ABSTRACT
Problems regarding anal sex are the most common sexual complaint of gay men attending the sex therapy practice. Sodomy laws banning anal sex in some American states were still enforced, and only universally struck down by the US Supreme Court in 2003. Very little time has passed since gay sex, and anal sex among men who have sex with men (MSM) in particular, was widely seen as either pathological or criminal. Applying the tripartite foundation of psychosexual therapy is as suitable when working with MSM as it is with the general population. Unprotected anal sex among MSM is still a major concern for UK sexual health agencies. Educational steps include not just explaining how the male genitals work, but also the use of anal diagrams to explore the workings of the anus, sphincters, and rectum. Under standing the anatomy of this part of the male body is essential in good anal sex.
