As estate agent, James Newman goes about his business, confidently valuing exclusive houses in the wealthy London commuter belt where he works, no one would guess he suffers from a humiliating genital defect.
It is a problem that affects around 1 in 300 men, blighting their relationships and condemning them to life-long physical and psychological trauma.
James, 49, was born with a condition called hypospadias.
Here the urethra — through which urine is expelled — emerges somewhere on the shaft or even the base of the penis, instead of at the tip.
Sometimes the head of penis is tipped backwards, making it impossible to urinate standing.
The condition is also linked with undescended testes, so sometimes the man is infertile.
Boys affected by it always have smaller-than-average penises.
As well as ridicule and humiliation if classmates discover the abnormality in school changing rooms, they later risk physical and emotional trauma in sexual relationships.
It is not known what causes it, although sometimes it runs in families.
Many affected men never know they have a recognised condition and their parents never seek help, so doctors have been prevented from tracing inheritance patterns.
The numbers affected have more than doubled in a generation, making it as common as cleft palate and hare lip.
Some experts have attributed this to parents’ slowly becoming more willing to seek help, while others have linked it to ‘gender-bending’ female hormones in the water supply as a result of the widespread use of the Pill.