This post originally appeared in the Newton blog on RealClearScience. Read the original here.
Thanks to a popular character on the exhilarating HBO fantasy series Game of Thrones, many viewers are learning the meaning of the word "eunuch" for the first time. The term describes a man who has been castrated, his testicles either removed or rendered nonfunctional by chemical means. In the show, the castrated Varys serves as the "master of whisperers": a cunning and calculating spymaster. Impervious to the lustful wants and weaknesses of other men, he is "sly, obsequious, and without scruples."
Despite its overall awesomeness, Game of Thrones leaves the incorrect impression that eunuchs are relegated to a fantastical, bygone era. In reality, there are more castrated men alive today that at any other point in history.
As many as 600,000 men in North America are living as eunuchs for medical reasons. The vast majority are afflicted with prostate cancer. Testosterone, the principal male sex hormone, is thought to prominently contribute to the growth of cancerous tumors in the prostate. Thus, as a way to impede the cancer's spread, many doctors recommend shutting down the hormone's primary source: the testes. This is accomplished either surgically, where the testicles are removed, or chemically, where patients receive anti-androgen drugs or injections of the female birth-control drug Depo-Provera.
Both the surgical and chemical methods have the same effects. Testosterone levels are drastically reduced. This in turn gives rise to a host of side effects.
"A castrated adult male will lose muscle but gain fat. He can expect hot flushes like those that women have at menopause. He will lose body hair, and his penis will shrink. Erections will be rare and weak, if they occur at all. He will be sterile," describes Richard Wassersug of the Australian Research Center in Sex, Health, and Society. Wassersug is himself a eunuch.
These side effects are psychologically and physically distressing to men undergoing treatment for prostate cancer. However, a much smaller set of men voluntarily choose castration precisely for the side effects. For them, castration is not a means to a cure. It is a cure.
The Eunuch Archive, the largest online society for men who are castrated or are considering it, features a great many brave, candid, and personal accounts from neutered men. Often, their desire to be castrated stems from abuse sustained during childhood, homosexuality, exposure to animal castration during youth, or religious condemnation. Others describe themselves as sex addicts or pedophiles, desperate for freedom from their out-of-control lifestyles or lurid fantasies.
"I was castrated because my sex drive was out of control. I was in debt from phone chat rooms and those fees. I bought a lot of porn. Paid for sex and met someone who abused me and took my money. My life was a mess. I needed riskier sex to feed my addictions. I put 100,000 miles on a car in two years out looking for a thrill. I needed to stop those actions," wrote one anonymous member.
The good news is that many of these stories have happy endings.
"Most voluntary eunuchs are pleased with the results of their emasculations." Wassersug noted in a 2007 study. "Despite a suggested association of androgen deprivation with depression, voluntary eunuchs appear to function well, both psychologically and socially."
Not all modern eunuchs are masters of whisperers -- almost none of them are really. They're just normal people. But like Varys, they often live secretive lives, concealing their gender status for fear of stigmatization. Wassersug firmly believes that this needs to change.
"Everyone should be aware that a multitude of men are either chemically or surgically castrated for a variety of reasons in contemporary Western society."
(Image: Varys via HBO)