Exactly. It's easy for cishets like me to assume our experiences are universal, because they're what we see reflected back at us most of the time in books, TV shows, ads, movies, etc. That's not always the case. My middle-aged gay male friends seem to have a different relationship to sex: they talk about it more, and it seems to be a core part of their identity rather than just a fun activity on the side.

Of course, that's a very broad generalisation, and I'm looking in from the outside. But still, I recognise that sexual disfunction could strike more directly at their core sense of self, and if my guess is right, that would make it an even more traumatic experience.