title: Eunuchs in contemporary society: expectations, consequences, and adjustments to castration (part II).
abstract: BACKGROUND
  There are men in the Western world who are voluntarily castrated and are not male-to-female transsexuals.
  
  
  OBJECTIVE
  We surveyed members of this group to understand their responses to androgen deprivation (AD) and how their experiences matched their expectations of AD.
  
  
  METHODS
  We posted a questionnaire on the Eunuch Archive (http://www.eunuch.org) that received responses from 92 voluntarily orchiectomized males who identified as eunuchs. Data from this questionnaire were supplemented with interviews with 19 of the eunuchs.
  
  
  METHODS
  Participants completed questionnaire items regarding: (i) the side effects they expected and experienced; (ii) their current physical and psychological condition; (iii) their level of regret; (iv) what they appreciated most about their castrated status; and (v) who performed their orchiectomies.
  
  
  RESULTS
  The most appreciated aspect of castration was the sense of control over sexual urges and appetite (52%). The major side effects experienced were loss of libido (66%), hot flashes (63%), and genital shrinkage (55%). The population had high self-rated sociability, and mental and physical health. Although there was an insignificant reduction in depression after castration, the overall level of self-reported obsessive-compulsive disorders decreased significantly (P < 0.01). Twenty-two percent of the population reported a change in sexual orientation. Many respondents (60%) took supplemental hormone treatments to counteract the side effects of AD. The use of both supplemental testosterone and high-dose estrogen correlated with a significant increase in self-reported sexual desire and activity above the agonadal level (P < 0.001). The majority of the castrations (53%) were not performed by medical professionals.
  
  
  CONCLUSIONS
  The medical community needs to be aware of men at risk of unsafe castrations in order to provide them with more information on the side effects of AD and access to safe orchiectomies.
authors.affiliation: Anatomy & Neurobiology, Dalhousie University, 5850 College Street, Halifax, Nova Scotia, Canada.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Brett
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Roberts
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Johnson
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wassersug
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002369:Castration / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D007989:Libido; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009919:Orchiectomy / Q000523:psychology*; D012649:Self Concept; D012652:Self Mutilation / Q000523:psychology*; D019529:Sexuality / Q000523:psychology*; D011795:Surveys and Questionnaires