This topic is about a young man who is dealing with significant challenges related to intimacy and pelvic pain after having a permanent ileostomy. He is experiencing severe pain during intimate moments and is struggling to find medical answers and support. Additionally, he faces difficulties in his personal relationships due to misunderstandings about his condition. Here are some pieces of advice and insights that might help:

1. Seek a thorough medical evaluation.
- Keep searching for a urologist or pelvic-floor neurologist who is committed to finding the root cause of your pain. The right doctor will eventually help you.
- Specifically inquire about conditions like Peyronie’s disease and other disorders that might cause pain during erections.
- Consider reaching out to major teaching hospitals in New York, as many specialists there might offer charity care or sliding-scale fees.

2. Utilize support services within the healthcare system.
- Ask your current doctor for referrals.
- Contact hospital social work departments; they can help you find specialists who might treat you for free or offer low-cost payment plans.

3. Advocate for yourself.
- If referrals are slow, call specialty practices directly.
- Prepare questions and don’t hesitate to challenge any dismissive doctors. Gather information from men on ostomy forums to be well-informed.

4. Consider time and conservative management.
- Some have found that abstaining for a period allowed their pain to resolve naturally.
- Resting your body might give nerves and tissues the chance to heal.

5. Manage dating and disclosure.
- Understand that negative reactions often stem from ignorance, not a reflection of your value.
- Share details about your ostomy only with partners who have earned your trust.
- Remember that supportive and understanding partners are out there, so don’t let past experiences discourage you.

6. Seek peer support.
- Consider starting a “For Men Only” thread to connect with others facing similar issues.
- The community can offer valuable insights and support, even if they aren’t medical professionals.

7. Protect your emotional well-being.
- Ignore or block anyone who mocks your condition online. Their behavior reflects on them, not you. Retaliation is optional, but remember to prioritize your peace of mind.