Original article Edit

Authors Edit

Richard J. Wassersug, Lesley F. Roberts, Michelle A. Brett, Thomas W. Johnson

Source Edit

The Journal of Sexual Medicine on Blackwell Synergy doi:10.1111/j.1743-6109.2007.00636.x

Abstract Edit

Introduction Edit

A number of men have extreme castration ideations. Many only fantasize about castration; others actualize their fantasies.

Aims Edit

We wish to identify factors that distinguish those who merely fantasize about being castrated from those who are at the greatest risk of genital mutilation.

Methods Edit

Seven hundred thirty-one individuals, who were not castrated, responded to a survey posted on We compared the responses of these "wannabes" to those of 92 men who were voluntarily castrated and responded to a companion survey.

Main Outcome Measures Edit

Respondents answered the questionnaire items relating to demographics, origin of interest in castration, and ambition toward eunuchdom.

Results Edit

Two categories of wannabes emerged. A large proportion (~40%) of wannabes' interest in castration was singularly of a fetishistic nature, and these men appeared to be at a relatively low risk of irreversible genital mutilation. Approximately 20% of the men, however, appeared to be at great risk of genital mutilation. They showed a greater desire to reduce libido, change their genital appearance, transition out of male, and prevent sexually offensive behavior. Nineteen percent of all wannabes have attempted self-castration, yet only 10% have sought medical assistance.

Conclusions Edit

We identify several motivating factors for extreme castration ideations and provide a classification for reasons why some males desire orchiectomies. Castration ideations fall under several categories of the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV), most notably a Gender Identity Disorder other than male-to-female (MtF) transsexual (i.e., male-to-eunuch) and a Body Identity Integrity Disorder. Physicians need to be aware of males who have strong desires for emasculation without a traditional MtF transsexual identity.

Analysis Edit

My first thought upon reading the title of the article was that castration probably has not much to do with Body Integrity Identity Disorder. It seems quite similar, a priori, to think "amputation of a limb = chopping one's dangly bits off", but then, the idea of castration implies so much more than just getting rid of a body part.

I read the article with interest, and it goes through explaining the methodology and the findings. The authors specified many reasons someone might want to castrate themselves, from two groups. From what I understand, one group mostly fantasized about it and would not go forward with it, the other group would. Some reasons cited were a desire to change sex(!) or to become gender neutral, and a desire for reduced libido. Only a short segment of the article discusses BIID.

It is an interesting article that made me reconsider my first thought. Yes, perhaps a desire for castration can be linked to BIID in some cases. But! I think it is important to realise that there are other, more prevalent, reasons for the need to castrate. I am worried. The public doesn't usualy worry about such subtleties, and may likely simply retain the idea that those who want castration do so because of BIID. Because chopping one's dick off carries many negative connotations, the impact of that thought on the public's perception of BIID may be quite bad. I'd venture to say that in the public's eye, it's even "worse" to want to cut off your penis than it is to want to cut off a leg! Let's face it, we already have quite an uphill battle to become accepted already.

But then, who am I to say that it is any less acceptable to need to have one's penis amputated than it is to need to be paralysed or have both legs chopped off? I was a victim of that very same prejudice I often accuse society of - negative bias, assuming it is not good to have a disability, or to be castrated. I now think that as long as the individual's need really stems from a self-image issue, and not something else entirely, then, why not include it in the BIID category? And more importantly, why stop the individual from acquiring their needed body image (as long as it *is* BIID and not some psychosis that dictates their "desire").

Here are some comments about what is included in the article.

Once again, this is a paper that focusses on an amputee-centric understanding of BIID. There are many needs "out there" caused by BIID, and amputation is just one of them... Paralysis, Deafness or Blindness are other needs often stated. Does the comparison between a desire for castration and other BIID related impairment stands as solidly when one considers these other impairments?

A correspondent also said that they thought those of us with a need for paralysis were really only wishing for a castration of sorts - considering that after paralysis the genitalia is unlikely to work or be felt as pre-injury, this is an easy assumption to make. We would need more investigating in order to be able to say more, but it is one of those statements that just "feel wrong".

Their self-image simply does not include part or all of their genitalia.

That statement is probably the one that made me reconsider my initial negative reaction at the idea of a link between desire for castration and BIID.

This desire may be indicative of a BIID, that is, apotemnophilia

Except that BIID is not a philia. Dr First, who coined the term Body Integrity Identity Disorder, did so specifically because of the lack of sexually driven need in the majority of people who have BIID. This then makes one wonder, is the desire for castration really BIID, or is it apotemnophilia? Subtle, but important difference. Or is it simply that some are resulting from BIID, others from apotemnophilia?

A BIID may also be seen in the desire to transition out of male, but not to become female, expressed by many of the wannabes.

This does not fit my understanding of BIID. BIID is about a need to acquire an impairment. While there may be body image issues when one wants to not be male, yet not be female either, this is far from being about impairment.

Whether an MtE [Male-to-Eunuch] transition can be classified as a BIID, or should be described as a new GID, will require further research.

Indeed, further research. A lack of data is making itself felt in most areas touching BIID. At the moment, I don't reject the idea that for some people, the need for castration may be derived from BIID. But I also think that the mere fact that GID-like terminology is used (MtE) points the finger away from BIID for most people.