What do psychiatrists say?

[kristoff]

I have seen a psychiatrist regularly for last five years, specifically because of my desire for castration. I first submitted myself for psychiatric evaluation after I was in the emergency room of a hospital after yet another attempt at self castration. The psychiatrist listened carefully, didn't seem shocked or anything, said that I was suffering from an obsession and that anti-depressant SSRIs had been helpful to people who act out compulsively against their better judgement. He prescribed Celexa and referred me to a psychiatrist for regular counseling.

I have to say that the Celexa worked almost immediately -- within a couple days I went from hurting myself every day (I'd crush my balls in a door every morning before my shower, etc.) to rarely even thinking about it.

My main psychiatrist treated me professionally as well. His personal view is that I have a paraphilia (which I don't quite agree with), but in any case he feels SSRI is reasonable treatment. He also asked me to bring in all my castration tools and drugs so we could destroy them together. Otherwise, he just listens and occasionally adjusts my dosage depending on how much self-control I'm exhibiting.

So for those non-transexuals seeking psychiatric treatment I would definitely recommend right away approaching it as a compulsive behavior and a paraphilia. Even if a psychiatrist is not familiar with treating paraphilia, there is a lot of literature to which they can refer and which will get you in the right direction. Once you are diagnosed with paraphilia you can even get hormone treatments prescribed (my psychiatrist is willing to do this).

As long as you fit into a classification that they can find literature on, psychiatrists will be comfortable treating almost anything.

On the other hand, some of us fit into categories called psychotic, schizophrenic, or bi-polar, or whatever label is convenient (I've been tagged with them all - big deal). Often the usual approaches don't fit or work. It requires a bit more effort and thought on both our part, and that of the attending physician/psychiatrist, and hopefully, thinking outside of "my box." All of these elements are worthy of consideration, but I suspect should never be considered as more than a jumping off point for any of us. I just prefer to suspend most limitations and requirements, consider my own perspective, and "bounce" it off several others who may or may not be sane (another bizarre and paradoxical word when one thinks about it.) Haste is truly our only enemy....

[Eunuchist (imported)]

But that is the main problem with psychiatry. Because, what does it really mean to be "successfully diagnosed and treated" in psychiatric terms? It simply means that they manage to get you under one of those fraudulent, way-too-broad DSM labels, convince you that you are mentally ill, and begin intoxicating your brain with dangerous chemicals (or worse, electroshock and in earlier times, psychosurgery), all under the disguise of "treatment". There is no objectivism, no cures in psychiatry; all they offer are the so-called palliative "treatment" by drugs, electroshock and a small amount of talk therapy in isolated cases.

So, what is the psychiatrist's answer tot he majority of the diagnoses found in DSM? Answer: SSRI's and yet more SSRI's + amphetamine-like stimulants and some more brain-disabling chemicals like lithium (yep, that's the same stuff you find in your batteries). Got depression? Try SSRI's. Got obsessive disorder? Try SSRI's. Anorectic? Try SSRI's. Got social phobia and anxiety? Try SSRI's. Premature ejaculation? Try SSRI's.. The list goes on. SSRI's doesn't work? Don't worry, we've got some more powerful toxins up our sleeve; if that doesn't work, a 500 Voltage blow to your diseased brain (I hope you are not getting into the delusion that nothing is wrong with your brain, because that's called "Noncompliance with treatment", and that's a real mental disease for sure, so don't you get any ideas) would surely do the trick. So, in a sense, what is psychiatry really about? Psychiatry is all about drugs and fraudulent diagnoses. Take the drugs out and there is virtually nothing left of it; the whole field of psychiatry would collapse entirely. Armed with drugs, anybody could easily became popular by offering "treatment", without DSM or even the most basic medical education, simply by prescribing meds to such compaints as "I am afraid to get out", "I have troubles sitting still in school", "I am constantly afraid of death", "Years have passed but I am still depressed over the death of my relative", etc.

Some of the oft-told arguments used against critics of psychiatry that I have encountered, are that their drugs have been helpful to a number of people, so psychiatry must be true. But so has been excorcism and prayer, fasting, meditation, yoga, narcotics, alcohol, smoking.. because a drug has worked as "expected" does not validate anything beyond a subjective experience of the "patient". For example, we do also know that "weed" is usually helpful against neurosis while a few glasses of cognac help boost self-confidence and raise mood, and so on.

There are, in reality, no such diseases as Schizophrenia (also known as "The Sacred Symbol of Psychiatry") and Bi-polar Disorder; instead, these labels represent a set of a number of picked symptoms that psychiatrists and society at large would consider "troublesome". Most of those diagnosed exhibit only a bunch of the defined symptoms and there have been many instances that one pyshciatrist diagnose "Schizophrenia" and the next "Bi-polar", and the third soemthing completely different (well, as long as you can get on the durgs, so..). The diagnostic criteria, even for these potentially serious "diseases", is so broad and inconclusive, that most of us could be diagnosed with enough effort on the side of the psychiatrist (as the Rosenhan experiment, among others, clearly establishes - the psychiatrists are simply unable to tell the difference between "sanity" and "insanity" except the most severe and self-evident episodes). The brain scans wich psychiatrists claim represent some sort of increased anomalies among so-called schizophrenics have been presented, although in each instance up to 40% of the schizophrenic's scans turned out to be within the normal range, and in most cases, their brains were already altered by psych meds (wich have a documented brain altering effect detected by the CT scans). The testing of the efficiency of anti-depressants, while constituting a significant bias because the side-effects of anti-depressants are easily noticeable by physicians, still shows only a small and at times less than effect vs. a placebo http://www.ablechild.org/newsarchive/dr ... -18-04.htm (wich is clearly not worth the side-effects). And we are not talking about the majority of the less serious "diseases", wich can and never will be identified by any independent tests.

Needless to say, psychiatrists have been searching for objective tests since 1892 and they keep on searching, some 36 years since the first CT scans were introduced.

[Eunuchist (imported)]

I definitely concur with Old Man River here...

On the other hand, I do think Gender Identity Disorder for some eunuchs and wannabes is very possibly a real issue, and not from the perspective of MtF. Why not MtE or Non-Male, Non-Female, A-gender transexual? Certainly makes for an interesting concept, particularly thinking of "genderless" eunuchs as transgender.... First heard an interesting dicussion of this concept from Uncle Flo. Perhaps he could enlighten us more?

But why neccessary disorder as opposed to alternative lifestyle? In such a case, we should define homosexuality as a "Sexual Identity Disorder", because of the priori assumption that heterosexuality and birth gender constitutes a standard/norm.

[kristoff]

But why neccessary disorder as opposed to alternative lifestyle? In such a case, we should define homosexuality as a "Sexual Identity Disorder", because of the a priori assumption that heterosexuality and birth gender constitutes a standard/norm.

You are getting my point....

[JeffEunuch (imported)]

I don't know whither this is going, but being gay is neither a disorder, nor an alternative lifestyle. Of course, it was regarded as a disorder not too many years ago, perhaps too many for Eunuchist's living memory (~30 y.o.?). Nor is it considered a lifestyle choice, although many gay people do choose to be sexual and to live in accordance with their sexual preference. The research I've seen says that anywhere from 4-10% of all men are gay, regardless of ethnicity, place of residence, etc. Of course, we do re-arrange ourselves geographically once we become adults.

A castration disire, the desire for total or partial emasculation, may be a psychiatric disorder. Going back several weeks to the origins of this thread, perhaps the issue should be how much of a disorder? How serious a disorder is it? The psychiatric community treats gender dysphoria as something that's minor enough that perhaps those with it should be treated by having their disorder satisfied. There's a procedure and protocol for transitioning to the other gender. A psychiatrist I once consulted identified genital dysphoria as a separate disorder that might well be treated by granting the desire for those with it. Some surgeons have worked with her and psychiatrists or counsellors thinking like her in undertaking fairly radical surgical castrations, often nullification, removal of the entirety of the genitalia, but more often partial emasculation, removal of the testicles only or partial penectomy (shortening of our members). Of course, for some the desire for body mods of any kind is an abnormality or a disorder. Whatever one's take on the subject, a castration disire and the desire for any body mods, especially modification of one's genitals, occur along a continuuum and are a disorder only to that extent.

Such disorders are often not a big deal, certainly not something that need be treated with pharmaceuticals. My own take is that pharmaceuticals should be reserved for personality disorders, that which they were designed to treat - bipolar, schizophrenia (sp?), etc. This doesn't mean that many individuals don't have both a personality disorder and a gender or genital dysphoria.

Sorry for the rant, guys, but I prefer that we treat the subject with the objectivity it deserves and not have the discussion deteriorate into a subjective discussion of psychiatry. And again, if a desire for castration is a disorder, there is the psychiatric point of view - not totally accepted by the entirety of the profession - that it can be worked with, that people's desire for transitioning to another gender, for asexuality or for removal of their genitals can be worked with such that the person's ability to live on in an altered state can be facilitated. And that's why there are surgeons that will work with psychiatrists. I've known several guys - and we all know of such - that are perfectly happy losing it all and being totally smooth in the crotch. And a few surgeons are confident enough or don't believe that such a desire is truly a 'disorder', certainly not of the personality or behavioural type, that they'll grant such desires without resort to counselling or psychiatrists. The latter usually help their clients determine if emasculation is their true desire. Most adult guys are capable of that decision.

[kristoff]

Although threads wander all over sometimes, your post is exactly where I have been going, perhaps provoking. Yes, I do have a less than stellar regard for many IN psychiatry, not the field itself, although it has much to be gained in knowledge and ability. My point above is the GID is truly not a disorder - except perhaps when one is distressed by it, and that one ought look at the concept of multiple genders and a need to accomodate / facilitate them. Would love to hear more from others, here or perhaps in another thread.

Interestingly enough, some of the rants above would be viewed by psychiatrists as being "paranoid." Opinions abound on all sides. I've always maintained that opinions are like assholes. Most everyone has one and half the time they are full of crap.

Oh well, gotta go pretend to work.

[Uncle Flo (imported)]

It seems as if the core to the problem of defining GID is that the definition of gender doesn't fit well into the reality of peoples experience. This would throw doubt onto the entire concept of gender as defined by psychiatric and sociological authorities. Does this mean that gender is purely a social construct? Probably not, but it does mean that the definition of gender is flawed and probably irrelevant to a broader discussion of human variety. There needs to be a broader understanding of human desires and behavior relative to the needs of the individual and the requirements of the society in which that individual lives. Yes, I am saying that the needs of a society are relative to the individuals in that society and not absolute in the sense of a proclamation from ones divine beliefs (although that is obviously part of the picture). Does this mean that psychiatry is a fraud? No, it means that it is struggling to reach greater relevancy and should be viewed in that light. As is the case in all endeavors there are practitioners that do not "reach for excelence", they should be viewed with disdain. --FLO--

[plix (imported)]

For me the problem is not psychiatrists, but the drugs behind them. I do think that psychotropic drugs, especially anti-depressants, are WAY overprescribed and people need to rely on treatments other than those pills for every little thing that goes wrong.

Like kristoff, I am psychotic, schizophrenic, bi-polar, as well as other labels like depressed, a few different types of anxious, and a personality disorder or two. According to psychiatry and other mental health fields, I am one screwed up individual.

Those labels aren't my issue as much as the fact that the first thing that comes of the psychiatrist's mouth, with no consideration of what may be causing the alleged disroder or what else might treat it, is to take an anti-depressant. Anti-depressants are the cure-all, know-all, end-all answer to anything that might be emotionally unstable about a person.

I've done Paxil, Prozac, Effexor, Wellbutrin, Celexa, and a few others. I continue to be diagnosed with the same disorders as before I touched any of them. They cause miserable side effects, especially before the castration. And my GPs are joining the anti-depressant fun as well. Any pain I have, any problem at all, is "probably anxiety - have an anti-depressant."

Anti-depressants do not cure all, do not know all, and do not end all, and that is all I have to say.

[SplitDik (imported)]

My point is that if you are looking to go to a psychiatrist to get support for your decision to be castrated, then you'll want to lead them toward a diagnosis for which chemical castration and surgical castration are accepted practice.

If you just want help, then you should let the psychiatrist do their own diagnosis, but the danger is that they will do something drastic and not in line with your expectations.

If you want to get a psychiatrist approval for castration, and you are a non-transgendered person, I suggest my approach.

Even with regular doctors, I think it is best to go in with some self-diagnosis -- otherwise you are at their whim. There is a lot of medical information out there and frankly much of what doctors "know" is what they read in their textbooks in school.

[Beau Geste (imported)]

Since the replies on this thread diverged somewhat into a discussion of the merits of psychiatry, rather than simply presenting what practitioners in that field had said, and someone reading through the three pages might have some difficulty gleaning out information on psychiatric commentary about desires for orchiectomy, I thought I might summarize the responses by members who related their experiences with professionals in the psychiatric field.

Tugon was counseled by a psychiatrist for post traumatic stress syndrome, some time after his orchiectomy. His response to tugon's decision to have orchiectomy due to gender dysphoria, was positive, and he thought the choice to have surgery was logical. The psychiatrist's judgement was that tugon was sane, and his action had effectively dealt with the dysphoria.

The Fraj was compelled to see a counsellor for self-harming when he was in his teens, some time before his orchiectomy. (It isn't stated whether he told the counsellor of his desire for castration.) The counsellor recommended behavioral therapy, and focused on the Fraj's urge to do things to himself. The counsellor did not explore the motives for the self-harming desires fully.

Hash went to two counsellors (not psychiatrists), who were little help. His own judgement is that he is sane, but testosterone could cause behavior that seemed insane.

JeffEunuch saw a psychiatrist who specialized in gender issues, and she was quite knowledgable about the distinction between gender dysphoria and genital dysphoria. Her attitude was that, while genital dysphoria is not normal, it was acceptable for older men to be castrated if she felt they would be satisfied if the genitals were excised, though the psychiatrist attempted to dissuade younger men. She also helped another patient to have a penectomy by sending a letter to his surgeon telling the surgeon that the patient understood the consequences of penectomy.

Eunuchist referred to studies on medline (I presume that is a website) in which

men with a castration desire were ref

erred to as "paranoid schizophrenics."

Kristoff reported that he had gotten help from at least one psychiatrist--I presume this was related to dysphoria--and had used medications which they prescribed. He feels that psychiatric treatment was beneficial to him.

Uncle Flo also reports that he was helped by a therapist, and by the medications which the psychiatrist prescribed. The reason for the psychiatric treatment was presumably linked to dysphoria.

Riverwind's psychiatrist has said he thinks Riverwind has a gender identity problem, which Riverwind finds to be humorous.

SplitDik has seen a psychiatrist regularly for five years because of his desire for castration. His first contact with a psychiatrist was as a result of a

n incident in which he went to an emergency roo

m after an attempt at self castration. The psychiatrist did not appear to be shocked, said that SplitDik had an obsession and prescribed Celexa. The Celexa eliminated the castration urges. SplitDik's regular psychiatrist says he has paraphilia, and feels SSRI is a reasonable treatment. He also had SplitDik bring in castration tools and drugs so that they could destroy the things.

Kristoff has been diagnosed as psychotic, schizophrenic, and bipolar, but considers the diagnoses questionable, and feels that standard psychiatric approaches often don't fit or work, and

physicians and psychiatrists should consider nonstandard therapies and explanations.

JeffEunuch commente

d that the psychiatric community treats gender dysphoria as being minor enough that perhaps those with it should have their desires satisfied--hence there is a protocol for transgendering. His judgement is that desire for surgery on the genitals is something which can be seen as something on a continuum, and are only a disorder under certain circumstances.

Plix has been diagnosed as psychotic, schizophrenic, bipolar, and depressed, and has been prescribed

anti-depressants. He feels that they had littl

e effect on any disorders he might have.

SplitDik comments that psychiatrists can be led to a diagnosis for which chemical and surgical castration are accepted practice.

Of course, this is a small sample of responses from practitioners in the field, and it can't be considered definitive. However, my general impression is that, if a psychiatrist has had experience with a number of people who have gender dysphoria or genital dysphoria (I'm not altogether sure what these terms mean, but apparently they are accepted among some or many psychiatrists) the practitioner generally views the matter as one in which the patient has a different way of thinking, rather than a mental illness. Maybe some effort should be made to identify psychiatrists who take this attitude, so that people with dysphoria can be referred to them.

If anyone feels I have misrepresented his response, you could contact one of the archive moderators and have them revise this post, or perhaps the moderator who reads it can simply make the revision.

As an observer, I'm still rather puzzled by the whole subject of the desire for emasculation, but reading posts on this archive has definitely been an educational experience, and one which has affected my attitudes toward those whose views of sex and gender differ from my own.