Zeki BAYRAKTAR, Şenol TURAN
The New Journal of Urology - 2026;21(2):100-104
Genital self-mutilation is a rare but serious urological surgical emergency; it is most often associated with psychosis, but it may also occur in the context of gender dysphoria in the absence of psychosis. A 23-year-old male, at age 20, amputated his penis and testes following online encouragement to pursue a female identity. Postoperatively, he experienced regret, distress, and requested reconstructive surgery to restore his male identity. His history included childhood bullying, obsessive-compulsive traits, and late-onset gender dysphoria, but no psychotic illness. This case highlights the interplay between gender dysphoria, psychosocial vulnerability, irreversible self-harm, and urgent urological management. It underscores detransition risk in rapid-onset gender dysphoria and the necessity of psychiatric evaluation, extended follow-up, and ethical consideration before irreversible genital surgery.
