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The age-group difference in psychological motivations for penile girth enhancement surgery in Chinese men: a
Yafei Zhang1,2, Zhen Wang1,2, Wei Wu2
1Wannan Medical University, Wuhu, Anhui Province, China.
Introduction:
Penile girth enhancement (PGE) surgery has seen a global rise, with motivations shifting from purely medical indications to psychological and socio-cultural drivers. Data from Chinese populations, particularly concerning the psychological profiles and age-group differences among men seeking PGE, remain scarce. This study aimed to investigate the psychological and cultural mechanisms driving the demand for PGE in Chinese men, with a focus on age-group differences.
Methods:
A single-center, cross-sectional study was conducted on 136 men presenting for consultation regarding PGE at the Department of Urology of a major teaching hospital in Hefei. Participants were divided into 2 age-based groups: Young (<30 years, n = 81) and Older (≥30 years, n = 55). Measures included the Masculine Gender Stress Inventory Score (MGSIS), Appearance-related Masculinity Stress (MGRSS-A), Social Comparison, Sexual Self-Esteem (SSE), and a composite Psychological Distress index (GAD-7/PHQ-9). Statistical analyses included independent-samples t-tests, binary logistic regression, and a structural equation model (SEM) to explore the psychological mechanism.
Results:
The total sample size was 136. Young men exhibited significantly higher scores in Social Comparison (mean: 68.78 vs 49.96, P < .001, Cohen's d = 1.52), Appearance-related Masculinity Stress (mean: 79.62 vs 53.03, P < .001, Cohen's d = 2.45), and Psychological Distress (mean: 62.80 vs 42.06, P < .001, Cohen's d = 1.88) compared to the Older group. Logistic regression identified Psychological Distress (OR = 1.08 per unit, 95% CI: 1.01-1.15, P = .021) as an independent predictor of surgical intent. The SEM confirmed a significant mediation pathway from age-group difference to psychological distress and then to surgical intent, with a standardized indirect effect of β_std = -0.25 (95% BCI: -0.40 to -0.10).
Discussion:
The demand for PGE in young Chinese men is predominantly driven by psychological and cultural stress related to appearance and social comparison, marking a paradigm shift from traditional functional or pathological concerns. This age-group difference underscores the influence of modern media and social environment on male body image. Clinically, mandatory pre-operative psychological screening and the establishment of clear referral pathways for men with high psychological distress are essential to ensure ethical practice and optimize patient outcomes in PGE surgery.
