If you have a weak stomach, you may want to sit this one out. A new case study published last week in Urology Case Reports details a man who intentionally chemically burned his penis, presumably with the goal of having it removed. The 57-year-old identified as female and had previously undergone androgen deprivation therapy, but after moving to a rural location, was no longer able to continue treatment.

The case study highlighted the challenges associated with surgically removing damaged tissue while simultaneously attempting to preserve enough to allow for a desirable outcome with "gender-affirming surgery" in the future. Due to worsening necrosis, however, doctors were required to remove the entire appendage.

One of the paper’s main takeaways was the importance of increasing access to "gender-affirming care" and mental health treatment in rural areas. I would like to take a moment to consider additional reasons why a person might choose to self-harm, particularly in the context of injuring one’s genitalia.

Non-suicidal self-injury can be a symptom of a variety of mental health issues, including depression, borderline personality disorder, and schizophrenia. Wanting to be rid of one’s genitals can also be a sign of unusual sexual proclivities, such as sexual masochism, in which an individual derives pleasure from being humiliated or abused. Another possible explanation is a past experience of sexual abuse or shame about one’s sexuality.

Genital surgery in transgender women, also known as vaginoplasty, typically involves the removal of the penis and testes, alongside the construction of a neovagina. Nowadays, this surgery can be modified to accommodate the “non-binary” trend, which involves having the physical appearance of both sexes or neither.

This can include the addition of an artificial phallus or vagina while keeping one’s pre-existing anatomy intact. In other cases, someone may wish to have no genitals, opting instead to maintain only organs necessary to facilitate the removal of bodily waste.

"What does that look like?" you may wonder. Judging from medical images, I would describe the final look as resembling a human kneecap, except located in one’s nether regions.

It is a common narrative that gender dysphoria can be cured by allowing a person to tailor their body as they wish, that this should be allowed at younger ages, and that denying this is emotionally cruel. Considering that bans on gender-affirming care for minors continue to face opposition , the last thing we should want is for children to gain access to these procedures.