A large survey of Japanese men aged 50 and older, conducted in 2026, has quietly overturned one of medicine's oldest assumptions about male sexuality: that erection is what men value most. When asked which sexual function they would least want to lose in the face of prostate cancer treatment, nearly half chose arousal — the capacity to feel desire — over performance, fertility, or orgasm. The finding invites medicine to reconsider not just how it treats the aging male body, but how it understands what it means to remain sexually alive.