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Hello dear members, This thought has been on my mind for some time. The recent post of an obituary for Dr. Spector got me thinking about posting.

As Dr. Kimmel continues to age, soon he will surely reach the point of retiring or worse yet death. He needs to have a suitable replacement in place to continue to serve our community.

I was thinking about it, and quite honestly , if he does only one procedure a week, at 2,000 dollars, and takes two weeks vacation, that is still 100,000 dollars a year income. Yes , I know there is a cost for the office space, staff , and supplies. With a younger , and more profit motivated doctor in the office, I can easily see the number of procedures doubling or even tripling.

It would seem to me, that an open minded ,fresh from residency Urologist , could do a whole lot worse than to take over Kimmel's practice. Reasonably, said new doctor could even only keep office hours there, a few days a week. He could then have a more mainstream practice elswhere, and keep the two very separate.

And were said young doctor to add doing partial penectomies, (which many on this board seek) he could easily see a gross revenue of 500 k or more.

It would also be wise to act as a clearing house for HRT prescriptions, for those who desire to use it. It is not illegal to ship medications, so said doctor could have a hand in that as well.

I am just wondering why no one has approached the good doctor to ask to be his successor, or why he hasn't sought one out ? Surely with little effort , he could find just the right person for his practice.

Raymar

When Dr. Spector retired from practice we searched for a replacement for about 6 months. Felix must have called a good 50 doctors in and around the Philadelphia/New York area. Murray was actually one of the first docs we talked to but it took some convincing before he would take over the patient base. Mostly it was the stigma of being a "castration" doctor that turned most off to the idea. It helped that Felix and Dr. Kimmel were friends before. It also helped having me there as a living example that we were not all insane and that there is indeed a genuine need for these services. It's funny, tugon and I were just talking about this yesterday. What would help is if we had a doctor to serve the community who WAS one of US! Any youngsters out there willing to go to med school? Seriously. If not it's going to take one or more of us to convince someone to take over eventually. I don't know what Dr. Kimmel thinks about retirement or turning over the practice. I can get hold of him though and find out. I also think we should all keep our eyes and ears open to possible docs who might be approachable in this regard.

Cheers!

Jeff

Like Jeff says, my understanding is that Kimmel only very reluctantly took over Spector's practice. I have always suspected that Kimmel is mostly in this for the money, not out of a genuine desire to help those who seek castration.

He makes a hell of a lot more than $100,000 a year. First of all, he does more than one castration a week. Second, he has a regular urology practice outside of the castration business.

Getting any doctor to agree to take over is going to be tough because of the potential legal liability. Kimmel has you sign a consent form, but there are questions as to how much that form is going to really stand up. There is no psychological evaluation to confirm that the person who desires castration is mentally stable. This, I believe, is a mistake and one that a new doctor will probably change. There should be at least one letter confirming mental stability required. With just the consent form, there is a good possibility someone who regrets it and wants to sue can find plenty of "experts" to testify that anyone who would voluntarily want castration cannot be mentally stable, and thus the form is invalid.

I don't know if Kimmel even has any plans to find someone to take over when he quits. If not, either we will have to talk him into it or find another doctor through some other means.

Hopefully with all the work being done by the EA to enlighten the medical community we may one day have doctors willing to provide the needed service. A doctor in every state would be nice. Along with this new awareness of men needing to become eunuchs hopefully will be protection of the doctors. I am sure that any doctor who performs surgeries to alter the looks or the body itself faces patients with regrets.

I can understand the benefit of having a psych consult before the cut. I wonder now how I would have fared if I would have needed one. With my self destructive behaviors, addictions and obsessions about castration would I have been turned down. I know some regret castration but if I had been denied I would not be the sane, stable person I am today. If I had contacted a surgeon and been denied I doubt I would be alive today.

I would like to see a program where you would meet with the doctor and sign up for castration. At that point the doctor would evaluate you and prescribe three to six months of chemical castration drugs. At your three month checkup he could do a T level test to be sure you really test drove being a eunuch. Then at that time schedule a surgical date if you still want to be a eunuch. This would give a cooling off time to really think about what you want vs rushing in and being castrated. You could sample the new life to further decide if this is how you would want to live. If you went back to the doctor he would be comfortable that this is right for you. Time and experience would be a good indicator if you are meant to be a eunuch.

what are the number of men that are castrated by choice each year?

bitemynuts (imported) wrote: Fri Feb 01, 2008 8:06 am what are the number of men that are castrated by choice each year?

Would not have a clue worldwide (including cutters, overseas docs, Italian barbers LOL, etc.). Felix (Dr. Spector) probably castrated about 400 or 500 per year at the height of his practice though.

Toward the end about 1/2 were TG and the other half were eunuch. I think there are more who want to be "just eunuch" than we would imagine.

Gee, pay for the schooling and I'll go.

Most doctors who retire and who are fortunate enough to have a healthy and prosperous practice sell it or, better, prior to their retirement take in a trainee/partner who then assumes their practice. It would be nice to think this is what might happen but, given the "special" nature of one facet of the practice may not be as appealing. Yet me must hope. Anyone who knows a resident or a third year med student might quietly discuss the situation with them. Whilst they may not be interested, word does circulate within the medical community and possibly some fore-thinking, newly minted doctor might see the potential.

The issue of doctors to perform this surgery is a real concern for me. I've been seeing a therapist at the transgender program at the University of Minnesota since early November. Jesus confirms that this is the top gender clinic in North America.

I'm still not clear, though, that they will ever be willing to approve my castration. Despite the fact that they are, relatively speaking at least, so forward thinking I suspect they will view my case as unusual. The committee that would need to approve surgery may have a problem getting a grasp on my particular gender identity and why it would require that solution.

My therapist clearly stated on my first visit that she viewed gender as a continuum. She does not hold the too frequently held bipolar, male or female, view of gender.

During that visit, after talking about my history and gender issues, I stated that I wanted to be castrated in three months. My therapist thought this was perfectly reasonable. [The fact that she gets this does not mean that everyone on the approving committee will get it. She's young and with it. Some of the others are not so young and perhaps not as with it.] At the time, I was thinking of making an appointment with Dr. Kimmel then and there. BTW, I'd already started taking Androcur, which I'm still on.

Shortly after I posted on EA that I'd be seeing the university therapist, Jesus wrote me saying he hoped he could speak with me soon. I've got to say, I was really surprised by this! Here's this guy from the Archive that I've never communicated with asking to speak with me. I knew a few things about him from some of his posts, particularly that he's an authority on male to eunuch transitions, whatever the motivation.

We wound up having a very long, informative and friendly conversation. He thought I was rushing things with the 'three month' plan. Unbelievably to me at the time, I agreed with him. He told me to wait at least 6 months, perhaps longer.

It's now been three months since I started seeing my gender therapist. I still haven't made a castration appointment with someone like Dr. Kimmel, although I am considering it very seriously now. For three months further down the road.

If I get a clear indication from the university that they will eventually approve the surgery, I may very well wait for that. If they strictly follow the Harry Benjamin guidelines, though, that could take another 9 months. Under that plan, really designed for M2Fs, you're required to live a 'real life experience' as a woman for a year (with demonstrated success and comfort) before being approved for surgery.

There are medical reasons, namely two recent diagnoses of osteoporosis and Bipolar II disorder (and a few other reasons I won't go into now), why I may not want to wait another 9 months. Being essentially hormone-free while chemically castrated is not helping my bones rebuild. Bipolar II disorder can be related to hormone imbalances, although I'll admit that right now I don't know if low testosterone is ever a factor with this. I've decided that I will want some form of a least minimal hormone replacement. That may wind up being some testosterone or a very small amount of estrogen.

I pointed out to my therapist on the first visit that proving I'd successfully lived as a eunuch for a year would be impossible. No one need know I was doing anything. It isn't like there is a eunuch way of dressing or acting that I could follow. I wouldn't be having my beard removed in preparation for the M2F transition. I wasn't going to walk around with an 'I am a chemically castrated eunuch' sign tied around my neck! It seems that the burden of proof for M2E, if you apply the Harry Benjamin standards, is impossible to meet.

She got what I was saying. I will get some kind of preliminary answer the next time I see her on what her take on the U's position on this will be. I want some reassurances soon. I'm very willing to look at options for making this all work through the U program. Right now I'm not sure that there will be a mutually agreeable solution.

Who will I go to then if the university won't help? Will Dr. Kimmel still be in practice?

Some of you might be thinking, 'why is he even bothering going through the university?'. Good question. Certainly it's partly for my own comfort. Unlike some on the Archive, I've had generally positive experiences with therapists (particularly clinical psychologists, less so with psychiatrists) and I've found therapy useful over the long haul. I've also been fortunate in that I've been able to afford therapy, although not always easily.

The longer I've participated on the Archive, the more clearly I understand the multiple motivations for castration. I can also see how some would feel an urgency to be castrated that they cannot resist. It's clear that for some men, going for castration without any guidance has turned out well. There are many others, though, who once participated on the Archive and went for castration. We don't know how things turned out for them. They stopped posting.

I agree with Tugon, whose experience makes him someone to listen to, that the best course of action is to try chemical castration first and have a psychological evaluation. In an ideal world, there would be many surgeons who understand the real need of some men to be castrated, whatever their motivation. All of this needs to be brought into the light. Too many feel shame for what is a very real need that is perfectly normal for them.

-Danya aka Todd (who wasn't going to post tonight because he's too tired, but couldn't resist this topic)

I have to say that I'm not comfortable with a surgeon who does voluntary castrations without requiring some kind of psychological evaluation first. I understand this is what Dr. Spector did and what Dr. Kimmel is now doing. I feel not requiring this is to walk a very dangerous line.

I feel a surgeon who does not require a psychological evaluation first is not properly looking out for the best interests of the patient. Yes a psychological evaluation is something more to have to go through to get castrated, and it might also help protect the surgeon in such cases. The surgeon in these cases does have to look out for their own best interests too.

But a psychological evaluation does help prevent situations where someone gets voluntarily castrated without fully thinking through what they are doing and why, or about all the consequences, or is someone who emotionally is someone who should not be voluntarily castrated.

A bad or tragic situation because some guy got voluntarily castrated without a psychological evaluation is something no one needs, and an evaluation could prevent that from happening. If a surgeon does take over from Dr. Kimmel, I hope he or she will require a psychological evaluation first before doing a voluntary castration.

Castration may be right for some. But an effort needs to be made to prevent a situation where a voluntary eunuch sadly or tragicly regrets their choice, and a psychological evaluation first can help prevent that.

I called Dr. K's office recently and talked to Mary. I asked her to put me on the schedule to be castrated later in the Spring. When I asked for an afternoon appointment she said he is only doing them now on M,W,F in the morning. I recall a few years ago he was doing morning and afternoon castrations. So he is half time on castrations now. I suppose the other days and every afternoon are normal practice time. At $2k per castration, I don't think compensation is an issue either way.

I Worship Women (imported) wrote: Fri Feb 01, 2008 2:48 pm I have to say that I'm not comfortable with a surgeon who does voluntary castrations without requiring some kind of psychological evaluation first. I understand this is what Dr. Spector did and what Dr. Kimmel is now doing. I feel not requiring this is to walk a very dangerous line.

I feel a surgeon who does not require a psychological evaluation first is not properly looking out for the best interests of the patient. Yes a psychological evaluation is something more to have to go through to get castrated, and it might also help protect the surgeon in such cases. The surgeon in these cases does have to look out for their own best interests too.

But a psychological evaluation does help prevent situations where someone gets voluntarily castrated without fully thinking through what they are doing and why, or about all the consequences, or is someone who emotionally is someone who should not be voluntarily castrated.

A bad or tragic situation because some guy got voluntarily castrated without a psychological evaluation is something no one needs, and an evaluation could prevent that from happening. If a surgeon does take over from Dr. Kimmel, I hope he or she will require a psychological evaluation first before doing a voluntary castration.

Castration may be right for some. But an effort needs to be made to prevent a situation where a voluntary eunuch sadly or tragicly regrets their choice, and a psychological evaluation first can help prevent that.

Actually, as for Dr. Spector (I don't know how Murray works), he did indeed talk, at length, to most patients considering castration. Although he was not a psychiatrist he had experience aplenty with the TG and eunuch communities. Experience counts for a lot. In fact, when he was in practice there were several people we turned down for the surgery and referred to counseling.

I do agree, however, that there should be some formal set of standards for male to eunuch as there are for male to female. Perhaps not as restrictive, obviously most eunuchs I know continue to dress and behave (generally) as a genetic male and would not need to live "in gender" in that way. Now a period on chemical castration as a prelude to physical castration should be mandatory IMHO as I have seen some very sad eunuchs who regret their decision. Not everyone adapts to this condition as naturally as I and others have. I absolutely love being a eunuch and believe it was always my destiny

Almost all SRS doctors will do so with a letter from one psychiatrist & one psychologist. Since the former are more or less rubber stampers, its best to get the letter from the psychologist (one who is an Diplomate of the American board of sexology or a similar credential) then show it ot the psychiatrist, explain the issue, and ask for a letter. Evals can vary from a hundred bucks to 500$. Just consider it part of the expenses of having it done properly.

I Worship Women (imported) wrote: Fri Feb 01, 2008 2:48 pm I have to say that I'm not comfortable with a surgeon who does voluntary castrations without requiring some kind of psychological evaluation first. I understand this is what Dr. Spector did and what Dr. Kimmel is now doing. I feel not requiring this is to walk a very dangerous line.

I feel a surgeon who does not require a psychological evaluation first is not properly looking out for the best interests of the patient. Yes a psychological evaluation is something more to have to go through to get castrated, and it might also help protect the surgeon in such cases. The surgeon in these cases does have to look out for their own best interests too.

But a psychological evaluation does help prevent situations where someone gets voluntarily castrated without fully thinking through what they are doing and why, or about all the consequences, or is someone who emotionally is someone who should not be voluntarily castrated.

A bad or tragic situation because some guy got voluntarily castrated without a psychological evaluation is something no one needs, and an evaluation could prevent that from happening. If a surgeon does take over from Dr. Kimmel, I hope he or she will require a psychological evaluation first before doing a voluntary castration.

Castration may be right for some. But an effort needs to be made to prevent a situation where a voluntary eunuch sadly or tragicly regrets their choice, and a psychological evaluation first can help prevent that.

Do we have any therapists here that can write a letter on this forum.

I wonder if it can be done over the phone.

Dr in colorado will do the surgery...it requires 2 letters..the therapist letter..a doctor letter saying the doctor explained to the patient the consequences of orchiectomy.

dr in florida is the same

they will do non ts males with the letters.

the doctor letter is easy...the therapist letter is hard.... I have been trying to compile a list of therapists and have had no luck....the therapists dr in colorado referred didnt have a clue as to what was needed.

One Therapist that can help out is all that is needed.

you have to call the therapists and talk direct, ask if they evaluate SRS candidates and recognize Male 2 Eunuch as a valid transition per Toms, Richard & their groups papers.

In my case it was easy on the first try because I was under medically needed chemical suppression and wanted to return to male status, E2M you could say.. I couldnt go off suppression as long as i had them attached, I also suffered from chronic testicular pain.

So much to comment on this thread. First, unfortunately, most doctors still feel that elective "unnecessary" surgery is doing harm.. Young doctors still believe in all the Hippocratic oath stuff. So it seems to me the first thing we must do is get doctors to understand that it is necessary for some of us, just as SRS is necessary for Transgendered women..

Second, I think it should be a requirement to be chemically castrated for some period of time (I have an idea how long , but I know several of you would lynch me if I suggested it).

Third, my cousin, a surgeon in a one doctor private practice, retired because of the fact he couldn't make 300k plus a year, due to insurance companies on one hand restricting the amount he could charge and on the other raising his liability insurance to 200k a year.

I'm sure the good Doctor makes a hell of a lot more than 100K.

I'm sure that a doctor who does voluntary castrations probable does 10 times or more castrations for prostate cancer.

That's my two cents.

Does anyone mind if I start signing Pauline instead of Gary

Any how for now,

Pauline.

Oh,god I have no idea why my last post is so well big. I hate computers. sorry I didn't mean for it to be that way.

gpb3aol (imported) wrote: Sat Feb 02, 2008 2:59 am Does anyone mind if I start signing Pauline instead of Gary

Any how for now,

Pauline.

No Pauline I do not think anyone would mind. On the EA it is easy to be who you are or want to be.

Chemical castration is definitely something that should be tried first, but it's important to keep in mind that for some even that may not be enough. In my case it likely would not have helped because my regrets did not start until after the one year period suggested by most. I had some unique issues going on that led to my castration desires, issues I did not understand then but do understand now (however, at 2.5 years later, it is far too late). Whether chemical castration will be successful in preventing someone who should not be castrated from being castrated will depend on what the reasons for wanting castration are and what psychopathologies exist within the individual. For someone who has a castration fetish or just think it might be something worth trying, chemical castration may very well prevent that person from making a mistake. But for others who have deeper mistaken reasons for wanting castration, chemical castration may not be enough. This is why a full set of guidelines that includes therapy, chemical castration, and other criteria need be set up for people seeking castration.

A therapist might have prevented a needless castration but they might have prevented a castration for someone like myself who needed it. A therapist could be beneficial but I would not want then to have the final say in what I needed done to my body.

My psychiatrist basicly wrote the following:

To Whom it May Concern

Don*** ****** was seen in my office today May 24, 2007. In my professional opinion Don is mentally capable and understands the procedure and effects of Bilateral Orchiectomy.

If you have any questions please contact us at ***.

Sincerely

Dr. W**************

Board Certified Psychiatrist

I think this simple form of letter is the only real extent that should be the job of the shrink.

Now my psycologist's letter goes on for an entire handwritten page of why she thinks i NEEDED the procedure.. But it was to basically help me plead my case with the urologist i was seeing at the time..

Lets hope that someone will start working with Dr Kimmel and things will not take effect adversley, or tires start to spin which it sounds like tires may begin to spin with some issues that have come up.

Lets hope the practices continues to stay open and that this is not an adverse repeat of what happend to Dr Spector.

Dr Spector was a D.O. which was older when specialities did not really matter so he was more self designated.

As for Dr Kimmel he is an M.D. and a Urologist which gives him the extra spin.

Lets hope that he stays around for a few more years and these upcomming issues do not adversley affect him to continue to practice, as I have heard guys have some very positive outcomes with him in the past few years, and have been happy TG or NON Tg some go on Testosterone and some go on other types of female hormones especially the younger guys I have known.

It all depends on the person in regards to healing times etc, however you can only expect to have pain and a few adverse effects occur and lets hope Dr Kimmel keeps up the good work and does not quickly go down hill as Dr Spector did, Dr Spector was very good in his day however the poor guy just aged and got too old, as for Dr Kimmel he is aging as well but it seems a little pre mature to me, I would hope he would have another 5 years of good Practice left in him.

Lets cross our fingures and hope for the best as it will be hard if he has issues that adversley come up to effect him and I hope this does not happen however do not like the looks that some people have deicded to adversley try to make things bigger than they actually are or try and blame another Physicians mistake or mistakes on Dr Kimmel.

In a few minimul cases has Dr Kimmel had some patients that may have had a longer recovery time, however each person is not the same and recovery time may be longer for one than another.

Lets hope for the best for everyones sake and well being.