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Castrated 'Eunuchs' are Trans, Need Affirming care, says Professional Body

Men who wish to remove their genitals have been folded into the definition of trans in the latest WPATH guidelines on gender-affirmation care

Castrated 'Eunuchs' are Trans, Need Affirming care, says Professional Body

The world body that writes the professional guidelines on transgender health, WPATH, has included a new chapter in its latest edition on how to affirm the wishes of men who identify, or wish to identify, as eunuchs.

A eunuch is the name given to a castrated male, and there exists a subculture of men who wish to remove some or all of their genitals, whether for aesthetic and fetishistic reasons. Others wish to undergo the procedure in order to reduce their levels of sexual desire.

The WPATH guidelines, the latest version of which is referred to as Soc8 (standards of care, eighth edition) offer recommendations on how to treat men who wish to present as women, women who wish to present as men, people with disorders of sexual development (known as intersex), as well as a category of “nonbinary” patients, who claim to belong to neither of the two biological sex categories.  

In this latest edition, the first update since 2012, eunuchs have been added to the list of identities for which affirmative surgery and treatment may be required. The guide states: "As with other gender diverse individuals, eunuchs may also seek castration to better align their bodies with their gender identity. As such, eunuch individuals are gender nonconforming individuals who have needs requiring medically necessary gender-affirming care."

Collaboration with The Eunuch Archive  

In May 2022, the feminist news site Reduxx revealed that WPATH had consulted with a member of a castration community website to help write the draft version of the Soc8 chapter on eunuch “care”. The site, called The Eunuch Archive, was investigated by journalist Genevieve Gluck, who found it hosts paedophile content, including child castration fiction and torture porn. After this connection was revealed, WPATH still maintained a reference to the site in the final version of the Soc8.

Stella O'Malley, a psychotherapist and founder of Genspect, who co-hosts the Genspect podcast A Wider Lens about transgender health, told 4W: "There are many puzzling and shocking aspects about the WPATH Soc8, however their decision to include eunuchs in this has discredited the entire endeavour."

The guide says children may identify as belonging to the eunuch subgroup. Ms O'Malley points out the incoherence of this position. "The guidelines say 'Due to to lack of research into children who identify as eunuch, we refrain from making specific suggestions,'" however, she says "...a child could not actually identify as a eunuch when, by definition, it is impossible for a child to be a eunach. How would a child even understand what a eunuch is?"

"This is a garbled document that demonstrates clearly that WPATH is fully taken over by activists and professionals' views are no longer evident."

Breastfeeding and pregnancy, future frontiers in transgender medicine

There are a number of communities centred on eunuchs on Reddit. A search for “nullo”, a term used by community members to refer to individuals who have had their gender “nullified” by excision or other methods, returned, among its top results, an uncensored homemade video of a man having his penis sawed off with a knife. Among the comments were men expressing a sexual desire to experience the procedure carried out by a female partner.

Another relatively common paraphilia, induced lactation for sexual purposes (lactophilia) is also referred to in the guidelines. Lactation in men is achieved via a combination of synthetic hormones and other chemical compounds, alongside pumping. The WPATH Soc8 guide claims that the phenomenon has not yet been adequately studied and so declines to offer recommendations for clinicians. However, the document points to a case report of a 30-year-old man who successfully breastfed a baby exclusively for six weeks.

The study authors appear to suggest that they advised the man on the best dosage of drugs and the pumping protocol. The study also approvingly lists the benefits of breastfeeding, and calls for more data that will allow clinicians to establish the correct dosage measures for successful and safe breastfeeding of infants by men. The subject of the study had undergone no surgeries and was a fully intact male.  

The guidelines also mention womb transplants, but note that, in the context of intersex individuals or others with congenital infertility, uterus transplant technology is currently not feasible, stating “While uterus transplantation has had preliminary success … there is no protocol to date that avoids exposure of the developing fetus to the risks associated with the medications used to avoid transplant rejection.”

Canadian medical professionals, who drafted a document on the ethical criteria for uterine transplants in 2012, recently published an updated version that calls for transgender women to be included for consideration for donor wombs. One of the authors who drafted both the original and updated versions of the criteria, Jacques Balayla from McGill University, told a faculty publication in March 2021:

“A woman who is born without a uterus and a man who transitions into a woman because of gender dysphoria have a similar claim to maternity if we consider them to have equivalent rights to fulfill the reproductive potential of their gender,” Balayla said. “And I think that we should.”


In June 2022, the UK's National Health Service (NHS) apologised after the organisation wrote a memo for staff suggesting that eunuch should be recognised as a gender identity. The document stated that men should be helped to be castrated, if they so desire.

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