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Howard Greilsheimer, MD; James E. Groves, MD

Arch Gen Psychiatry. 1979;36(4):441-446.

Abstract
• Men who intentionally mutilate or remove their own genitals are likely to be psychotic at the time of the act, to have a number of goals and aims relating to conflicts about the male role, and to be vulnerable to sociocultural and psychological forces in a causal network as yet unknown. However, from a review of the cases of 53 male self-mutilators, it appears that a significant number involve individuals not psychotic at the time of the act but rather having character disorders and rageful feelings toward themselves or women, and transsexual males who premeditate their own gender conversion surgery. The psychiatric consultant's role in the management of such an individual in the general hospital setting includes not only care of a patient with a psychotic or impulse disorder but also involves support of the house staff, who are distressed by the fear, guilt, hopelessness, anger, and revulsion that the patient's act of genital selfmutilation causes.

Author Affiliations
From the Harvard Medical School, the Veterans Administration Outpatient Clinic, and the Consultation Section, Psychiatry Service, Massachusetts General Hospital, Boston.

Footnotes
Accepted for publication Aug 31, 1977.

Reprint requests to 10 Dana St, Cambridge, MA 02138 (Dr Greilsheimer).

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