RESUMO
We used a survey posted on the Internet to explore the motivation of men who are interested in being castrated. Out of 134 respondents, 23 (17%) reported already having been castrated. The 104 (78%) individuals who said they had not been castrated were asked why they wanted to be castrated and why they had not actualized that desire. They were given multiple-choice answers to select from. The major reason (selected by 40% of respondents) for desiring castration was to achieve a "eunuch calm" and freedom from sexual urges; however, a large proportion (approximately 30%) of respondents found fantasies about being castrated sexually exciting and a similar percentage desired castration for the "cosmetic" appearance it achieved (which we interpret to mean scrotal removal along with an orchiectomy). This high interest in castration as either a sexual stimulus (a fetish) or a cosmetic enhancement was unexpected and contrasted with the more classically stated motivation for voluntary castration in the psychiatric literature, i.e., libido control and transsexualism. Internet discussion groups that serve these men may encourage them to act out their castration fantasies. Alternately, Internet discussions may give them a displacement outlet for their fantasies and decrease the risk of castration by nonmedically qualified "street-cutters" or by self-mutilation. Forty percent of our respondents claimed that they would have an orchiectomy, if it were cheap, safe, and simple. A quarter wanted to try chemical castration first, but 40% were embarrassed to talk to their doctors about their interest in castration. Information now available on the Internet provides these men with increasingly easy access to street-cutters and directions on how to perform surgical castrations, putting them at risk of permanent injury and disability. Physicians need to be aware of these risks.