Persons Who Need To Be Fixed

[Beau Geste (imported)]

As far as I can tell, testicular cancer and cancer of the penis are the only conditions for which it can ordinarily be considered a medical necessity for all or part of the male reproductive organs to be removed, or, in common parlance, for the person to be fixed.

Although orchiectomy is a common treatment for cancer of the prostate, from what I have read and heard, the progress of that type of cancer is sufficiently slow, that it often isn't clear whether removal of the testes is required for treatment of the disease--the patient is likely to expire from other causes before he succumbs to the effects of cancer.

My impression is that, in cases of penile cancer, all or part of the organ has to be removed to prevent metastis. I would guess that, if the cancer has spread to other parts of the reproductive system, it probably has also become extensive enough to be fatal to the person, and excision of the testes would not be an effective treatment.

But the question which would seem to be posed by what some members of the archive have said (and by information from other sources) is, whether an objective protocol of some type could ever be formulated, as to whether there are individuals who need to be fixed, as it were, because of their mental characteristics. I have read in some accounts, that, prior to their orchiectomies, individuals were physically damaging their testes and other sex organs, in ways which were unsafe, and which could have led to life-threatening injuries--the implication being, that orchiectomy was indicated to keep the person from placing himself at risk for his general health. There are also persons who become obsessed with their own dysphoria, and constantly think of suicide, as well as, in some cases, ultimately attempting suicide. Do these persons need to be fixed, for their own safety?

Another category would seem to be those who are unable to control their sex urges, whether those urges cause them to do violence to women, or their urges drive them to pedophilic offenses. Do these individuals need to be fixed, for reasons of public safety?

The idea of "need" is also something which, I would think, would have to be defined in a protocol for determing when someone needs orchiectomy. If, on balance, someone would appear likely to be distinctly better off after removal of the sex organs, can it be said that he "needs" to have the surgery? It must be said, that it doesn't seem easy to predict what the outcome of surgery of that kind will be, either in terms of physical effects or in terms of psychological effects. Still, at the time of the surgery, the person may fully believe that he needs to have the operation, and perhaps the sense of urgency which the individual feels, produces a perception that there is no reasonable option to the amputation.

I do, of course, think that the final decision should be up to the person who would be operated on. But it still seems as though some kind of systematic approach to the problem of decisions of that type, ought to be attempted, or at least the possiblity of that type of approach should be explored. Those who give advice and counsel in matters of sexual surgery, would have some reference from which to make their recommendations.

[kristoff]

As far as I can tell, testicular cancer and cancer of the penis are the only conditions for which it can ordinarily be considered a medical necessity for all or part of the male reproductive organs to be removed, or, in common parlance, for the person to be fixed.

Although orchiectomy is a common treatment for cancer of the prostate, from what I have read and heard, the progress of that type of cancer is sufficiently slow, that it often isn't clear whether removal of the testes is required for treatment of the disease--the patient is likely to expire from other causes before he succumbs to the effects of cancer.

Actually, the reason so many of these prostate cancer subjects are able to survive long enough to die from other and natural causes, beyond prostate cancer, is because they have indeed been castrated. Testosterone essentially feeds and hastens the metastasis of prostatic cancers. Castration significantly prolongs life by dramatically slowing the spread of the cancer, even though it doesn't cure.

My impression is that, in cases of penile cancer, all or part of the organ has to be removed to prevent metastis. I would guess that, if the cancer has spread to other parts of the reproductive system, it probably has also become extensive enough to be fatal to the person, and excision of the testes would not be an effective treatment.

This is also why surgery is only one response to such cancers. Also utilized are such things as chemotherapy and radiation. They attack not only the localized cancers, but also those that have metastasized.

But the question which would seem to be posed by what some members of the archive have said (and by information from other sources) is, whether an objective protocol of some type could ever be formulated, as to whether there are individuals who need to be fixed, as it were, because of their mental characteristics. I have read in some accounts, that, prior to their orchiectomies, individuals were physically damaging their testes and other sex organs, in ways which were unsafe, and which could have led to life-threatening injuries--the implication being, that orchiectomy was indicated to keep the person from placing himself at risk for his general health. There are also persons who become obsessed with their own dysphoria, and constantly think of suicide, as well as, in some cases, ultimately attempting suicide. Do these persons need to be fixed, for their own safety?

Please do some research and reading on the horrors of "eugenics" and mental (or other) capacities, as well as the difficulties of living with BIID (Body Integrity Identity Disorder) (I believe it should be *dysphoria,* not *disorder.*). Please also read some of the histories of WWII and Hitler and his racial and *other* cleansing, i.e., criminals, mental defectives, etc...

Another category would seem to be those who are unable to control their sex urges, whether those urges cause them to do violence to women, or their urges drive them to pedophilic offenses. Do these individuals need to be fixed, for reasons of public safety?

This is a *whole 'nother ballgame." There has been a SUBSTANTIAL amount written about this, and more to come, I am sure. Not gonna touch this any further. And let's NOT turn this thread into another diatribe about sex offenders, please.

The idea of "need" is also something which, I would think, would have to be defined in a protocol for determing when someone needs orchiectomy. If, on balance, someone would appear likely to be distinctly better off after removal of the sex organs, can it be said that he "needs" to have the surgery? It must be said, that it doesn't seem easy to predict what the outcome of surgery of that kind will be, either in terms of physical effects or in terms of psychological effects. Still, at the time of the surgery, the person may fully believe that he needs to have the operation, and perhaps the sense of urgency which the individual feels, produces a perception that there is no reasonable option to the amputation.

Again, refer to the topic of BIID (limited as it is), as well as Gender Dysphoria. That should give one a good start on the subject.

I do, of course, think that the final decision should be up to the person who would be operated on. But it still seems as though some kind of systematic approach to the problem of decisions of that type, ought to be attempted, or at least the possiblity of that type of approach should be explored. Those who give advice and counsel in matters of sexual surgery, would have some reference from which to make their recommendations.

I believe counseling and exploration should always be involved here, no matter the course or cause (including cancer...), although urgency can be involved.... The potential castrate should, of course, have significant, if not complete, authority of consent (again, I won't touch criminal stuff here). I suspect that you are correct in suggesting a more *systematized* approach, but one has to protect against being too rigid. There has to be flexibility to accomodate humanity.

[mrt (imported)]

My understanding is that cancer grows faster with androgens (testosterone) so, for men who have cancer that can not be surgicaly removed this is a "trick" used to extend life. The side effects are of course pretty bad. I know that they have many more pateints now who opt for chemical castration because they are apposed to being cut. Some are now trying to switch testosterone with estrogen which gives them some quality of life but yikes. Talk about a walk on the wild side to not be transexual and being fed large doses of estrogen. That has to be difficult but probably far better then being hormone free.

There are clearly more reasons then cancer for this operation. Some of which include...

1) Transexuals gender issues.

2) Folks with "criminal" sex drives.

3) Damaged Testes (Atrophic, Torsion, Chronic Pain etc)

4) Religion.

I do agree with #1, 2 and 3 depending on some circumstances. #4 I would agree on if we are talking about Pedophile Church freaks.

You mentioned those that just don't like them. Here I hate to be the bad guy but I ponder this one and think. What if a person didn't like his arms and legs. Should a doctor be asked to perform amputations? As a Doctor I think I would say "No way!" If the person starts to saw away on his own should the doctor treat him for "amputation" or "Mental Health?"

As far as I can tell, testicular cancer and cancer of the penis are the only conditions for which it can ordinarily be considered a medical necessity for all or part of the male reproductive organs to be removed, or, in common parlance, for the person to be fixed.

Although orchiectomy is a common treatment for cancer of the prostate, from what I have read and heard, the progress of that type of cancer is sufficiently slow, that it often isn't clear whether removal of the testes is required for treatment of the disease--the patient is likely to expire from other causes before he succumbs to the effects of cancer.

My impression is that, in cases of penile cancer, all or part of the organ has to be removed to prevent metastis. I would guess that, if the cancer has spread to other parts of the reproductive system, it probably has also become extensive enough to be fatal to the person, and excision of the testes would not be an effective treatment.

But the question which would seem to be posed by what some members of the archive have said (and by information from other sources) is, whether an objective protocol of some type could ever be formulated, as to whether there are individuals who need to be fixed, as it were, because of their mental characteristics. I have read in some accounts, that, prior to their orchiectomies, individuals were physically damaging their testes and other sex organs, in ways which were unsafe, and which could have led to life-threatening injuries--the implication being, that orchiectomy was indicated to keep the person from placing himself at risk for his general health. There are also persons who become obsessed with their own dysphoria, and constantly think of suicide, as well as, in some cases, ultimately attempting suicide. Do these persons need to be fixed, for their own safety?

Another category would seem to be those who are unable to control their sex urges, whether those urges cause them to do violence to women, or their urges drive them to pedophilic offenses. Do these individuals need to be fixed, for reasons of public safety?

The idea of "need" is also something which, I would think, would have to be defined in a protocol for determing when someone needs orchiectomy. If, on balance, someone would appear likely to be distinctly better off after removal of the sex organs, can it be said that he "needs" to have the surgery? It must be said, that it doesn't seem easy to predict what the outcome of surgery of that kind will be, either in terms of physical effects or in terms of psychological effects. Still, at the time of the surgery, the person may fully believe that he needs to have the operation, and perhaps the sense of urgency which the individual feels, produces a perception that there is no reasonable option to the amputation.

I do, of course, think that the final decision should be up to the person who would be operated on. But it still seems as though some kind of systematic approach to the problem of decisions of that type, ought to be attempted, or at least the possiblity of that type of approach should be explored. Those who give advice and counsel in matters of sexual surgery, would have some reference from which to make their recommendations.

[Eunuchist (imported)]

The side effects are of course pretty bad. I know that they have many more pateints now who opt for chemical castration because they are apposed to being cut. ?

"

Actually, according to several published reports, the side effects appear to be minimal and well tolerated by the patients. Most of the patients are happier with this form of treatment than those choosing other alternatives with similar cancer stages.

Some are now trying to switch testosterone with estrogen which gives them some quality of life but yikes.

Interestingly, at least according to one published study (http://www.ncbi.nlm.nih.gov/entrez/quer ... uery_hl=13)examining the mental effects of various treatment options for advanced prostate cancer, it was the conclusion of the authors that patients treated with estrogen only (wich was found to produce similar reduction of t as orchiectomy) had a higher score on the depression scale than the orchiectomy and radiation treated group. It seems that the ability to have sex played a major role for these men; for a typical male who is not interested in losing his sex drive, it is understandable that developing impotence would make him less happy. Increased feminization following estrogen treatment, similarly, was obviously another reason of concern for these men. Of course, the very idea of one being terminally ill is probably itself a major contributing factor to depression; however, the reduction of cancer symptoms following castration would usually be an important relief and a source of a greater quality of life for these patients.

I think that cancer patients generally are of very little relevance to voluntary eunuchism as their experience with castration is normally out of a strictly clinical neccessity. The same probably applies to, I would think, sex offenders and those who were castrated as a result of accidents. In these people, castration as a therapy may produce clear benefits as intended but again, their experience with castration is less valid for the majority of us here who have done it for far more personal/religious reasons, perhaps additionally coupled with certain needs wich otherwise might be defined as "medical needs" (overactive sex drive, increased masculinization, etc.).

There are clearly more reasons then cancer for this operation. Some of which include...

1) Transexuals gender issues.

2) Folks with "criminal" sex drives.

3) Damaged Testes (Atrophic, Torsion, Chronic Pain etc)

4) Religion. .

To this I would also very much add an important category called "personal reasons", wich in itself is a very broad definition and can encompass both reasons of a psychological and physical/biological character. Judging by the many accounts posted on EA, it seems that "personal reasons" is the most often mentioned definition as a rationale for castration. Examples of "personal reasons" can be some or a combination of several needs, such as:

1) Aesthetic (smooth look, "want them gone", etc.)

2) Eunuch Gender Identity

3) Dissatisfaction with cosmetic/health related consequences of gonadal hormones (eunuch health benefits)

4) Relationship issues

Etc.

You mentioned those that just don't like them. Here I hate to be the bad guy but I ponder this one and think. What if a person didn't like his arms and legs. Should a doctor be asked to perform amputations? ?

"

Your reasoning rests on a common but largely misguided premise, wich states that testicles are somehow equal to other body parts/organs, and as such would be a violation of the Hippocratic Oath if removed while otherwise "healthy". Far from being the case (pre-puberty, testosterone side effects, lifespan, pet neutering/spaying), even if we assume an individual who only wants castration because of them "hanging there", he is still very likely to benefit because (1) his psychological need would be finally fulfilled (2) most eunuchs report a great comfort of being ball-less and (3) with the use of HRT the difference between pre- and post-op would be very small. Castration as such does not result in any handicaps or life-shortening effects that would normally accompany someone who would cut off their limbs or any other healthy internal organs just for the sake of it.

[mrt (imported)]

Actually, according to several published reports, the side effects appear to be minimal and well tolerated by the patients. Most of the patients are happier with this form of treatment than those choosing other alternatives with similar cancer stages.

Interestingly, at least according to one published study (http://www.ncbi.nlm.nih.gov/entrez/quer ... uery_hl=13)examining the mental effects of various treatment options for advanced prostate cancer, it was the conclusion of the authors that patients treated with estrogen only (wich was found to produce similar reduction of t as orchiectomy) had a higher score on the depression scale than the orchiectomy and radiation treated group. It seems that the ability to have sex played a major role for these men; for a typical male who is not interested in losing his sex drive, it is understandable that developing impotence would make him less happy. Increased feminization following estrogen treatment, similarly, was obviously another reason of concern for these men. Of course, the very idea of one being terminally ill is probably itself a major contributing factor to depression; however, the reduction of cancer symptoms following castration would usually be an important relief and a source of a greater quality of life for these patients.

I think that cancer patients generally are of very little relevance to voluntary eunuchism as their experience with castration is normally out of a strictly clinical neccessity. The same probably applies to, I would think, sex offenders and those who were castrated as a result of accidents. In these people, castration as a therapy may produce clear benefits as intended but again, their experience with castration is less valid for the majority of us here who have done it for far more personal/religious reasons, perhaps additionally coupled with certain needs wich otherwise might be defined as "medical needs" (overactive sex drive, increased masculinization, etc.).

To this I would also very much add an important category called "personal reasons", wich in itself is a very broad definition and can encompass both reasons of a psychological and physical/biological character. Judging by the many accounts posted on EA, it seems that "personal reasons" is the most often mentioned definition as a rationale for castration. Examples of "personal reasons" can be some or a combination of several needs, such as:

1) Aesthetic (smooth look, "want them gone", etc.)

2) Eunuch Gender Identity

3) Dissatisfaction with cosmetic/health related consequences of gonadal hormones (eunuch health benefits)

4) Relationship issues

Etc.

Your reasoning err

s on a common but largely misguided premise, wich states that testicles are somehow equal to other body parts/organs, and as such would be a violation of the Hippocratic Oath if removed while otherwise "healthy". Far from being the case (pre-puberty, testosterone side effects, lifespan, pet neutering/spaying), even if we assume an individual who only wants castration because of them "hanging there", he is still very likely to benefit because (1) his psychological need would be finally fulfilled (2) most eunuchs report a great comfort of being ball-less and (3) with the use of HRT the difference between pre- and post-op would be very small. Castration as such does not result in any handicaps or life-shortening effects that would normally accompany someone who would cut off their limbs or any other healthy internal organs just for the sake of it.

I disagree with the "science" of your answer. Most eunuchs agree? How did you do your study? Who was included? I look at just this board and the guys who opt for a pure eunuch experience (no HRT) don't all agree here on a pro castration site that this makes them happy. And if they do opt for HRT well then you have life time costs involved.

I don't know if I'm misguided. Where do you get the value of limbs data from? Is one eyeball worth three fingers? Is two testicles worth a tongue? Just wondering out loud where you get that data? Yes, I know I'm just blathering and I admit I'm not a doctor, don't play one on TV but don't you agree that "First. Do no harm" is a pretty broad statement? They don't weigh the value of organs. I suggest for comparison you ask a surgeon to remove your spleen or apendix. They are not required and probably it would cause less trouble then after you had a Bilateral Orchidectomy. I think the majority of Doctors opt for not cutting "functional" items if they can avoid it. Sure I think some of the lack of interest in doing "voluntary" castrations is fear of later law suits. But I think in a general sense a guy who asks for it for (picking one reason) the smooth look will has some "splaining" to do with his medical board unless he is backed up by other medical and mental health expert types. I'm thinking how I would react if a young man asked me to castrate him because he had complained he had a bad relationship. Would "ARE YOU INSANE?" be too strong do you think?

Remember also that a there "may" be future costs involved if the patient opts for HRT. Life time hormone injections or rub on gels add up and there maybe some feedback from the insurance folks who will start to list that Doctor on the "Expensive" list.

As to the point about patients being happier castrated. I have several relatives who opted to die rather then be cut. Was that right? For them it was. *Note I think its insane but I understand it. BTW I have one now who is doing Estrogen for his prostate cancer. He is indeed a very unhappy man. But he is alive!

Oh, well. Thats just my 2 cents worth.

[Kangan (imported)]

I do, of course, think that the final decision should be up to the person who would be operated on.

I wish it was that simple. We think nothing of neutering our pets and livestock. How do we convince the medical community that it is okay to neuter those who voluntarily want (and need) it.

Let's leave the cancer patients out of this dicussion. I think the need for orchiectomy in prostate or testicular cancer is obvious.

On the other hand, if it is a castration fantasy (not a real world need) that drives that person to ask for castration, then I think that castration is not going to provide a good result.

What is less clear to the medical community are the "needs" of the rest of us wannabee eunuchs. For example: a sex offender who does not wish to repeat the offense; an asexual person who wishes to be rid of the need for masturbation; a person with gender identity issues; etc.

[mrt (imported)]

I wish it was that simple. We think nothing of neutering our pets and livestock. How do we convince the medical community that it is okay to neuter those who voluntarily want (and need) it.

Let's leave the cancer patients out of this dicussion. I think the need for orchiectomy in prostate or testicular cancer is obvious.

On the other hand, if it is a castration fantasy (not a real world need) that drives that person to ask for castration, then I think that castration is not going to provide a good result.

What is less clear to the medical community are the "needs" of the rest of us wannabee eunuchs. For example: a sex offender who does not wish to repeat the offense; an asexual person who wishes to be rid of the need for masturbation; a person with gender identity issues; etc.

I think we agree. I do want to ask out loud where we wish our doctors to be. Do they have the "right" to refuse service for "optional" surgery. And who decides what is optional? If I put myself in the role of the surgeon and I have a patient who thinks they would really get off on being castrated I would say "This is MY choice to tell this guy no, or refer him to a therapist." Ditto if a young man came to me and said his girlfriend dumped him and he doesn't want anything to do with sex ever again. Now, for me if a person had gender issues? I do think that is valid and would want to help them but I would want to be very sure they really were transgendered before I made it impossible to go back. I also think nutting a sex offender would not be a problem. But I would not want to be the court appointed surgeon who would do unwilling patients. *Courts make errors and I would perfer to let the criminal choose jail time (like 109 years) if he wished then operate on a man who was falsely convicted.

[Eunuchist (imported)]

I disagree with the "science" of your answer. Most eunuchs agree? How did you do your study? Who was included?

It seems that there is some misunderstanding here; what I was saying, basically, is that most eunuchs (regardless of their experience with hormones) appear to have expressed great satisfaction with the very fact of not having "hanging balls" that are "in the way" of obtaining a greater sense of physical comfort and mobility (wich probably relates to difficulties of sitting\moving in certain poses, and the enormous vulnerability men otherwise have in the groin area). My "sources" here primarily come from statements made on the EA and private communication. As I have not encountered any statements to the contrary, it is my impression that this constitutes a shared experience by most eunuchs.

Of course, the comfort that comes from being "ball-less" does not need to have anything to do with the hormonal impact of castration.

I don't know if I'm misguided. Where do you get the value of limbs data from? Is one eyeball worth three fingers? Is two testicles worth a tongue? Just wondering out loud where you get that data? .... Do no harm" is a pretty broad statement? They don't weigh the value of organs.

My point was mainly an objection to the attempts of linking such a technically minor and largely reversible procedure as a volunteer castration to the irreversible amputation of healthy limbs (wich I presume to be a very rare occurance), as if pertaining it to be on equal footing with something wich inevitably leads to direct physical disability (to varying degrees), and that it therefore ought to be viewed as a form of "mental derangement" (as mostly because what we do not, cannot, or want to understand, or fear, sadly, the best we can come up with is defining it as "sick"). In my view, and as I believe I already expressed in my previous message, volunteer castration is not any worse than tattooing or plastic surgeries, and in certain cases likely originates from very similar needs (such as those who merely wish castration as a body modification). This is also why doctors like Kimmel and the ORR clinic in Belgium are allowed to legally perform castrations without any psychiatric evaluation being required, save for a signed consent application, just as is the case for tattoos and plastic surgeries. Clearly, this would not have been the case for people who are seeking to dismember their limbs or other internal organs (wich would have to be done clandestinely), hence, I feel that this sort of "extrapolation" is completely irrelevant. For the physicians, it seems that there is a certain "value judgement" involved, after all; especially when the removal of the organ does not result in disability and the patient is likely to (significantly) benefit from the removal.

In fact, when it comes to those who are suffering from the adverse psychological and physical effects of testosterone, as I have been, IMHO, it would be pretty much an act of "harm" of not doing anything to help these people attain the relief they are so desperately asking for, and as Beau also suggested, there might be an additional risk of a complicated DYI or suicide involved.

I think the majority of Doctors opt for not cutting "functional" items if they can avoid it.

Exactly. But here they can`t really afford avoiding it; as the former APA president Robert Spitzer once said to a concerned surgeon treating a transsexual: "Well, forget about the body parts. Help the patient".

I'm thinking how I would react if a young man asked me to castrate him because he had complained he had a bad relationship. Would "ARE YOU INSANE?" be too strong do you think?

By "relationship" I meant mainly older men retaining an exhausting libido (wich puts them in danger of cheating and sexual frustration), who seek castration (it could also be chemical castration) because their wives are no longer interested in sex. Of course, an active libido is also a source of concern for asexuals who want to retain a non-sexual intimacy with their partner, without being constantly distracted by (for them) uncomfortable and unintentional sexual arousal. In most cases, castration result in an increased affection and desire for "cuddling", wich is experienced as far more pleasureable and intense than before.

However, I am personally not up to the task of judging someone`s mental state because of their rationale for castration or other "milder" forms of body modification (maybe unless a sufficient amount of detail is available, wich allows for as complete overview of the situation as possible). In most cases, my position would be that "Unless we are talking about individuals who are clearly (a) mentally retarded (b) under the influence of drugs (c) are legally insane, they should have their full right of choosing or refusing medical treatment as long as they are fully informed of the consequences".

As to the point about patients being happier castrated. I have several relatives who opted to die rather then be cut. Was that right? For them it was. *Note I think its insane but I understand it. BTW I have one now who is doing Estrogen for his prostate cancer. He is indeed a very unhappy man. But he is alive!

Perhaps I should have said «satisfied» instead of «happier» with choice of treatment; after all, I don`t think happiness is quite the description one would use for someone who is struck with advanced cancer.

Published research indicates that patients who deliberately choose castration (surgical or chemical) are, in most cases, well satisfied with their respective choices during followup, and (in one of the studies) virtually all of the patients respond that they would "do it again", if neccessary (as, however, the patients who did not chose the therapy, although to a lesser degree; however, they also had smaller cancer stages to begin with). For example:

http://www.blackwell-synergy.com/doi/ab ... 05.05802.x

http://jncicancerspectrum.oxfordjournal ... ;94/6/430/

http://www.sciencedirect.com/science?_o ... 78f087961f

[Eunuchist (imported)]

I wish it was that simple. We think nothing of neutering our pets and livestock. .

Correct me if I am worng, but I have also heard that it is supposed to be fairly easy to obtain an elective ovariectomy as means of "preventive routine" against a future risk of breast and ovarian cancers, making it theoretically possible for any female to get "castrated" on demand. If this is indeed the case, as a minimum, a similar approach should also become readily available for men in the future.

[Uncle Flo (imported)]

Correct me if I am worng, but I have also heard that it is supposed to be fairly easy to obtain an elective ovariectomy as means of "preventive routine" against a future risk of breast and ovarian cancers, making it theoretically possible for any female to get "castrated" on demand. If this is indeed the case, as a minimum, a similar approach should also become readily available for men in the future.

I have discussed this very topic with several women (wife, daughter ,a few friends). They view this situation as one of gender discrimination of the sort that shouldn't exist but, nonetheless, does. Their attitude is that men's and women's reproductive organs are valued differently, and that men's organs are overvalued in this instance. --FLO--