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. 2024 Jun 9;12(3):qfae038.
doi: 10.1093/sexmed/qfae038. eCollection 2024 Jun.

Variation in perceptions of genital ablation between aspiring eunuchs and individuals with paraphilic sexual fantasies

Jamie Agapoff  1 , Richard J Wassersug  2 , Thomas W Johnson  3 , Erik Wibowo  4
Affiliations

Variation in perceptions of genital ablation between aspiring eunuchs and individuals with paraphilic sexual fantasies

Jamie Agapoff et al. Sex Med. .

Abstract

Background: Although uncommon, some individuals assigned male at birth (AMAB) seek voluntary genital ablative procedures, and others fantasize about it.

Aim: To learn more about the views of genital ablation and injuries in those who aspire to be castrated as compared with those who only fantasize about it.

Methods: A survey was run on the Eunuch Archive internet community. Content analysis was conducted on the responses of 342 AMAB individuals with castration fantasy but no desire for actual surgery (fantasizers) vs 294 AMAB individuals who expressed a desire for genital ablation (aspiring).

Outcomes: Study outcomes were responses to open-ended questions about genital ablations and injury.

Results: Aspiring individuals were more likely to perceive a "physical appearance benefit" from orchiectomy, but fewer could recall how they first learned about the procedure. Some reasons that aspiring persons gave for desiring an orchiectomy included "achieving preferred self" and "health reasons." Fantasizers, in contrast, worried about the potential side effects of orchiectomy, and more believed there to be no benefit to it.

Clinical implications: Psychiatrists and other clinicians need to understand their patients' views on genital ablation to properly diagnose and provide the best personalized care.

Strengths and limitations: Strengths include a large sample of respondents. Limitations include the accuracy of the anonymous survey data.

Conclusions: This study demonstrates divergent interests on genital ablation among AMAB individuals who have not had an any genital ablation yet have intense interest in the topic.

Keywords: body integrity dysphoria; castration; eunuchs; gender dysphoria; gender incongruence; paraphilia.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Clinical and diagnostic considerations for aspiring eunuchs and fantasizers.
See this image and copyright information in PMC

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