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Parents Care More About Sons' Penis Size Than Obesity

Photograph by Twenty20

New parents are inundated with charts about their newborn's length, head circumference, weight and growth trajectories. The numbers and percentiles, which represent averages for optimal health, follow kids in their medical charts from birth and through childhood.

But there's one area of concern for many parents that is not included in the health records of little boys: penis size. And doctors are noticing that worries about a too-small penis tend to come from moms and dads (mostly dads) whose sons are overweight or obese.

There's a reason for that.

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In a recent post on the New York Times Well blog, Dr. Perri Klass explains that while most little boys' penises fall into the normal range from birth, being overweight or obese can give the illusion of a smaller-than-average penis by the time boys reach their tweens. Though excess fat is the actual problem (both visually and health-wise), doctors report that penis size is what parents (especially dads) are asking about.

Klass writes that these questions about penis size have become more common over the past decade, and it's at a time when they're also seeing more overweight young patients. Parents of 10- and 11-year-old boys, apparently, frequently remark that their sons' penises appear too short. Doctors told Klass that mostly moms bring it up—though they say it's the dads who are obsessing about it.

So what's the deal with pre-adult penis sizes?

Klass writes that infant and toddler penises can look very small in the first place, since they haven't yet gone through puberty. When boys are larger (especially overweight or obese), their average-size genitals seem even smaller—sometimes because the penis gets buried in the "fat pad" in front of the pubic bone. That fat pad and pre-pubescence conspire to create what doctors unofficially call a "hidden penis," when the organ has not yet benefited from growth during puberty and is significantly covered by the fat pad.

For some boys, both of those things (plus a condition that one doctor calls "slidey penis") all but make the male organ disappear. In these cases, "the soft tissue below the skin of the penis doesn’t adhere well to the Buck’s fascia, the thick covering that surrounds the penile nerves and arteries," explained Dr. Aseem Shukla, a pediatric urologist at Children’s Hospital of Philadelphia and associate professor of urology at the Perelman School of Medicine at the University of Pennsylvania. So the shaft sinks into the body, and only the skin (or foreskin in uncircumcised boys) is visible.

There are surgical options to fix "slidey penis," though doctors prefer to wait until after puberty, when these things sometimes fix themselves. In other cases, weight loss gives a more accurate idea of size.

In very few cases, boys are born with a condition called a micro-penis, though this is typically diagnosed at birth.

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Shukla acknowledges these are uncomfortable conversations, but ones that often end with relief for the boys. Usually, he advises them to lose a little weight and also to get through puberty. He'll also sometimes demonstrate to the boys who are concerned and overweight that, in terms of penis size, they're prefectly normal and not in need of treatment.

“I push down and I show them the length and width,” Shukla said. Then he tells them they're completely fine and will have a great life.

Now that that's settled... As parents, can we find more important things to obsess about?

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