Male to Eunuch Standards of Care

[BernadetteTS (imported)]

Instead of inducing cancer (a very bad idea) to get your balls removed, I've heard that extreme pain from a sports injury may get the desired result.

My apologies if my point was a little vague. The point stated more clearly would be that there is no disease where the treatment of choice is sex change. Eunuchs have an advantage over transsexuals if they are clever. There are medical conditions where the treatment is orchiectomy or penectomy. It is possible that some of the situations can be artificially induced resulting in the medical necessity for removal.

Create a file of cases that resulted in loss of testicles or penis. Create a database of medical conditions where the treatment is orchiectomy. Add the steps a person would take to cause that condition. This would be purely informational.

Wonder what YouTube would do if this phony TV show was posted?

(Show Promo voiceover guy) In this season of CrotchBusters we have expored over 80 cases of medically necessary orchiectomy. This concludes this week's episode of CrotchBusters on wives who did not know that they could injure their husbands permanently if they were playing and tried to see how many times they could make their husband's balls twist around inside his scrotum. No one should ever twist their testicles arond more than 2 times or they risk testicular tortion leading to orchiectomy. The chances of orchiectomy from testicular tortion is nearly 100% after 24 hours and 80% between 12 and 24 hours. (source Wikipedia; Testicular tortion) On next week's episode of CrotchBusters. We look at 3 cases of trauma that resulted in the loss of testicles. In our first segment, motorcycle jumper crushes his balls in a bad landing. In our second segment, a farmer loses his when a cow kicks him. In the third segment this factory worker is hit in the crotch by a stack of quarter sized metal slugs when he failed to operate his 800 ton punch press properly (this one happened two machines down from me in the factory where I used to work). Our CrotchBusters research staff will then calculate the the impact and demonstrate from what height a 10 pound bowling ball would have to be dropped to cause equivelent trauma. (End segment, go to commercial)

See how it works? You don't tell anyone to do it. You just explore how it has happened before and the conditions necessary. Include the disclaimer the Jack Ass show uses about not doing this at home. Motivation is never an issue. It is presented in the form of entertainment and information not medical advice.

BernadetteTS

[JoaoGenerico (imported)]

This is one of the most interesting threads I've read in the forum and I am sad I am not in position to contribute more.

I found the pragmatic take of Plix very interesting. I would say we could consider some (non-exclusive) fronts of attack:

1) To convince that in some cases, the desire of having the testicles removed is not pathological, so doctors can *go ahead* and do the procedure.

The definition of "pathological" is as much social, as a it is medical. How they decided homosexuality was not a pathology anymore? By vote! I think that a study on the motivations which lead the psychiatrists to remove homosexuality from the list of mental diseases could help to determine if (and in which cases) the same could be made for eunuchs.

2) To convince that in some cases, the desire of having the testicles removed is *indeed* pathological, but it is in the *best interest* of the patient to *go ahead* with the procedure, instead of trying to subject him to years of suffering and fruitless therapies.

3) Try to delimit what are the "classical" signs of danger, the circunstances where the doctor should to refuse to go ahead with the procedure. This doesn`t have to be strict --- to use a French expression, they should provide some garde-fous.

Just my twopence.

[JesusA (imported)]

Lets have a wide ranging discussion - perhaps we can evolve our own SOC.

It’s been nearly a month since the last post on this thread. There are still areas of it that need discussion, however.

If we are ever to convince the medical community to be of assistance to those who want voluntary castration, either for Male-to-Eunuch (MtE) or for Body Integrity Identity Disorder (BIID) reasons, there need to be guidelines established. This community needs to be actively involved in the writing of such guidelines.

This is, of course, a long-term project, not something that we can accomplish quickly. My goal would be to produce, with major input (and co-authorship) from the members here, a presentation for the 2009 biennial symposium of the World Professional Association for Transgender Health (WPATH) that will be held in Oslo, Norway. Input from the many members there would go toward a revision for possible publication in the International Journal of Transgenderism.

WPATH is the current iteration of the Harry Benjamin International Gender Dysphoria Association (HBIGDA) and is the major professional organization devoted to all aspects of gender dysphoria. While, I think, most would agree that the original “Harry Benjamin Standards” were far too rigid, their very rigidity was important for their acceptance. Practical application of the standards has led to a far greater acceptance of transgenderism in society. Medical personnel are far more ready to assist because there are accepted and approved standards.

Over time, the successful treatment of “plain vanilla” Male-to-Female and Female-to-Male through hormones and/or surgery has led to more relaxed and reasonable application of the gradually revised standards.

The eunuch community needs to begin the process toward wider acceptance through the development of a parallel set of criteria for the medical community to work from.

While I’m willing to do much of the legwork in pulling this together, the real input has to be from members of the this community. Please write up any thoughts you have for this thread. If you agree with something that’s already been written give it support here. If you disagree, say so and say why.

I will try to compile the ideas expressed here and then involve those who want to be a part of it in further discussion, both on and off the Archive. (I know that Kristoff will be an active part of the discussion and writing!)

[Beau Geste (imported)]

I realize that therapeutic orchiectomy is a tangential matter relative to this discussion, but, out of curiosity, is there a standard protocol for the care of those for whom orchiectomy is a treatment for prostate malignancy? In principle, removal of the testes should be no different than removal of any other endocrine glands, but it's clear that orchiectomy is quite a lot different than, for example, a goiter operation. Because of the slow development of prostate cancer, there has to be some leeway regarding recommendations for orchiectomy as a therapy measure. And, of course, because of the slow growth of prostate cancer, physicians sometimes recommend no surgery at all. If I recall correctly, one Archive member mentioned that he had had relatives who declined surgery and whose life spans were shortened as a result.

Standards of care for those who desire orchiectomy because of chronic orchialgia, might also be considered to be a separate issue, even though most doctors would consider surgery in cases such as those to be elective. Although, as I'm sure Flo and others could tell you, choosing surgery as a palliative for constant pain, is far from being a simple matter of whim.

For that matter, back in the days when mentally retarded (challenged in the present terminology) persons were evirated, were there standard protocols for deciding who was desexed and who wasn't? Clearly, not everyone who might have had the surgery, was actually operated on. Of course, the decision about orchiectomy was probably made in most cases in an ad hoc way, and the notion of carefully defined "standards of care" to be used in making the decision, would probably have been laughed at by many of those who managed the homes for mentally retarded folk.

I think the comments Plix made, which, if I read them correctly, can be interpreted, in part, as the idea that someone who has an orchiectomy, is only M2E if he wants to be; are a sensible take on the orchiectomy issue. Maybe you could call it M2E+M. I think Krister and Plix have both, at times, pointed out that they can identify either as eunuchs or as men, and I wouldn't disagree with that. There doesn't have to be a gender change after orchiectomy, and I would guess that the vast majority of men who have orchiectomies as therapy for prostate cancer, don't actually see themselves as having changed from one gender to another.

[mrt (imported)]

i know it sounds single minded when I bring up Orchialgia but in this case I think it has revelance to this question. Orchiectomy for prostate cancer is an "automatic." (Or was and is still a valid option) The surgeons don't question its need. Ditto for Testicular cancer. They don't even have to know for sure. A suspect testicle comes out because digging around in one that is "iffy" can spread the cancer.

Now go to Orchialgia. Chronic pain from the testicles / cords. Getting from start to finish (Assuming you opt for Orchiectomy) can take a long long time to forever. I think I understand the "first do no harm" and how some doctors will equate Orchiectomy with steralization and need for a lifetime of HRT but in my case I WAS sterile and on a lifetime of HRT and it was STILL not even close to being an option until everything else under the sun was tried or at least discussed to death. And everyone had to sign off. Me, my GP, my Pain Doctor the Urologist and a Shrink.

I think we are looking at this the wrong way. The way the medical people look at this is partly their oath as doctors and partly one of legal attacks by patients.

Why involve a shrink before an orchiectomy is offered? Based on what my Shrink said "Its to insure there is no future law suit saying the patient was incapable of making this choice" Is it also a good idea to have the patient go over his reason to want this surgery? In the case of Transexuals who are changing their lives 180? YES! In my case was it a good idea? Yes, but not to the same extent I think. My life changed little to none.

For a M2E patient is the idea of living that life for some set time of value? If I follow the idea in how it works for Transexuals? Yes! A person who has lived as a "male" for 24 years and desires to be female should (I think) give it a try to make sure just in case. For a person who thinks being a Eunuch without any Hormones is a perfect world of Logic without any negatives I think its a damn good idea to live the life to be sure. And if it can be done in a way thats reversable? Yes. And again not only for the patient but the surgeon who can't reattach testicles / penis that have been pulled out and thrown in the medical waste.

I dunno... I don't know if my thoughts on this have as much value because I'm more of a m2M myself...

My 2 cents - MrT

I realize that therapeutic orchiectomy is a tangential matter relative to this discussion, but, out of curiosity, is there a standard protocol for the care of those for whom orchiectomy is a treatment for prostate malignancy? In principle, removal of the testes should be no different than removal of any other endocrine glands, but it's clear that orchiectomy is quite a lot different than, for example, a goiter operation. Because of the slow development of prostate cancer, there has to be some leeway regarding recommendations for orchiectomy as a therapy measure. And, of course, because of the slow growth of prostate cancer, physicians sometimes recommend no surgery at all. If I recall correctly, one Archive member mentioned that he had had relatives who declined surgery and whose life spans were shortened as a result.

Standards of care for those who desire orchiectomy because of chronic orchilagia, might also be considered to be a separate issue, even though most doctors would consider surgery in cases such as those to be elective. Although, as I'm sure Flo and others could tell you, choosing surgery as a palliative for constant pain, is far from being a simple matter of whim.

For that matter, back in the days when mentally retarded (challenged in the present terminology) persons were evirated, were there standard protocols for deciding who was desexed and who wasn't? Clearly, not everyone who might have had the surgery, was actually operated on. Of course, the decision about orchiectomy was probably made in most cases in an ad hoc way, and the notion of carefully defined "standards of care" to be used in making the decision, would probably have been laughed at by many of those who managed the homes for mentally retarded folk.

I think the comments Plix made, which, if I read them correctly, can be interpreted, in part, as the idea that someone who has an orchiectomy, is only M2E if he wants to be; are a sensible take on the orchiectomy issue. Maybe you could call it M2E+M. I think Krister and Plix have both, at times, pointed out that they can identify either as eunuchs or as men, and I wouldn't disagree with that. There doesn't have to be a gender change after orchiectomy, and I would guess that the vast majority of men who have orchiectomies as therapy for prostate cancer, don't actually see themselves as having changed from one gender to another.

[jacquies (imported)]

I personally think that most of us are of sound mind for the simple fact that we know our bodies and our mind .How can they get into ours without the feelings that we feel.The mind is a powerful thing and only we ourselves can determine if it is right or wrong .I am sure that most of us have dwell on both issues for many many years to have come to this huge step in our own lives ,so I say give us the freedom to become who we should be

[kristoff]

I personally think that most of us are of sound mind for the simple fact that we know our bodies and our mind .How can they get into ours without the feelings that we feel.The mind is a powerful thing and only we ourselves can determine if it is right or wrong .I am sure that most of us have dwell on both issues for many many years to have come to this huge step in our own lives ,so I say give us the freedom to become who we should be

Freedom to be who you wish is not the crux of the issue. The crux is getting others to assist you in that endeavor (i.e., doctors). One has to work with that system in order to get them to work with you. Like it or not! It is called reality. As such, one needs to provide for an avenue within which to operate in order to be effective. Better one that is self-determined within the system than one that is imposed, no?

So what should the standards be so that doctors will help and are protected from repercussion and recrimination (read lawsuits)? That is what we are looking for here.

[kennath7 (imported)]

I think the best way would to build it one step at a time from many different prospectives

Step 1 would be interview the person (s) weed out fantasy’s from those who are serious

Step 2 may be assigning a counselor to assist the indivgual in research so that there is a real person to talk to an to kind of see that the research gets done

Step 3 may be teaching the person how they will have to take care of them selves after and problems to watch out for that they need to get professional help for and may be a list of phone no’s of dr. to contact

I am sure there is a way to get dr’s to fill these spots individually or collective but where I do not know I do know the moor you get involved the moor it will cost right now it cost the price of inter net travel expense and dr kimmel

Just some ideas

[jacquies (imported)]

I realize what you are saying but if we who wants to partake in this huge step should not be able to come back with (law-suit) towards the medical field .So I believe that we are the ones responsible in PART that helped to apply these restrictions upon ourselves .So now we have to choose other means of fulfilling our need exp other countries or underground.

[ramses (imported)]

Lawsuits are the basis of the whole problem and doctors have to be protected. All the plaintiffs lawyer has to ask MOST jurys is "If he was sane, would he have ask you to cut his balls off?" Most people see the desire for castration as defacto evidence of a mental problem. We here are more enlightened to the issue (or all insane...) and see things different than about 99.5% of the general public. Therefore, the need for a legal/medical SOC.