Voluntary castration: They felt penile removal made them more physically attractive; & at least two individuals thought that a penectomy would make them a better submissive sexual partner

Characteristics of Males Who Obtained a Voluntary Penectomy. Erik Wibowo, Samantha T. S. Wong, Richard J. Wassersug & Thomas W. Johnson. Archives of Sexual Behavior, Dec 16 2019. https://link.springer.com/article/10.1007/s10508-019-01607-8

Abstract: We report here on survey data from 11 genetic males, who had voluntary penectomies without any explicit medical need, yet did not desire testicular ablation. This group was compared to a control group of men who completed the same survey but had no genital ablation. The penectomy group was less likely to identify as male than the control group. They were also more likely to have attempted self-injury to their penis (at a median age of 41.5 years), been attracted to males without penises, and felt that they were more physically attractive without a penis than the controls. Motivations for voluntary penectomy were aesthetics (i.e., a feeling that the penile removal made them more physically attractive) or eroticism (i.e., at least two individuals thought that a penectomy would make them a better submissive sexual partner). In terms of sexual function, the penectomized and control groups reported comparable sexual function, with six penectomized individuals claiming to still be able to get and keep an erection, suggesting possible incomplete penile ablation. In their childhood, penectomized individuals were more likely than the controls to have pretended to be castrated and to have involved the absence of genitals of their toys in their childhood play. We discuss characteristics and sexual outcomes for individuals who have had a voluntary penectomy. A future study with a larger sample size on men who desire penectomies is warranted.



                              Discussion

In this study, we compared various self-reported data from
genetic males, who elected voluntary penectomy, with data
from men with intact genitals, who did not express any
desire for genital removal. We found some differences
between the two groups, in that penectomized men were
more likely (1) to identify as non-male for their gender, (2)
to have attempted self-genital injury, (3) to be attracted to
males without penises, (4) to feel attractive without penis,
(5) to have pretended to be genital-less in their childhood
and (6) to have involved the absence of genitals of their toys
in their childhood play. Other psychosexual outcomes that
can be affected by hormonal levels such as sexual function,
depression and anxiety were comparable between the two
groups.

Psychiatric Condition
From this study, a majority (8 out of 11) of the penectomized individuals
felt attractive without a penis and this feeling may have
contributed to their desire for a penectomy. In addition, at least
two individuals thought that the absence of penis allowed them
to be a better submissive sexual partner, i.e., their penectomy
desire was sexually motivated. However, we cannot explicitly
conclude if the penectomized individuals in our study have a
psychiatric condition without psychiatric evaluation. We asked if
they had been diagnosed for any medical conditions, and only two
answered, one with inflammatory bowel disease and the other
with anxiety/depression. Neither alluded to a major psychiatric
disorder. Collectively our data suggest that there are two motivations
for desiring a penectomy in our sample. Some individuals
feel that their penis is not part of their body and they may have
body integrity dysphoria. Others have a paraphilic motivation,
where they eroticize not having a penis as making them a better
submissive sexual partner.
Early Life Experience
One unexpected finding from this study was that most of
the penectomized individuals grew up in a medium-large
city, had not observed animal castration nor had been threatened
with castration in their childhood. This is in contrast
to data on individuals with an orchiectomy, many of whom
were raised on a farm, had reported participating in animal
castration and were threatened with castration during their
childhood (Vale et al., 2013). However, the Vale et al. study
included predominantly men who had just an orchiectomy,
with only 7.5% of the men penectomized. We compared data
from the penectomized men in the Vale et al. study and the
current study, but no difference was found in terms of living
conditions during childhood. The fact of being raised
in a populous location, unlike on a farm, may explain why
the penectomized individuals had never witnessed animal
castration. These findings suggest that the etiology for voluntary
penectomy and voluntary castration are likely to be
different. It remains unknown to what extent social setting
and population density influenced interest in penectomy for
these individuals.
Among those who had played with male toy figurines
that lacked external genitalia, the penectomized individuals
were more likely to notice and incorporate the absence of
genitals in their play than non-penectomized individuals.
Although our sample size is small, it suggests that for
some individuals an extreme desire for a penectomy may
be linked to their childhood exposure to such anatomically
inaccurate male action figures. Half of the penectomized
individuals (as compared to 21% of the controls), who had
played with such toys, acknowledged eroticizing their play.
It is unclear whether interest in genital ablation for these
individuals preceded play with the toys or whether interest
in such toys came from an existing displeasure with their
external genitalia. Previously, studies on girls suggest that
exposure to Barbie dolls may influence their perception
of what is an ideal body (Dittmar, Halliwell, & Ive 2006;
Rice, Prichard, Tiggemann, & Slater, 2016). Thus, there is
a possibility that, in a similar fashion, exposure to genitalless
male toys may partially contribute to the penectomy
desire by some individuals in our study sample.
In addition, we found that the penectomized individuals
were more likely to have pretended to lack male external
genitalia than the controls. Interestingly, among those in
both groups, who had pretended to lack male genitalia,
they reported starting to pretend to be genital free at about
5 years of age and after playing with genital-less male toy
figurines. To what extent this earlier experience contributed
to the desire for a penectomy or its early emergence remains
unclear. However, years (for most, decades) later, the penectomized
individuals were more likely to have attempted selfinjury
to their penis than the controls. While we did not ask
when the desire for a penectomy first arose, possibly they
delayed getting a penile ablation because they were aware of
the medical risks associated with the procedure.
There are further differences between our results and what
Vale et al. (2013) reported on childhood abuse in their study
of the Eunuch Archive community. We did not find any difference
between the penectomized men and the controls, but
Vale et al. found a higher likelihood of experiencing sexual
abuse among individuals, who had or were considering having
genital ablations, than their control group. Again, that
study included mostly castrated individuals, and the questions
for assessing childhood trauma differed between the two
studies. However, the varied results raise again the possibility
of different etiology for genital ablation for the two populations,
with penectomized individuals less likely to experience
childhood abuse than the castrated individuals. Additional
data on this topic have been collected by our team, and further
analyses are warranted.

Sexual Parameters
In this study, the religiosity levels were comparable between
the penectomized and control groups. Previously, one study
showed that individuals who had voluntary genital ablations
were more likely to attend religious services and had been
raised in a religious household than men with intact genitalia
(Vale et al., 2013). However, again, that study included participants,
who had received genital removal, with less than
10% being penectomized. Thus, their data may be skewed
toward those who were solely castrated.
We found that the self-report sexual function for the two
groups was similar. This is not surprising as penectomized individuals
were not orchiectomized and, thus, are not deprived of
natural gonadal hormones. What is intriguing is that six out
of 11 penectomized individuals reported that they still could
easily “get and keep” an erection despite having been penectomized.
Unfortunately, we do not know the extent of the penile
ablation in our sample, i.e., we do not know, for example, if the
individuals were fully or only partially penectomized. Those
with partial penectomy may still be able to have some penetrative
sex by using the remaining penile stump. Even with a
full penectomy, the roots of the penis remain embedded in the
perineum, and such individuals may still sense some erection
in the penile root.
Our data on erection contrast with what has been reported
for the majority of penectomized penile cancer patients, who
report impaired erectile function (Maddineni, Lau, & Sangar,
2009; Sosnowski et al., 2016). However, most penile cancer
is in men over the age of 55 (www.cance r.org/cance r/penil
e-cance r/cause s-risks -preve ntion /risk-facto rs.html), and older
than the average age of the penectomized individuals in our
study. This comparison suggests that the reasons for having
a penectomy may contribute to one’s perceived erection after
the procedure—penile cancer patients undergo the treatment to
survive, whereas the individuals in our study purposely sought
penectomy when it was not explicitly medically necessary.
What we cannot deduce is how much of these perceived
erections are phantom erections, where one feels an erection
in the absence of a penis (Wade & Finger, 2010). Previous
studies have indicated that some male-to-female transsexuals
(Ramachandran & McGeoch, 2008), men penectomized for
other reasons such as penile cancer (Fisher 1999; Crone-Münzebrock,
1951 as cited in Lawrence 2010) experience phantom
erections after penectomy.

Limitations
Our study has several limitations. First, our sample size of individuals,
who have been penectomized but retained their testicles,
was small, i.e., just 11 individuals out of the 1023 who responded
to our survey. This affirms, however, how uncommon it is for men
to seek a penectomy in the absence of other genital modifications.
It is important to note that our survey was posted on Eunuch.org,
a website for people who are primarily interested in “castration”
and not necessarily “penectomy.” Respondents to our survey
were men with interest in all castration-related topics, but only
approximately 10% of the respondents claimed to have had genital
ablations. We know of no dedicated website for people who are
interested in penectomy alone.
Secondly, as the data were self-reported and anonymously
obtained, we cannot confirm the veracity of the data on genital
ablations. Participants were asked broadly about their genital
ablation status, but not interrogated about the exact extent of
penile tissue removal. Information on childhood experiences
is susceptible to recall bias. Lastly, regarding the controls, that
group was composed of men who visited the Eunuch Archive
website and thus have interest in genital removal, which may
be rarer in the general population.