The Hidden Cut - S1E5: The Reflex Cut
Redefining Erectile Dysfunction: The Nervous System's Quiet Rebellion
I remember when Viagra first came out. It felt like a punchline at the time.
Something whispered about on late-night TV or referenced in sitcoms with a wink. A little blue pill—almost too absurd to be real.
It wasn’t for us, though. It was for old men. For grandpas. For guys in those TV commercials with gray temples and khakis. But somewhere between then and now…
Something shifted.
Because suddenly, those ads weren’t aimed at retirement-age men anymore.
They were aimed at my peers. At men in their thirties. Men in their twenties.
At us.
And the tone had changed too. This wasn’t whispered about anymore.
It was marketed boldly—casually. ED meds by mail. Subscription-based. Discreet packaging. Chewable mints.
“No big deal.” “Totally normal.” “Everybody needs a little help sometimes.”
And maybe that’s true. But I couldn’t help wondering:
When did this become so common? When did needing a pill to feel desire—or to prove performance—become something we just… accepted?
And more importantly: Why weren’t we asking where the problem actually started?
Listen to the podcast episode here.
Why weren’t we asking why so many men were struggling to connect—to feel—to stay present in their own bodies? Why weren’t we listening to the one part of the body that had stopped cooperating?
What if it wasn’t broken? What if it was trying to tell us something?
The Rise of ED: The Age of the Pill, the Screen, and the Scalpel
Erectile dysfunction has long been framed as one of two things:
A sign of aging… or a sign of inadequacy.
Either your body’s giving out—or you’re not man enough.
But there’s another explanation that rarely gets airtime. And it’s a lot more complicated. Because in recent years, researchers and clinicians have noticed a shift. ED isn’t just showing up in older men anymore.
It’s showing up in men under 40. Under 30. Even in their early twenties.
One study published in the Journal of Sexual Medicine found that about 1 in 4 men seeking help for ED were under 40—and many of them had no underlying physical cause.
Their testosterone levels were fine. Their blood flow was normal. They were “healthy.” But still—something wasn’t working.
In clinical terms, it’s called psychogenic ED.
But that name doesn’t quite capture the depth of what’s happening. Because this isn’t just a matter of mental blocks or performance anxiety. It’s not about whether you want to perform.
It’s about whether your nervous system believes it’s safe to.
And for a growing number of men, the answer is no. Not because they don’t want to be present. But because presence has been coded as dangerous.
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In a culture where men are taught to perform instead of feel—
To suppress instead of express—
To conquer instead of connect—
The body eventually learns that arousal is a job. Not an experience. And like any job under pressure, it starts to shut down.
So maybe the problem isn’t the penis. Maybe it’s the pressure.
Maybe the dysfunction isn’t biological. It’s cultural.
We’ve built an entire system around the idea that a man’s worth is tied to what his body can produce—erections, orgasms, babies, power.
And if that body refuses? We treat it like it’s broken. But what if it’s not?
What if erectile dysfunction isn’t a failure to perform…
But a refusal to keep pretending?
The Trauma Connection
We like to think of arousal as something simple. A switch we flip. A chemical spark. A physical response. But the truth is, sexual function is emotional function. And emotional function begins with safety.
Safety in the body. Safety in relationship. Safety in being seen.
Without that safety, the nervous system does exactly what it’s designed to do:
It protects you. Even from pleasure. This is the trauma connection.
Not trauma as a memory you can describe—but trauma as a pattern your body memorized before you could speak.
We talked about this in Episode 4: That early pain, like circumcision, especially when performed without anesthesia or comfort, can leave behind a kind of imprint.
A message the body receives before the brain is even online: Touch can hurt. Your body is not yours. Connection is not safe.
That message doesn’t disappear with time. It sinks deeper.
And when it’s layered with a culture that discourages male vulnerability, shames emotional expression, and treats sex like a performance…
You get a generation of men whose bodies don’t know how to stay present.
The nervous system moves into fight, flight, or freeze—
But instead of running from a bear, it’s pulling away from intimacy.
This is why arousal can vanish the moment a man tries to connect emotionally. Why sex becomes something mechanical. Why pleasure gets chased through intensity—porn, domination, novelty—but not through presence.
Because the moment presence arrives, the nervous system says: We’ve been here before. This is not safe. Shut it down.
This isn’t dysfunction. This is a survival strategy.
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Subscribe to follow the thread—from laugh tracks to foreskins to the emotional fallout we’re only just beginning to name.
And in trauma theory, this is called dorsal vagal shutdown—when the body numbs out, disconnects, and goes quiet in the face of unresolved threat.
It looks like failure. But it’s actually a protective adaptation.
The body isn’t broken. It’s responding exactly how it was trained to respond—
In silence. In shame. In secrecy.
So maybe the question isn’t why aren’t men performing?
Maybe the question is: What were they taught to survive?
The Performance Trap
Somewhere along the line, we stopped thinking of sex as connection—
And started thinking of it as performance.
For men, especially, it became a kind of job. Be hard. Stay hard. Make her finish. Don’t finish too fast. But don’t take too long. Never say no. Never have an off day. And if you do? You’re broken.
That’s the message. Quiet. Constant. Unrelenting.
And for many, it started early. Before they ever had a real sexual experience—they had porn.
Porn, where the man is always erect. Always dominant. Always ready.
Porn, where the body is a prop, and connection is replaced by conquest.
Add to that the desensitization that may come from circumcision—a body that was rewired before memory, told how to look but never how to feel—and now you’ve got millions of men trying to live up to a role their nervous systems never signed off on.
And when they can’t deliver? They don’t ask for support. They blame themselves. Or worse, they shut down.
Because the script has no space for softness. No allowance for fluctuation. No understanding that arousal isn’t performance—it’s presence. And presence can’t be forced.
But we live in a culture that doesn’t make space for that truth.
Instead, we’ve built an entire identity around the myth of the ever-ready man:
The man who never says no. The man who’s always up for it. The man who proves himself through his ability to produce.
We’ve tied sexual performance to masculinity so tightly—that when the performance falters, the identity collapses with it.
So what does a man do when his body refuses to play the part?
He hides. He compensates. He reaches for something to make the problem go away. Which leads us straight into the next phase of the story—
The one where the solution is sold in a box. And no one asks what the original wound might have been.
The Pharmaceutical Escape Hatch
When the performance breaks down, the market steps in. And the message is simple: “Don’t worry. We’ve got a fix.”
The little blue pill. The chemical patch. The modern miracle.
No need to examine what went wrong. No need to ask what your body is trying to say. Just take this—and keep going.
Viagra hit the market in 1998. It was originally developed as a treatment for angina. The erections were a side effect.
But soon, the side effect became the product.
And what began as a solution for older men with vascular issues…
became the silent partner in a much larger story. A story about men struggling to feel. About men whose bodies were starting to resist a system built on pressure and shame.
A story that no one wanted to talk about—but that everyone wanted to sell a cure for.
By the early 2000s, ED drugs were being marketed as lifestyle enhancements.
Young men began using them recreationally. Not because they needed help—but because they needed to compete.
To perform harder. Last longer. Erase the doubt.
And when younger men began experiencing ED in larger numbers—the response wasn’t concern. It was opportunity. New startups. Online prescriptions. “Discrete” delivery in minimal packaging.
A full-blown industry, built around men who were slowly disconnecting from their own desire—but had never been taught how to listen to it in the first place.
And the solution? Don’t stop. Don’t feel. Just take the pill.
This isn’t healing. It’s a bypass. A detour around the real problem. Because healing asks questions. Healing says: What happened to you?
But the pharmaceutical model says: “Don’t worry about it. We’ve already moved on.”
And maybe that’s the most dangerous part.
Not that the pill exists—but that we stopped asking why it became necessary.
The Wisdom of the No
What if the breakdown… is the beginning? What if the body, in its refusal to perform, is not failing—but finally telling the truth? What if the “dysfunction” is actually a boundary?
A signal flare from deep within, saying: I won’t fake it anymore. I won’t play this part you wrote for me. I won’t perform when I’m not connected.
That’s not weakness. That’s wisdom.
In a world that tells men to override, suppress, ignore—a body that won’t rise to the occasion might be the only thing still rooted in truth.
Maybe the erection didn’t vanish because the man was broken. Maybe it vanished because the pressure finally became unbearable.
Because connection without presence isn’t intimacy. And arousal without safety isn’t desire. It’s duty. And some bodies… finally say no.
That no is not a problem. It’s a chance. A quiet doorway into the question so few men have ever been allowed to ask: What do I actually feel?
When you remove the pressure—what’s left? When you remove the performance—what’s still true?
Maybe for the first time in your life, the body has stopped pretending. And maybe, just maybe, that’s not something to medicate. Maybe it’s something to honor.
Because the body is not your enemy. It’s the only part of you that has never lied. And when it says no—it's not rejection. It's an invitation.
To rest. To rewire. To return.
Not to a version of you that could perform—but to a version of you that can finally feel.
In the next episode, we’ll explore the quiet shift that began breaking the century-old spell—when parents started saying no, and hospitals stopped telling the whole story.
Until then, I’m Lisa. And this… is The Hidden Cut—a series about what’s been removed, revised, and left on history’s cutting room floor.
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