This morning I received the email below from a psychologist colleague who is well known for his work with prostate cancer patients. As many of you know, PCa is testosterone dependent and a great many men with prostate cancer are castrated -- mostly chemically (known as Androgen Deprivation Therapy - ADT), though many of them surgically.

Here's the request for advice and help:

Do you know a gay man on ADT [though surgical would certainly do just as well for advice] who has adjusted well who might be willing to talk to a patient of mine.

My patient has a rapidly rising PSA after RP and has been told that once his PSA gets high enough he will have to start ADT. He saw The Imitation Game the other night and concluded, that for gay men, their life is over when they are on ADT. He thought he might as well suicide like Alan Turing....

I have been counseling him on the phone; he lives in Edmonton. I'm the best person he has found to talk to but he really wants to talk with a single gay man on ADT....

Any suggestions are welcome.

Any and all advice would be greatly appreciated. Having prostate cancer is not the important part of the request; being gay and castrated without HRT is. I'm sure that this person is not the only one and John Robinson, the psychologist who made the request, is highly influential. Anything we can do to help will spread through the prostate cancer community to help many others.

It sounds as if the gentleman in question is having a difficult time separating his sexuality from his drive. Which, prior to having an operation is understandable. Has the doctor gone down the road of letting him know that while, yes, his sexuality will change, the surgery is also likely to make it to where he won't care about sex. Basically he'll enjoy other things that he enjoys now, without the sex drive getting in the way.

One important piece missing for me is we do not know the age of the individual in question, a young man in his 20's who is involuntarily being castrated will likely take this much differently than a man in his 70's who has had a long and fulfilling sex life.

The short bit of time I had without my testosterone showed me that sex isn't everything. It was actually quite relaxing to not have a sex drive for a while and it allowed me to concentrate on other joys in life. Losing testosterone doesn't equal loss of enjoying life. It could open up new doors to other pleasures, though probably not sexual ones. I would be happy to talk to him, but I'm not sure the short time without testosterone I had would give me a good enough basis to do so. However, I would at least have a glimpse for him to understand what it may be like.

My concern out of everything read above is his suicidal ideation related to castration. His balls don't make him a man, what's between his ears does. There is at least one user here I think would be good for him to talk to, but that person will have to ID themselves.

--LT

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JesusA (imported) wrote: Sun Jan 25, 2015 1:59 pm He saw The Imitation Game the other night and concluded, that for gay men, their life is over when they are on ADT. He thought he might as well suicide like Alan Turing....

I have no relevant experience with homosexuality or with castration without HRT, but I think it's worth noting that the movie in question should not be the basis for making such an important medical decision. Turing had a unique personality. He was unusual not just for his genius IQ and his homosexuality but for other personality quirks as well. What happened to him has at least as much to do with that personality and the unique circumstances he faced as it has to do with his chemical castration. It would be unrealistic to assume that his case would be typical of chemically castrated gay men in general based on his life alone and in particular based on a Hollywood depiction of his life. I think it's important to get this man a more realistic picture, and I wish I had one to offer.

Sandi

As far as I am concerned, Sandi earns one year free membership in the EA for that post. Pay attention to an even handed and common sense post.

Keep in mind that it was a MOVIE, and Hollywood presented a Hollywood look at Turing's life. He had to take Estrogen for a year, and he had been off of it for a year before he died.

He even told someone that was shocked by his having to take the hormone that it wasn't so bad.

Some even believed his death was an accident instead of a suicide. He often used cyanide in his experiments.

Movies take a bit of this and a bit of that from history and come up with what will make a good story. Although I enjoyed the movie at the time, the movie wasn't Turing's story. He actually got along well with people and had a sense of humor.

Although the Russian spy was a real character, he didn't work with Turing, who probably never even met him. Turing was actually fairly open about his homosexuality, and no one ever thought Turing was a spy or that he protected any spy.

C&TL2745 (imported) wrote: Sun Jan 25, 2015 3:41 pm I have no relevant experience with homosexuality or with castration without HRT, but I think it's worth noting that the movie in question should not be the basis for making such an important medical decision. Turing had a unique personality. He was unusual not just for his genius IQ and his homosexuality but for other personality quirks as well. What happened to him has at least as much to do with that personality and the unique circumstances he faced as it has to do with his chemical castration. It would be unrealistic to assume that his case would be typical of chemically castrated gay men in general based on his life alone and in particular based on a Hollywood depiction of his life. I think it's important to get this man a more realistic picture, and I wish I had one to offer.

Sandi

I have also seen that movie and I agree with Sandi and will also add that ADT drugs have probably come a long way since 1946 as well, so don't accept Turing's experience as gospel and definite in happening today. Another factor is that from my observance of his behaviour as portrayed in the movie, he was a very high functioning autistic and this will also affect the way the drugs react with the system.

Gay or Straight loosing your balls is not the end of the world, in many cases its the beginning. His sex is between his ears not between his legs. My advise is that he should at least try chemical castration for a year before trying to end his life, if he is talking about that then I think he may have many more issues besides the loss of his balls.

River

It sounds like he has a sexual fixation of some sort. The self-treatment of the fixation is a result of using sex to self-treat a functional case of depression. Sex becomes the object of living. It would be a form of sexual addiction. He needs a therapist in a bad way. If you only live for sex you do not have a very fulfilling life.

I started off doing ADT for the first 3 months to make sure I wanted full castration. I did.

I lived without testosterone for a couple years. It was exactly what I wanted. I eventually went back on testosterone to get rid of the hot flashes. For some reason mine didn't go away.

Anyway, I'm gay (though not single), I had a negligible testosterone level (~6-20 IIRC) for a couple years. Happy to talk.

lol my hot flashes lasted about 5 or 6 years, the worst were over in the first two and I still felt heat to about 8 years the last several years nothing.