One time I was riding western and my horse tripped on a dirt clod and then bucked, and I landed RIGHT on the horn. It hurt soooo bad.
I can't imagine if I'd been a guy. Ha ha. I do personally know one guy who WAS seriously and permanently injured when he fell on the horn.
I started out riding western, and that's all I rode as a kid. I didn't get in an English saddle until I was 18. I could never go back. English saddles are sooo much more comfortable to me. I know western were supposedly made for long-distance riding, but I get hideously sore after hours in one. My knees complain, my butt complains. And I can't feel the horse!
I have three personal saddles; a general purpose English, a dressage saddle and an endurance saddle. The dressage saddle is the most comfortable, it's like riding on a couch. Heh. The endurance saddle is also quite comfortable, and way better for hours in the saddle than a western, if you ask me. XD
I mostly teach dressage. I only have a couple students who ride western. My kids usually ask to ride in a western saddle once, which I of course oblige... and then never want to do it again. Heh.