As it seems, I suffer from Male-to-Eunuch Gender Dysphoria quite heavily. At least this explains best how I feel. So far, so good. Unfortunately this diagnosis doesn't help me at all as it obviously doesn't open a way for a treatment which could really improve my life. For example, getting a letter of support for surgical measurements seems to be impossible in Germany. Cases like mine are mostly seen as some kind of BIID which I don't agree. Being accepted as a special kind of transgender and being treated in a similar way seems to be impossible.

I know there is some research on this topic and that existance of a third, neutral gender becomes more and more accepted. So I would like to know the following:

How much progress is already achieved on this topic?

Are there already standards of care defined for the treatment of Male-to-Eunuch Gender Dysphoria, and which treatments are suggested?

Are there any numbers of MtE people who already have been castrated and/or penectomized, and did the surgery improve their lifes?

Is there currently any possibility of getting a letter supporting a nullification? How?

One big problem seems to be there is no data regarding the question wether surgical treatment is a necessary treatment which is suitable to improve the situation, as it is proven in transgender treatment. My therapist pointed out that there is still no proof that a nullification would help me, simply because there is no data about it, not because there is a hint for its ineffectiveness.

Any information about recent results of research is highly appreciated, as I am in a very desperate situation already.

While progress has been slow (it's very difficult to move the medical community), there has been quite a lot in North America and in the Netherlands. We have seen some progress elsewhere, most recently in Sweden. Little has happened yet in Germany, however. I am hoping that the biennial conference of the World Professional Association for Transgender Health (WPATH) in Amsterdam in June will help. I have proposed a session on Male-to-Eunuch, although the final program has yet to be determined. (I have made my plane and hotel reservations for the conference and will be there to talk individually with European practitioners in addition to probably being on the program.)

The current Standards of Care of WPATH includes genders outside the binary, without specifying Male-to-Eunuch (or anything else) as one of the alternatives. An article arguing that MtE should be specifically included has been accepted for the next issue of the International Journal of Transgenderism and should be in print before the June meeting.

The WPATH Standards of Care are available as a FREE PDF download from their web site (wpath.org). In addition to the English in which it was originally written, there are translated versions in eleven other languages. You may need to educate your medical practitioners with a downloaded version in their own language. It is currently translated into:

French, German, Spanish, Portuguese, Norwegian, Serbian, Croatian, Russian, Japanese, Chinese, and most recently Korean. (All are free on the WPATH site.)

While I will be at a conference and away from my main computer for the next few days, if you send me a Private Message with an email address that will accept PDF attachments, I will send you some of the relevant articles that may help to convince your therapist that your desires are valid ones as soon as I return. The offer is open to all members of the Eunuch Archive. I will be happy to send copies of the articles to anyone who wants them.

Thanks for your information, I just sent you a PM.

Am I right, the current Standards of Care already support surgical treatment for MtE? Or do I just misunderstand your information?

Jesus:

Please feel free to embellish or correct anything I say below, but I feel I covered where things are at presently in the US.

T van Keel:

Though others were nullos before I was, as the person who could arguably be considered patient #1 for completing his nullification through the development of a standards of care process for Male to Eunuch (I went through therapist appointments, got a letter of support, and was allowed to proceed with surgery to become nullified) I can tell you that the standards of care are not yet there. I was allowed to proceed simply for the fact that the DSM-V (Diagnostic and Statistical Manual version 5) had Male-to-eunuch included in a section called "needs further study." It's a brief mention, but it's in there and marks one of the first times Male-to-eunuch has appeared in legitimate medical literature. That mention gave my doctor the cover he needed to perform my surgery. He has the diagnosis, "Gender non-conforming, not otherwise specified" and this mention in the DSM-V to point to if he gets asked. All of my medical charting mentions these items.

I've allowed my case to be used to help make the case for others. Other than some complications that arose from the surgery itself, which I'm in the process of having corrected, I'm better adjusted, feel more comfortable in my body, and engage better with life as a result of being allowed to have this surgery. I'm quite content to be a nullo.

At the moment the medical community is proceeding cautiously, but is starting to perform these surgeries with more frequency as they get more comfortable with them and have time to review how those of us that are undergoing them are responding to our new situations.

It's happening, but it may take some time before it's more widely recognized.

Thanks for your reply. It confirmes that the way is still very difficult. But it's good to hear that a -slowly- growing number of medical personal is willing to hear our needs, do some pioneer work and help to establish new standards. I had just an appointment with an other therapist, but making great progress is still not visible. He is one of the people who did the translation of the WPATH Standards of Care, as I've read in that document. I don't know if this fact will be good or bad for my case - too much time already went by without making progress, although highly respected therapists were involved. At least he should know that paper very good.

What page of the DSM is that mention on? It would be nice to read what's there firsthand.

You're right, I haven't found that passage yet, too.

I hope Jesus will chime in here, as I only know what I've been told by the doctors I work with, and how things worked in my situation. It could be it was described to me in the way I specified, but doesn't not show up in the literature in that way.

Any thoughts Jesus?

I returned home last night from a conference in a very different field, although there was one fascinating paper that provided some interesting overlap. I will write about that on a different thread.

As Losethem wrote, he may very well be Patient #1 for successfully using the WPATH Standards of Care to achieve his goal of nullification. There may have been someone ahead of him of whom I am unaware, but I am certain that there will be many who are able to follow his pioneering efforts. I spent a long while talking with the two surgeons in the practice that Losethem was able to use, working to convince them of the validity of MtE as a proper Gender Dysphoria under the Standards of Care. Counselors (psychologists and psychiatrists) are much easier to convince than are surgeons, although I know that there are now several surgeons scattered across the country who will follow the latest version of the SoC.

Outside of the United States and Canada, it is still very difficult, although there are several who are working to improve the situation. Your own personal efforts will help the general cause.

So far, "eunuch" has not made it into either the WPATH Standards of Care (version 7) or the APA's

Losethem (imported) wrote: Thu Apr 07, 2016 5:29 pm Diagnostic and Statistical Manual

(DSM-5) as a specific diagnosis. However, both are clearly open to genders outside the male/female binary. You will need to work to convince your particula

JesusA (imported) wrote: Thu Apr 07, 2016 8:27 am r therapist that your desires are valid ones

within the published criteria.

T

JesusA (imported) wrote: Thu Apr 07, 2016 8:27 am he next issue of the International Journal of Transgenderism

will have another article arguing that eunuch is a proper end point for transition.

You will need to approach your counselor showing that you know what is in the WPATH and DSM-5 documents. I have put together five additional articles that might be of use and will email them to anyone who requests them. They include a copy of the upcoming article in IJT, so you will be able to see it ahead of your counselor.

Thank you very much for the papers. Let's hope they will be helpful. Maybe Losethem was a little bit lucky, as he was already castrated so it might have been much easier to get an OK for penectomy.

What about the paragraph “needs further study” in the DSM-V, which pages contain it? I wasn't able to find it yet.