Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: YR has received a speaking honorarium from Besins Health Care and travel funding from Coloplast Netherlands to give a lecture during a symposium sponsored by Coloplast. These lectures are not related to the content of this editorial. He was president of the European Society for Sexual Medicine (ESSM), a non-profit scientific organisation, during 2018-19. The BMJ policy on financial interests is here: https://www.bmj.com/sites/default/files/attachments/resources/2016/03/16-current-bmj-education-coi-form.pdf.