Abstract
Background Although uncommon, some individuals assigned male at birth (AMAB) seek voluntary genital ablative procedures, and others fantasize about it.Aim To learn more about the views of genital ablation and injuries in those who aspire to be castrated as compared with those who only fantasize about it.Methods A survey was run on the Eunuch Archive internet community. Content analysis was conducted on the responses of 342 AMAB individuals with castration fantasy but no desire for actual surgery (fantasizers) vs 294 AMAB individuals who expressed a desire for genital ablation (aspiring).Outcomes Study outcomes were responses to open-ended questions about genital ablations and injury.Results Aspiring individuals were more likely to perceive a "physical appearance benefit" from orchiectomy, but fewer could recall how they first learned about the procedure. Some reasons that aspiring persons gave for desiring an orchiectomy included "achieving preferred self" and "health reasons." Fantasizers, in contrast, worried about the potential side effects of orchiectomy, and more believed there to be no benefit to it.Clinical Implications Psychiatrists and other clinicians need to understand their patients' views on genital ablation to properly diagnose and provide the best personalized care.Strengths and Limitations Strengths include a large sample of respondents. Limitations include the accuracy of the anonymous survey data.Conclusions This study demonstrates divergent interests on genital ablation among AMAB individuals who have not had an any genital ablation yet have intense interest in the topic.