Does size matter? It does to the seriously under-endowed. Help is at hand, says Louise Jury
Gregg's size has made him feel inferior all his life. "I have had more rejections than I care to remember," he announces through a web site called Small Etc. "Do you think there is anyone who could want someone like me?"

The subject of his angst is his smaller-than-desired male member. Small Etc was set up by "J" eight years ago as a support group for men with small penises. Its members communicate through their computers. Though it often looks like a dating agency for small gay men, the Small Etc web site claims to have 1,500 members, both gay and straight, who find reassurance in discovering they are not alone. Perhaps the gay community is more forgiving than the heterosexual one, for the answer to Gregg's plaintive plea among the gay men in the small ads is definite enthusiasm. "More interested with the size of your heart than the size of what's between your legs," says one. "I enjoy a wide range of sexual pleasures with your limits respected," claims another.

People tend to snigger when it comes to the subject of size. Discussion rarely makes it out of the problem pages or the locker room. Male egos being what they are, penis size is a measure of the man. "They see it as a question of self-esteem," says Mick Cooper, co-author of The MANual, a self-help guide for men. "The size of the penis is related to self-worth." They don't, in general, believe that the better endowed get better sex. They just dread that moment when a woman (or indeed, a man) gazes upon them and laughs. This is no irrational fear. Testimonies to agony aunts prove it does happen, though, one hopes in a spirit of humanity, rarely. Some men have genuinely small penises, either because of congenital abnormality or some kind of trauma, such as a circumcision that went wrong. Others are normal but believe they're not.

Dr Vernon Coleman, the People's long-standing medical advisor, has a whole telephone helpline dedicated to the small penis. Meanwhile, increasing numbers of men are turning to cosmetic surgery (though this is a route Dr Coleman advises against).

Peter Coles, a director of the Harley Medical Group, which provides cosmetic surgery in London and several other cities, says increasing numbers of men are turning to them for help. Compared with five years ago, when 90 per cent of cosmetic surgery business was for women, they now get around half a dozen inquiries a day about penis extensions, which cost between pounds 2,500 and pounds 3,500. The majority of callers go ahead with the operation.

"We're able to increase the length of the flaccid penis by between 1in and 2.5in. We're also able to enhance the girth by around 100 per cent. Very rarely can I recall a patient who's not happy with the extra length we've said they're going to get, though we're quite conservative about what we tell them."

However, the clinic stresses that if they want a longer penis to satisfy their lover the operation won't really work. Surgery increases the flaccid rather than the erect state. "The object is to make them feel better about themselves," Mr Coles says. "An awful lot of people duck out of having a shower at the gym or pool because they feel inhibited So this is about making a patient feel normal." For many men, the psychological pressure becomes worse as the years go by, he says. "A perfectly rational person can become more and more inhibited. Sometimes they have to take time off work. They know they're being silly and that makes it worse."

Where sex is concerned, communication is the key, says Mick Cooper. "The reality is that for some women it can be a problem," he says, with an honesty many a woman might applaud. "One of the problems with this issue is it gets polarised. There's this attitude that small penises are terrible and that women hate them so men respond by saying that it doesn't matter at all and that women don't mind. That kind of response is as inaccurate as saying that women just want men with bigger penises. To say size doesn't matter is an avoidance of the issue. There must be negotiation."

Small Etc is at