Everything I Learned About Sex from the ‘Instagram for Doctors’

Rarely is sex as thoroughly de-mystified and laid bare in all its disgusting, visceral truth as it is on Figure 1, a social network that's been called the "Instagram for doctors." But can it teach us anything useful about human sexuality? Figure 1 is an app co-created by Toronto doctor Joshua Landy. Since the app's 2013 launch, doctors around the world have signed up to post images of the weirdest—or most textbook—cases they come across on the daily. As you might imagine, there's lots of sex stuff, sometimes annotated with fun captions like, "What kind of papule could this be?"

Doctors on the site just so happen to love it. They shoot the shit and spend comment threads discussing just what's wrong with the people in the photos. The app's purpose is to create an evolving body of on-the-job knowledge for doctors, Landy told the Toronto Star, but is the impact the same for non-doctor types? Well, as a representative of the company told me, "the site is a resource for healthcare professionals, not laypeople, and sex is not a major theme on the site."

So, there's that. But that caveat-cum-warning didn't stop me from trying to learn everything I could about the risks of sex from a site apparently too raw and real for the uninitiated public to peruse. What follows are the most important lessons I learned about sex on Figure 1.

Do Not Stick Things Too Deep Into Your Butt

The human butt is extremely resilient, but it comes with great responsibility. Yes, you can put things up there, and for the most part it's all good fun, until a giant carrot doesn't want to come out.

​On Figure 1, I saw one such anally inserted carrot inside a 64 year-old man (almost definitely a sex thing), a ton of opium in little baggies (probably not a sex thing), and a butt plug, which was actually kind of nice to see because someone having a plug way, way up their asshole turned out to be one of the more conventional things I saw on the app.

The stuff that people stick up their butts or vaginas, or any other cavity for that matter, are referred to as "foreign bodies" by the medical community, and they can be really dangerous. Bowel perforation, a puncture in the wall of the gastrointestinal tract that floods the abdominal cavity with feces and causes infections, is "the most dangerous complication of a rectal foreign body," according to the authors of a 2014 retrospective study on rectally-inserted objects. Foreign bodies also require clever tricks to remove, in some cases. For stuff stuck way up there, or if perforation has occurred, the process might require a laparotomy—a surgical incision that gives doctors access to your abdominal cavity. There's also the risk that repeated insertion of giant objects can lead to rectal prolapse—when the walls of your rectum fall out your butt. It's a thing in porn known as "rosebudding," and Figure 1 doesn't make it look very sexy.

All this is to say that you should be careful about what you stick up your anus, unless you want to end up on Figure 1, where chumps like me will ogle at your misfortune with a mix of revulsion and macabre interest. As Figure 1 user "labbot" put it, "If going to do it [sic], need to know ok parameters and risks."

Penile Fractures Are Terrifying

This one's for all the penis owners out there. The stuff of sensational TLC sex specials, Figure 1 taught me that penile fractures are actually not a joke—they look really horrifying and painful. Especially bad ones make once-serviceable members look like big, bruised grapefruits. A penile fracture involves rupturing the fibrous erectile tissue through a vigorous sex act, usually. A 2014 study of dozens of penis fracture cases in Brazil found that having the receiving partner on top was the most common recipe for a cracked dick—you will literally hear a "crack" sound if you fracture your penis—followed by doggy style. There are myriad ways to crack your dick, however, and penile fractures caused by sex may even be a uniquely American phenomenon. A 2004 study published in Reviews in Urology found that in Japan only 19 percent of penile fractures are directly caused by sex. The majority are a result of furious masturbation or rolling over on your boner in bed. In Mediterranean countries, the study says, the vast majority of penile fractures come from self-inflicted erection "snapping" to keep it up. Doctors usually have to cut your dick open to fix a fracture, as "rachel308" explained in one comment thread. "If I'm correct, in the repair surgery the skin is essentially degloved to access the interior. That is what you're seeing—the corpus cavernosum. I have also seen a procedure that I likened to a fasciotomy in compartment syndrome where they cut the skin to avoid damage from the hematoma. It was on Figure 1 actually!"

​How about that!​

Practice Safe Sex So You Do Not Get a Heinous Infection

Sexually-transmitted infections (STIs) are pretty normal these days, actually, and there shouldn't really be a lot of stigma attached to them since nearly everyone will catch a case of the Herpes Simplex Virus (HSV) at some point in their lives, according to the CDC. But let me tell you, I have seen some truly messed up dicks and vaginas on Figure 1, ravaged by this really, really common virus. At the very least, the images on Figure 1 were a reminder to be extra careful in the bedroom: use condoms, get checked often, and be open with your partners about their sexual history and health. And, of course, be understanding if you find out that your partner has an infection.

Do Not Buy a Metal Cock Ring. Seriously.

Cock rings are a sex toy enjoyed by penis-havers of all sexual persuasions who wish to keep their erection, well, erect by restricting the flow of blood from the penis' tissue. It sounds kind of uncomfortable, but maybe it works? Regardless, Figure 1 taught me that if you are ever going to do this, definitely don't use a metal cockring. One photo on the site featured a painful-looking engorged penis with a wedding ring-sized cock ring. Metal cock rings are difficult to remove because they aren't as malleable as rubber or leather varieties, and lead to "penile strangulation" that may result in losing the ability to maintain an erection or the onset of necrosis and gangrene in the penis' tissue. And, if you want to see what a shriveled, amputated, gangrenous penis looks like, here you go, courtesy of Figure 1.

If that image (or mental image, if you didn't click the link) isn't enough to convince you, here's what "Woundrn1" said taking a metal cock ring off in the ER could mean for your dong:

"Had similar but much worse case. [Patient] passed scrotum through ring also. To ER 3days later. Scrotum removed. Penis shaft debrided. Hyperbarics, 6 weeks of wound [Vacuum Assisted Closure], skin grafts. Ultimately retained ability to urinate. Cut off the ring by any means possible." It's worth noting here that rubber cock rings (even rubber bands) can still be disastrous for your penis. The difference is that they can usually be taken off easier in an emergency.

​

We Are All Completely Disgusting

If that other kind of ubiquitous nudity on the web—porn—is often lambasted for portraying unrealistic ideals of the human body, promoting harmful dynamics in the bedroom, or just plain old misrepresenting what sex between two imperfect, unwaxed, un-fluffed humans looks like, then Figure 1 is basically the anti-porn repository of the internet. This is the dirty stuff of reality.

But, in a totally maybe-not-okay way, the images on Figure 1 are comforting. Humans are disgusting. Weird shit happens to our bodies all the time. We're not photoshopped, airbrushed, picture-perfect creatures. We're really gross. And we sometimes mash these imperfect bodies together in a sweaty, guttural expression of that imperfectness—sex. Just be careful about it.

This story is part of Motherboard's Sex Ed Week, a series of sex-focused science and technology stories. Check out more stories ​here.