Contemporary castration: why the modern day eunuch remains invisible

Let’s study emasculation. No, we don’t mean the loss of political power. That’s a metaphorical sense. We mean the real thing: the removal or chemical destruction of a man’s testes. And here we refer not to the manufacturing of courtiers in Constantinople, nor to the construction of a caste of opera singers, but to modern day emasculations.

Although to many people castration signifies a barbarism that disappeared with the demise of the Ottoman empire, the Chinese dynasties, and the castrati movement in European music, there are surely more men living with removed or functionally arrested testes today than at any other time in history. A minority either identify as women and have sex reassignment surgery or sought castration simply to suppress their libidos.1 2 By far the majority, though, are prostate cancer patients, and it’s this group that we focus on here.

Chemically shutting down or surgically removing the main source of testosterone—the testes—can slow the spread of prostate cancer. Castration, of course, has extensive side effects.3 A castrated adult male will lose muscle but gain fat.4 He can expect hot flushes like those that women have at menopause.5 He will lose body hair, …