Updated FAQ- Need Input

[kristoff]

The following is an updated draft of our FAQ. We are looking for input from the members, and especially new members.

Do the answers adequately answer the questions posed?

Are there questions that have not been asked that should be?

What else do you need to know?

Frequently Asked Questions (FAQ)

• What does castration mean?

Castration is the shutting down or surgical removal of the testicles so that they no longer produce either sperm or sex hormones (=androgens), the major one of which is testosterone. Removing a female's ovaries is sometimes also termed castration.

Castration can be achieved either physically or chemically. If the testicles are surgically removed, it is called an orchiectomy. It is also possible to castrate by crushing the testicles or by cutting off their blood supply. Chemical castration can be achieved with various drugs – oral medications, injections, or toxins injected directly into the testicles.

The most common reason for castration today is treatment for prostate cancer (which is testosterone dependant). About one-third of all men diagnosed with prostate cancer are castrated within six months of that diagnosis. It is estimated that with current rates of diagnosis and current treatment options, about 4% of all men will be castrated within their lifetimes because of prostate cancer. When used for prostate cancer therapy the euphemismS “Androgen Deprivation Therapy” or "Hormonal Therapy" are frequently used instead of “castration.”

There are many other, less frequent, reasons for castration, including gender dysphoria, body integrity identity disorder, orchialgia (severe testicle pain), accidents, various illnesses, and many other reasons. All of the various reasons are discussed here on the Eunuch Archive.

• What is a Eunuch?

A eunuch is anyone who was born male or assigned male sex at birth whose testicles have been removed or destroyed. Most of the eunuchs alive today have been chemically castrated and have non-functioning testicles, though there are many men who have had their testicles physically removed. This removal or destruction of the testicles is called “castration.”

Eunuchs are the oldest recognized gender outside the male/female binary. The earliest clear mention of eunuchs is to be found in cuneiform tablets from the Sumerian city of Lagash in the 21st century BCE. The sons of slave weaving women were systematically castrated and set to work hauling barges on the canals next to castrated donkeys. There have been millions of eunuchs perfoming a multitude of tasks in the four thousand years since then.

• What are some reasons to be castrated?

Please see revised version in Post #8 below.

• What are some reasons NOT to be castrated?

• Fantasy about castration / sado-masochistic fantasies

• Belief that one has “excessive” libido

• To satisfy someone else’s desires

• How will castration affect my fertility?

Please see revised version in Post #8 below.

• How will a penectomy affect my fertility?

Some men have their penis removed, whether through accident, illness, or intentional removal. This is called a “penectomy.” If the testicles are not removed or destroyed and remain fully functional, there is no change in fertility, however medical help may be required to extract sperm to fertilize a woman’s egg.

• How will castration change my personality?

Both testosterone and, to a much lesser extent, estrogen have an effect on personality. Sex hormones are present in the fetus and make some permanent contributions to personality even before birth. Castration will remove most production of testosterone (a bit is produced in the adrenal glands) and personality will change from that of an adult male with full testosterone. Addition of estrogen (as with Male-to-Female transition) will make slight further changes.

Those taking testosterone as full hormone replacement therapy will have no personality change.

On the commonly used Big Five Personality Inventory, males who have been castrated and use no testosterone (or very little testosterone) will generally demonstrate higher Agreeableness and Conscientiousness than males who have normal adult levels of testosterone. Their place on the Neuroticism scale will be the same as males and very different from the female level. There is a distinct eunuch personality structure, which was valued by empires across Eurasia for government bureaucrats and high-ranking military officers.

• How will castration affect my sex drive?

This is a situation that will vary with the individual and with any hormone replacement therapy that is used. The testicles produce more than just testosterone, so T replacement will usually, but not always, maintain the same sex drive as before castration. No testosterone usually, but not always, results in a significantly reduced libido.

Some eunuchs on full HRT report that their sex drive is greater than before castration. Some taking no testosterone report near or complete asexuality with no erections or nocturnal emissions and frequently a reduction in the size of the penis.

• What changes can I expect in my body after castration?

Eunuchs not using testosterone replacement may experience weight gain, including subcutaneous body fat. (This is a thin layer of fat that causes the skin to become softer and smoother.) You will need a lifetime diet and exercise program to avoid significant weight gain.

Loss or thinning of body hair below the neck, but male pattern baldness usually slows down or stops. Reduced body odor. The pitch of your voice will not change.

Loss of lean muscle mass (hence muscle weakness, increased fatigue, and loss of stamina). Your shoulders may become narrower, and you will likely lose muscle definition in your upper torso without a VIGOROUS exercise program.

Little to mild breast development (gynecomastia), and mild fat redistribution around the hips and thighs.

The penis may shrink from lack of erections.

• What are the major emotional and psychological concerns with castration?

DEPRESSION! This MUST be your #1 concern.

Post-surgical depression is very common as testosterone levels crash. Chronic depression IS a major concern, and MAY require professional therapy (including antidepressants) before, during, and after the surgery.

You need to consider the issue of depression BEFORE castration. If it is an issue beforehand, it may become a much larger one afterward. Some eunuchs may have to take various amounts of testosterone to alleviate depression and other problems.

Also, be aware of POSSIBLE moodiness and tearfulness. Do not be surprised if you start crying more frequently over what may seem to be trivial matters.

• What are the major physical concerns with castration?

Please see revised version in Post #8 below.

• What kind of long term medical care will I need?

After the surgery has healed there are no specific ongoing medical needs that need to be addressed unless taking HRT (hormone replacement therapy).

As noted elsewhere in the FAQ, however, special attention should be paid to the issue of osteoporosis on the physical side and depression on the mental side.

Most physicians have no experience in caring for the hypogonadal male. Consider finding a physician who has a thorough working knowledge on the problems and treatments of menopausal and post-menopausal women. While the biology of a eunuch and a post-menopausal woman are not identical, there is some significant overlap.

• More Information

There are some threads on the Eunuch Archive with more detailed information about the issues addressed in these Frequently Asked Questions. Below are links to some of them. Feel free to explore widely for more information and to ask any questions that you might have.

Castration Primer:

www.eunuch.org/forums/showthread.php?10 ... ion-Primer (http://www.eunuch.org/forums/showthread ... ion-Primer)

Consequences of Castration:

www.eunuch.org/forums/showthread.php?46 ... Castration (http://www.eunuch.org/forums/showthread ... Castration)

About Chemical Castration - Read This First:

www.eunuch.org/forums/showthread.php?16 ... This-First (http://www.eunuch.org/forums/showthread ... This-First)

ARE THERE ANY OTHER THREADS THAT SHOULD BE ADDED HERE?

[JesusA (imported)]

Should we add:

• What does BIID mean?

• What is Male-to-Eunuch?

Should those be part of the Frequently Asked Questions and/or should they be stickies at the top of their respective forums?

[pennyante (imported)]

Thank you for considering input from newer members.

In the section, "

How will castration affect my fertility?

", please consider a slight modification to this sentence: "With chemical castration, if done for only a short while, it is usually reversible". My suggestion would be to replace the word "usually" with the word "sometimes".

Also, there is another scenario that does occur but does not seem to be addressed anywhere on the board that I have found: That is the male who is becomes chemically castrated through "other chemical means", such as the side effect from high-dose chemotherapy administered to treat blood cancer diseases such as certain kinds of leukemia and lymphoma.

While these patients are sometimes/usually/always counseled to bank sperm in advance of the treatment regimen if they want to father children afterwards, it seems that the associated castrating side effects which closely resemble "intentional" chemical castration are never discussed or addressed prior to treatment, and it can be quite a shock to suddenly have no libido or erectile capacity and suddenly be slammed big-time by depression and general malaise after the chemotherapy. The castrating effects of certain high-dose chemotherapy drugs are well-documented in medical literature if one searches, but one would expect and hope that these effects would be addressed prior to treatment administration, too, just as the subject of fertility is addressed with the patient prior to chemotherapy treatment.

So, at a higher level, there ARE other types of cancer that can cause eunuchism besides testicular and/or prostate cancer.

Thanks again for inviting input, and thank you all, too, for the hard work that you do to keep this board running.

-PA

[Skudster (imported)]

Should we add:

• What does BIID mean?

• What is Male-to-Eunuch?

I believe both should be added to the FAQ area. Members would not have to search as hard for general information about the subjects there. After reading the FAQ area more detailed information can be gotten doing searches in the areas they are interested in. I believe I have Biid issues and would like to see postings about latest research in that area. Reading Kristoff's posting above I believe it is well written, easy to understand and to the point. Skudster

[unencumbered (imported)]

Well written and easy to read.

I would like to see something about the correlation between castration, which shrinks the size of the prostate gland, and significantly reducing the chance of getting prostate cancer. Four months post-castration, my urologist found mine to be "small" despite my using TRT, and having normal PSA score.

[gandalf (imported)]

I agree with Jesus. Those two should be added. the more things can be made clear to members/visitors will probably lessen the queries on those subjects.

[JesusA (imported)]

Here are first (and very ROUGH) drafts for the two new items mentioned above. I will also work on revisions suggested by Pennyante and Unencumbered and will post them here soon. More ideas from members, both old and new, would definitely be appreciated.

• What does BIID mean?

BIID is short for Body Integrity Identity Disorder, which is defined by psychiatrists as a feeling that some body part does not belong and that one would become "whole" were it to be removed. Neuroanatomists have termed a brain "miswiring" in the right parietal lobe as Xenomelia (which means "foreign limb"). It is a failure of the brain to properly map an existing body part such that it feels like a foreign object attached to the body. Most commonly affected are left leg and genitals. Unfortunately, most urologists and surgeons do not recognize it under either name although there is hope for change.

• What is Male-to-Eunuch?

The DSM-5 (the bible of psychiatry) defines Gender Dysphoria as "a strong desire to be rid of one's primary and/or secondary sex characteristics because of a marked incongruence with one's experienced/expressed gender." Most common, of course, is a desire to be the "opposite" gender – hence Male-to-Female or Female-to-Male. Many individuals, however, know themselves to be outside the rigid gender binary. For some who were assigned "male" sex at birth, their goal is to be "not male, but not female either." On the Eunuch Archive, we term that a Male-to-Eunuch Gender Dysphoria (MtE for short). Some may be termed "Genderqueer," "Gender Neutral," or some other such term and feel comfortable simply knowing who they really are. Others seek a surgical solution to escape masculinity.

[JesusA (imported)]

The three items below have been slightly rewritten as a result of suggestions from EA members. The changes are highlighted in BLUE type. All three are, of course, still open to further changes. Further suggestions for the FAQ will be gratefully accepted from all who are members here.

•

What are the major physical concerns with castration?

Osteoporosis should be your #2 concern (see the FAQ on the main psychological concerns for information about #1 - depression). The loss of testosterone has similar effects on the body as the loss of estrogen during menopause in women.

Any eunuch, especially without the use of HRT, should take at least 1,500 MG of calcium and 400 IU of Vitamin D daily. Shortly before or after castration, you should have a bone density scan, and after that a scan every two years. A proper diet and exercise program will help in the battle against osteoporosis.

There is also a known correlation between low testosterone and Type 2 Diabetes. It's unclear whether it's a direct causation or whether it's that low T leads to less energy, which leads to less exercise and to weight gain – both of which are known causes of Type 2 Diabetes. Everyone needs to exercise and watch their diet. Those with low T need to be especially vigilant.

Hot flushes and night sweats until your body fully adjusts. Very much a case-by-case happening, although reports are that it is fairly frequent with eunuchs not taking HRT. It is also very common to experience this when HRT is used. This condition is similar to women experiencing menopause. Some eunuchs take low levels of estrogen or testosterone to counteract this. Consult your physician.

•

How will castration affect my fe

rtility?

Castration, whether chemical or surgical, results i

n total sterility. With chemical castration, if done for only a short while, it is usually, though not always, reversible. With surgical castration, it is permanent and irreversible. This absolute and total sterility is the main reason why powerful men in antiquity chose eunuchs to guard their women.

If you have any inkling that you might possibly ever want to produce a biological child of your own, you need to bank sperm before undergoing either chemical or surgical castration.

High dose chemotherapy and radiation therapy as part of cancer treatment can also result in infertility, sometimes including effects comparable to castration.

• What are some reasons to be castrated?

• Medical necessity (prostate cancer, testicular cancer, testicular torsion, etc.)

• Accidents

• Gender dysphoria (both Male-to-Female and Male-to-Eunuch)

• Severe orchialgia (testicular pain) that had resisted other treatment

• Body Integrity Identity Disorder (still very controversial in the medical community)

• There is evidence that castration with no testosterone replacement therapy may reduce, though not eliminate, the risk of prostate cancer.

[unencumbered (imported)]

...

There is also a known correlation between low testosterone and Type 2 Diabetes. It's unclear whether it's a direct causation or whether it's that low T leads to less energy, which leads to less exercise and to weight gain – both of which are known causes of Type 2 Diabetes. Everyone needs to exercise and watch their diet. Those with low T need to be especially vigilant..

There is evidence that castration with no testosterone replacement therapy may reduce, though not eliminate, the risk of prostate cancer....

My GP recognized my possibly developing Type 2 diabetes but my blood test came back normal. I believe that as long as I continue to eat healthy and exercise to keep my optimal weight that I will not have this issue.

Castration causes the prostate to atrophy, which reduces

the chance of getting prostate cancer.

There is some correlation between when one was castrated and the likelihood of developing this disease, the younger the less likely. It has been shown in some studies that the prostate is very small six months post surgery. My GP told me that I now have a very small chance of getting this disease in spite of my use of testosterone. At four months post-surgery, my urologist said my prostate was "small" although I am using T.

I'd like to know what other castrated men experiences have been regarding their prostate.

[pennyante (imported)]

Jesus,

Nice upgrades! Thanks!