wpath updated ?

[hormonalEunuch (imported)]

I'm having a penectomy and perineal urethrostomy. My surgeon is calling it "genital reconstruction—male to nonbinary"— so I think there are a lot of ways to go with this sort of thing.

[Losethem (imported)]

The issue is that it has not been officially written up beyond the codes I mentioned, and the diagnoses which Jesus has mentioned. So you have all sorts of folks trying to put their own definition into the medical lexicon to make a name for themselves. The ONLY ones that will matter are those that make it into the actual standards of care at some point. At this point there is no classification, hence a person like us will get a diagnosis of 64.8 or 64.9 out of the DSM-V.

The therapist mentioned and the surgeon mentioned are simply finding something to call it to put in their notes/charting as they must put something.

In the USA therapists will be using the DSM-V definition, as it's the latest.

What I've heard it called in the past 20 years:

male-to-eunuch (MtE)

Nullo

Mascunull

Male-to-nonbinary

Eunuch

Neutois

Gender nullification

I'm guessing when the standards come out, the one that will stick will be MtE.

[keyman419 (imported)]

I went back to my letters and both the psychologist and psychiatrist who examined me used the term "genital nullification" but in all honesty that's usually the term I used in discussions after using the medical terms of radical penectomy with urethrostomy, and bilateral orchiectomy the first time. The psychiatrist mentioned a "marked incongruence between his expressed sexual identity (asexual) and his primary sexual characteristics" and diagnosed me with ICD-10 F64.1, Severe Male Hypoactive Sexual Desire Disorder. This diagnosis "justifies" the surgery requested. The psychologist who is a certified transgender and sexual health therapist asked me for clarification at our first meeting as to what a genital nullification actually meant. Once explained it was out of the way and we got down to the business of the needs for it.

I think it's still new enough that you will find various terms and definitions. Don't sweat the details, start with the medical terms and do get offended if someone wants to call it something slightly different.

[notsomanly (imported)]

While I recognize all of these reasons for castration, I feel like I'm none of the above and having trouble convincing the medical community that some men would be happier men without being so strongly controlled by testosterone. I've been taking estradiol and progesterone not because I'm transgender, but I just feel so much better. My wife appreciates that I'm becoming a better life partner and I feel like an upgraded male v2.0 who is free of the harmful side effects of testosterone. There are a few practitioners who seem aware of the meditation-like benefits of hormone adjustments and that's who I'm trying to find.

[GordonGG (imported)]

Exactly my reasons as well. I was lucky to find two practitioners that went along with it. A doctor for the meds, and a urologist to do the orchi.

While I recognize all of these reasons for castration, I feel like I'm none of the above and having trouble convincing the medical community that some men would be happier men without being so strongly controlled by testosterone. I've been taking estradiol and progesterone not because I'm transgender, but I just feel so much better. My wife appreciates that I'm becoming a better life partner and I feel like an upgraded male v2.0 who is free of the harmful side effects of testosterone. There are a few practitioners who seem aware of the meditation-like benefits of hormone adjustments and that's who I'm trying to find.

[notsomanly (imported)]

Exactly my reasons as well. I was lucky to find two practitioners that went along with it. A doctor for the meds, and a urologist to do the orchi.

I saw my internist today hoping to be referred to an endocrinologist, but she said that my situation is not part of standard medical care. I get it. She's a good doctor but has constraints. The best she could do is refer me to a psychiatrist, but what could he/she know about my situation that would give any insight into my current happy state? She understood my point of view and suggested that someone who councils people with sexual disorders might have encountered others who are happy with having low testosterone. I'd describe it as being free of the harmful side effects of T. I was completely up front about how I damaged my testicles and why I was now self-medicating on replacement with estradiol and progesterone. While she appreciated my honesty, there was nothing she could do.

So I'm now looking for a professional in the Chicago area who understands that not all men want to remain under the influence of T and that pharmacologic intervention is a better course for their lives than spending money on therapists. Any help finding such a provider in my area would be greatly appreciated.

[AnneK_TG (imported)]

So I'm now looking for a professional in the Chicago area who understands that not all men want to remain under the influence of T

Perhaps you can find someone who works with the transgender community. There should be something in the Chicago area. If nothing else, that would be a good place to start.

A search on "chicago transgender clinic" turns up some possibilities.

[Cseriess (imported)]

Perhaps Howard Brown clinics, lifeworks psychotherapy? I might start at HB.

[notsomanly (imported)]

I was thinking along the same lines. Thanks.

[notsomanly (imported)]

Perhaps Howard Brown clinics, lifeworks psychotherapy? I might start at HB.

I'll check them out. Thanks.