The Development of Standards of Care for Individuals with a Male-to-Eunuch Gender Identity Disorder
Bibliographic record
Abstract
Currently, the WPATH Standards of Care (SOC) provide guidelines for the treatment of male-to-female (MtF) transsexuals suffering from a gender identity disorder (GID). However, a large number of men with gender dysphoria who desire to be emasculated do not fit the classical pattern of MtF transsexualism. They loathe their manhood, but do not identify as, nor wish to be, female. Instead, they seek castration to become something outside the binary sexes. The formal term for such an individual is “eunuch,” which we here refer to as an MtE transgendered individual. The WPATH SOC, as currently written, are not applicable to these individuals. Indeed, neither the Diagnostic and Statistical Manual IV (DSM-IV) nor the International Classification of Diseases 10 (ICD-10) currently recognizes MtE transgenderism as a specific GID. The closest category into which MtE transgenderism fits in the DSM-IV is “GID Not Otherwise Specified” (GIDNOS). This vague diagnostic category has been a barrier for MtE individuals to receive treatment. An online survey posted at www.eunuch.org provided data on more than 300 individuals who have had voluntary genital ablations (as well as approximately 1,300 self-identified “eunuch wannabes”). More than half of the men who had surgery either did it themselves or resorted to medically unqualified underground “cutters.” This article offers a draft MtE SOC that outlines the criteria that we believe should be satisfied prior to surgical treatment. This draft MtE SOC is designed to initiate discussion of an unserved population of individuals with gender dysphoria, who are currently at risk of serious injury or death from the lack of medical care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.071 | 0.189 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.005 | 0.013 |
| Research integrity | 0.003 | 0.009 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".