Citation

Bourgeois M. Contracept. Fertil. Sex. (Paris) 1984; 12(4): 597-601.

Vernacular Title

L'automutilation genitale.

Copyright

(Copyright © 1984, S.A.R.L)

DOI

unavailable

PMID

12339451

Abstract

Genital self-mutilation is usually believed to be rare and to be predominantly practiced by men, especially those suffering grave mental illness. Castration occupies a central place in psychoanalytical theory, which suggests various symbols for the supposedly diverse fantasy of castration. A review of the literature revealed only about 60 cases. 3 diagnostic categories have been suggested for such cases: schizophrenics, transvestites or transsexuals, and patients with religious and cultural complexes. Factors believed to be common to persons practicing genital self-mutilation include intense sexual confusion, masochistic relationships with and submission to women, strong feminine identification, repudiation of the penis, and depression relieved by the mutilation. Explicit motivations were expressed in over 60% of cases, including desire to be a woman, existence of homosexual sentiments, real or imagined illness, and heterosexual sentiments. Extreme religiosity, psychotic symptoms, and a feeling of failure in the masculine role are often mentioned. 5 patients in 1 series of 53 attempted suicide and 1 succeeded. 87% were considered psychotic. 25% ingested alcohol before the act. 3 characteristics among psychotic subjects suggest a high risk of mutilation: very young psychotic men with sexual obsessions and fears, older men with psychotic depression or grave somatic illness, and men tending to become violent on drinking alcohol. Nonpsychotic subjects tend to display rage against themselves. Nonpsychotic transsexuals often had old fantasies of mutilation, and in 1/5 of cases some previous attempt had been made. A series of 3 cases observed by the author displayed a variety of circumstances: a 23-year old man with no observed psychosis wished to be free of sexual tumult and desire to masturbate for religious reasons, a 42-year old man had a fit of delirium and castrated himself with a saber, and a 32-year old chronic psychotic emasculated himself with his pajama cord and died shortly thereafter. Very few cases of female self-mutilation have been observed.

Language: fr