Male genital self-mutilation: a systematic review of psychiatric disorders and psychosocial factors

Thomas A. Veeder, Raphael J. Leo

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


Objective To identify psychiatric diagnoses and psychosocial factors associated with intentional male genital self-mutilation (GSM) of specific injury subtypes. Methods A search of MEDLINE, EMBASE, PsycINFO, PubMed, Web of Science and CINAHL for cases of GSM was conducted until December 2015, based on GSM and related terms. Cases were examined for injury subtype, psychiatric diagnosis and psychosocial factors. Chi-square analyses were employed to determine differences in frequency of such factors across injury subtypes. Results Data were obtained from 173 cases: genital mutilation (n=21), penile amputation (n=62), castration (n=56) and combined amputation/castration (n=34). Common psychiatric disorders included schizophrenia spectrum (49%), substance use (18.5%), personality (15.9%) and gender dysphoric disorders (15.3%). Chi-square analyses revealed that schizophrenia spectrum disorders occurred significantly more often among auto-amputates as compared with self-castrators or mutilators. Gender dysphoria occurred significantly more often among self-castrators than auto-amputates. No significant differences emerged regarding psychosocial factors across GSM subtypes. However, associations were observed between psychosocial factors and psychiatric diagnoses. Although altogether not commonly reported, experiential factors were reported in 82% of psychotic individuals. Treatment inaccessibility was noted among 71% of gender dysphorics engaging in auto-castration. Conclusion Clinicians must consider the diverse range of psychiatric disorders and psychosocial factors underlying GSM.

Original languageEnglish (US)
Pages (from-to)43-50
Number of pages8
JournalGeneral Hospital Psychiatry
StatePublished - Jan 1 2017


  • Genital mutilation
  • Klingsor syndrome
  • Self-amputation
  • Self-castration
  • Systematic review

ASJC Scopus subject areas

  • Psychiatry and Mental health


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