Three cases of genital self‐surgery and their relationship to transexualism∗

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Abstract
In three cases of self‐performed genital surgery, the ideology was related to, but not the same as that of, transexualism. One man, genuinely paranoid, wanted to be a hypospadiac so as to reveal to mankind the lost secret of the alchemists, namely, the urethral orgasm. Another, also paranoid, amputated his penis and wanted an ileostomy, so as not to contaminate his rectal vagina with feces. A third, not paranoid, castrated himself so as to be able to feel more girlish, while not having to abandon his close relationship and companionship with his wife. In all three cases there was no evidence of true masochism. There was an element of the secretiveness of Münchausen's syndrome, which served to avoid moral chastisement and social stigmatization. The etiology of the syndrome is unknown, as is the prognosis with and without the surgery that the patients so earnestly request and give, at least in part, to themselves.

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