title: An American hijra: a report of a case of genital self-mutilation to become India's "third sex".
abstract: We report a case of male genital self-mutilation related to the subject's desire to become a "hijra," the "third sex" described in East Indian mythology. The patient is the first American hijra of which we are aware. He emasculated himself, performed a penectomy, and created a perineal urethrostomy. This report adds another potential cause for genital mutilation of which the urologist should be aware, along with accidents, gender dysphoria, psychotic self-injurious behavior, and assault.
authors.affiliation: Department of Urology, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
authors.forename: Viraj
authors.initials: V
authors.lastname: Master
authors.forename: Richard
authors.initials: R
authors.lastname: Santucci
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D006801:Humans; D007194:India; D008297:Male; D009229:Mythology; D009919:Orchiectomy; D010413:Penis / Q000601:surgery; D012652:Self Mutilation / Q000523:psychology; D014189:Transsexualism; D014481:United States / Q000208:ethnology; D014521:Urethra / Q000601:surgery; D014546:Urinary Catheterization