Abstract
Background: Little is known about childhood experiences, outcomes, and self-recollections of those men who were voluntarily castrated as adults.Aim: The 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.Methods: We 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.Outcomes: Learning 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.Results: As 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 (chi(2) (1) = 5.342, P < 0.05), had thoughts of performing self-castration (chi(2) (1) = 10.389, P < 0.01), witnessed animal castration (chi(2) (1) = 10.023, P < 0.01), been threatened with castration as a child (chi(2) (1) = 21.749, P < 0.001), had childhood physical trauma (chi(2) (1) = 4.318, P < 0.05), had childhood emotional trauma (chi(2) (1) = 3.939, P < 0.05), and had childhood sexual trauma (chi(2) (1) = 5.862, P < 0.05).Clinical implications: Mental 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 limitations: This 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.Conclusion: Understanding 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.