If the seat is higher than the handlebars my posture is going to put more pressure on my genitals and even with a cut-out style saddle I end up with a downward tilt of 3-4 degrees for maximum comfort. Part of the problem is less robust butt muscles and this was a problem when I first started doing 100 mile rides until they got in condition. If my seat is too far back by even a half an inch it also results in more of my weight on the front of the saddle.