Men’s sexuality is dependent on their inner life. It’s more than just a biological urge. Sex, gender, and identity are deeply interrelated for men. If a man has low self-esteem or feels depressed, anxious, insecure, ashamed, guilty, or alone, it has a direct effect on how he feels about himself sexually. If he feels dissed in his job, too small, too short, too fat, too poor, it can directly impact his ability to become aroused.