The findings about possible sexual adverse effects of finasteride therapy as reported by Belknap and colleagues1 in this issue of JAMA Dermatology are best understood as 3 separate issues woven together: (1) What is the evidence that use of finasteride for androgenetic alopecia (AGA) impairs male sexual function, especially persistently? (2) How adequate were clinical trials for assessing these harms? (3) How well reported was this evidence in scientific journals, especially in meta-analyses?