Is my bum healthy?  Where is the ‘A-zone’? How do I use a dilator?  

Dr. Evan Goldstein is the leading anal health expert in the United States, founder of Future Method, and one of the few surgeons in the world whose practice, Bespoke Surgical, is dedicated to treating and restoring the human butt. He holds a perennial spot on the list of top doctors for the New York metro area and Crain’s New York Business listed him as one of their notable LGBTQ+ leaders and executives.  Drawing on a lifetime of personal and professional experience, Dr Goldstein has put together all the medically accurate, scientifically-backed information you need to get your peach healthy and maximize your pleasure, whilst busting the myths around anal sex that are holding you back. 

Despite growing interest in the media, embarrassment and shame still surround conversations about anal sex and health and, consequently, for many of us, our bums are a mystery. But isn’t it about time that all changed?  

Butt Seriously is the first-of-a-kind guide to all things anal. Covering toys, training exercises, sex positions and offering helpful advice for when things go wrong, its designed to address all of those questions you may have felt too embarrassed to ask.  Whether you’re just getting started or looking to stretch your imagination, this refreshingly inclusive and sex-positive bum resource.

How can you tell if a bum is healthy?

What I look for in a healthy bum is the alignment of form, function, and aesthetics. I work with my clients to make sure they are pooping and wiping without any issues, and also are able to use their bum to accomplish all of their sexual desires (if that’s something they’re interested in). If there is any misalignment or you are experiencing any ailments, then your bum isn’t healthy. This is exactly what we analyze at my New York practice, Bespoke Surgical, and what was one of the main drivers behind my book, Butt Seriously: The Definitive Guide to Anal Health, Pleasure, and Everything In-Between. I wanted to educate the masses about the definition of a healthy bum, how to maintain and perfect your sexual activities, and then, if something does go wrong, what the at-home remedies or medical and surgical treatments needed to truly allow your sexual wellness to be brought to the forefront. A healthy hole is paramount to the betterment of your soul.

What are the biggest myths and misconceptions about bums?

You’re going to have to buy my book for these! Just kidding.

People think wet wipes are the best thing to clean up after going to the bathroom. However, they aren’t just wiping away the bad stuff – they’re also changing the anal microbiome, which can lead to significant irritation and can even activate herpes and HPV wart infections in people who already have it. Wet wipes are actually terrible for not only your body, but also the environment.

People think you can jump right into anal sex without any prior practice or preparation. The anal region is more complicated than that and requires a deeper understanding (no pun intended) to ensure a pain-free and injury-free experience. The anal skin needs time to strengthen and learn how to become more elastic. Simultaneously, the anal muscles (your three sets of sphincters) need to learn how to not only fully relax, but do so as a unit. Slow and steady wins the race when it comes to anal sex, and in the book, I go into extensive detail about my anal dilation protocol and the tools you need to successfully engage in anal play.

People think bleeding and pain during anal sex is totally normal. This is so not true. In fact, if there’s blood or it’s painful, then something isn’t right. Anal play is 60 percent functional and 40 percent mental. Butt Seriously dives into all facets of sexual life for the bottom (or the one receiving penetration). It even explains what to do if you experience pain or bleeding, including easy at-home remedies and identifying when it’s time to see a medical professional who specializes in anal sexual wellness. Thankfully, there are many appropriate diagnostic tests, specifically for the anal community, along with treatment programs to allow successful anal play without any complications.

Why is there a lot of taboo around anal pleasure?

I see anal pleasure as the final frontier. Clearly, it’s multifactorial, with psychosocial, cultural, religious, and familial dynamics playing a role, including our own internalized issues. However, I think there is so much heteronormative influence behind the ability to actually enjoy anal play. I see so many male clients at my private practice who are still ashamed of enjoying anal stimulation and the fear of what their friends and partners will think of them. That’s what I love about the younger generations – they’re more willing to embrace life without labels or fear of what others will think and focusing more on doing what they enjoy. Hopefully this will influence the rest of society. I will say that I’m optimistic as I’ve seen an increasing amount of pop culture references to anal play and the normalization of all things anal is getting there. Slowly, but surely. I talk about the various issues related to stigmas and taboos around anal play in Butt Seriously because this helps put things into context.

Where is the ‘A-zone’?

The A-zone is where you can find maximum pleasure in the anal region. For people AMAB, it encompasses the prostate, and for people AFAB, it encompasses the positive nerve endings that also transfer to the vagina, cervix, and uterus. It’s about 5-7 cm inside the anal canal and has a powerful supply of nerve endings that allow you to reach heightened orgasms that make regular orgasms pale in comparison. To help people find the A-zone, I included detailed diagrams in the book, and there is even a chapter dedicated entirely to anal anatomy, so people can truly get an understanding of where everything lies and how it can be stimulated to achieve orgasms that can be felt from head to toe.

How should a dilator be used and what is its purpose?

Anal dilation is the first step to getting into butt play. At Future Method, a brand I founded back in 2019 that brings the science of sex into sexual wellness, we developed an anatomically correct glass anal dilator kit using my years of experience as an anal surgeon. The set of three dilators needed to be able to successfully train the three anal muscles to fully relax and relax in unison, all the while strengthening and expanding the skin to withstand the immense pressures of sex. It takes time and patience while you work your way up from the smallest dilator for two weeks, to the medium dilator for two additional weeks, and then finally the largest dilator for another two weeks. It’s like going to the gym. I want people to do two sets of twelve reps two times a week. In Butt Seriously, we dive real deep into the mechanics behind anal dilating, along with the best lubes and approaches to pelvic positioning. The key is in the process. Slow and steady, with lots of lube and properly understanding your anatomy, goes a long way to fruitful anal play.

Talk to us about Butt Seriously. What shall we expect from this book?

Butt Seriously is a comprehensive guide to everything you ever wanted to learn – and everything you never knew you needed to learn – about your bum. It’s more than just anal sex. I cover myths and taboos. I define functionality and break it down anatomically. I start by diving into our bathroom habits, talking about proper defecation, wiping, and hygiene tips. No one teaches us the right way to poop, and this has a major impact on all our lives, whether you engage in anal sex or not. Then, I progress into anal play using my thought process as it relates to my surgical practice – what I have learned over the past 15 years. The “how-to” to anal dilation and the lead into great anal sex. This includes the best positions and what to do if you’re already more advanced and looking to perfect your game rather than get into it for the first time. From there, I talk about what to do if things go wrong, whether you’re experiencing simple limitations or you’re in pain and/or bleeding. Things will go wrong at some point and I want people to know what to do if that happens and when to seek affirming care. I finish with aesthetics and how a beautiful booty is important for so many reasons, not just sex. This book isn’t just for gay men – it’s for everyone with an asshole. Yes, straight guys and women dealing with post-pregnancy issues can benefit from this book. Even for parents learning how to teach their children the proper mechanics of pooping and science-backed sexual education. There’s something for everyone.

What advice would you give to someone without experience in anal pleasure?

The most important thing to remember is that you can’t just dive into anal pleasure. There are steps that people should follow, like the ones I outline in Butt Seriously. It starts with learning more about our own bodies and anatomy, before you move into dilation work to train your skin and muscle for what (or who) is to come. If it’s possible, getting a comprehensive internal and external anal exam, including anal manometry testing, can have substantial benefits. At my private practice, I perform these types of exams in conjunction with our pelvic floor therapist, to make sure there are no underlying issues that can inhibit someone’s exploration into anal pleasure. If you’re someone who wants to explore anal pleasure, but you’re too afraid to try it, or you’re experiencing pain or limitations so you avoid it can really fuck with your mental and physical well-being – and not in a good way. I implore you not to give up and instead seek professional help to figure out how to bring anal pleasure into your life.

What are the most difficult questions to answer?

I think more about how many people never attempt anal pleasure or stop trying because of negative experiences when they first tried it. But if people had an outlet to ask the right questions and seek out the proper advice, it would benefit so many lives. It’s one of the main reasons why I think this book has the potential to be so powerful. It asks the questions we don’t know we should ask or can’t ask, and provides the answers that we never knew existed or had the opportunity to discuss before. But now it’s out and in the open, and I couldn’t be more excited.