I'm a newly-registered poster here, but I've been a lurker for years. I've had intense castration desires for almost 20 years now. I'm almost 40, and I've decided to start doing something about it.

I want to try to do this the "right" way. I'm in the US. About eight years ago, I self-medicated with imported Androcur for a year. I loved how I felt and what it did to my sexuality, but after getting some questionable liver test results, I sadly decided to give it up. The castration effects lasted about six months after I stopped, then went away, but I know that I want to feel that way forever.

What should I tell my therapist? Is there any hope of getting castrated without being male-to-female transgender? Will I be committed for expressing these desires? I know there was a paper in 2010 that advocated establishing WPATH standards of care for male-to-eunuch, but I don't know if there's been any further advances in that direction since then.

Also, I don't expect insurance to cover the operation itself. But will they cover a minimal amount of T replacement to stop osteoporosis, or am I on the hook for that too, since the initial castration is probably elective in their books?

Breakfastbin (imported) wrote: Fri Apr 09, 2021 9:40 am I'm a newly-registered poster here, but I've been a lurker for years. I've had intense castration desires for almost 20 years now. I'm almost 40, and I've decided to start doing something about it.

I want to try to do this the "right" way. I'm in the US. About eight years ago, I self-medicated with imported Androcur for a year. I loved how I felt and what it did to my sexuality, but after getting some questionable liver test results, I sadly decided to give it up. The castration effects lasted about six months after I stopped, then went away, but I know that I want to feel that way forever.

What should I tell my therapist? Is there any hope of getting castrated without being male-to-female transgender? Will I be committed for expressing these desires? I know there was a paper in 2010 that advocated establishing WPATH standards of care for male-to-eunuch, but I don't know if there's been any further advances in that direction since then.

Also, I don't expect insurance to cover the operation itself. But will they cover a minimal amount of T replacement to stop osteoporosis, or am I on the hook for that too, since the initial castration is probably elective in their books?

Hey,

Welcome out of the shadows. Have you read this thread? http://forums.eunuch.org/showthread.php ... -Castrated

TMFL

Hey,

TopManFL (imported) wrote: Fri Apr 09, 2021 10:35 am Welcome out of the shadows. Have you read this thread? http://forums.eunuch.org/showthread.php ... -Castrated

TMFL

Yes, that's one of the things that helped me decide to post here. I'm looking for some specific advice on how to frame my desires so the therapist will help me.

Standards of care are still being worked on and were to be published by now, but there is some hold-up. As I understand it that hold-up is not the subject itself but in technical editing of the eunuch SOC. Right now folks like you and I are being treated under the diagnosis code of 302.6 Unspecified Gender Dysphoria in the DSM-V (DSM five). This is what I was diagnosed with when I went to seek a penectomy to complete my nullification in 2015, and is still the current diagnosis today. It is used for men who desire the amputation of their penis, testicles, or both (nullo).

You'd be surprised how quickly this has changed in just the past 5 years. When I found a doctor to help me, I was his first patient whose desire was to be nullified, and I was a sort of test case. Now he does this for people as routinely (when criteria is met) as he would for MtF and FtM individuals.

The chapter being created for men like us in the DSM is not yet included, but it is being worked on as we speak. However, you should be able to find a therapist to work with you on your desire to be castrated (have an orchiectomy). I'd seek out a therapist who works with transgender individuals who is not themselves transgender. They'll be more likely to be open to a conclusion that does not fit inside the gender binary (male or female), which is what we are... to achieve comfort, we are all sort of in the middle somewhere. Though I present as male, I feel I am a nullo.

Framing your desire... find a good therapist and be HONEST WITH THEM. They're not going to lock you in the loony bin for expressing a desire to start working on facets of your gender you are uncomfortable with. You are seeking to be comfortable in your body, and your present genital configuration is causing you some sort of distress, especially since you've been thinking about it consistently for the past 20 years.

If this is what you truly feel you need to feel complete, there is help available through legitimate medical means. Like any other transition surgeries (that's what it's called even if you will still present male), you may have to pay for them yourself, unless you're in a state which mandates coverage for such in medical insurance policies, which I'm not sure if the one you state you live in does.

Speaking of where you live... I'm not that far away in my location. I'd enjoy getting to know you and offer an ear should you need one as you navigate the process. Perhaps even meet one day if we're both agreeable to doing so.

Good luck!

--LT

To follow up on what LT has written, the new edition of the Standards of Care for the World Professional Association for Transgender Health (the handbook that the professionals use) was SUPPOSED to be published and in print by March of last year. The editors are incredibly slow and are still feeling their way with how everything should be worded. I now expect publication sometime around the end of this year. It's NOT the eunuch chapter that's holding things up. All the chapters are in a similar state.

To take LT's suggestions just a bit farther, your personal information indicates that you live in Maryland. That's a good place to be to seek help. Your first step should be the WPATH web site (www.wpath.org (http://www.wpath.org)). Go to the drop-down providers list and type in your state. There will be about 50 listed for MD, together with their specialties. Clicking on any of their names will give you an address and telephone number. Call a few offices; them what you want. You should be able to find someone compatible with only a few calls.

A suggested standards of care was published in the International Journal of Transgenderism clear back in 2010. You can remind the provider that it's there and you can tell him or her that you know that a full chapter on eunuchs will be in the 8th edition of the SOC, once it's published:

Vale K, Johnson TW, Jansen MS, Lawson BK, Lieberman T, Willett KH, Wassersug RJ. (2010). The development of standards of care for individuals with a male-to-eunuch gender identity disorder. International Journal of Transgenderism; 12:40-51.

(It's no longer called a "gender identity disorder," but rather "gender dysphoria." The name change is important.

I can send a PDF copy of the article to anyone who sends me a Private Message with an email address that accepts attachments.

I did a search for therapists, contacted a few, got referrals to others. Some never responded to my initial attempt to contact them, others responded that they aren't currently accepting new patients, but offered the name of a colleague I might consider. I did find someone who was accepting new patients and has worked with other individuals who identified as non-binary. I haven't pushed on the recommendation letter, but that was one thing he mentioned before our first meeting that he would be willing to write one and that he knows of doctors in the area who would perform an orchiectomy without being part of the usual MTF transgender procedure. Good luck in finding the right support system.

I have no experience as a patient but do have a psychologist friend. She has mentioned that any good shrink can detect deception, so I'd say be as honest as possible. However, with a growing number of doctors willing to preform orchiectomies on just informed consent why not save your money and simply find one. Hopefully the new protocols mentioned above will eventually make it easier for a non MtF person seeking to be rid of his balls.

Breakfastbin (imported) wrote: Fri Apr 09, 2021 9:40 am What should I tell my therapist? Is there any hope of getting castrated without being male-to-female transgender? Will I be committed for expressing these desires?

Tell your therapist the truth. They work for you but cannot do their job unless you are truthful. The only time anyone gets committed is if they are an imminent risk of serious harm to self or others and nothing you have said indicates that to be the case. You are just another nonbinary transgender person seeking gender affirming treatment, which is a sign that you are doing the right thing for your mental health. You have even had a trial with Androcur, which is great evidence. DSM-5 Gender Dysphoria was specifically written to be inclusive of people in our position. An increasing number of medical professionals are aware and willing to treat us.

I am in New Zealand. I had my orchi last year. My old-school psychiatrist would not diagnose gender dysphoria because I did not want to become a woman (he clings to DSM-IV Criterion A), but he found me sane and rational, and that was enough for my urologist.

First off, NO!...you will not be committed for expressing those desires. Let me say that upfront.

Second, depending on the state you live in, insurance MIGHT cover it. Check with your insurance carrier first.

Third, if you trust your therapist, just walk in and out with it. Believe me, they've heard it all. If you don't trust them, probably shouldn't go to them in the first place.

I speak from experience here. I basically went through the same thing you went through about a month ago. Completely terrified about discussing this with my shrink. Turned out completely fine. You are going to be a little freaked before hand, that's normal. But that proverbial weight will be lifted after you discuss it. Trust me. I know. I'm here, as are the rest of us, should you need anything (advice, etc.) between now and your next therapy appointment.