Reproduced below is the original article about eunuchs and Dr. Spector's clinic, as it appeared on the December 2000 issue of Philly Mag. The article has been offline for a few years, however, a copy of it still exists at the internet archive, and is reproduced here for archive purposes.

http://web.archive.org/web/200202100139 ... nos_1.html

The Sopranos - part 1

Men are coming to Philadelphia to be castrated. They are coming from all over the country — from as far away as Germany and Ireland — to see Dr. Felix Spector, an 83-year-old osteopathic physician who emasculates as many as 10 willing males a month. Practicing out of a home office in Center City, Spector charges $1,600 for the procedure, which is performed under regional anesthetic and generally takes less than two hours. Afterward, Spector chaperones his patients around town, pointing out historic sites like Benjamin Franklin's grave and Independence Hall. The following day, he inspects and dresses their surgical wounds and sends them on their way, to lives he hopes are improved.

Spector's web site (www.felixspector.com) catalogs the nature of his practice, offering the following description beneath images of the doctor's face and Independence Hall:

Conveniently situated in historic Philadelphia, Dr. Felix Spector is a licensed

osteopathic medical physician exclusively treating those individuals seeking

* Male to female transsexual care

* Control of libido in men

* Achievement of eunuch status for medical or religious reasons

Why would a man, any man, want to have his testicles removed?

Some of Spector's patients are repeat sexual offenders, seeking castration to put an end to overwhelming urges. Others are male-to-female transsexuals, men who believe themselves to be women. As for religious reasons, the Bible passage his patients often cite as relevant is in Mark 9:43 — "If your hand causes you to sin, cut it off." Spector has also castrated men whose wives have undergone menopause and are no longer receptive to their desires. The procedure, technically called an orchiectomy, involves removing both testicles while leaving the penis intact. It largely eliminates testosterone from the bloodstream, in most cases quelling the patient's libido and secondary sexual characteristics, such as facial hair. Unlike surgeons who perform sex-reassignment surgery, Spector doesn't require his clients to undergo lengthy counseling before the procedure. He is the only doctor in the United States who routinely performs elective castration with few questions asked, which may, in part, explain his popularity. "I don't require any big red tape about it," he tells me. "Those who are out of control are constantly fighting this, and they can't be talked into anything."

A quiet young man with mangy black hair answers the door to Spector's office. He is dressed in blue jeans and a flannel shirt, introduces himself as Jeff, and shows me in. Spector's desk and shelves are crowded with patient records. A vintage examination table stands in the far corner; a PC workstation occupies a second desk near the interior door.

After a moment, a frail-looking man with a timid smile emerges from his living quarters upstairs. Felix Spector has maintained a full head of hair into his eighth decade; he wears a thick pair of red-framed bifocals that are much too large for his face. After growing up in Philadelphia and South Jersey, he attended Temple and the Philadelphia College of Osteopathic Medicine. For nearly five decades, his medical career has been rife with controversy. In the mid-'80s, the Philadelphia Inquirer cataloged the myriad troubles Spector has faced: Among other charges, he has been cited for falsifying pharmacy records and for billing irregularities that provoked the state to kick him off the Medicaid rolls. After one of Spector's run-ins with the law, in the 1960s, a Philadelphia judge ordered him to perform two years of missionary work in Africa.

But the Pennsylvania State Board of Osteopathic Medicine confirms that Spector's license to practice medicine is current, and that no disciplinary action has been taken against him in the past decade. Spector isn't proud of his checkered past. He speaks of his background and family with a studied, clinical distance: His two grown children "live in New England and have their own lives." His marriage ended many years ago in divorce; his ex-wife has since died.

He was first approached by a transsexual patient in 1957. The man wanted to know: Would Dr. Spector be willing to castrate him? After careful consideration, Spector decided he would. Word quickly spread in the transsexual community. While still maintaining his general practice in North Philadelphia, Spector began occasionally castrating transsexuals. He did so for decades, largely attracting patients from East Coast cities. In the mid-'90s, at the urging of an assistant, he turned to the World Wide Web to advertise his services. Almost overnight, he found enough of a market for elective castration that he limited his practice almost exclusively to the procedure.

As we talk, Spector describes his patients and the difficulty they face finding treatment in the mainstream medical community. Jeff has been sitting in on our conversation, nodding in agreement, smiling knowingly to himself as he stares at the floor.

"You look like you have something to add," I say.

Spector and Jeff stare at one another for a moment. Then Jeff shrugs.

"Well," Spector says, "he's a eunuch."

Early in gestation, all fetuses have female genitalia. As boys develop in the womb, their XY chromosome pattern induces the gonads to develop into testicles, which in turn begin to produce testosterone. The hormone circulates through the fetus's bloodstream, causing what would otherwise be a clitoris to enlarge and become a penis. The labia majoria alter to form a scrotal sack. Testosterone is believed to have a masculinizing effect on certain areas of the brain during fetal development. Years later, at puberty, the hormone's concentration in the bloodstream soars. Boys' voices change. They start building up muscle mass. They grow facial hair. Testosterone affects men's psychological makeup, predisposing them to competitive and aggressive behavior.

Not all guys want this. For transsexuals, the rationale for elective castration is fairly straightforward. For repeat sex offenders, castration may help control impulses that lead to sexual crimes. (While castration is highly controversial as a penal measure, an Atlanta judge ordered it as a condition of parole in the case of a convicted child molester last January.) But Jeff isn't a transsexual, or a sex offender, or a religious zealot, or an older gentleman whose post-menopausal wife is no longer interested in sex. Jeff is a 33-year-old former computer technician in fine health who opted to have himself castrated.

Growing up in rural Zanesville, Ohio, Jeff was a good student. He spent his free time building model airplanes and naval vessels, and enjoyed music. He entered high school at the dawn of the Reagan years, which he recalls as a time when "fitting in" was particularly important. Jeff ran in a circle that worked on "street machines" — souped-up sports cars. His social life sounds fairly typical of a rural upbringing, but his home life was far from normal. The farm he grew up on belonged to his grandparents; his parents had divorced and surrendered Jeff's custody shortly after his birth. He had limited contact with his mother, and recalls meeting his father only once. His grandfather succumbed to lung cancer while Jeff was still in middle school. After that, it was just Jeff and his grandmother.

His earliest sexual longings, directed towards girls and boys alike, began after his 10th birthday. For Jeff, these weren't pleasant feelings. "I understand that a lot of boys at that age feel, 'Hey, this is great, this feels good!' It never really felt all that good to me," he says. Sexual desire just didn't "work" for him; in describing it, he uses the word "inconvenient" a lot. "I spent hours and hours masturbating and having sexual fantasies, and they were getting in the way of everything. My grades slipped, my focus on my future slipped," he recalls. By his 11th birthday, Jeff wanted whatever was going on inside his body to stop.

One afternoon, he took a large pair of fabric shears from his grandmother's sewing table, closed himself in the bathroom, and slowly began cutting the skin at the base of his scrotum. He doesn't recall this hurting all that much. But when blood started spilling from his lacerated genitals, he got scared and put the scissors down. Jeff's grandmother, who has since passed away, drove him to the emergency room.

"The ER doc was a little shocked," Jeff says, slightly amused at the memory. "He asked why, but I couldn't give an articulate answer at that point."

Jeff was admitted to the hospital as a psychiatric patient, and was put on a 72-hour suicide watch.

As his adolescence progressed, Jeff never dated. After graduating from high school, he enlisted in the Air Force, where sex wasn't much of an issue. Upon his discharge, he wandered back to Zanesville. One night at a local watering hole — "the wrong place to meet a lot of people" — he was approached by a young woman named Tanya. They wound up going back to his place. "It didn't really seem to be anything all that special," he says of his first sexual encounter.

Their relationship only lasted a couple of weeks, but Jeff remembers it as "disastrous." Shortly after it ended, Jeff attempted self-castration again. This time, he drove himself to the emergency room.

Jeff moved to Columbus, where he saw a sex therapist who treated some transsexuals. "I basically told her the entire history and the way I feel about sex," Jeff says, "and she's like, 'Well, I think you have some issues with your sexuality which are not compatible with your psychological gender identity.' And I'm like, 'Well, yeah!'"

For the first time in his life, Jeff was talking to someone who understood his condition. But despite extended therapy, he never grew to accept his sexual urges, and his fixation with castration continued. Jeff says his therapist eventually supported the idea: "But having a psychologist's okay and finding a doctor willing to perform the procedure are two very different things." He made inquiries and wrote to doctors, all of whom turned him down — until the summer of 1999, when he happened across the home page of Dr. Felix Spector.

"I called Dr. Spector, and he said, 'Well, wait a couple of months,' I guess to make sure I was serious," Jeff explains. "So I called him back in a couple of months and said, 'Okay, I have the money, and I really want to have this taken care of.'" Spector has only a faint memory of Jeff's phone calls; he gets similar queries every day.

A year ago last October, Jeff drove eight hours from Columbus to Philadelphia, checked into a small b&b in Center City, and went to Spector's office to discuss the procedure. "I talked for a while about my goals," Jeff recalls, "and he was probing, making sure I still wanted to do it, making sure I understood that it was irreversible. He said, 'Go back, get a good night's sleep, think about it, if you're serious, show up at 11 o'clock tomorrow morning."

Back at his b&b, Jeff shaved off all his pubic hair and settled into bed. He arrived at Spector's office the following morning, signed a consent form, and used the bathroom. Spector asked him to disrobe from the waist down. He scrubbed Jeff's midsection — between his navel and his thighs — with betadine, and anesthetized his genitals with an injection on either side of his pubic bone. Spector then taped the head of Jeff's penis to his lower abdomen, exposing the scrotal sac. After 15 minutes, Spector tested the area for numbness and then made his incision, bisecting Jeff's scrotum from top to bottom. He peeled away the connective tissue that held Jeff's testicles in place, tied off the arteries that supplied them with blood, and finally cut them out. The dream — obsession, perhaps — that Jeff had been harboring for more than two-thirds of his life was finally fulfilled.

Not all of spector's patients are as socially isolated as Jeff. There's Frankie, for example — a bright, affable, happily married transsexual engineer from Michigan whom the doctor recently castrated. Frankie intends to follow up with full sex reassignment surgery. He has four young children, one of whom he is careful to banish from the room when I call. So far, Frankie's kids are in the dark about his plans for the future. How does all this sit with his wife, I inquire?

"We've been married 15 years and we're very much in love, always have been, and it's a love of who we are, not what we are," he explains. "We want to grow old together. Although it'll be a strange place to be, when we're done: We'll be a same-sex couple legally married."

The product of a strict Mormon upbringing, Frankie never questioned his church's basic tenets about life and God. Heterosexuality, marriage, children — they weren't optional. "It was just, 'You're a guy, you don't do that,'" he says. "Just like I never cross-dressed before. I did really want to be the woman in the clothes, but I never could bring myself to do it because it just [felt] so wrong inside. Now that I'm castrated, I feel like I'm liberated. It doesn't bother me at all."

Beyond his gender-identity issues, Frankie says, he had health reasons for seeking castration. Being a man was bad for him; for one thing, he was a terribly impatient driver: "You know, cuttin' in and out of traffic without regards to an accident or dying. I was overweight, and eating junk food all the time. My cholesterol was off the charts."

Last July, he came to Philadelphia. When he returned to Michigan, his testicles were gone. Unlike mainstream transsexual-care experts, Felix Spector didn't require Frankie to live publicly as a woman or undergo counseling and hormone therapy before operating. "These doctors wanted me to put on a dress and heels for over a year before they'd even consider surgery or any real help for me," Frankie says disdainfully. "And that's impossible." He tells me he's well over six feet tall, balding, and has a muscular build. Cross-dressing wouldn't make him look like a woman, he says — it would make him look like a clown.

Beyond the control measures imposed by the medical community, sex reassignment surgery can be prohibitively expensive (your hmo won't be picking up the tab) and is only performed by a handful of surgeons in the world. Full male-to-female sex reassignment surgery involves, in addition to castration, penectomy and vaginoplasty (the surgical creation of an artificial vagina), breast augmentation and hormone therapy.

Frankie and Jeff say Felix Spector champions the rights of individuals with severe sexual identity disorders. I contact Johns Hopkins University Hospital, one of the world's academic centers for sex research, to see if this is a widely held opinion. Johns Hopkins helped pioneer sex reassignment surgery in the middle of the 20th century, but has since ended such procedures. Dr. Paul McHugh, the hospital's psychiatrist in chief, was one of the faculty members who brought sex reassignment to a halt.

"I saw these patients who call themselves transsexuals," McHugh explains. "They were almost all adult males. They represented themselves to me as females, but whenever I would bring a female in to talk with them, the females would come out and say, 'That's a guy imitating a female.'"

One of McHugh's colleagues conducted a study of post-operative male-to-female transsexuals. Many reported that they were happy to be women, but other aspects of their lives — the depression that often accompanies transsexuality, their interpersonal relationships — hadn't improved. "The problem lay between the ears, not the legs," McHugh says. "Just as anorexics believe that they are fat, so these people believe that they are something else."

What about those like Jeff, I ask, who are hell-bent on castration and might, for lack of a willing surgeon, pay someone with no medical training to operate on them — or attempt the procedure themselves?

"It's still mutilating the patient, in my opinion, and I don't want to be part of it," McHugh says. "I don't do tattoos, either, you know. Lots of people want tattoos, and I don't do them. The fact that they go out and do it in these awful parlors doesn't mean that I'm going to start doing it here."

Spector, who is familiar with this sort of criticism, isn't convinced that McHugh's attitudes are based entirely on medical experience. "I think that the attitudes engendered during the Victorian age in England — and, by extension, anywhere else in the Western community — would have a lot to do with this," he says. "If a person wants something that is not generally accepted or favored, they have an uphill battle. When it comes to those who seek this particular kind of help, it's here and available, and who's to say what's right and what's wrong?"

Other psychiatrists at Hopkins have more moderate views than McHugh's. Dr. Fred Berlin, an associate professor of psychiatry and behavioral sciences and the founder of the National Institute for the Study, Prevention and Treatment of Sexual Trauma, respectfully disagrees (perhaps bravely; McHugh is his superior) with the judgment that surgery is never appropriate. "If you've got a fully informed adult who feels that nobody else is able to help, and they really are capable of making their own judgments, and conservative methods like psychotherapy have been tried first, it's a little bit hard to argue that these people should be prohibited, if they and the doctor have the sense that this is their last resort," Berlin says.

This is just the argument Frankie makes for elective castration. "At age 41, I can vote. I already served in the military. I've been law-abiding. I don't even have a speeding ticket," Frankie says. "So if this is the course I choose, and I'm paying for it out of my own pocket — especially with my wife's support — then who's to tell me no?"

Both Frankie and Jeff report that they have benefited significantly from castration. They are grateful that Felix Spector was willing to do what no other doctor would.

But as Paul McHugh's experience suggests, not all the men Spector has aided have gone on to better lives. In 1991, Spector castrated a New Jersey transsexual named Glenn Nelson, with the blessing of a Haddonfield psychologist. A Colorado surgeon later completed Nelson's sex reassignment surgery. Nelson, who began the using the first name Leslie, killed two South Jersey law enforcement officials in 1995. Two years later, she was convicted and sentenced to death by lethal injection; she is currently awaiting a new sentencing trial. At Nelson's original trial, one doctor testified that the castration and sex reassignment surgery may have contributed to Nelson's emotional turmoil.

Dr. Terrence Malloy, a urologist at Pennsylvania Hospital, has other concerns about Spector's practice. Urologists frequently perform orchiectomies on testicular cancer patients, and also on some prostate cancer patients. (Prostate cancers are fueled by testosterone, and some sufferers elect to cut the hormone off at its source.) But the procedure is never done on an outpatient basis. As with any major surgery, Malloy says, there is always a significant risk of complications. One of Spector's patients suffered such a complication recently.

In late October, during a week in which Spector performed several castrations, a Georgia man showed up at a local emergency room several hours after the procedure. The patient's scrotum was severely swollen, and ballooned with blood. Surgeons reopened his surgical wound, successfully tied off the broken arteries, and inserted a drain. Such a complication is not common, but it raises some questions about Spector's technique. "What surgeon ever closes an incision when you see bleeding going on?" one treating physician asks. "You don't just sit there and hope that God's going to make a blood clot come." Spector maintains that orchiectomies are safe as outpatient procedures. Post-surgical bleeding is a normal complication, he says, which in this case could have been controlled in his office rather than the emergency room.

Jeff and i are having lunch at a little restaurant on Antique Row, near Felix Spector's office, on a warm autumn afternoon. He tells me how happy he has been since his castration. He spent years preoccupied with the surgery; his post-operative life has been full of new interests and free of what was, at times, crippling depression. On a general level, he feels more at peace with himself.

"About your gender," I ask. "Do you consider yourself a man?"

"No," Jeff says.

"You consider yourself a eunuch?"

"Yes. That means genderless."

When I write this article and the need for a pronoun arises, will Jeff feel uncomfortable if I use the word "he"?

"That's fine, because I was born a genetic male. In society, it's not polite to say 'it.' Although that is the correct pronoun," Jeff says.

After recovering from his operation, Jeff renovated large portions of his house in Columbus. He was already considering a career switch when he returned to Philadelphia last summer to visit Spector, to whom he felt indebted. The doctor had recently lost an administrative assistant who helped maintain his web site. By the end of Jeff's visit, he had a job offer. Jeff moved to Center City last summer, and has been living in Spector's basement, helping the doctor run his practice. He is applying to nursing programs; having his life so dramatically improved by medicine, he says, has inspired him to join the field.

In the meantime, Spector says, as the three of us chat in his office, "I need somebody who knows something about computers."

An interest from Jeff's childhood has resurfaced since the operation: He has begun taking voice lessons. Jeff the eunuch has fallen in love with opera, particularly the castrati operas and arias, written hundreds of years ago for males who were emasculated before puberty could deepen their voices.

"Give him an example," Spector urges.

Jeff blushes a bit and says, "He wants me to sing for you."

"By all means," I say, realizing the opportunity before me — nobody has heard a eunuch give life to this form of music for hundreds of years. Then Jeff sings. Just a few bars, higher than I've ever heard a man sing before, at a reverberating pitch that's eerie, beautiful and shrill. It's so wondrous and strange that, rudely, I neglect to applaud.