Evan Goldstein can make it tighter. Or looser. Or paler or smoother, or less blemished. He aims to address your pain and ease your shame. And now he has written what he calls an “anal bible”: a book titled “Butt Seriously,” a how-to guide for “engaging anally.”
Here’s where you stop reading, or shield your phone from other commuters. Why is that? Humans have dealt with butt stuff for eons, yet the anus remains a kind of final frontier, a synecdoche of humor and anxiety, a root of homophobia. We still need jolly cartoon bears to sell us toilet paper. “Everyone Poops” was published for children nearly 50 years ago, but it still feels like a punchline for adults. Everyone has a butt, but not everyone wants to talk about it sincerely, frankly or in depth. Squeamishness and double-entendres abound. (See: in depth.)
Goldstein has made these anxieties his life’s work. His entire public persona is a reaction against the social taboos that once imprisoned him.
“The goal for me,” he says, “has always been the betterment of the bottom.” Meaning the butt itself, and also the person whose butt is an avenue for pleasure.
Pursuing that goal has earned him a nickname: “the bottom whisperer.” It’s also earned him fans and skeptics. It’s also earned him lots and lots of money.
Goldstein has treated patients of many genders and sexualities, but the majority of his clientele are gay, male and cisgender. People come from all over the country to visit his medical office in Greenwich Village. Here, a patient might receive anal Botox, test their grip and pliability with the help of an “anorectal manometry” device, or pick up nutritional supplements and hygiene kits sold under Goldstein’s own label. The walls are painted with Farrow & Ball (Hague Blue, dusky and un-clinical). There are several tasteful male nudes and one portrait of Lady Gaga from her “Fame” era. The bathroom has a urinal that he specially imported from the United Kingdom.
“I’m so gay, I found a European urinal,” Goldstein says.
He regularly takes his twin sons skiing in Aspen, Colo. He loves sports cars, especially vintage Porsches. (He owns eight automobiles.) Then there’s the 6,000-square-foot, Colonial-style home up the Hudson River, in Katonah, N.Y., that he and his husband, fashion designer Andy Chia Yu, bought from WeWork co-founder Adam Neumann in 2020. Martha Stewart lives across the street, and they’ve become friends. Since they moved in, Goldstein and Yu have installed tennis and basketball courts, and they’ve bought adjoining acres (farmhouse included).
Goldstein’s path to this life was circuitous: He didn’t come out of the closet until he was 30; he was married to a woman for several years; and he went to school thinking he would be a cardiothoracic surgeon. That all seems worlds away from his life today in Westchester County, where he and his husband threw a party for Stewart last summer that inflamed the old-money NIMBYs and lit up Page Six. Stewart wore silk pajamas. Goldstein wore sweatshorts. The “tacky” event, with a mess of vendors, was akin to a “South Beach Food Festival,” complained one anonymous neighbor in the Page Six article. “People are jealous,” one person said. “There were never parties like this in Westchester before, but it’s new money!”
New money? Maybe. But Goldstein made this new money by addressing a very old issue.
For many years, shame and silence shrouded Goldstein’s own sexuality. He grew up on Staten Island, “right by the dump,” he says. His father was a physical education teacher who became the commissioner of New York City’s Public Schools Athletic League.
“You had to be tough,” he says of his childhood. “You had to be street smart.”
As a teenager in the ’90s, Goldstein volunteered at a hospital as AIDS ravaged the gay community. When he was 14, a cousin who had AIDS died. Goldstein experimented with both men and women during his adolescence, but the AIDS crisis made being openly gay seem impossible.
He went to college at the University of Wisconsin at Madison. As a student, Goldstein sustained a painful anal fissure (which he blames on poor diet and prolonged sitting, not sexual activity). A doctor recommended a surgical procedure called a sphincterotomy, which led to an abscess, a second surgery and pain that continues to this day.
He refers to his anal fissure in college as his origin story. “Looking back,” he says, “I think that that was the universe’s way of pushing me into this space.”
He moved back to the New York area and graduated in 2002 from the University of Medicine and Dentistry of New Jersey (which has since been dissolved and absorbed by Rutgers and Rowan universities).
At his surgical residency at Maimonides Medical Center in New York, he met his future wife. During his two-year marriage to her, he met his future husband, Andy, via a chatroom on gay.com. Goldstein speaks warmly of his ex-wife, whom he divorced in 2007, and expresses regret that he entered the relationship before he had come to terms with who he was.
“If I could have gone back, I would have definitely changed the trajectory,” Goldstein says. “But I was kind of a product of my upbringing, the surgical society, the world.”
If he was silent and ashamed in the past, today he is proud and vocal about all things gay and sexual. It’s part of his personality and his marketing strategy. “You know, people don’t talk about sex, let alone anal sex, let alone gay sex,” he says. “If the guys don’t talk about it, how am I going to get the client?”
So he got people talking. In 2010, he shifted his professional focus to anal health. He hired a communications team to promote his practice, the name of which conveys a sort of Fashion Week exclusivity: Bespoke Surgical. Today, Goldstein’s staff includes a publicist, a manager and an SEO company, all overseen by a chief of staff.
He also began promoting himself online as a media personality: a straightforward and brutally honest butt doctor performing a scope of medical care that takes sexual function into account. His social media presence includes a video series called “The Hole Truth,” roundtable discussions called “Tail Talks” (one of which was held at actor Alan Cumming’s nightclub), and many photos of cropped hunky torsos shot by the photographer Maxwell Poth.
Goldstein has been a guest on sex columnist Dan Savage’s podcast more than once. He recently appeared in the artsy gay magazine Butt, posing in his lab coat next to a man in a jockstrap. “Butt Seriously” was published last month, as a “cheeky yet authoritative guide to anal health and anal sex.” The book’s chapter titles include “You’re Not Alone” and “Booty Camp: Your 6-Week Dilation Plan.”
Goldstein has positioned himself as “the leading anal health expert in the United States.” But what do other experts have to say about that?
Goldstein is, of course, not the only proctologist online, nor the only one focused on sexual health. You have characters such as Jonathan Baker (a.k.a. “rectalrockstar”) and Lance Frank (“lanceinyourpants”) making breezy Instagram content about anal health. Even in New York, there’s the similarly named surgeon Stephen E. Goldstone, who also serves gay patients. Much of Goldstein’s practice involves standard care and routine procedures, such as hemorrhoid treatment and prostate exams.
But some of his specialized approaches are controversial. Goldstein is a champion of using Botox on the anus — a procedure he frequently refers to as a “game changer” — to help make sex more comfortable for his patients and to ease the healing of fissures by relaxing surrounding muscles.
Goldstein is also happy to perform cosmetic procedures. He offers anal bleaching and will happily remove a harmless skin tag if a patient doesn’t like the way it looks. This approach has raised eyebrows in the medical community.
“Doing nothing is actually a perfectly legitimate option … for a majority of colorectal medical conditions,” says Vitaliy Poylin, a colorectal surgeon and an associate professor of gastrointestinal surgery at Northwestern University. “Fissure is annoying, skin tag is annoying, but it’s not going to kill you. You don’t have to do anything about it.” Poylin also emphasized that even minor surgical procedures carry the risk of problems such as incontinence or pain.
Goldstein sees it differently. “If someone’s coming into your office and making an appointment because their skin tag is an issue, it’s an issue,” he says. He cites both the psychological effects and the physical damage that skin tags can have on sexual function. He also stresses that, before opting for a surgical solution, he offers less invasive at-home solutions, such as dilation and dietary changes.
“At the end of the day, you’ve got to move the needle so that this guy can have sex and feel sexy,” Goldstein says. “And if we’re not doing that, we’re failing.”
He also offers his own sexual-wellness products — fiber supplements, dilators and enema kits — in the reception area of his office.
“I think it’s awesome that he is normalizing anal health and giving care for people who may not have had access to information,” says Julie Cantor, a lawyer and medical doctor who writes about medical ethics. But Cantor is suspicious of any doctor who sells their own branded products, and worries that Goldstein blurs the line between patient and customer.
“I never want anybody to feel pressure in buying and using my products,” Goldstein says, but he thinks his community is underserved by the market.
Goldstein is certified to perform general surgery but isn’t board-certified in colorectal surgery — a distinction that indicates specialty and mastery, but one that is not required to perform colorectal surgery. Goldstein dismissed this as a concern.
“I am more trained in anal and sexual wellness than everyone that goes to colorectal fellowship,” Goldstein claims. That’s impossible to verify, but also maybe beside the point. Goldstein believes he’s the best, and it’s easy to market oneself that way in a space that, historically, few people have claimed.
On a summer day a while back, Goldstein let me shadow him while he performed surgeries. He arrived at his Midtown surgical center at 7:30 a.m. carrying a gray Louis Vuitton duffel from Virgil Abloh’s “2054” collection.
A printout with the names of the day’s patients, titled “The Supposi-Story,” was taped to a cabinet in the operating facility.
I watched Goldstein remove a hemorrhoid from a patient as Joy Division’s “Love Will Tear Us Apart” played from a nearby computer speaker.
While working, Goldstein frequently punctuates his sentences with “bro” or “buddy.” A few days earlier, at the Bespoke office, when a physical therapist asked why a patient’s sphincter was prone to spasming, Goldstein replied: “Probably because he’s from Long Island.”
“He talks to you like another gay man,” says Michael Renner, 32, who received anal Botox treatments from Goldstein and calls the doctor “Saint Evan.” “The fact that he even refers to your butt as your ‘a–’ sometimes, it just makes you feel like you’re talking to another human being.”
But other patients said this approach minimized the seriousness of the procedures.
“There’s a certain energy that you get from him when you’re in his office that sometimes feels like you’re being hustled,” says Sam Banks, 37, a yoga instructor and masseur who went to Goldstein for three surgeries. “It almost becomes too casual.”
One former patient of Goldstein’s, who spoke on the condition of anonymity to discuss his private medical history, took to Instagram to warn others of his experience and describe painful complications from a first procedure that led to two more unanticipated surgeries. The patient said he was not given adequate information about the risks or sufficient aftercare guidance before he agreed to the surgery.
Goldstein says that he was not aware of these Instagram posts but acknowledged that complications are a part of his work. “Anal surgery is painful,” he says, adding that he couldn’t speak to whether his patients properly follow post-surgical protocols. “There’s risks and there’s complications and there’s percentages that are non-healing. Unfortunately, it’s part of being in medicine.”
Banks, the yoga instructor, says Goldstein “truly did give me a piece of my life back that was missing for 10 years.” Still, he thinks he could have received better preparation and aftercare from Goldstein, and he’s troubled that he had difficulty finding a second opinion from a doctor who has as much experience with gay patients.
“This person has cornered a market, and that — historically, in any industry — can be to that person’s detriment if there’s no diversity of practice,” Banks says.
Goldstein is clearly meeting a community need. But when you’re basically the loudest voice in an underpopulated space, it’s hard to separate medical fact from medical opinion.
And Goldstein’s a complex guy. He frames his work as altruistic, but lives an ostentatious lifestyle, even by the standards of a New York doctor. He doesn’t think people should douche before anal sex, but his company sells douching products. His medical mission is to eliminate shame, yet he can’t shake some of his own.
“I wish I could lose my own inhibitions,” Goldstein says. “I have a lot of body dysmorphia.”
Do these contradictions make him a canny businessman? A good doctor? Both?
The answer is in his workload (and maybe in the size of those parties in Westchester). At 12:30 p.m. on that summer day, I watched Goldstein mark off the final name on “The Supposi-Story.” He had operated on eight patients. On busy days, Goldstein can operate on as many as 15.
“Everyone always asks: ‘You’ve seen so much a–. Are you still into it?’ I’m still into a–,” Goldstein says. “Especially ones that are beautiful. I usually see ones that are not, and the whole point is to make it beautiful.”
correction
An earlier version of this article incorrectly described Evan Goldstein as having an early goal of becoming a cardiologist. He had wanted to become a cardiothoracic surgeon. The article has been corrected.
