Older Scientific Journal Articles
Posted: Sat May 28, 2011 4:00 am
In reviewing the literature on castration in the peer reviewed psychiatric journals I found this article. Maybe others would like to post older journal articles in this thread. I wonder what happened to the eunuch who would now be in his 60's:
Am J Psychiatry 137:5, May 1980
A Case Study of Autocastration.
BY ROMAN PAB1S, PH.D., MASOOD A. MIRZA, M.D., AND SEYMOUR TOZMAN, M.D.
Although transsexual surgery has received considerable attention, autocastration remains a rarity (1, 2). Self-castration is usually performed in a state of psychotic confusion, except for those few men throughout history who castrated themselves for religious reasons (2, 3). Our case report describes a man with minimal psychotic confusion, although elements of psychotic
depression were evident, who committed autocastration in a premeditated and carefully thought out manner, possibly as a substitute for suicide.
Case Report
Mr. A, a 29-year-old man, was admitted to our hospital emergency room after excising his scrotum and testes with a
kitchen knife. He committed autocastration while immersed in the ocean because, he alleged, the ocean was cool and
would act as an anesthetic. He then returned home and handed his testicles to his mother. Apparently, he felt that at
his birth she had halfdied, and he intended to give back to her the life she had given him at birth. His mother flushed the
testicles down the toilet and promptly called an ambulance. Mr. As act was not impulsive; he had previously consulted a
surgeon about an orchidectomy, but the surgeon refused to perform the operation. While in the hospital and receiving psychiatric treatment,
Mr. As anxiety and depression diminished and many of his delusions vanished. He exhibited no regrets about his drastic
act and seemed, in fact, relieved. He was particularly happy about losing some of his facial hair because the hairs multiply
and germinate and are dirty. In the following months his facial hair grew back (with compensating adrenal testosterone
production), and he again exhibited accelerating agitation, although he responded well to psychiatric support.
Mr. A is now considering a testicular prosthesis but has no interest in a transsexual procedure.
During his childhood Mr. A exhibited behavioral problems severe enough for him to spend 10 years in a class for emotionally
disturbed children. Despite emotional difficulties he finished high school satisfactorily. At age 17 he withdrew
from social activities and at his parents prodding, he consulted a psychiatrist who felt that Mr. A was suffering from
psychotic depression. At this time Mr. A also reported a frequent visual percept that things were getting smaller and
farther away (micropsia and teleopia), and he had a longstanding delusion that masturbating was draining my brain
of nuclear material. Masturbation aggravated his guilt and shame and, consequently, his anxiety. During this time he
sought prostitutes and demanded humiliating, sado-masochistic acts. He also engaged in homosexual prostitution, assuming
a passive, masochistic role. He always insisted,however, that he was heterosexual and that his homosexual
acts were committed only for money. His sexual activities compounded his feelings of guilt, anxiety, and depression until suicide seemed the only solution. He chose autocastration instead, an act which was less final than suicide but would destroy the object of his guilt his genitals, specifically his testicles, which represented his germinative capacity, his progeny, and his future self.
Discussion
We think Mr. As autocastration was either a substitute for suicide or a focal suicide as described by Menninger (4) rather than the result of transsexual sex misidentification or dissatisfaction with his masculinity. Mr. A was driven to commit his act while under a sustained and mounting sexual tension, which he could not understand. In fact, he developed an elaborate delusional system to explain his unusual state of tension. His apparent decrease in sexual drive and anxiety
after autocastration suggests the possibility that the male hormone testosterone might be related to development of such tension.
Am J Psychiatry 137:5, May 1980
A Case Study of Autocastration.
BY ROMAN PAB1S, PH.D., MASOOD A. MIRZA, M.D., AND SEYMOUR TOZMAN, M.D.
Although transsexual surgery has received considerable attention, autocastration remains a rarity (1, 2). Self-castration is usually performed in a state of psychotic confusion, except for those few men throughout history who castrated themselves for religious reasons (2, 3). Our case report describes a man with minimal psychotic confusion, although elements of psychotic
depression were evident, who committed autocastration in a premeditated and carefully thought out manner, possibly as a substitute for suicide.
Case Report
Mr. A, a 29-year-old man, was admitted to our hospital emergency room after excising his scrotum and testes with a
kitchen knife. He committed autocastration while immersed in the ocean because, he alleged, the ocean was cool and
would act as an anesthetic. He then returned home and handed his testicles to his mother. Apparently, he felt that at
his birth she had halfdied, and he intended to give back to her the life she had given him at birth. His mother flushed the
testicles down the toilet and promptly called an ambulance. Mr. As act was not impulsive; he had previously consulted a
surgeon about an orchidectomy, but the surgeon refused to perform the operation. While in the hospital and receiving psychiatric treatment,
Mr. As anxiety and depression diminished and many of his delusions vanished. He exhibited no regrets about his drastic
act and seemed, in fact, relieved. He was particularly happy about losing some of his facial hair because the hairs multiply
and germinate and are dirty. In the following months his facial hair grew back (with compensating adrenal testosterone
production), and he again exhibited accelerating agitation, although he responded well to psychiatric support.
Mr. A is now considering a testicular prosthesis but has no interest in a transsexual procedure.
During his childhood Mr. A exhibited behavioral problems severe enough for him to spend 10 years in a class for emotionally
disturbed children. Despite emotional difficulties he finished high school satisfactorily. At age 17 he withdrew
from social activities and at his parents prodding, he consulted a psychiatrist who felt that Mr. A was suffering from
psychotic depression. At this time Mr. A also reported a frequent visual percept that things were getting smaller and
farther away (micropsia and teleopia), and he had a longstanding delusion that masturbating was draining my brain
of nuclear material. Masturbation aggravated his guilt and shame and, consequently, his anxiety. During this time he
sought prostitutes and demanded humiliating, sado-masochistic acts. He also engaged in homosexual prostitution, assuming
a passive, masochistic role. He always insisted,however, that he was heterosexual and that his homosexual
acts were committed only for money. His sexual activities compounded his feelings of guilt, anxiety, and depression until suicide seemed the only solution. He chose autocastration instead, an act which was less final than suicide but would destroy the object of his guilt his genitals, specifically his testicles, which represented his germinative capacity, his progeny, and his future self.
Discussion
We think Mr. As autocastration was either a substitute for suicide or a focal suicide as described by Menninger (4) rather than the result of transsexual sex misidentification or dissatisfaction with his masculinity. Mr. A was driven to commit his act while under a sustained and mounting sexual tension, which he could not understand. In fact, he developed an elaborate delusional system to explain his unusual state of tension. His apparent decrease in sexual drive and anxiety
after autocastration suggests the possibility that the male hormone testosterone might be related to development of such tension.
