Castrating Boys And Adolescents

[Blaise (imported)]

I remember that day! What a shock it was. The law probably has to have a boundary, but who really knows what the proper limits are?

[A-1 (imported)]

I've always wondered about this whole maturity thing. Maturity is pretty subjective, I think. There are quite a few choices people of all ages make that a lot of people feel would suggest immaturity, but there are others who see no problems with these choices. So how do we determine what makes a person deserve to be considered mature?

I am not so sure we can judge maturity based on a few actions here and there. Everyone makes stupid choices every once in a while. It doesn't matter how old or mature you are.

Rather, I feel in order to truly judge a person's level of maturity, you need to look at their overall character.

I will agree with you that many young people are immature. I come across college age students daily who are painfully immature, and this immaturity is probably a large part of why I have never associated much with people my own age.

What I cannot agree with is this belief most people have that age automaically equals maturity. I have known many adults in my lifetime who I would consider quite immature, and I have known many children who I felt were more mature than most adults. While age typically equals more life experience, even life experience does not equal maturity. One has to learn from that life experience and grow as a person because of it.

Speaking of me, I haven't hit that magical developmental milestone of age 25 yet, so I am not yet mature. Exactly on my 25th birthday, my brain will finish maturing, and on that day I can instantly expect a rush of maturity to hit me. I am looking forward to it.

Yeah, and when you are 35 you will be brain-dead enough to run for U.S. President.

Seriously, 'minors' who seem mature are called 'precouscious'. Such a term is not from peer experience, but from associating with adults who demand maturity.

There IS NO clear-cut answer.

[YankeeClipper (imported)]

During this discussion, several good points have come up.

1) "What if the BtE leater decides he wants a family?" Simple: ADOPT Please! As I have on at least 2 occasions, there are plenty of children looking for a good home. Adoption can, in some ways, be a mixed blessing; you're never sure about the child's background, but work with a good psychologist therapist, or psychiatrist can help with any issues that might arise before you proceed.

2.) Why does it seem that most of the discussion about having a family implies that having testes limits a eunuch from marrying or adopting. I'm unaware of any such laws, and the same for single parent adoptions.

3.) Why does it seem that most of the discussion about having a family implies that everyone wants to start his family with infants.

4.) Long-term studies of adults who lack testes during his teenge years: Research on boys (physically) with Kleinfelter's Syndrome have exactly the characteristics expected in any adult that hasn't or never would go through puberty. In Kleinfelter's, though, it is caused by a

lack of increase in testosterone from the pituitary gland that

cause the testes to start maturing and with it the start of puberty. A course of HRT triggers the testes which then continue producing testosterone as in any other male. What are the results of those that never choose HRT, but instead, choose to remain immature phisically? There is a perfect group to study.

Again, ironically, for those that do not choose to go from BtM, not by their own choice,but, by some other cause, by nature or traumatic injury, prior to the onset of puberty, are allowed, by law, to remain as they are, until they can make an informed decision. What typically happens is that the doctor will wait for the boy to choose HRT. Parent are often told to leave the boy alone, particularly when the cost of on-going HRT treatments becomes into the discussion. Let him choose, typically that occurs around age 15, when he sees other boys in the showers at school, developing. If he wants to be in athletic sports, he will gain an appreciation of what testosterone (HRT) can provide. In other cases, the "boys" adapts to his body as it, and leave "well-enough" alone.

Testicular cancer (occurring in the late teens and early 20's, well after puberty) survivors, have little choice but to remain a eunuchs, with all of the side-effects of any other MtE, and often, because the concern of the redevelopment of the cancer, HRT is disallowed, so often, they remain MtE by absolute physical necessity.

5.) Identifying BtE boys: MtE, BtG, GtB, MtF, and FtM all feel that body is "wrong". They feel very uncomfortable in the body that are "stuck in. In the case of BtG and GtB, it when expected behavior does match the everyday actions and interactions that cause adults (usually the parents) to seek out professional assistance. The type of "assistance too depends on the type of training, background and "whims" of the professional chosen. In the case od MtF and FtM, they are often required to under counseling, for as much as 2 years, before the operations begin. For MtE, it the difficulty in finding a doctor that will perform the required operation. At least now, BtG and GtB is finally being recognized in parts of the medical community.

However, for BtE's, there is no level of discomfort. He is absolutely happy just as he is. He is VERY uncomfortable with the profound chagnges that he sees occurring in older boys that are transitioning into teenage and adult males. He wants no part of it, for various reasons already discussed here. The problem starts for BtE when, and if, he says: Mom and Dad, I happy I'm being a boy and stay just want to as I am!" Nearly as bad a reaction to a gay person "coming out of the closet." Well, off to therapist, certainly in the former case, less so the latter, we go.

6.) How do we determine which boys"need" to transition into a pre-pubertal eunuch? During the annual physical, there has to be a consultative review with each of the young patients starting at age 10 and then annually (or semi-annually), until T2 occurs (I think T2 is still young enough to avoid the MtE issues, the development of testes and penis are still quite modest,though I could be mistaken), to determine what the boy thinks of of his on-coming entry into manhood. How many would say "Are you nuts?" Very few would say anything else. Those that don't want is coming, they need very careful therapy.

And by this, I don't mean the coercive therapy that is too often the goal: to convince the boy the he is "wrong-headed" about becoming a man. The therapist became man, shouldn't this boy want the same thing? This is where training and education of mental-health professionals is critical. Determining which boys are passing through a phase (thought of akin to a passing of gay boys who are expected to become straight men) or that they are extremely committed to remaining a boy (possibly to point of self-harm) is crucial.

7.) Long-term use of blockers: Using actual case of boys that are potential BtG or BtE that choose to resume puberty as they are is a good place to start. This will help to understand what the exposure to blockers over the course of several years. The same for cancer survivors that stop Androcur after remission of cancer. Do the testes resume functioning again? Or do they wither as those of steroid users? do the testes of BtG testes wither while on blockers? With a slow growth in BtG's coming, we will be able to answer the long-term effects of blockers.

For all of those of us that would like to have been BtE, I wish there had been some rational and reasonable outlet for expressing this desire BEFORE puberty.

It really does come down to the boy convincing those around him that he serious about being BtE. That really is my view of BtE, just simply remaining in the body of the boy that he knows and loves, not body of a man that represents everything hes does not want. It's not like being a man is some foreign concept. In my case, the were many reasons, not least of which was father, that I wanted to remain just the boy I was.

IF HE SAYS IT, HE MEANS IT! Good lord, why and how else would he work up the courage to "come of the closet" about such a thing? So many of here wish we could have done so in a save way. I wanted to, but I knew that even the hint of such a thought would have had me brought to a counselor the following day. And, not to discover the true cause and reasoning, but, rather that was extremely mistaken in thinking that. This one of though worst times for adults to "know best" what is "best" for little Johnny. Really, little Johnny just wants to stay little Johnny. Just that simple, at least in his eyes.

I hope these comments answer at least some of your questions, and can provide further discussion points.

YC

[YankeeClipper (imported)]

Well, I can't speak for anyone else, only for myself, but by the time I was 12 I knew for certain I didn't want to grow up sexually. I didn't want a deep voice, or hair on my body, or or a large penis. And I knew enough at that point that I knew having my testicles removed would take care of that for me, so I knew I didn't want them anymore.

You're absolutely right that no doctor would remove a boy's healthy testicles (hell, it's hard enough to find a doctor who will remove an adult's healthy testicles unless the adult is transitioning MtF), so this thread is all kind of academic. Having said that, I think it's good to discuss what might take place in an ideal world. And I think prescribing androgen blockers for boys who want to become eunuchs eventually, and not just for boys who know their destiny is to be girls, would be a good thing. As YC points out, without blockers, by the time a male can finally be castrated it's too late. The voice has deepened, the penis has enlarged, the hair has grown, and when you do have your testicles removed you have to go through testosterone withdrawal (hot flashes, etc.).

But that's a really good question.

"Having said that, I think it's good to discuss what might take place in an ideal world.

" No. 10 years ago, BtG and GtB was not even on the horizon; MtE was not common, and never discussed. Now all three have become visible. 20 years ago, MtF and FtM were barely tolerated, large invisible, and seldom discussed; now it is visible and most commonly accepted. I don't see it implausible that in 10 hence, we will see BtE as in the same category as BtG and GtB is now. Hopefully sooner.

Jesus and I have discussed ways to get the MtE and BtE into the next "Standards of Care." I hope the section on BtE will be the smallest (MtE the next smallest, due due "male menopause"), since they is no transition time, as wherein the SRS candidate must live as they desire to live, for up to 2 years, before any of the required operations are performed. The Only "Care" is to insure that the BtE "FULLY" understand ALL of the impact of staying a boy means. Jesus and I hope that all known Gender Disphora (there are 2 remaining conditions not discussed here, in part because this is primarily a men's forum, Gt-non-G and Ft-non-F, but they also need consideration, MtE and BtE are very simple procedures compared to any of the others), will become part of DSM-V.

When I have time (?) I will pull together similar threads to this one. Alternatively, I may ask others here to do so. The more people help in making this a comprehensive review, will we have any chance at all of getting any of this into the DSM-V and the associated "Standards of Care."

In the meantime, what is non-academic part that medical professionals make the "wrong" decision of what is "best" for the patient, based training, education, and similar (if any) experiences he's had. Only once the DSM-V and the "Standards" hhave been published will this finally begin to change.

-YC

[YankeeClipper (imported)]

I am torn because I think your all making a good point about people who know from an early age that they are gay or trans-gendered. But doing anything the causes sterility is an important point to consider. I think its very likely that attitudes about raising a family DO change unlike sexual or

ientation.

I can't say this often enough: Please, Please, Please ADOPT... Many testicular cancer survivors do as do gay and lesbian couple just that.

Lets say you have a young guy who decides he does not wish to be male. Be it M2F or Eunuch it doesn't matter. If he states that he doesn't want the trouble of raising kids and he knows he never does. Well their is the problem that people really DO change.

Please, why do most people seem to want to put up with the infancy stage? I considered adopting a boy (say 5 or 6) when I was around 35, but laws were what they were...

I don't know if its hormonal or if there is just a change in attitude as you get older but I know first hand I had it. At 19 I approached a clinic about being sterlized and they simply said "

Nope.. We don't do it for men your age."

His "Nope..." was a potentially deadly answer! Too many "Nope..."s result in "self-medication." In this case, it could have led to self-castration. His correct should have been: "I only perform that procedure after you have consulted with a professional..." You were LUCKY!

That hopefully will be addressed by the DSM-V, providing better guidance to mental-health professionals so they can determine your level of certainty. When I talk about suicide with my Psychiatrist, he reaches for the DSM-IV. With the DSM-V as a reference, if he comes to the conclusion that castration is a proper course of action for you he can refer you to a specialist that will follow his recommendations.

And yes, puberty is starting earlier, and attitudes do change, this is where the DSM-V will play a key role: changing the attitude about how to "work" with us, not to try to have us "fit the mold

."

*With my problems it was probably not needed but I did change and I know many others who have changed and have families.

Strictly from the Doctor

's viewpoint, if they provide a service to sterilize people,

where there is even a fair chance that they will regret it,

how can they do it?

As with any other patient: need/necessity. If you are a PCP, then you mostly do referral work to other doctors. Conversely, if you are a specialist, you get most of your patients through referrals.

I appreciate the parents who bring younger kids in who are TS and say we want to start this process early to get maximum effect and I'm not even sure thats wrong but I think its more complex then that. You have to consider the desire for bio kids at some point.

Same applies for a BtE as to BtG and GtB, delay the onset of puberty. and the BtE, it is just as important for him to consider in the same way, and with similar needs, and rights as the other two. This is where it it vital that the DSM-V be published with updated information in the realm. Using the DSM-IV as a reference, there is no consideration given to BtG and GtB, only that puberty must be endured in the wrong body.

Same for BtE, the difference is he knows all about being a boy, and probably what being a man is about. I'm not talking about going to college, or working after high school, we all talk about working as adults as boys. No one here was trying to avoid those. just the (primarily) physical effects brought on by puberty.

In case of serious and determined (not accidental) BtE's, consultation is needed BEFORE balls meet bricks. Then medical intervention becomes the necessity. For other boys, BtE by accident, consultation becomes a necessity after the accident to determine when to want to go from EtM, if ever. HRT cost has to be a serious consideration for them in the decision-making process, not left out.

I know what your implication is; but aren't all children biological? Even, IVF's are, and it's paid for out of my insurance payments, and now, since I live in MA, whether I want to or not, I absolutely must have. That was Mitt Romney's idea of providing inexpensive health for all. HA - Insurance rate have gone up - captive market... Why do you think Mitt ran for President? He got kicked out...

Maybe if the same situation was presented where the parents were fully on board the kid was at least close to the age of "reason" and they made some sort of attempt to bank sperm or eggs???

Impossible, it's a Catch-22: no puberty, no sperm or eggs to bank; if they produce sperm or eggs, they are no longer T1. Too late to prevent the changes that have already occurred.

I just think asking a 10 or 12 year old to make serious medical decisions is insane.

[\QUOTE]

Well, actually, a bit more involved that that. With counseling by mental-health professionals, a child can certainly have a better understanding of the ramifications involved (DSM-V needed here!). A common thread here, is at how young and certain we wanted to remain boys physically. At 6 we know we are gay, at 8 we know we don't puberty.

Proper ages? Blockers before puberty begins, at least that. for the procedure itself 12 is one realm, 15 is all together different. If he is still the only boy among the young men of his age and has not decided otherwise,

What we don't know is how many eunuchs are out there that don't receive the needed mental heath care to handle the results occurring after castation.

Some are here, they do talk about it. The most common of those are in their 20's and early 30's, survivors of cancer and vehicular accidents. For this group, too often the physical changes are addressed, but proper mental health care is not received.

Part of the reason I restarted this discussion was to have questions like yours brought forward and worked through.

-YC

[YankeeClipper (imported)]

I don't agree on a couple of points. For one maybe its just me but I didn't think I would ever want to be a parent but I grew up and what? Matured? Got more experience with the world had a different view?

Thats why I think its very twitchy to even think about allowing 10 and 12 year olds to make decision about the next 70+ years of their lives. What teenager or younger wants to be a mature adult and father kids? I guess few to none. Just as a lot of young men don't think they want to get married. Why do that when you can "screw around" with different women? Aging changes a lot of these attitudes and there is nothing you can do other then age to understand them *I think?

What teenager or younger wants to be a mature adult?

For many, they can't wait... It just seem to take way too long for them... for boys that want to drag out puberty, why not provide consultation, and if the evaluation shows that puberty should be delayed, work with him. Blockers do just, block (actually, simply delay) the onset of delay. Stop taking them, and puberty resume at the same rate it would have for that boy, just at a later date.

I admit I'm torn a bit because I have a lot of empathy for transexual people and yes, I understand that puberty makes changes that make transition more complicated / difficult to impossible. Still.....

Has anyone brought up the fact that even Chemical Castration has potential life time effects. Long term use will probably make that 10 year old sterile after a year or two. That seems like a pretty hard sell to any doctor prescribing it to me. How is he/she going to handle the law suits from the group that grow up and want a do over?

A bit of confusion here: Androcur (for males) and other blockers are not chemical castration medications. As always, the proper dosage is absolutely critical. Also progesterone, must be on-going for MtF, at least before castration, otherwise, the T level will slowly begin to rise. It is not a steroid, nor cause any of those issues associated with steroid usage. While blockers are being used, boys and girls must be carefully monitored for any contra-indication and discontinued immediately if needed.

See: http://www.netdoctor.co.uk/medicines/100000131.html

On the normal dosage, it bring down T levels down, most commonly in prostate cancer survivors. From that group, it has been shown T levels rise back to typical levels with the discontinued use of it. For the them, it is Androcur or castration, not a choice of Androcur instead of physical castration.

Andocur, at a proper dosage, does not cause the testes to wither and die. This not unimportant; I have chatted with one teen with HIV in the UK. He was reading off the drugs and dosages, 5 were for the HIV, the other was Androcur. He weighed 100 pounds, but the PHS had him at a dosage for a 300 pound man (the highest single pill dosage currently). His testes became small pebbles. The goal was to do what it did (destroy his testes and with it, his sexual drive), the goal was to get him off the street, no more tricking, which it pretty much did.

I like your questions. Good for additional thoughts and answers. What I want here is this type of discussion that has been occurring here, not simply naysayers or simply agreeing with my view. My view does not belong in the DSM-V. Our views needs to be adequately addressed as part of the development of the DSM-V.

-YC

[DonK1954 (imported)]

I also don't believe there are millions of boys who would want to remain pre-sexual -- it's a rather specialized desire, in my opinion. And even among those who would, not all would express this desire to their parents or doctors. So right away I think a boy who would tell his parents or doctors that he wants his testicles removed has a high probability of being motivated to actually go through with it.

So I think it's entirely reasonable to administer anti-androgens or GnRH agonists at Tanner 1 or 2 to let these boys grow without developing until they reach an age when their testicles can be removed. I suspect a few boys might be weeded out when they realize they don't like being different from their friends, but the vast majority will be confirmed in the feeling that they want to stay boys, so they can become eunuchs probably around ages 15 or 16.

[YankeeClipper (imported)]

I've across a medical condition that does not fit completely within this topic:

Case: A 14 year-old youth, that was probably in T 2, with a failure of the development of th distal (external) portion of the penis. The glans is present and appears to be of normal size, partially remaining within the location of the point at which the base of the distal penis normally starts. About 1/2 of the glans is visible through the opening that is present in groin wall. His testes are of normal size. It is a documented condition: peno-scrotal hypospadias, see:

http://www.meddean.luc.edu/lumen/MedEd/ ... npendv.htm

(valid link/site - P.)

In this case it appears the the urethra did form correctly within the penis proper, but no development of the distal penis shaft occurred. The scrotum and testes have developed normally. There is complete lack of development of the distal penis including any foreskin or mucous membrane.

For very obvious reasons...* That in itself, I find remarkable, though I find almost too many teenage boys are willing to talk about this.

I raise this because of the boy's apparent inability to perform in any sexual manner when other boys his age are typically masturbating (at least), and his testosterone levels and sexual drive is comparable to other boys his age. I believe he would probably have use a toilet instead of a urinal.

Would this aspect be bothersome or not? Since this defect occurred gestation, he never developed the ability to use a urinal, so I doubt it would be much of a bother to him.

I raise this, not because I would imply that castration be recommended because of this condition, but that the youth be referred by his MD to a mental health professional and he be given a thorough presentation and understanding of the effects of a lack of the distal penis would present as puberty progresses.

The counseling should prior to the start of puberty, probably no later than the end of T 1.

I'm not sure where else to raise this issue, it may already be covered in DSM-IV.

Though this has yet not been directly addressed in this forum, I am introducing it here because there may be reason that castration of the boy might be proposed by a mental health professional, or possibly at least propose the use of blockers until he can make a determination to live as he is, within the limitations that are present; seek plastic surgery; or physical castration. Plastic surgery is only an option in the later teen years. This condition must at least some impact on a developing boy or teenager.

One question - is there anyone here that has this condition; and if so what course action did you take, if any?

Given the sex drive of a typical teenage boy, I can see where this could be very difficult/frustrating for him to "endure." First thought that comes to my mind is the usual need to seek sexual relief upon waking in the morning something not possible for him.

Though this thread is called "

Castrating Boys And Adolescents,

" this condition does have serious implications for maturating boys and adolescents.

From my brief readings from the medical arena, this is viewed only as a physical condition, not one that could require support from mental health professional. I disagree with that assessment.

Comments, please...

-YC

* - YC and all - I edited this post because of the wording. PLEASE do not word any more posts like this, divulging the information that you did. If you stop and think, I believe you will see the reason why I edited this. We don't need that kind of liability here, and I hope the intent of the post is still intact. No pun intended! - P.

[Paolo]

Perhaps Jesus can chime in on this one.

Usually, the case for genital alteration to assign gender of male or female is based upon what is present at birth, and is done very early. This usually happens with intersexed children, although it seems that in some areas, at least, this mindset is beginning to change. Age 14 sounds a bit old, to me, for anything not to have been done. Of course, they could have been waiting to see if puberty would trigger growth of the penis, I can't say. I'm no expert on this!

I personally don't think the idea of castration to avoid puberty, if he isn't there already (likely he is, at some stage nowadays), would sit too well with a 14 year old boy. I know it scares the pants off of most of the boys (younger than that) that I know when the topic of genital injury comes up! Again, no pun intended.

[JesusA (imported)]

This is a fascinating thread with (mostly) rational and informed comments on a potentially hightly inflammatory topic. At this time, it’s difficult enough to get most people to recognize that there are children who are MtF or FtM, let alone any other variant. The issue of transition before adulthood is still being hotly argued in the medical community.

On a different thread on the Archive, Support Your NPR Station

(http://www.eunuch.org/vbulletin/showthread.php?t=

13275), I have posted transcripts of two outstanding NPR programs discussing transgender children and whether or not they should be allowed to have their puberty chemically delayed. I have argued with Ken Zucker about his firm stand that children should be required to go through puberty before transitioning, but he sticks by his position. He argues that of the many boys he has seen in his clinic, of those who believed themselves to be girls before they reached puberty, only 20% went on to transition after they went through full male puberty. This is quite different from the experience of Peggy Cohen-Kettenis in the Netherlands where, of about 100 transgender children who were put on hormone blockers to delay puberty and who were allowed to transition without ever going through the “wrong” puberty, not one has shown any regret for their transition.

Even with the far more common MtF and FtM transitions there is great debate in the medical community. I expect that it will be a decade or more before MtE can become a part of any rational decision-making process concerning children.

In the attempt to gather more data for the debate, however, I have posted a set of four questions about childhood on the thread seeking information toward a Male-to-Eunuch Standards of Care documents. The questions are in post #38 at MtE SOC

(http://www.eunuch.org/vbulletin/showthread.php?t=

12841&page=3).

Information from anyone willing to share his childhood experiences would be greatly appreciated, and certainly valuable for the writing of the document.