Exposures to information about castration and emotional trauma before puberty are associated with men’s risk of seeking genital ablation as adults

Abstract

AbstractBackgroundLittle is known about childhood experiences, outcomes, and self-recollections of those men who were voluntarily castrated as adults.AimThe study sought to determine how learning about castration before and after 13 years of age is associated with differential childhood experiences, outcomes, and self-recollections of those who were voluntarily castrated as adults.MethodsWe designed a survey of voluntarily castrated individuals, who learned about castration before and after 13 years of age. Our survey consisted of both validated questionnaires and questions. Data were from 208 individuals. Both descriptive and quantitative statistics were performed.OutcomesLearning about castration before 13 years of age is associated with more adverse childhood experiences (ACEs) such as being threatened with castration and other forms of emotional, physical, and sexual trauma.ResultsAs compared with those who learned about castration after 13 years of age, those who knew about castration earlier were more likely to have self-injured their penis (χ21 = 5.342, P < 0.05), had thoughts of performing self-castration (χ21 = 10.389, P < 0.01), witnessed animal castration (χ21 = 10.023, P < 0.01), been threatened with castration as a child (χ21 = 21.749, P < 0.001), had childhood physical trauma (χ21 = 4.318, P < 0.05), had childhood emotional trauma (χ21 = 3.939, P < 0.05), and had childhood sexual trauma (χ21 = 5.862, P < 0.05).Clinical ImplicationsMental health screening and support should be offered to any men seeking emasculating procedures in line with the World Professional Association of Transgender Health’s Standards of Care Version 8.Strengths and LimitationsThis study had a large sample size and used a validated questionnaire to evaluate for ACEs. The average age of respondents was above 50 years of age, which may increase recall bias.ConclusionUnderstanding how ACEs influence the age when some eunuchs first desire, pretend, and become castrated can help clinicians develop better assessments and treatment protocols for individuals with male-to-eunuch gender dysphoria, and other conditions in which emasculating medical procedures are requested.