The Erection Question by Liz Prato

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Most Memorable: July 2015

hands on mans shoulders massage table


e·rec·tion: an enlarged and rigid state of the penis, typically in sexual excitement.


I get asked about erections way more than “What’s causing my neck pain?” or “Do you know any good hamstring stretches?” or “What do you think this weird thing on my foot is?” It’s ironic, because as a massage therapist the one topic you’re trained to really, really avoid is sex. If we do discuss sex, it’s supposed to be in this very clinical way that makes it explicitly clear that sex has nothing – nothing at all, got it? – to do with therapeutic massage. So, for years I’ve been giving inquiring minds the party line: Some men get erections, but they’re usually only a physiological response to relaxation and increased blood flow, and are not an indication of sexual arousal or expectation. In other words, erections happen. These erections, I conclude, are benign.

“So, what are the other kind?” a guy once asked. “Hostile?”

Massage school was the first to teach me that there were two types of erections: hostile and benign. My instructors taught me how to deal with each erectile happenstance, ranging from saying nothing at all, to having a clinical discussion with the engorged client about what’s appropriate behavior during a massage. I was confident that, by the time I graduated from massage school, I would have no problems dealing with erections, hostile or otherwise. After all, I’d seen a few in my private life without eliciting trauma, and (thought) I had a clear concept of professional boundaries. This would be no big deal.

My first encounter with a hostile erection popped up a lot sooner than I expected. It was a few weeks before I graduated, in the student massage clinic. The school offered $20 massages to the public in exchange for students gaining hands-on experience. My school was a blond brick office building with bleached linoleum floors and industrial-grade carpet (in other words, not a bordello), and my student uniform was khaki pants and a green polo shirt (not a mini skirt and knee-high fuck me boots). My client was in his mid-twenties, with dark hair and a cheesy mustache. The massage began with him lying on his stomach, so if there was an erection, I didn’t see it. Sure, he moaned and groaned a little, but, Hey, some people are expressive, I reasoned. But when he turned over, there it was, pitching a tent under the thin white sheet.

Okay, ignore it, was my tactic. I figured bringing attention to the erection was always the wrong way to go, and just massaged his shoulders. That’s when his moaning turning into loud groaning. “Oh, God, oh, yes! It feels so good!”

I laughed like a 13-year-old girl—so loudly that a student in the next room heard me and thought, “Wow, they must be having a good time over there.” It was just so awkward I didn’t know what else to do. Then Cheesy Mustache Man tugged the sheet down around his thrashing hips and gave me a peek at the goods. That’s when my laughing stopped.

There was no serious conversation, no clinical voice. There was just me jerking my hands off his shoulders like I’d received a 500-volt shock, and saying, “Okay. We’re done.” I left the room quickly and proceeded to do the heebie-jeebie dance.

Only a week after my bungling of the hostile hard-on, I was in a class learning how to give safe, nurturing massage to survivors of sexual abuse. The subject of how to handle those pesky erections came up (and can I just say how difficult it is to write on this subject without tripping over innuendo?). One classmate believed a good offense was the best defense, so she mounted a machete on her office wall. She’d point to it and tell her male clients, “This is what happens if you get an erection.” After all, nothing says “this is a safe place” like menacing garden tools.



sex·u·al·i·ty: the capacity for sexual feelings


Here’s the tricky part of the whole “sex isn’t a part of therapeutic massage” paradigm: humans are sexual beings. Clients are humans. Ergo, clients are sexual beings. Researchers have found that another person’s gender is the first piece of information our brain categorizes when we first meet them. The theory is that, evolutionarily, our biggest concern was, “Can you help me reproduce?” No matter how evolved we are, there’s still a lizard brain in every situation – whether it’s at a bar, a bank or a massage studio – that engages in a tacit dialogue about what our sexual relationship will be: You’re hot, you’re not, I’m married, you’re straight, I’m gay, you’re my boss, let’s just be friends, let’s go to bed, I’m not a hooker so keep that thing under control, Bucko.

I’m not advocating that massage clinics turn into a sexual free-for-all. I treasure the boundaries that keep overt sexual behavior separate from my work. But this insistence that erections during massage aren’t sexual seems naïve, at the very least. It’s not rocket science, or psychopathology. Guys get erections during massage because they’re naked and someone is rubbing their thigh or their butt and it feels good. Their penis is a sex organ, erection is a sexual response, and, therefore, they’re sexually aroused. It doesn’t mean they expect a Happy Ending. It doesn’t mean they’re perverts. It just means they had a human response to physical pleasure. Are they supposed to feel ashamed of that?



mas·sage: the action of rubbing or pressing someone’s body in a way that helps muscles to relax or reduces pain in muscles and joints. See also: massage parlor.


Very few men actually get erections on my massage table – very few who want to even make it through my door. I can usually weed them out on the telephone or via email (not the erections, but the guys attached to them). They have their own language that tips me off they’re looking for sexual services. “I’m on my way through town,” they say. “Can you see me in about two hours?” (Never mind that they’re calling at 8:30 at night). “How soft is your touch?” (They want me to use words like hard and soft and gentle and deep). “Do I have to be covered by a sheet?” (Is there a legitimate reason for not wanting your penis covered? Some medical condition that escaped my attention in physiology and pathology class?). I answer their questions in my professional voice, which is an octave lower and less giggly than my real-life voice. The guy always says, “Um. Yeah. Well, I’m gonna have to check my schedule and get back to you.” I never hear from him again. See, they’re weeding me out, too.

Among my clients who have never even had a benign erection on my massage table are: my friends’ husbands, gay men, my father, and men old enough to be my father who kind of see me as a daughter. What they all have in common is that the mere thought of engaging in sex with me is horrifying. But if massage-table erections were a non-sexual response, wouldn’t these men be as subject to them as every other guy? No. There’s some inner knowledge they have about our relationship that–whether consciously or sub–keeps erections at bay.

There’s another irony about the insistence that erections during massage can’t be sexual: by expecting or forcing clients to divorce themselves from their sexuality — even for an hour — massage therapists are asking them to be less human. Popular rhetoric in bodywork is that we help people “get into their bodies.” We encourage them to “integrate” all pieces of themselves. For many people a body is just something they have to lug through the world. Practices like massage and yoga encourage people to become more cohesive in their body, mind, and spirit. But how the hell are they supposed to obtain wholeness if a condition of massage is that they leave a part of their humanity – their sexual side – outside? What if massage therapists left all this rigidity and fear about erections outside, instead?

Of course, the rigidity arises from a very real place. Massage has long been associated with prostitution, and we’ve got to differentiate our therapeutic profession from that. The boundaries have to be crystal clear. The fear of erections comes from a very real place, too. The penis can be used as a weapon of violence and humiliation against women. Remember the Machete Mama, my classmate who threatened castration for the mere whisper of an erection? She had been sexually abused as a child.


Sexual addiction: a progressive intimacy disorder characterized by compulsive sexual thoughts and acts. About seventy-one percent of child molesters are sex addicts.


I used to have a forty-something client named Tom who saw me weekly. He was referred by a psychotherapist who treats sex addicts. It’s not as creepy as it sounds. I’ve worked with several recovering sex addicts, and they’re no more interested in a Happy Ending than anyone else who lies on my table. These folks have a pretty good idea of where to go for sex and don’t want to waste my time and theirs if that’s what they’re looking for. What they are looking for is touch that’s not a futile attempt to mask their emotional pain. See, for them, sex isn’t about pleasure, and it sure as hell isn’t about intimacy. It’s usually about trying to cover up some horrible wound inside of them, but that’s like trying to douse a flame with kerosene. All it does is create a firestorm of emptiness and shame. When they come to me they want touch that isn’t sexual. They want intimacy with boundaries. They want – and they get – no self-hatred.

When I lay my hands against their skin, it might very well be the first time that touch hasn’t been manipulative or degrading. So they come back. Each time I touch them, they relax a bit more. They feel a little more pleasure. They get a little less scared. It reminds me of how we all walk around carrying fear and self-doubt and weeping wounds, and we’re just doing the best we can to dance around all that pain. I wish I didn’t need to be reminded of that, but I’m so glad I am.

I had never asked about the specifics of Tom’s sex addiction, and he never offered. I knew he spent many years in therapy working to overcome his destructive behaviors and his abusive childhood. He volunteered for a suicide crisis hotline and at a shelter for runaway teens. He was getting a degree in addiction counseling. He was trying to do good. One day, about a year after he’d been seeing me, Tom told me his psychotherapist was concerned that his work at the homeless shelter could cause a relapse in his sex addiction.

“Why would your work there be a problem?” I asked. I couldn’t imagine there was a lot of Internet porn—considered crack for sex addicts—in a teen homeless shelter.

The room got quiet, but it was one of those silences that screeches loud.

“Oh,” I said. It hit me much more softly than you’d think a realization like that would. “The teenage girls. He’s worried about you being with the girls.”

“Yes,” Tom said. “Teenage girls. That’s my addiction.”

I focused on the rhythm of my hands against his hamstrings. Up and down, around and around. I figured if I just kept my hands on Tom, I’d remember that this is a person who had probably been scared shitless to tell me the truth, and was probably scared shitless now that he had.

“Did I just totally freak you out?” he asked.

“That’s what I’m trying to figure out.” It was just my hands across his legs. Muscle fibers. Fascia. My hands across Tom’s arms and his neck and his back. His body rose and fell beneath my palms.

“You’re the same man to me now that you’ve been for the last year,” I said.

Because over the last twelve months I’d come to know Tom as kind and curious and sweet and vulnerable, and every single day he was trying like hell to be a better man. He wasn’t out there trolling for girls at the mall or in chat rooms or even looking at underage porn. Twenty years had passed since he’d had sex with a teen girl (he was twenty, she was thirteen), but this was still his struggle, one loaded with stigma. It took courage for him to admit it to me, certainly a lot more courage than it took for me to just be there with him. So that’s what I did. I stayed with him. I felt his body rise and fall beneath my hands.



gray a·re·a: an ill-defined situation not readily conforming to an existing set of rules.


That, right there, is why all these boundaries about sex and massage are utterly critical, but also need to be malleable. If I allowed my massage office to be sexually charged, if the boundaries around sexual contact were unclear, Tom wouldn’t have, couldn’t have felt safe enough to receive touch from me on a regular basis. He also wouldn’t have trusted me with his secret, and there wouldn’t have been the opportunity for healing. At the same time, if my boundaries around sex were rigid I wouldn’t have allowed a recovering sex addict into my office, and I sure as hell wouldn’t have allowed him to speak about his addiction.

A lot of people will continue to see the erection question in black and white: it’s either one way, or the other. The Machete Mama had a wound so raw, so deep, that the blade on the wall was the only way to make her feel safe. Some massage therapists pile heavy blankets on top of their male clients, to keep everything tamped down (it might be there, but let’s just not see it). Others see an exclusively female clientele. I admit, I’m heading toward the latter direction all the time. Sometimes, navigating the alternative is just too exhausting. Despite my entire “sexuality is just part of being human,” thesis, I still feel uncomfortable when a client gets an erection. My mind races to, What does this mean? and, What should I do?, and then I’m no longer focused on this person’s body, mind, and soul. I have turned them into a problem, where they are either this way or that. But I don’t want to see my clients in black and white. The human gray area is where I want my hands to glide.

LizPrato_AuthorPhotoLiz Prato is the author of Baby’s On Fire: Stories (Press 53). Excerpts from her recently completed memoir have been published by The Rumpus, Subtropics, Summerset Review, and Nailed. Her work has also appeared in Hayden’s Ferry Review, The Butter, Carve, Hunger Mountain, and Massage & Bodywork Magazine (who, it turns out, does not wish to publish essays about erections). She writes, teaches, edits, gives massage, enjoys life with her husband, and acts a bit too much like a Crazy Cat Lady in Portland, Oregon. Website:


  15 comments for “The Erection Question by Liz Prato

  1. I had my first and last full body massage almost ten years ago. I went with my wife and we were escorted to separate rooms. I had no idea what to expect. The massage therapist was much older than I. I was in my mid twenties and she was in her late 60s. I was not attracted to her in any way. However, to my surprise during the massage I had an intense erection. I was utterly embarrassed. She did not say anything about it. I was terrified and had trouble relaxing. To this day I have not returned for fear of it happening again. I am researching the topic to muster the courage to try again.

  2. Been receiving massages for years now, every so often getting an errection.

    Sometimes, it’s even a male massage therapist.
    Am I gay? Certainly not, I just have extreme issues with blood flow and nerves through my hips.
    When touched on my butt thighs or abdomen, I will probably get an errection, even if it was Rosie O’Donald.

    While getting my massage last week, I got an errection.
    At the moment I’m incapable of sexually relieving myself, thus my anxiety towards the situation was at its highest.
    Thankfully she didn’t say anything and just continued, or so I thought.

    Today I had the horrible experience of going into my Doctors office to be told that she won’t be seeing me anymore cause i got an errection, by multiple people in the office whom I didn’t disclose this information to, or tell the massage therapist too.

    It was extremely embarassing doing the walk of shame out of my Doctors office with everyone knowing I had an errection the other day.

    Having severe depression and Autism, the incident threw me into a suicidal episode.
    Even though I need massages on a regular basis to function, I’m not sure I could work up the courage to see another one.
    I just hope this world kills me before I do at this point. :/

  3. Had my first massage today and was worried sick about it happening to me, sure enough it did, I was so embarrassed!!

  4. Well stated, but a question remains for me. My wife and I recently has a couples massage that we both enjoyed very much. Afterwords my wife asked me directly if I had gotten aroused during the massage. It turns out that I was briefly aroused and was honest with her. I went on to explain that being such an excellent massage that as I became more relaxed the arousal quickly went away. Further, that I linked arousal with tension (I believe this is common with male sexual responses) and that arousal was inconsistent with enjoying the relaxing aspects of the massage.
    Then I returned the question. I was quite surprised at my wife’s response. She was also aroused and nearly had an orgasm. It turns out that she commonly has the imperceptible mini orgasms during a massage. That the relaxation of the massage brings on this response and that this is the reason she enjoys massages. And this is not dependent on the gender of the MT.
    Having read up on the Internet on this I have found that this response is not only common, but the MT often see it as a direct result of the patient relaxing and views it as a compliment.
    Wow is that different from how female MT speak of aroused (forget about climaxing) male patients.
    My question is this: do you accept that a secret female arousal (even climax) is complete acceptable while the same for a male patient is completely unacceptable?
    And if so how is that explainable?

    • Nora you need to learn you cannot make generalizations about these situations while what this man did certainly isn’t right and is indeed STATUTORY rape you cannot call this man a rapist for all you know the girl gave full consent and I have heard of and seen first hand cases where these kinds of situations occur that the underage participant is fully understanding and consenting.

      • so do you just go trawling through posts that are nearly a year old looking for something to drop rape apology on or what

  5. I felt you relaxing me with your words. This is a subject I’m terrified of, and you made it make sense. I love it.

  6. This is an excellent commentary, so often massage therapists sit in this weird space where boundaries are fluid and we don’t know how to deal or what to do. Thanks for writing this 😀

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