Bespoke Surgical: A Place for All Assholes
All day, I see assholes. I don’t discriminate — I treat all assholes, regardless of gender or sexuality.
Luckily, the narrative of anal intercourse has become commonplace, thanks to coverage in the popular press these days, swaying way beyond just us homos. Last week, Women’s Health featured a quote from me on — you guessed it — the “how to” of anal. As a result, I received a few emails and DM’s asking if I only treated gay men at Bespoke Surgical, so I decided to take this week to set things straight (but not too straight, of course). And on Thursday, be sure to check out our Instagram, where I will help dispel one myth that was highlighted in the Women’s Health piece.
To start things off, I want to clear the air and let everyone know that I treat anyone with anal issues. It just so happens to be that the gay population’s ass-penetration-per-capita is clearly higher. One would think there would be stark differences in the reasons for any anal intervention between the sexes, but the majority stems from the overall aesthetics. Without a beautiful hole, the mental and physical properties of any sexual engagement is a limiting factor in satisfaction. The actual use of the ass for penetration isn’t really a concern for most women, though clearly there is an uptick in women wanting to engage anally.
But who, really, do I see in my office?
First, for many women, their bodies go through battle during their pregnancy, with unforgiving changes occurring throughout. Secondly, women’s holes are just as susceptible to the pressures leading to trauma caused from defecation that men go through, especially since women don’t defecate nearly as much since so many have off-cycle BM patterns. And lastly, if anal play is involved, most just go from never having anything up their ass to going balls to the wall (literally) without any prior anal exercises. I call this the “nothing-to-cock” scenario. With all of these, the asshole is not excluded from these morphological changes with dilated veins (hemorrhoids), tears (anal fissures), or extra skin tags all being quite commonplace. Also, with vaginal delivery and a possible episiotomy done to allow an easier extrusion of the baby — the stitch work and final closure may lead to the anal ailments mentioned above, or more of extra skin in the perineum (the region connecting the vagina to the anal opening). Whatever the localized issue, the symptoms range from irritation to lack of being able to properly clean to bleeding and discomfort, and/or the mental anguish of these irregularities. Though my questioning leads down the path of anal engagement, whether or not it was used prior or the wishes to engage after, it — for the most part — is further down on their wish list, while aesthetics are at the top.
This leads to a discussion on operating on women’s anal openings. Women have much softer skin all around, including the bum, which not only causes localized trauma to occur, but also sometimes the stitch work doesn’t stay aligned. In these scenarios, I do a lot more of leaving open wounds (not stitching closed) and/or lasering. Botox is instrumental in allowing relaxation, post-surgically, which is imperative since (again) most women do not engage anally and, therefore, their muscles can be quite tight. Also, as we discussed prior on the perineum — the line connecting the anus with the vagina is critical to maintain. By making sure the scarring is not only aligned, but also sitting flush, it ensures the transition a beautiful sight. My approach needs to change the understanding of all these principles so that the final product matches the desired aesthetic.
What about the mental aspect? Both sexes share the mental anguish that these fucking pathologies cause. It’s amazing how much this affects one’s overall sexuality, or, more so, sensuality. To not feel sexy is not okay. Whether it’s a huge, mountainous skin tag or the smallest external protrusion, it matters more how this affects oneself overall. To not be honest with oneself can take away years of sexual engagement, which can never be given back. The key is to be honest and introspective or involve your partner(s) to make an educated decision on the course of your sexual body parts and all the ramifications that come with it. Unfortunately, most that do undergo these procedures say, “I should have done this years ago!” To which I reply, “Better late than never!”
Regardless of any future anal involvement, we at Bespoke Surgical will not only correct the ailments and/or aesthetic concerns, but also set it up for that possible engagement, if you so desire. Post-surgical treatments do involve anal play, with medical dilators. This helps heal the scar appropriately, while simultaneously bringing to light anal pleasure. The “nothing-to-cock” approach doesn’t work for men’s holes and will definitely not for the opposite sex either. It’s a monitored and gradual progression to reach the end goal.
In summary, Bespoke Surgical treats all cummers! But, all joking aside, we are named Bespoke Surgical for a reason. I approach my work in a way that allows me to understand that not all assholes are created equal. With that comes altering the surgical approach to obtain the outcomes everyone wants. It’s the truest art form to adapt, adding to the diversity of our practice, which truly allows us to fit the Bespoke model. The “why do you care how your ass looks?” approach is so not appropriate in the current times of sexual health and with popular press and us leading this charge, we hope to change practices and principles to fulfill everyone’s sexual desires, regardless of gender. As our friend and photographer, Maxwell Poth, always says, “You are loved!”
Stay in touch on Instagram: me and Bespoke Surgical.
Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical. Dr. Goldstein has extensive experience educating and shedding light on health care issues relating to the gay community, and has been published in several national publications including The Advocate, OUT Magazine, Vice, Refinery 29, NY Mag and more.