Older Scientific Journal Articles

[Milkman (imported)]

In reviewing the literature on castration in the peer reviewed psychiatric journals I found this article. Maybe others would like to post older journal articles in this thread. I wonder what happened to the eunuch who would now be in his 60's:

Am J Psychiatry 137:5, May 1980

A Case Study of Autocastration.

BY ROMAN PAB1S, PH.D., MASOOD A. MIRZA, M.D., AND SEYMOUR TOZMAN, M.D.

Although transsexual surgery has received considerable attention, autocastration remains a rarity (1, 2). Self-castration is usually performed in a state of psychotic confusion, except for those few men throughout history who castrated themselves for religious reasons (2, 3). Our case report describes a man with minimal psychotic confusion, although elements of psychotic

depression were evident, who committed autocastration in a premeditated and carefully thought out manner, possibly as a substitute for suicide.

Case Report

Mr. A, a 29-year-old man, was admitted to our hospital emergency room after excising his scrotum and testes with a

kitchen knife. He committed autocastration while immersed in the ocean because, he alleged, the ocean ‘ ‘was cool and

would act as an anesthetic. ‘ ‘ He then returned home and handed his testicles to his mother. Apparently, he felt that at

his birth ‘ ‘ she had halfdied,” and he intended to give back to her the life she had given him at birth. His mother flushed the

testicles down the toilet and promptly called an ambulance. Mr. A’s act was not impulsive; he had previously consulted a

surgeon about an orchidectomy, but the surgeon refused to perform the operation. While in the hospital and receiving psychiatric treatment,

Mr. A’s anxiety and depression diminished and many of his delusions vanished. He exhibited no regrets about his drastic

act and seemed, in fact, relieved. He was particularly happy about losing some of his facial hair because the hairs “multiply

and germinate and are dirty.’ ‘ In the following months his facial hair grew back (with compensating adrenal testosterone

production), and he again exhibited accelerating agitation, although he responded well to psychiatric support.

Mr. A is now considering a testicular prosthesis but has no interest in a transsexual procedure.

During his childhood Mr. A exhibited behavioral problems severe enough for him to spend 10 years in a class for emotionally

disturbed children. Despite emotional difficulties he finished high school satisfactorily. At age 17 he withdrew

from social activities and at his parents’ prodding, he consulted a psychiatrist who felt that Mr. A was suffering from

psychotic depression. At this time Mr. A also reported a frequent visual percept that things were ‘ ‘getting smaller and

farther away” (micropsia and teleopia), and he had a longstanding delusion that masturbating was ‘ ‘draining my brain

of nuclear material. “ Masturbation aggravated his guilt and shame and, consequently, his anxiety. During this time he

sought prostitutes and demanded humiliating, sado-masochistic acts. He also engaged in homosexual prostitution, assuming

a passive, masochistic role. He always insisted,however, that he was heterosexual and that his homosexual

acts were committed only for money. His sexual activities compounded his feelings of guilt, anxiety, and depression until suicide seemed the only solution. He chose autocastration instead, an act which was less final than suicide but would destroy the object of his guilt his genitals, specifically his testicles, which represented his germinative capacity, his progeny, and his future self.

Discussion

We think Mr. A’s autocastration was either a substitute for suicide or a focal suicide as described by Menninger (4) rather than the result of transsexual sex misidentification or dissatisfaction with his masculinity. Mr. A was driven to commit his act while under a sustained and mounting sexual tension, which he could not understand. In fact, he developed an elaborate delusional system to explain his unusual state of tension. His apparent decrease in sexual drive and anxiety

after autocastration suggests the possibility that the male hormone testosterone might be related to development of such tension.

[Caith721 (imported)]

His apparent decrease in sexual drive and anxiety after autocastration suggests the possibility that the male hormone testosterone might be related to development of such tension.

Gee, ya think?!?

[Crownjewels (imported)]

He was particularly happy about losing some of his facial hair because the hairs “multiply

and germinate and are dirty." " In the following months his facial hair grew back (with compensating adrenal testosterone

production)

".

Interesting to note the report's claim that the adrenals were pushing out more testosterone to compensate. Is this a researched fact?

[Milkman (imported)]

Here is another older discussion of whether or not schziophrenia is always related to auto-castration:

The British Journal of Psychiatry 1987 150: 565-566

Autocastration in Ontario Federal Penitentiary Inmates

SIR:

With regard to the report by Waugh (Journal, November 1986, 149, 656—658),the summary asserts that autocastration usually occurs in men with chronic paranoid schizophrenia. The evidence for this is not clear in the text, and it seems to contradict our experience, with an admittedly selected population, at the Regional Treatment Centre (Ontario).

TheTreatment Centre provides in-patient psychiatric

care for the approximately 3000 federal penitentiary

inmates of the region. The following brief case

studies cover seven cases of attempted or successful

autocastration on record since 1980.

Case reports:

(1) A 23-year-old inmate was incarcerated for

life for the second degree murder of his mother, which

occurred during an argument about his transsexual behaviour.

In 1980 he inserted foreign bodies into his genitalia as

an attempt to force surgical castration. During reparative

surgery his physique caught the attention of the urologist,

and subsequent tests confirmed an XYY karyotype. In 1983

he lacerated his scrotum, intending castration, as part of

a suicide attempt in protest at prison authorities' refusal

to finance sex reassignment surgery. Final psychiatric

diagnoses were of transsexualism and schizoid personality

disorder.

(2) A 50-year-old Hungarian immigrant, also serving life

for murder, in l98@cut his scrotum, removed his testicles,

and flushed them down the toilet, then swallowed the razor

blade. He revealed that he did so to pre-empt a Mafia

inspired scheme for other inmates to crush his testicles in

punishment. Final diagnosis was of paranoid schizophrenia.

(3)A 38-year-old inmate,serving two years for theft,with

earlier convictions for prostitution, in 1984 lacerated his

scrotum, removed the right testicle, and by stuffing the

cavity with cigarette ends, forced a complete surgical orchi

dectomy. Diagnoses were of transsexualism and antisocial

personality disorder.

(4) A 41-year-old man lacerated his scrotum as part of a

suicide attempt after revocation of his parole. He had

served ten years of a composite 24 year sentence for a series

of rapes. While out on parole and because of impotence he

had refused continued provera treatment, which in turn

lead to the revocation. Diagnoses were of adjustment dis

order with depressive features, and antisocial personality

disorder.

(5) A 40-year-old transsexual,who had castrated himself

in 1979, slashed at his penis in 1980 and again in 1983 in

protest at being placed in a male,rather than female,institution after his conviction for a series of armed robberies.

Diagnoses were of gender dysphoria and personality

disorder, unspecified.

(6) A 34-year-old serving ten years for six counts of

robbery in 1984 almost completely severed his genitalia

and slashed his wrists, intending suicide. He did it, he

said, to punish himself. His sexual orientation was

normal; diagnoses were of substance abuse and borderline

personality disorder.

(7)A 27-year-old transsexual serving a l5-year composite

sentence for assault and attempted murder in 1983,under

the influence of illicit drugs, attempted

castration to force sex reassignment surgery. Diagnoses

were of transsexualism substance abuse,and personality

disorder, unspecified.

Of these seven patients, three of them successful,

only one was diagnosed as having a psychosis. The others all showed personality disorder of various kinds. Almost all had a previous history of self mutilation, slashing of the wrists, or previous suicide

attempts. The largest group, four patients, consisted

of long-standing transsexuals whose disturbed personalities had possibly suggested a poor prognosis

for sex reassignment surgery, and who consequently

had been refused such surgery by the various specialists they had encountered. Of interest in a generally

young population is the higher than average age of

the group. While the high proportion of personality

disorders may simply reflect the catchment population, which may also account in part for the low

number of psychotic patients, this report serves to

emphasize that such behavior is not necessarily, nor

particularly often, associated with paranoid schizophrenia. The most common associations seem to be a

disturbance of sexual identity, a previous history of

self-mutilation, and personality disorder.

G. NEILCONACHER

GEORGE H. WFSTW0OD

Regional Treatment Centre,

Kingston Penitentiary

Ontario, Canada