In 1967, John Money and Duane Alexander published an article on the treatment of four individuals with anorchia (no testicles, with unknown cause) and four with present but non-functional or minimally functional testicles. The four with anorchia would be very similar to prepubertal eunuchs in that they had testicles, but their testicles had disappeared by the time that they were toddlers. What follows is about the four with anorchia, who were seen at various times over a period of some years.

The four individuals were first seen by John Money at ages 13, 17, and two at 21. One of the 21 year-olds had had a brief bout of oral testosterone at age 12, but he decided then against continuing it, despite that his mother was a nurse and his twin brother had fully functional testicles. He reported that he just thought that his brother had "gotten everything." He only began testosterone treatment with Money after he was referred to Money's clinic after an emergency appendectomy at age 21. Money and Alexander report a much fuller history for him than for any of the others in the study.

All four of the anorchic individuals were reported as having "eunuchoid" appearance - macroskeletal development (longer than normal arms and legs) and a penis of prepubertal size, although with a slight amount of pubic hair from adrenal androgens. All retained treble voices. All four had regular, though infrequent, erections before treatment with testosterone, ranging from about one per week to a few every day. Three reported that thoughts of a pretty girl or looking at a pin-up stimulated their erections. (The question wasn't asked of the fourth.) Masturbation frequency ranged from "occasional" to "1 to 3 times a week." All reached some sort of pleasurable climax, though with no ejaculation. The reported climax was described variously as "tickling," "gushing," "throbbing," "pulsing," and "like climbing a mountain and falling off the edge." All reported that the addition of testosterone did not change the nature of the sensation or add a new feeling, but increased the intensity and depth of the feeling.

One of them reported that, in mutual masturbation sessions with other boys his age, he reached "climax" at an age before other boys could ejaculate. The 13 year-old was the only one who did not regularly date girls before testosterone treatment.

All four reported an increase in frequency of erections after beginning testosterone. All reported that testosterone had no effect on the content of their erotic dreams and daydreams, though frequency increased. All began to have ejaculations some months into treatment.

The article includes much more information about one individual. He reported that he began "dating" at age 12 and had his first successful sexual intercourse with a girl at age 16. He married at age 19 and both he and his wife (in separate interviews) reported that they had pleasurable sexual intercourse about three or four times per week. Since he was very slow to reach his climax, his wife reported that she regularly experienced an orgasm with sexual intercourse. When first examined by John Money at age 21, his penis was of prepubertal size and he had a small wrinkled scrotum. He had no palpable prostate gland, very light pubic hair and a high-pitched voice. X-rays showed a "bone age" of 12 to 14 years.

Money reported that he was poised, self-confident, and adult in his conversation, though still looking like a young teenager. He did report that he sometimes felt self-conscious about his immature appearance, particularly during his teenage years. It was not enough to keep him from dating, swimming, showering with the other boys, or getting a job as a shipping clerk. He said that he received almost no teasing from other boys, although he once had to verbally defend himself in the shower room from a boy who called him "ball-less."

When asked about masturbation, he said that in his teens he and some friends would sometimes go to the park or one of their bedrooms to masturbate together. The others were able to ejaculate, but he never was. He said that he might keep his penis erect for an hour or so.

Regular testosterone injections caused him to go through a very delayed puberty and masculinize. He reported that his sexual frequency went from 3 or 4 times per week to 6 or 7 times. He experienced his first ejaculation, which added to the pleasure of intercourse.

The man then stopped taking testosterone for 8 months to see what would happen.

As now equivalent to a post pubertal, rather than a prepubertal eunuch, he complained about loss of energy, less frequent erections and the loss of the ability to ejaculate. He was able to obtain, with difficulty, a sufficient erection for sexual intercourse with his wife, although the frequency dropped to about once a week. He thought that he had a greater sex drive before taking testosterone and going through puberty than he had after puberty with no testosterone.

He went back on testosterone, learned to give himself the monthly injections and was not seen again by Money.

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Money, John & Duane Alexander. (1967). Eroticism and sexual function in developmental anorchia and hyporchia with pubertal failure. Journal of Sex Research, vol. 3, no. 1, pp. 31-47.

NOTE: Duane Alexander was still a medical student when much of the writing of this article was done. He later went on to become an eminent pediatrician and the director of the National Institute of Child Health and Human Development. After he retired in 2009, he became the senior scientific advisor to the Fogarty International Center of the National Institutes of Health, a position that he still holds.

That is interesting to read. It gives me some confirmation to my emperic observations after reading pub med and other stuff, that over time T-receptors get desensitized.

During real puberty T levels do not increase over night, instead they start to rise slowly, requiring about two years to reach close to maximum levels. But it feels like T-levels rise to maximum within few months. Regarding erections and sexual drive/fantasies. And in older men higher T-levels do not give neccessarily more erections or sex drive.

T seems to be addictive substance as well.

I'm disappointed by the response here. I thought that someone might bring up what I thought most interesting about the brief case study by Money for me to expand upon. I would certainly like much more information than the article has, but there's a hint of something quite important....

We have data about someone who clearly had testicles before birth (necessary to produce a penis and to masculinize his brain). Those testicles were not present (for unknown reasons) by the time he would have normally gone through puberty, making him a prepubertal eunuch. He was pushed through puberty at age 21 to 22 to become fully male, other than being sterile without testicles. He then went off testosterone to become a post pubertal eunuch for a period of time. One individual with all three stages.

The few bits that Money included in his article from that 8-month period without T (as a post pubertal eunuch) are very interesting. He reported that he suffered from loss of energy, to below what he had had as a prepubertal eunuch. He complained that his sex drive and sexual ability were both greater as a prepubertal eunuch than as a post pubertal one. As a prepubertal eunuch he had erections multiple times per day. He was able to have mutually satisfying sexual intercourse, which he initiated, with his wife three or four times per week (for over two years of marriage before beginning T). As a post pubertal eunuch he reported that he no longer got erections when he saw a pretty girl. He had sex with his wife only about once a week. When he did have intercourse he reported that it was not as pleasurable as it was when he was a prepubertal eunuch.

All four of those in the article, despite having not had testicles since they were very young, had frequent erections and masturbated regularly. So much for prepubertal eunuchs being "sexless." They were also all strictly heterosexual, contrary to so much of the EA fiction.

The four who were described in the article would be in their late 60s or early 70s today. In the style of medical articles of the time, they are described by their real initials. The four are PB, OT, LM, and RB. They may still be living in the Baltimore area.

That piece was really interesting.

But I am not sure how to respond. (And in part it brings at least some emotions, which I am not sure I can properly express).

I wonder - was testosterone even necessary, or was it, like other Money's experiment... (not sure if what I wrote makes sense).

I mean - both husband and wife are mostly happy (or I read it that way), no testicles means that it is not jumpstarting puberty for fertility or similar reasons. And ending up dependent on testosterone. I just do not know.

I hadn't had a chance to read this in detail until now, but it's interesting - I suspect the "addictive" effect of testosterone is epigenetic in nature, causing permanent (but potentially reversible) effects on DNA methylation and acetylation. (a potential CRISPR/CAS9 target?)

How often do patients like this present? This seems like a really good target for modern, high-throughput massively-multiwell gene-activity screening assays. (https://en.wikipedia.org/wiki/DNA_microarray) What genes get switched on and off at each of the three checkpoints here? (prepubertal eunuch-to-male, male-to postpubertal eunuch, postpubertal eunuch-to-male) Combined with data on eunuchs living longer, I bet we could suss out the difference, and put it in a pill.

Also, given the use of testosterone and testosteroids in doping primarily because they cause wear and tear to heal faster, I bet the same assays could figure out what exactly they do to encourage healing, and put that in a pill, too - but without the chronic high blood pressure or 'roid rage.

Certainly there is some desensitisation to Testosterone going on when body is exposed to high testosterone levels.

During normal puberty Testosterone levels rise slowly not very abruptly, but it feels like sex drive goes through roof almost immediately. When people experience wetdreams it always happen during puberty.

It would be interesting to know what degrades T-sensitivity and why. there could be solution for people who have T-levels in normal range but have very little sex drive.

I remember that before puberty I masturbated at least once a week. I was pretty sexual being.

Side question. IF being Castrated before puberty or not having testicles at birth causes arms and legs to grow exceptionally large, Is this a trait found only in Humans or do all Mammals suffer this effect if Castrated before puberty? Do Horses or Cattle grow longer legs than those left intact? Certainly there should be animal husbandry practices that would take this into account, and be a desired goal with certain animals like horses who could cover more ground with longer legs.

Come to think of it, Eunuchorn, I never noticed that with animals.

Castration in farm animals is used to increase the rate of growth of body mass ,ie fatter quicker ,as well as calmer. I think it is soft tissue rather than hard tissue that grows.

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