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Articles about TMS

Alfred C. Kinsey had this to say about prone masturbation in his landmark 1948 study Sexual Behavior in the Human Male (Philadelphia: Saunders), p. 509:

There are some boys who attempt to masturbate by moving the penis against a bed or against some other object; but for most males this technique is rare and confined to an incidental experience or two. *** Many of the persons who depend on this mode of masturbation think of the act as a substitute for heterosexual coitus, and there are some clinicians who specifically recommend such a technique, in conjunction with fantasy, on the ground that it may have some carry-over into later heterosexual activity. But however good the theory may appear to be, it finds no substantiation in the specific record, for the great majority of boys use simpler manual techniques in masturbation, and make perfectly satisfactory heterosexual adjustments anyway. It is also to be noted that males have been known to masturbate against a bed while fantasying frictation or anal relations in the homosexual.

Kinsey recorded the prevalance of prone masturbation as follows, although his breakpoints "much," "some," and "rare" do not correspond well to the more specific breakpoints this site uses: "almost always," "most of the time," "sometimes," "rarely or never."

Q. How often do you masturbate by pelvic thrusts while prone?

White
College Ed. White
Non-College Ed. Black

None 58.2% 72.4% 68.9%

Have tried 1.4% 0.4% 0.8%

Rarely 1.9% 1.8% 0%

Little 21.6% 12.9% 18.2%

Some 4.0% 1.2% 5.3%

Much 12.9% 11.2% 6.8%

Number of cases 3819 490 132

Source: Paul H. Gebhard and Alan B. Johnson, ed., The Kinsey Data: Marginal Tabulations of the 1938-1963 Interviews Conducted by the Institute for Sex Research. Philadelphia: Saunders, 1979, Table 161, p. 210.

The survey gives "much" as the maximum, but it would be useful to know how much "much" is. Obviously most of these men did not masturbate prone exclusively, because in answer to Kinsey's question about the frequency of masturbating by hand on the penis, the percentage of the three groups answering "much" were respectively 90.9, 95.5, and 95.1 percent. (Gebhard & Johnson, Table 160, p. 209.)

Wardell Pomeroy says this about prone masturbation in the third edition (Random House, 1991) of his book Boys and Sex:

A minority of boys, probably no more than 5 to 10 percent, lie on their bellies and use a pushing motion to rub the penis against the bed or a pillow, in a movement like intercourse itself. Younger boys use this method more often.

Thanks to reader J. for bringing that quote to my attention

Shere Hite tabulates in her unscientific best-seller The Hite Report on Male Sexuality (Bookthrift, 1983, p. 1106) that 82 percent of males masturbate using manual stimulation of the penis, while 15 percent masturbate prone. (Two percent masturbate using other methods and one percent of men claim to not masturbate.) She notes (p. 507) that many more had masturbated prone when they were younger, and she points out (p. 502) that regular masturbation almost never involves thrusting.

Eva Margolies alluded to TMS in her 1994 book Undressing the American Male: Men with Sexual Problems and What You Can Do to Help Them (Dutton). On p. 115, in a section headed "Sexual Habits of the Older Virgin," she says this:

An addiction to a particular and often idiosyncratic way of masturbating: The result is that a man becomes overly sensitized to the sensations he receives from his own hand, as well as to the perfect adjustments -- faster, slower, harder, softer -- that a person can only get through masturbation. He may also develop very particular types of motion, such as shaking his penis or tickling just the tip, to which he becomes responsive. He may also become used to masturbating by rubbing against a pillow or mattress. This is a sign of regressed sexuality as well as a problem in translating arousal to a partner. (emphasis added)

Dr. Sank's article about TMS

TMS was first described in a 1998 article by Dr. Lawrence I. Sank of the Center for Cognitive Therapy in Bethesda, Md. What follows is the abstract of his article and a summary of it prepared for this site.

Source: Journal of Sex & Marital Therapy. 24(1):37-42, 1998 (Jan.-Mar.)

Abstract: This article describes a previously unreported pattern of atypical masturbatory behavior, which presents as either an erectile or orgasmic disorder in men. Four case histories are described of men who masturbated in an idiosyncratic manner. The distinguishing features of the masturbatory style include a prone position and daily masturbation over a period of years. It is suggested that the primary care physician or specialist (urologist or neurologist) screen for this problematic style when presented with male sexual dysfunction. Further, and more controversially, it is suggested that a primary prevention model would argue for masturbatory instruction in the home, classroom, or pediatric clinical setting.

Sank notes that much attention over the past 30 years in sexual therapy practice, self-help books, and the media has been paid to the sexual problems of women and how masturbation can help them. He notes that there is a lack of comparable help for men and states that the problem in men, unlike women, is not that they don't masturbate, but that they might not masturbate correctly, leading to "a long history of sexual failure." (p. 42)

Sank describes four men he treated in his practice with a problem he defines as Traumatic Masturbatory Syndrome (TMS).

A 62-year-old African-American male who had recently started his first sexual relationship after decades spent in a religious order. This man had learned to masturbate without his hands (i.e., face down) after being admonished at eight years old by a priest not to touch his penis for pleasure. The man was unable to erect in a satisfactory manner to have intercourse with his new wife.
A 35-year-old gay Asian male suffering from erectile dysfunction and inorgasmia. He had not masturbated until in his 20s and then only by masturbating prone against his mattress. He was unable to partake in intercourse.
A 24-year-old gay white male suffering from inorgasmia. He could reach orgasm only rarely, and then only while not erect. He masturbated prone by thrusting his penis between his thumbs with his formed into fists.
A 35-year-old white male with erectile dysfunction. He was not able to have intercourse beyond a few seconds of penetration. He would then typically masturbate prone to orgasm. He was surprised to learn that prone masturbation is unusual.

Sank notes that finding out a patient practices prone masturbation is problematic because it is difficult for a health care practitioner to bring up the subject of masturbation at all, to say nothing of discussing how the patient masturbates. He urges practitioners to do so in spite of this, because of the existence of the four cases he presents.

Sank declines to suggest in the article that prone masturbation is the sole cause of the mens' problems and calls for more inquiry into the condition. He notes that in each case, the referring physicians ruled out physical problems. He suggests that TMS does not cause permanent physical trauma, although he states that this too needs further study by doctors of medicine. He notes that "errant forms of masturbation" may have been created as the result of psychological disorders.

Sank declines to outline his treatment strategy for TMS, but notes it involves resensitizing the penis through "individualized behavioral exercises and psychotherapy when appropriate." (p. 41)

Sank recommends teaching of proper masturbatory technique to "emerging pubescent youngsters" in the family, school, or pediatric medical practice. He also recommends that health care professionals be made aware of the existence of TMS and its implication when male sexual dysfunction is presented in their practices.

Articles about TMS

Dr. Sank's article about TMS

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