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(Granted, I didn't tell him EVERYTHING I do down there.) My understanding was that there was no causal relationship, assuming no serious injuries occur. Peter Shalit, a physician in Seattle and a member of the Gay and Lesbian Medical Association.

But her higher brain functions get in the way, as she has internalized our culture's body shaming.

She has likened me "sticking my nose down there" to "sticking my head in the toilet." Whenever I sexy-talk about licking her, she reacts with a mood killing "eww." But she says she would enjoy it if she could let me. When we have sex, she cuts foreplay short and gets straight to penetration.

A fucked-up top can quickly become an out-of-control top, and a fucked-up bottom can be numb to feelings of discomfort that mean "slow down," "stop and add more lube," or "stop altogether." Despite the fact that millions of people safely engage in anal play, many people believe that anal play does irreparable harm to the anus—or the soul—and that sadly includes many doctors.

"There is a misconception that these activities can cause damage by stretching or tearing the tissue, when actually the anus is very elastic and much of the 'permission to enter' actually involves intentional relaxation of the muscles by the bottom" and not force applied by the top, Dr. (The top applies gentle pressure, the bottom breathes, relaxes, and opens up.) "If a person suffers from constipation, that should be addressed as its own problem and not blamed on any type of anal sexual activity," said Dr. "In addition: For obvious reasons, it's not fun to bottom if you're constipated, so it would be good to have this problem evaluated and treated by a nonjudgmental health-care provider who understands that anal penetration—by fist, penis, or dildo—does not cause constipation." Finally, FIST, your doctor was misinformed, which is not helpful.

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