Episode 30 – What does it meant to be emasculated? Written and hosted by Lisa Dawn Hamilton Music and audio by Jeremy Dahl

Note: This is the script used to create the episode with references added. It has typos. It is not a transcript, but the audio sticks pretty close to the writing.

Intro

Welcome to Do We Know Things? A podcast where we examine things we think we know about sex. Content warning: This podcast will include discussions about , genital cutting, and briefly pedophilia and childhood sexual abuse. Hi everyone! I am Dr. Lisa Dawn Hamilton, professor of psychology and sex educator. Today on Do We Know Things, what does it mean to be emasculated? Intro

When you think of the word , what comes to mind? I think most of us think about it metaphorically, like some sort of challenge to a man’s masculinity. Men might feel emasculated if they are humiliated in public, experience a loss of agency, or are seem as being controlled by a woman. There are lots of sexist and femmephobic underpinnings to these beliefs, but that’s a topic for another episode!

My guest today, Dr. Richard Wassersug, is here to talk about physical emasculation. He studies people who have their testes removed or who are chemically castrated by blocking their testosterone. On this episode we tackle all sorts of questions about emasculation. What happens when you take a biological male and make him a ? Who are modern day eunuchs and eunuch wannabes? What happens when you take away a person’s testosterone? What does it do to their sexuality, to their bodies, and to their brains? How does cancer fit into all of this?

That’s coming up on Do We Know Things?

But first!

Dr. Wassersug will introduce himself shortly, but here is an introduction from my perspective. I first met today’s guest in 2011, shortly after I moved to New Brunswick. At that time, Richard was a professor in the medical school at Dalhousie University in Halifax, Nova Scotia, where he worked for decades. When he found out a new hormone researcher was in the Maritimes, he reached out to me and suggested we meet. We met for lunch in Halifax a short while later and talked for almost hours straight. I had paid for 90 mins of parking, but I was so engrossed in our conversation that I forgot all about it. Fortunately, I didn’t get a parking ticket! We have been friends and collaborators ever since.

Richard is the most research-focused and possibly the most extroverted person I have ever met. Richard is always theorizing and his brain is always on researcher mode. I am not sure if there is any other mode. He retired years ago, but then started a support program and continued, and maybe even ramped up his research output. I do not think his mind is capable of retiring.

When I am in Vancouver, where he now lives, we often get together to discuss and debate our overlapping scholarly interests, usually revolving around hormones and social influences on gender roles. He often jokes that he can’t think without talking, and I love talking research with him. We don’t always see eye to eye, but we have great discussions.

Richard has been one of my greatest mentors and supporters since I became a professor. He has also been one of the greatest supporters of this podcast. I am so grateful to have him as a friend, and I am thrilled to share a glimpse into his mind and his research with you today.

So without further ado, here is Richard Wassersug.

Transcript of Interview with Richard Wassersug

Richard Wassersug: I am an honorary professor in the medical school at the University of British Columbia. And I am a biologist who does research in a whole variety of different areas, one of them of which is emasculation.

LDH: And we're here today to talk about emasculation and we'll see where all the different directions that takes us. But let's start out with you, how did you get into studying emasculation?

RW: Ah, that is a good and personal question. So, it turns out that I am a prostate cancer patient. I'm doing fine, I got the cancer diagnosis over 20 years ago. And I failed primary treatments that would have been curative. And in that situation the standard treatment for prostate cancer that has not been cured is what they call “ deprivation therapy”, which is typically (in North America) . Early on, I knew something about the history of castration, or emasculation, and started reading about it in terms of, for instance, eunuchs in history. So, emasculation formally means to remove or cause the to shut down. This can be done surgically, through an , which is a medical term for removing the testicles, or it can be done chemically. And for prostate cancer patients, it's done chemically. And I just got curious, with a sort of a black sense of humor, about, well okay, I'm on these drugs… people were castrated in the past. Most prostate cancer patients don't like that term or use that term, but I started reading about it and I realized there was a whole fascinating area of different populations, in the past and even now, that are emasculated for a whole variety of different reasons and that studying them could actually be, indirectly, a way of understanding masculinity itself. That is, if you want to know “what is masculinity?”, if you remove it, then you have a way of understanding “what is the emasculation?” by looking at the changes that are brought on by,

Do We Know Things? Episode 30 Script 2 essentially, by emasculation. So, I'm very much concerned about the care and welfare the prostate cancer patients but as an academic area, I study emasculation in a variety of other populations.

LDH: Very interesting. So, as someone who was chemically castrated because of prostate cancer treatments, you started going down this journey of castration broadly, and emasculation broadly. So, when you give lectures, for example, on emasculation, how do people respond? What do people think emasculation is? Because I think most people don't really fully understand from the angle that you're looking at it.

RW: Well, I love that question. Particularly, with a show like Do We Know Things because it's fascinating to see how people understand or misunderstand the term. And I have been absolutely intrigued by the answers I've gotten. So, once for a small school back in Halifax, I gave a talk to a woman studies class and I asked at the beginning, “so I study emasculation, what does it mean to be emasculated?” And hands went up and one of the first comments was “it meant to deny women political power” which was from a gender studies, women's studies program, I suppose is a is an answer. A more common answer I get is “pedophiles, sexual predators are castrated” and in fact that is very rare in the western world and only under very limited circumstances. The correct answer, unfortunately, is advanced prostate cancer patients or prostate cancer patients who go on these drugs [Androgen Deprivation Drugs]. Although again, they don't look at it that way. And, of course, there are the male to female are going to have a castration as part of their surgical transitioning. So, all of those are emasculated populations.

LDH: I'm curious though, do people ever… because to me, before I met you and before we started talking about emasculation, I always thought of it as more of a psychological concept. So, the idea that you were emasculated means that someone has undermined your masculinity in some way. But from your perspective, and the technical, official perspective, it really is about having your testicles removed.

RW: This is the issue about terms that are used, both metaphorically, and in terms that are used literally. And what's happened, of course, with terms like emasculation, castration… to say someone's a eunuch now doesn't necessarily mean that they were a prostate cancer patient who had who's on androgen deprivation therapy. Because it has such a valence, the term. So, some of these terms are understood, used far more commonly, in a metaphorical sense. And to say someone's emasculated, I would say is exactly that. I mean to say that someone has the, you hear the expression “that guy has no balls”, right? Now, does he have testicles? He probably does. And so, it moves the term far more metaphorically than anatomically. But I did start as an anatomist, so I consider both. And I try to make sure we understand when we're talking about metaphors and we're talking about anatomical structures.

LDH: Right. And so, your study of historical eunuchs led you to some modern day eunuchs. What can you tell us about eunuchs outside of prostate cancer patients or including prostate cancer patients as well?

RW: All right. So, that's absolutely fascinating and that was a direction which I didn't imagine myself going. And that research starts about 15 years ago. Because as I started reading about

Do We Know Things? Episode 30 Script 3 eunuchs, I was online and I came across on adult chat groups; sites for eunuch wannabes. People who wanted to be castrated and who were they? And I set up a little question… I ran to a guy who was, actually, asked a question online “why do you want to be castrated?” And I contacted him, found out that in fact he had answers from 11 people who had been castrated voluntarily. And we ended up publishing a paper and I thought it was astonishing that we had a sample size of 11.

That's led to other, in this last decade or so, other studies where we got up to over 100. Then we got up to over 300. So, we know they're real. There are modern day individuals who do wish to be emasculated. And then, of course, is why? And what are the outcomes? And what are the side effects of how it's done? …If it's surgical or chemical and so forth. So, that's a whole other area that I'm studying. And these are in fact voluntary, modern day eunuchs. They are not, in the typical sense, . Because we usually think of transgender as fitting something of a gender or sexual binary. That is if a male wishes not to be a male, we think that he must wish to be a female. I mean that would be the sort of a standard popular trans narrative. But these individuals don't wish to be females, they just wish to be emasculated.

I'm still involved with a variety of studies. We published a slew of papers on what are the risk factors for ending up in that situation? What are the outcomes? We realize now that there's actually subpopulations within the population of individuals who seek emasculation. So, I can say there were sort of three populations; there are those who really feel condemned by their sexuality, that is they would be like to be doing something else with their brain than thinking about sex and they realized that if they got rid of their testicles or their testosterone, their sex drive would go down massively (and it would), and that some of those people actually have a religious motivation.

So, if you go to the Sermon on the Mount, Matthew 191 talks about, actually has this bizarre text which says there are those who are born eunuchs, those who are made eunuchs by men, and those who choose to be eunuchs for the kingdom of heaven. And, actually, early Christianity had sex or a philosophy that may be the way to get mental purity, if I can use that sort of made-up term, was to get rid of your testicles. Saint Augustine challenged that and we don't have castrated priests in Christianity these days. Some people might have said there may be an advantage to that if we had that, who knows? But this idea of, “I got to ascend my sexuality, if I'm going to either get to heaven or get to a better life and be able to think the way I want to think, I got to get rid of my testicles.

So, that would be the major group but there are also people who, actually, have a body dysmorphia. And this is really rather rare but you do hear about individuals who think that their life will be better if they can cut off a foot. It turns out that a fairly large percentage of the people who are on this forum feel that they're happy with their hormonal profile but that stuff hanging between their legs looks odd and just shouldn't be there. So, that's a body dysmorphia. And then there's a third group which I don't have a good sense for. But this is people who are into a severe extremist, feels a little judgmental, extreme sadomasochism (Wassersug et al., 2004).

LDH: Okay.

1 Matthew 19:12 https://biblehub.com/matthew/19-12.htm

Do We Know Things? Episode 30 Script 4

RW: And masochists and it turns out that some of the individuals who are voluntarily castrated are happy to go around and offer their services to castrate other individuals. And this gets in the report of the news every few years about somebody who's offering their service to do for other people. And when we survey them, they tend to have an exceptionally large number of tattoos, piercings and the other hand may have other body modifications. Split dick is one of them, etc. I mean that is extreme piercings, genital piercings, and so forth. So, they're into some heavy-duty body mod and they typically go back on testosterone. They're happy with their testosterone profile. In fact if anything they may be more aggressive even though they had their actual testicles removed. Because of, again, their supplemental hormonal profiles.

LDH: Okay, so it's, for them, it's not about the hormones because they are supplementing. Okay, I just want to double check, I think you said there were four groups. So, one is…

RW: No, three within the voluntary eunuchs that we can see; people who wish so be castrated...

LDH: Ok

RW: So the fourth groups of people who have an absolute need for other reasons, be they transsexuals or prostate cancer patients. But, let me let me give an example. Early on you asked about who do they think gets emasculated are sexual predators? It turns out that society thinks that, many in people society, well I can’t speak for all of society, think that sexual predators- or recidivist sexual predators, for sure, should be castrated. It turns out that the data show that some states allow chemical castration for recidivist sexual predators, but the rules are not consistent. And in many cases, it's actually harder for those people to get the drugs, to go on them, than it is they not necessarily happy with their with their, you know, sexual predation or whatever got them incarcerated. But there's a sort of a sense that “wait a second, that's not fair that we give you a chemical solution to your deviant behavior, we would rather you suffer and try to will your way out of it”.

So, I find it's impressive that there are more people, at least when the study was done out of Texas, who are actually seeking a chemical solution to the sexual improprieties that were ruining their lives were actually finding it more difficult to get. So anyway, there's a whole- there are three primary groups of voluntary modern day eunuchs. Our estimates are that probably seven to ten thousand voluntary eunuchs in North America right now. And one of the big issues, and I'll stop after this to let you ask some questions so I don't monologue, but one of the big issues is where can they get the service? Because, unfortunately, even though there's increasing numbers of clinical programs to serve the trans population, the presumption is that if you have gender dysphoria, then you wish to be female and if you simply say I don't want to be female I just want my testicles removed, there's not that many physicians, urologists, or surgeons, whatever who will do the through the procedure. There's an increasing number but still, it's an unserved population.

LDH: Right. And so, you're saying they're doing it themselves or getting other castratees to do it for them. How do they get castrations done for those who do go through with it?

Do We Know Things? Episode 30 Script 5 RW: This is a challenge. So, my colleague, Tom Johnson, who is a cultural anthropologist, and we published a lot together in our studies of voluntary unique populations. We did a survey and it turns out that over half of those who have had a voluntary orchiectomy, either self-castrated or had it done by an underground cutter (e.g., (Jackowich et al., 2014; Johnson & Irwig, 2014; Vale et al., 2010) on sites and there's a site called eunuch.org you can look it up. This is where people who are fascinated with castration or wish to you know discuss it and have fantasies and want to post them to tell people… occasionally people show up they're offering their services and they're scared away. That site is not interested in promoting illegal castrations. But as of about five years ago, the majority, over 50 percent of the castrations were done illegally.

The other pathways include pretending you are a transgender individual who wishes to be female. You go through the first stage of the , you get your orchiectomy and you don't come back. And there's a paper published in the last year out of the Netherlands showing that there is an increasing number of people who are showing up in their clinic seeking an orchiectomy who don't come back for the rest of the surgery (van der Sluis et al., 2020). So, we know they're real. I mean very much so. But we - the eunuch.org community does not- I say we, because I help them in some ways, and they help us with our surveys… but we do not condone underground cutters.

LDH: Mhm

RW: This is just real bad news. There's also scenarios, though, of how you can get castrated. There are individuals who are will inject toxins into their testicles, alcohol, calcium chloride or various toxins. And then if in pain or whatever, they show up in the emergency room they find a fibrous lump in the that the doctors think the person has a testicular tumor, and they get their castration done. And then in these cases of these people reporting, “I felt terribly embarrassed that the doctor was terribly upset because he was sure I had a testicular tumor and I didn't have any and I got castrated. But I didn't tell him that I that I had been injecting you know alcohol, vodka into my testicle”

LDH: Wow, that's fascinating that there is this population of people who are clearly seeking this surgery and that because it isn't deemed a normal or appropriate thing to do, the medical establishment generally is not providing the service. But then, of course, they put themselves under risk by engaging in all sorts of hazardous behaviors.

RW: Oh absolutely. I mean this is certainly a theme for the work that I'm doing with my anthropology colleagues and other people, I've had students and so forth on these various studies. But it is to get these people recognized and give them proper medical care, so they don't have to see themselves as working underground. There's other issues along those lines. They wish to be asexual and there's a recent paper I saw in the Canadian Journal of Human Sexuality on asexuality and talked about how to be asexual in our society is considered inappropriate (Thorpe & Arbeau, 2020). Whether you're dealing with the cis population or the trans population, we have all of these sex and gender minorities as if that's somehow one group and the asexuals see themselves as not part of that group. So, anybody who wishes to be asexual and doesn't fit a cis or a trans common narrative, okay, doesn't fit in in the mindset of anyone. And in fact, I mean, I think you know this, I'm actually an evolutionary biology biologist and realized that evolution is

Do We Know Things? Episode 30 Script 6 about reproduction and the idea that someone wishes to not be reproductive is, um, sort of unnatural. But on the other hand, if it's destroying their lives or their psychological profile is so bad that they could be destroying other people's lives, then with the planet that's pretty well populated right now, they should have the option, I would say, of shutting down their testicles, or removing them.

LDH: Do you think in that case if someone is concerned about harm to themselves or others that chemical castration or the medications that are given to, potentially, sexual predators and also prostate cancer patients, is that a viable option?

RW: Absolutely. So, I mean, there are a whole variety of different populations who are on these same drugs. So, for instance, I'm a an author in a book on androgen deprivation therapy for prostate cancer patients (Wassersug et al., 2018) and these same drugs are the ones that are offered to recidivist sexual predators, these are the same drugs and the same drugs that are used for puberty blockers for adolescent transsexuals. They're all the same drugs and that we do need to know their long-term effects. But we also know that they can be used short-term. So clearly, we favor anybody who thinks that they want to be off of testosterone, they go on these drugs before they inject vodka to their testicles.

LDH: Mhm

RW: Because they can stop and still have functional testicles. The other part of that is that it would be diagnostic. So, for instance, if a person says “I hate my testicles and my .” We don't know whether it's because they hate the product of the testicles or they hate the appearance.

LDH: Mhm

RW: If they hate testosterone's effect on their body and you give them an anti-testosterone agent, these drugs like Lupron that crash your testosterone, and they feel better, then we know that it was really they hated the testosterone.

LDH: Mhm

RW: If you gave them the drugs and they still look down at their body and say “I don't like that stuff”, they don't feel any better at all then you know that they have a body dysmorphia. So, we much favor a medical, pharmacological exploration before one goes for a surgical exploration, or an activity, or an intervention, I should say.

LDH: Absolutely. I know you've done studies through eunuch.org about predictors of what leads to people wanting to be eunuchs or wanting to be castrated. And I know you've mentioned there's three different kinds, but I also know there's one of those things is religiosity, so that's a predictor but what are some of the other predictors that you see?

RW: I’ve done several studies and five things come up (Vale et al., 2013). One is growing up in a really religious household, which presumably, an honestly religious household, which would have condemned sexuality. Two, having been a victim of childhood sexual abuse. So, if you

Do We Know Things? Episode 30 Script 7 grow up in a small town, go to church and sexuality is “bad”, meanwhile the priest or the reverend or whoever, invites you over to his house for oral sex or something like that, you could be terribly conflicted. Growing up in a small town seemed to be a bias.

LDH: Hm!

RW: Having witnessed animal castrations, so, in order to end up in this sphere you have to know what castration is, right?

LDH: Right

RW: So, religiosity, having been exposed to childhood sexual abuse, and sexual orientation comes up a lot. There's almost as many people in the eunuch.org community who are gay as straight but there's a surprisingly large number that report being bisexual.

LDH: Okay

RW: But the last one is having been threatened by castration by a parental or adult figure. So, you live in a farm in a small religious town in rural America, and a red United States of America, or wherever, they condemn sexuality, but they you get to see them castrate farm animals. And then someone says jokingly “if you don't behave, I'm going to cut that off” and we have cases and quotes from patients “mom found me playing with my when I was seven years old in the bathtub and told me that if I did that again she's going to cut it off.” Then you get towards puberty, you have your first sexual thoughts and the first thing you think about is castration.

LDH: Mhm

RW: And then, all of a sudden, it flips from being a credible fear to even being a paraphilic interest.

LDH: Right.

RW: And you brutalize your testicles because you both hate your sexuality, and it's your sexual allure, arousal.

LDH: Mhm

RW: And it's rough. And we see this, but these people don't necessarily get castrated at the age of, you know, of 14, 18, whatever. The average age of castration is around 40s or 50s. However, when you look at the number of risk factors:; it's around 40 if you have two or three, it goes down to 30 if you have four, it goes down to the 20s if you have five.

LDH: Mhm

RW: So, these things all add up.

Do We Know Things? Episode 30 Script 8 LDH: Right.

RW: And, so, I think there's a group that need he-, help sounds too patronizing, they need to be recognized as the first step to opening up pathways for them to get interventions that don't leave them having brutalized their own body.

LDH: Right

RW: Or having brought into the emergency room bleeding so badly, and these are real cases that come up often enough.

LDH: Right.

RW: Because of the self-castration.

LDH: So, as an expert in androgen deprivation therapy, I know you have studied the psychological and physical effects of taking these drugs that essentially chemically castrate people. One of the things that you've been a real advocate for is bringing this education to prostate cancer patients or other people who would take these drugs, so what are the effects of chemically castrating an individual?

RW: That of course is a huge question. And that was a major moment in my own life, is that when I went on these drugs the effects were quite different than what I expected. And the literature was not very helpful.

LDH: So, what did you expect?

RW: Well, I knew- I panicked, sort of like, they could have cognitive effects and I was like “oh my god, I won't remember my name. I won't be able to lecture, I won't be able to… my career will be over.” And I've seen prostate cancer patients who have said that. Interestingly enough, it really depends on what their field is. So, the people I think of the hardest time are people who are still young in their career, and prostate cancer is usually diagnosed around 65, so if you are a computer coder and if you do any computer coding you know that you're moving text all around, it it's a visual spatial activity. And they seem to find- from what I see, and this is anecdotal, have the hardest time. But I found that the biggest problem I had cognitively was with visual spatial processing. And men have different visual spatial processing, if you allow me some stereotypes here, than women, there's some good studies on this, and they are testosterone dependent to a certain extent. Guys will do these, you know, these little mental games where you have pictures of blocks linked up in all different patterns and then rotated and you've got to see which is the rotation. Typically, men do better on that than others, than women. If you do the game concentration, where you take a deck of cards you turn them all over, by the age of seven women do better than men and finding the pairs. They look for spatial patterns up close, men have this sort of grand idea, I'll make it women…

LDH: Yeah, I was gonna say, I'll just jump in and say that these are on average.

Do We Know Things? Episode 30 Script 9 RW: Absolutely! These are massively general stereotypes. I know they make sure that everybody knows that, I'm very proud that I'm being interviewed here by a scientist. That said, I found the hardest things of all were visual spatial stuff. So, there were computer games I like to do, I couldn't do them. And I realized that I better clean up my desk because these things matter in real life. If you have piles of paper in your desk, the phone rings or whatever you pick up, you move something, and all of a sudden, what was on the top is now somewhere in the stack and you can't remember where it is. And there was a moment where I walked out of a shopping mall, big shopping mall down in the states with you know parking lot that was large and huge, I couldn't remember where my car was.

LDH: *Laughs*

RW: And I was I was still in my 50s and I was thinking “oh god I'm going you know senile already” and then I thought “well, maybe it's the drugs”.

LDH: Right.

RW: So, testosterone can affect visual spatial processing to some extent. Other things that are real and we have to be concerned about for the patients and for the voluntary eunuchs, is depression. So, depression appears to be a fairly serious risk factor for prostate cancer patients on these drugs but of course having prostate cancer, that may not be cured, can be depressing unto itself (Deka et al., 2019).

LDH: Right.

RW: Interesting enough, the voluntary eunuchs who got castrated but do not show nearly the same amount of depression (Brett et al., 2007). And it may be that their life was so miserable by the testosterone, they're getting off the testosterone, alleviated some of the depression.

LDH: Riiiight.

RW: Okay, so, there's that level of complexity. But there's all sorts of other things as well that are concerned for the different populations who go on these agents. Osteoporosis, it turns out that when women go through menopause they're at increased risk of osteoporosis. When guys on these go on these drugs, they are similarly at increased risk of osteoporosis and there's been discussions now about the possible risk of adolescent trans gender folks who go on them as puberty blocking agents, as to whether this is going to affect the mineralization of their skeletal system and whether they may be at risk of weaker bones.

LDH: Right.

RW: Weaker bones alone is not a problem. Weaker bones if you fall down is a problem because you're more likely to break them right.

LDH: *Laughs* right

Do We Know Things? Episode 30 Script 10 RW: And prostate cancer patients on these drugs are higher risk and do have a higher bone fracture rate. So, those are just some of the side effects. And of course, there's got to be loss of sexual interest and that is a huge problem, not just for some of the guys, but if they have a partner and their partner appreciates the attention that comes from sexual interest and the patient loses the interest… now his problems become the partner's problem.

LDH: Mhm

RW: Our book on androgen deprivation therapy discusses all that, because we're concerned not just about the patients, but the partners. Because, there's one thing they can do, and that is that they keep up their level of physical exercise, that could help fight off the depression. It can help keep the bones strong and these drugs can cause a loss of muscle mass, so it can help them maintain muscle mass. These drugs can cause some anemia in men and it can help fight that off. So, we have a program, it's the androgen deprivation educational program, you can post the link on your website (http://www.lifeonadt.com/adteducationalprogram).

LDH: Sure. Another couple of side effects I wanted to mention about the drugs are the feminization of the body.

RW: Okay, fair enough. That's a very important point because in fact, and I think it's a big if it's a one take-home message, emasculation is not feminization.

LDH: Right.

RW: So, the feminizing side effects of these drugs are particularly loss of muscle mass, loss of body hair, hot flashes, which is actually due to, interestingly enough, the loss of the female hormone , because it turns out guys have that hormone but we make it from our testosterone…

LDH: Right.

RW: We go into menopause if we go on these drugs.

LDH: Mhm

RW: Depending on the drugs that are used, there can be some breast development but not the typically the common ones. The ones I mentioned earlier was Lupron and that drug has not very much breast development.

LDH: Okay. I didn't realize that.

RW: But you can also, there's a study going on in the U.K., because you could use for androgen deprivation therapy, high dose estrogen.

LDH: Right, yes

Do We Know Things? Episode 30 Script 11 RW: Because either hormone, that is testosterone estrogen, when it comes to the brain, can signal we get too much of this stuff, shut the system down. It doesn't, at the points where this happens in the brain, the brain doesn't care whether it's estrogen or testosterone coming in, so we can shut the whole system down by a surge of estrogen.

There are pictures of me that I'm fully bearded, as an adult, if you get emasculated as an adult, chemically or surgically, you don't lose facial hair, you don't use lose pubic hair. You lose the hair on your arms, your legs, your torso. Your voice doesn't go up, that happens with puberty. That's not reversible and the drugs like Lupron, these really do crash the sex drive. Interestingly enough, the estrogen doesn't crash it as much. So, paradoxically, a male on estrogen can retain some of his sex drive more than if he's off of the estrogen. So, this is how complicated it gets. And in fact one of my co-authors is Dr. Eric Wibowow is now in New Zealand and I was astonished because I actually tried estradiol, a high dose for ADT and found that my sex drive and my cognitive awareness and so forth seemed to be going back to normal. I felt more normal as a prostate cancer patient an estradiol than I did on Lupron.

LDH: Right.

RW: And I said “well, this is too amazing.” This can’t be- I didn't even know if this is true, and Eric came and joined me as a graduate student, we castrated male rats, we gave them add-back estrogen, we showed that estrogen could preserve male sex drive in a castrated rodent. I mean, so, I'm very proud of the fact that we could go back and do basic research because, of course, the rodent has no idea what's happening to it, I assume. It certainly is not concerned that he's not going to get to heaven because he has a sex drive. *Laughs*

LDH: Indeed

RW: So, I'm not doing that type of basic research now, but I think it needs to be done.

LDH: Mhm. So, we've talked a lot about the physical changes and the cognitive changes that happen for an individual, but I know for many people there are also cognitive changes in terms of perception of others and also emotional changes that occur when taking Lupron or estradiol. What was your experience?

RW: When I was off of testosterone, and I am now, I found myself far more attentive to facial expressions of other people. There was a moment in my life where I realized that I hadn't noticed that before, but I think what I said did not make that that person comfortable. And I decided if I'm on this, I got to be more attentive to this. And I found myself far more attentive to facial expressions. So, when I went off of testosterone, I found myself, I could cry in movies. Now for a male, that defeats a male stereotype. If you have that level of sensitivity then you can start to think “what can I do about this?,” as opposed to getting angry about it. So, I do think getting off of testosterone does change one's cognitive processing, but I think it really comes down to whether you're going to be animalistic and reflexively reactive. What I call a reactive masculinity.

Do We Know Things? Episode 30 Script 12 LDH: Well, let's leave it there. Thank you so much Dr. Richard Westersugg for being here today. It was a delight to talk to you, as usual.

RW: It's an honor and I don't know if you're going to tell people this but we've had a chance to collaborate and it has been truly an honor to work with you Dr. Hamilton.

LDH: Thank you.

Conclusion

I hope you found that interview as fascinating as I did. Before I met Richard, I had never considered eunuchs in the modern world. If you had asked me what comes to mind when I hear the word eunuch, I would say harem guards or castrati opera singers. I knew about chemical castration, but only thought of it in terms of sex offenders. Sexuality and hormones are two of my own areas of research expertise, but there is always more to learn. For me, learning about self-identified eunuchs and prostate cancer patients on androgen deprivation therapy has really broadened my thinking about both sexuality and hormones. I hope it does the same for you!

That’s all for this episode. If you have any feedback or peer review of this episode, I am always excited to hear from you. You send me a voice memo recorded on your phone or just a written email to [email protected]

You can find a script for this episode with references and extra info on the website at doweknowthings.com

Acknowledgements

All music and sounds – Jeremy Dahl – Check him out at palebluedot.ca

Script Assistance by Matt Tunnacliffe

I am Lisa Dawn Hamilton. You can find me on Twitter and Instagram @doweknowthings and you can email me at [email protected]

Do We Know Things? is released every second Monday and you can find it anywhere you get your podcasts.

Of course, I would love it if you could subscribe and rate and review the podcast on iTunes. Thanks for listening. I will talk to you next time on Do We Know Things?

Do We Know Things? Episode 30 Script 13 References

Brett, M. A., Roberts, L. F., Johnson, T. W., & Wassersug, R. J. (2007). Eunuchs in

contemporary society: Expectations, consequences, and adjustments to castration (Part

II). The Journal of Sexual Medicine, 4(4), 946–955. https://doi.org/10.1111/j.1743-

6109.2007.00522.x

Deka, R., Rose, B. S., Bryant, A. K., Sarkar, R. R., Nalawade, V., McKay, R., Murphy, J. D., &

Simpson, D. R. (2019). Androgen deprivation therapy and depression in men with

prostate cancer treated with definitive radiation therapy. Cancer, 125(7), 1070–1080.

https://doi.org/10.1002/cncr.31982

Jackowich, R. A., Vale, R., Vale, K., Wassersug, R. J., & Johnson, T. W. (2014). Voluntary

genital ablations: Contrasting the cutters and their clients. Sexual Medicine, 2(3), 121–

132. https://doi.org/10.1002/sm2.33

Johnson, T. W., & Irwig, M. S. (2014). The hidden world of self-castration and testicular self-

injury. Nature Reviews Urology, 11(5), 297–300. https://doi.org/10.1038/nrurol.2014.84

Thorpe, C., & Arbeau, K. (2020). Judging an absence: Factors influencing attitudes towards

asexuality. Canadian Journal of Human Sexuality, 29(3), 307–313.

https://doi.org/10.3138/cjhs.2020-0003

Vale, K., Johnson, T. W., Jansen, M. S., Lawson, B. K., Lieberman, T., Willette, K. H., &

Wassersug, R. J. (2010). The development of standards of care for individuals with a

male-to-eunuch disorder. International Journal of Transgenderism, 12(1),

40–51. https://doi.org/10.1080/15532731003749095

Vale, K., Siemens, I., Johnson, T. W., & Wassersug, R. J. (2013). Religiosity, childhood abuse,

and other risk factors correlated with voluntary genital ablation. Canadian Journal of

Do We Know Things? Episode 30 Script 14 Behavioural Science / Revue Canadienne Des Sciences Du Comportement, 45(3), 230–

237. https://doi.org/https:/psycnet.apa.org/doi/10.1037/a0031122 van der Sluis WB, Steensma TD, Bouman MB. (2020). Orchiectomy in transgender individuals:

A motivation analysis and report of surgical outcomes. International Journal of

Transgender Health, 21(2), 176-181. doi: 10.1080/26895269.2020.1749921.

Wassersug, R. J., Walker, L. M., & Robinson, J. W. (2018). Androgen deprivation therapy: An

essential guide for prostate cancer patients and their loved ones. (2nd Edition). Springer

Publishing.

Wassersug, R. J., Zelenietz, S. A., & Squire, G. F. (2004). New age eunuchs: Motivation and

rationale for voluntary castration. Archives of Sexual Behavior, 33(5), 433–442.

https://doi.org/10.1023/B:ASEB.0000037424.94190.df

Do We Know Things? Episode 30 Script 15