good?

What gave you pleasure, even for a moment? Was it a touch, a sound, a look, a moment of connection? Where in your body did you feel it?

Tip: Map the body. Your skin is full of nerve endings, and pleasure isn’t limited to your genitals: try the nape of the neck, inner thighs, lower back, and scalp. Download the erogenous zone worksheet → On your own, try medibation, or mindful masturbation: slow down and notice what turns you on and how. The goal isn’t orgasm, though you’re allowed to. The goal is to be present with your sexual self.

5. What happened afterward?

How did sex end? Did you talk about cleanup, cuddling, or how it felt? How did you feel about yourself afterward?

Tip: Make aftercare part of the plan, even with a hookup. Check in with “How did that feel?” instead of “Did I perform?” — and talk to yourself the way you’d talk to a friend. Aftercare is where a kinder script for next time starts.

When to see a sex therapist

If the worry follows you into every encounter, you don’t have to white-knuckle it.

I use ACT, mindfulness, CBT, and self-compassion to help gay, bi, and queer men get out of their heads and back into their bodies.

Performance Anxiety Therapy · Erectile Dysfunction Therapy

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