In September 2022, the International Journal of Transgender Health published the updated eighth edition of the “Standards of Care for the Health of Transgender and Gender Diverse People.” The document had been compiled by a large panel of scientists and clinicians on behalf of the World Professional Association for Transgender Health (WPATH), an organization formed in the 1970s “to promote evidence-based care, education, research, public policy, and respect in transgender health.” The updated guidelines included several chapters dealing with categories of persons newly included under the widening umbrella of “Transgender and Gender Diverse.”
The shortest among these new sections is Chapter 9, on “eunuchs.” The presence of this term in a medical document stands out for several reasons. Unlike classifications of recent invention like “nonbinary,” “eunuch” refers to a type of person whose existence has been recognized for most of recorded human history. Moreover, the word conjures up an image of a sexless being created by archaic systems of slavery and despotism—the very antithesis of the modern ideals of personal and sexual freedom that underpin the LGBT movement. If WPATH is offering guidance to clinicians on treating this category of patient, that suggests that a person might freely and rationally choose to undergo surgery not in order not to change from one sex or gender to the other, but to become something long seen as degraded. The fact that this is the case points to discomfiting ambiguities in our evolving regime of sex and gender.
The WPATH chapter on eunuchs begins by asserting that “among the many people who benefit from gender-affirming medical care, those who identify as eunuchs are among the least visible,” and it goes on to define “eunuch individuals” as “those assigned male at birth (AMAB)” who “wish to eliminate masculine physical features, masculine genitals, or genital functioning,” as well as those who have already had their testicles removed or disabled for medical reasons and “identify as eunuch.” It concludes by recommending that health care providers “consider medical intervention, surgical intervention, or both” if “there is a high risk that withholding treatment” may lead to harm through “self-surgery” or “surgery by unqualified practitioners.”
When WPATH’s new material dealing with “eunuchs” surfaced, it threw new fuel on the already raging fire of controversy over transgender identity and medical care in Britain. When, as early as June 2022, even before WPATH’s eighth edition of the Standards of Care had been formally published, NHS Scotland posted an advance draft on their website, it provoked a swift backlash. Susan Smith, the head of For Women Scotland and a leading opponent of Scotland’s pending Gender Recognition Act, expressed shock and disgust that the health service would “align with any organisation pushing ‘eunuch identity’ … This is a barbaric practice which, for centuries, was used to demean and abuse young men and boys.”
The NHS subsequently deleted and disavowed the document, claiming that it was posted “in error,” but the British press was fascinated by the novelty of casting the category of “eunuch” as a gender identity. LBC ran an article about the Scotland fracas under the title, “NHS apologises for claiming eunuch is a gender identity,” and in September, when the new WPATH guidelines formally hit the presses, the Daily Mail ran the headline: “Eunuch is a gender, says prominent pro-trans advocacy group.” The article underlined the evident absurdity of the notion by pointing out that “Historically, [eunuchs] would be servants or slaves who had their sex organs removed against their will,” citing the fictitious Lord Verys from Game of Thrones as an illustration.
“WPATH’s eunuch chapter is vague, oblique, and self-contradictory.”
While the WPATH guidelines don’t explicitly state that “eunuch” is a gender identity, they can be seen to imply as much when they claim that like other “gender diverse individuals, eunuchs may also seek castration to better align their bodies with their gender identity.” However, in the next paragraph, they state that “eunuch individuals identify their gender identities in various ways.” In reality, WPATH’s eunuch chapter is vague, oblique, and self-contradictory because it tries to fit a square peg into a round hole. The guiding assumption behind transgender care has been that individuals first adopt or express an internalized gender, and then seek medical interventions to “align with” or “confirm to” this identity. This logic doesn’t apply to modern-day self-identified eunuchs, who typically seem to proceed in the opposite direction, first seeking to change their bodies, and then adopting or fashioning identities in order to reflect them.
The category of “eunuch” has been revived and embraced over the past quarter-century by a wide range of men who, for a staggering variety of reasons, most of which do not stem from identity per se, seek to be castrated. The internet has allowed these men to coalesce, communicate, and record their experiences and desires. A website called “Eunuch Archive,” since launching in 1998, has attracted over 130,000 registered users and even more guests, who have produced over 200,000 posts organized in 23,000 threads. The site attests to the slow emergence of a subculture driven not by identity, but by an overwhelming and often dangerous desire for castration.
This urge usually emerges in childhood or adolescence, and often, although shrouded in shame and secrecy, becomes all-consuming. Many posts by longtime users allude to the “bad old days” when aspiring eunuchs sought out “cutters”—amateur or disreputable surgeons who agreed to perform the procedure under the table, often leading to injury or death, in a process that some liken to back-alley abortions. Only gradually did a network emerge of professionals willing to administer surgical or chemical castration safely on the basis of informed consent.
Some who seek castration harm themselves in order to obtain it. In 2015, the journal Sexual Medicine published a case report of an otherwise healthy adult heterosexual man with no history of sexual abuse who appeared in his doctor’s office with testicular pain, swelling, lumps, and other symptoms of what seemed to be cancer. His biopsies came back negative, however, and the patient acknowledged that he had been injecting alcohol into his testicles for a year in the hope that they would have to be surgically removed. He said that if medical professionals would not perform the procedure, he would attempt to do so himself. He underwent a psych evaluation and was found to be sane, but some time later appeared in the emergency room, having removed his testicles at home and needing ligatures to contain the bleeding. Afterwards, he was again declared sane, given testosterone gel to maintain sexual function, and as of publication time, was reportedly content.
One may wonder why anyone would resort to such a ghastly act—much less how someone could do so and be declared “sane.” Yet the report in Sexual Medicine does not explore the patient’s motives or state of mind. Rather, it places the incident under the heading, “A Rare Case of Male‐to‐Eunuch Gender Dysphoria.” Thus, although the patient never even reportedly used the words “gender” or “eunuch,” the authors assume his motive to be self-explanatory if it can be attributed to the desire to change genders. In the same way, the WPATH guidelines reason by analogy from transgenderism. Both WPATH and Sexual Health, in seeking to extend medical legitimacy to the act of castration, mystify rather than illuminate the motives behind it.
“Their motives are at once more strange and more ordinary than one might expect.”
The words and deeds of self-declared eunuchs show that their motives are at once more strange and more ordinary than one might expect—more bizarre from the vantage point of our present-day obsession with gender and sexuality, but eerily familiar from a more distant historical perspective.
Gender is tangential to the eunuch’s quest. A long discussion thread on Eunuch Archive from 2018 reveals that there is no consistency in how eunuchs place themselves in the gender schema. Many see themselves as belonging to a subcategory of males, or present themselves publicly as men but privately consider “eunuch” as their sex. A small portion understand themselves as androgynous, combining male and female aspects, while others prefer to think of themselves as “neutral” or as lacking gender entirely. Most eunuchs are indifferent to gender pronouns or conventions of speech and dress; the author of a 2018 post even complained, “I don’t understand exactly what the terms ‘gender’ or ‘gender identity’ mean.”
The subculture defines itself on the basis of the common goal of castration. The category of “eunuch” is merely a means to an end, invoked in furtherance of unity within the group and legitimacy without. Eunuch organizers and advocates are clearly aware that male castration has a much longer and better-attested history than does sex reassignment. They invoke the category of “eunuch” to lay claim to that historical precedent while accommodating the group’s variety—as evidenced, for instance, by the landing page of Eunuch Archive, which features a Greco-Roman colonnade with Corinthian capitals against a Turkish mosaic tile backdrop.
This still leaves open, of course, the question of why anyone would want to be castrated in the first place. The forums on Eunuch Archive reveal a wide variety of motives, the broad themes of which come into focus under careful examination. Most desire only an orchiectomy (removal of the testicles), while others seek penectomies as well. Some users and guests on the archive express an erotic attraction to the fantasy of being castrated (especially by a female surgeon), but actual eunuchs warn that this is a poor and insufficient motive, and very few of these fetishists ever go through with the act. Some fraction of eunuchs are obsessed with body modifications like tattoos and piercings, and desire a “smooth” pubic area—but it is unclear how often aesthetics are the sole or primary motive for castration. Some eunuchs report having suffered childhood injuries which caused pain or disfigurement of their testicles, while many others evidently suffer from Body Identity Integrity Disorder, a neurological condition that causes sufferers to perceive an appendage—most often either the genitals or the left leg—as an alien attachment, and to desperately desire its removal.
But the most prevalent motives for a man to wish to become a eunuch cluster around a sense of horror and disgust at his own genitalia and at their effects upon his mind and body. This revulsion tends to emerge in his childhood or adolescence, especially puberty, as he perceives physical masculinity, sexuality, or both as alien forces seizing control of him. The self-alienation persists into adulthood, and the man wishes to be freed from the tyrannical power of testosterone and the feelings of aggression, emotional volatility, and irrational sexual impulses that it fuels.
One contributor to Eunuch Archive, who claimed to have stopped just short of removing his own genitals at home with garden shears, wrote in 2021 that “an erection [symbolizes] a lack of control, and when it seemingly happens by itself without input, it exerts a hold over my emotions. It’s like my body is raping me. And there hasn’t been a time where I haven’t cried as a result of this.” This user expresses in more extreme terms a complex of feelings shared by many eunuchs. Conversely, those who have undergone castration boast of achieving the vaunted “eunuch calm”: a state of balance and serenity following the drop in testosterone. One eunuch wrote in 2023 that after his procedure, he “felt liberated! It was only pure me that was left! I enjoyed that sexless mind I got with castration.”
This is not to say that modern eunuchs are asexual—many of them, like their ancient predecessors, still produce enough testosterone to achieve arousal, and some take supplements in order to continue their sex lives—but they feel greater rational control over their sexual drives. Hence, while the man who removes his testicles may appear crazy to most ordinary people, from the point of view of the eunuch, it is the rest of us—volatile, lustful, needlessly competitive and avaricious—that are insane.
Modern eunuchs perceive their lives as a struggle between mind and matter, spirit and flesh. Although extreme, the eunuchs’ laments echo Saint Augustine’s anguished Confessions and of his argument that the erection uniquely symbolizes original sin. The similarity to Christian ascetic traditions may be unconscious, but it is not surprising considering the eunuchs’ social backgrounds, which do not reflect the demographics that one would associate with the cutting edge of the LGBT movement. A survey of eunuchs published in 2022 in Archives of Sexual Behavior found that a disproportionate share of them had grown up in rural farming communities (where most of them witnessed or took part in the castrating of livestock), and that they were more likely than others to have been raised in religious households.
Some eunuchs overtly relate their need for castration to their spirituality. In 2024, a user who described himself as a man in his late 20s posted on Eunuch Archive that, having suffered a childhood injury to his testicles, he does not “feel like a normal man. I’m still basically androgynous, but I’m becoming more like an asexual eunuch. Being a religious, celibate, eunuch is meaningful to me. I’m not sexually active and I pray a lot.” (Considering their backgrounds, it should not be surprising that the eunuchs’ political views, too, are widely varied. Discussion of politics—especially the topic of abortion—is strictly forbidden on Eunuch Archive.)
Many readers will surely object that modern eunuchs’ religious justifications of castration are at best a perversion of Christian teachings. But religiously motivated, voluntary castration has a long history that both predates Christianity and has echoes in Christian history. The act of castration was first performed in prehistory upon livestock, most likely for two distinct reasons. The first was to impart desired traits like greater size and docility. The second was sacrificial: The procreative power of the sacrificial animal (usually a bull) was appropriated and offered to a god or (more often) a goddess in return for the blessings of fertility and abundance. The logic of castration as the ultimate fertility offering can be seen enshrined in Greek myth, according to which the god Chronos, the king of the Titans, castrated his father, the sky-god Ouranos, and threw his genitals into the sea, after which the foam that they stirred up gave birth to Aphrodite, the goddess of love and fertility.
As the archaeologist Piotr Scholz argues in Eunuchs and Castrati: A Cultural History, each of these two modes of castration in time carried over to human victims. The victors in war enslaved and castrated the vanquished parties, turning prisoners of war into docile slaves who, due to their infertility, were found to be useful in guarding—and in time, running—the royal household. Meanwhile, ancient fertility cults castrated adult and adolescent men to propitiate female deities.
What is more, the human survivors of the sacrificial act were found, depending upon their age when castrated, to take on feminine qualities, such as a higher voice, concentration of fat around the hips, and sometimes breasts, which could be seen to mimic their female patron deities. The androgynous eunuchs came to serve as cultic priests and intermediaries between the human and the divine. The Egyptian pharaoh Akhenaten, when shown as a quasi-divine priestly figure making sacrificial offerings to the sun, was depicted with the typical eunuch body shape.
Cults with eunuch priests were common in the Hellenistic world, and one of them—that devoted to the fearsome fertility goddess Cybele and her self-castrated lover Attis—flourished in the Roman era as experts in fertility and conception. Its cross-dressing priests, called Galli, preserved the link between human and animal sacrifice, customarily performing the initiatory act upon themselves amidst a sexual and mystical frenzy, after which they were qualified to take part in sacrificial ceremonies involving bathing in the blood of a newly castrated bull.
Although extravagant blood rites like those of Galli have all but died out, some modern sects still rely upon a similar logic linking fertility, androgyny, sacrifice, and castration. In India, biological males who take on feminine dress and demeanor, known as hijras, customarily perform ritual blessings for childbirths; some hijras voluntarily undergo castration as part of their devotions to the mythic hero Aravan, who reportedly sacrificed himself to the goddess Kali, and whose effigy head is said to insure conception for childless women.
Elements of Christianity can also be seen as associating holiness with the transcending of sex. Saint Paul writes in Galatians that among the baptized, there is no male nor female, and in Matthew 22, Christ preaches that “at the resurrection people will neither marry nor be given in marriage; they will be like the angels in heaven.” In Christian art and literature, angels are customarily depicted as beardless males, like eunuchs—much as Bodhisattvas in the Buddhist tradition appear as androgynous figures without genitalia. Medieval Christian hagiographies are replete with stories of holy women who took on male dress and personae. In America, the Rhode Island Quaker prophet Jemimah Wilkinson awakened from a fever in 1776 claiming to have died and been reborn as the sexless “Publick Universal Friend,” and soon gathered a sect of apocalyptic believers.
The practice of castration itself has an ambiguous status in Christian teachings. In Matthew 19, Christ cautions that not all men are able to abide by the strictest laws of sex and marriage, and remarks that “there are some eunuchs, which were so born from their mother’s womb: and there are some eunuchs, which were made eunuchs of men: and there be eunuchs, which have made themselves eunuchs for the kingdom of heaven’s sake.” The exact meaning of this passage has been a subject of controversy for centuries, but even commentators who deny that it is an endorsement of castration, like Thomas Aquinas, tacitly accept that in it the eunuch is presented in positive terms as a figure for the person who has restrained his unruly desires through a will conformed to divine dictates. Others have taken Christ’s pronouncement in Matthew 5 that, “if thy right hand offend thee, cut it off, and cast it from thee” more literally as an endorsement of castration. This line of reasoning reportedly influenced the early church father Origen when, according to later biographies, he castrated himself. The same is true of many later Christian ascetics, such as Boston Corbett, a Civil-War era soldier and fervent Methodist lay preacher who removed his testicles with a pair of scissors following a divine vision. (Corbett’s other claim to fame was killing John Wilkes Booth.)
The Italian castrati singers who were central to the golden age of Catholic liturgical music were often likened to the angels of the heavenly choir, and were patronized by the Vatican until the last castrato performance in the Sistine Chapel in 1913. Meanwhile, in 18th-century Russia, the most devout members of a Christian ascetic splinter sect, the Skoptsy, began removing their sexual parts, including the genitals and breasts. The movement flourished through the 19th century, and although it came under Soviet persecution in the 1920s, many members fled and carried on the castration rites in Romania, where they dominated the horse-cab industry until recent times.
Nonetheless, self-castration has long occupied a marginal and ambiguous position in Christian practice, even as it has reappeared in more extremist religious contexts. For example, the “Heaven’s Gate” cult of the 1990s embraced male castration as a means to suppress sexual difference in preparation for “shedding their containers” in collective suicide.
All of this suggests the prospective integration of voluntary castration into medical practice isn’t a new sexual fetish or gender fad, but the transposition of age-old impulses from a religious to a medical context. Modern eunuchs may not use explicitly religious language, which has no purchase in medical science, but their goals—an androgynous body, a higher spiritual state or “sexless mind”—remain much the same.
“The gender clinic becomes the site of ultimate self-realization.”
What is more, the appearance of the eunuch in the pages of WPATH’s Standards of Care arguably reveals the convergence of therapeutic and spiritual thought. The eighth edition of the SOC provides an index of changing norms and assumptions in gender medicine, as internal self-conception or “identity” is held to take precedence over the body, which must be refashioned to conform to the “preferred self.” According to the introduction, the new edition transcends the “narrow focus on … medical treatments for alleviation of gender dysphoria” to embrace “gender-affirming care for the whole person.” Even the term “transsexual,” with its clinical and surgical overtones, after having appeared in the title of the seventh edition only eleven years earlier, is banished to the relic heap of archaic terms for the “gender diverse.” The gender clinic becomes the site of ultimate self-realization, taking on the role vacated by religious pilgrimage sites linked to healing and transformation.
In this context, it may have been inevitable that the eunuch would make the leap from the religious underground to the gender clinic. The development is an instance of a particular form of secularization. The act of castration now follows in the line of other bodily transformations, such as childbirth, circumcision, and preparation for death, which have been medicalized and professionalized, transferred from religious and domestic contexts into clinical ones. If this rite is not integrated into licit medical practice, it will most likely continue somewhere else, as suggested by a British criminal case in 2023 in which a so-called “eunuch-maker” was found to have run an illegal underground clinic and posted videos of the operations online for profit.
Wherever modern society ultimately locates the practice of castration, the figure of the eunuch, with all of the psychological and metaphysical associations that he carries upon his person, has been with us since the dawn of civilization and isn’t likely to go away any time soon. The rest of us will have to make peace with him, and with the fundamental strangeness of human impulses, one way or another.