I think you're correct with your assessment, here. There is a disconnect between what is said online and by doctors - some of that is absolutely born out of ignorance. Some of it is also "anecdotal" in the sense that specialists or derms might prescribe Fin to thousands of patients over the course of years and not hear about many adverse events. Though, that shouldn't be taken as an indication that they did or did not happen.

Here is an FDA summary of several Finasteride, Proscar, and Propecia clinical trial data.. Scroll down to page 9 or so when it starts getting into the adverse events.

Note: I'm not providing a summary here, but note that the data (out of thousands of users) for long-term use of Proscar and Propecia (dosage variance) shows 2-4% dropout rates for adverse sexual side effects. The dropout rates for placebo groups is similar, but usually lower. The summary points out that less than 1% of these events can be attributed to Fin/Proscar use.

That is still statistically significant and means that Finasteride does very likely cause these sides (I also didn't get into the non-sexual sides). But one should note the relative infrequency of these events as well. Less than 1% attributable to Fin certainly isn't something that you would conclude if you spent too much time online and reading anecdotes from strangers.

I'm sure some anti-Fin account will pick up on this and tell me that I'm full of shit and/or that this research is part of a big pharma conspiracy. For the record, I'm 100% sure Fin comes with risks (some potentially very bad ones), but it's good to read collective data like this that helps to quantify those risks.