A case of non-psychotic autocastration: the importance of cultural factors.

Male genital self-mutilation has been known to occur in psychotic patients. We report a case of premeditated autocastration in the absence of clinical disorder, both at the time of the mutilation and upon follow-up. Coming from a strict Slavic family, this patient repressed gender identity issues for decades. After migrating to Western Europe, his sexual ambiguity became actuated. His motives can be understood in the light of his personal and cultural background. This case shows that cultural factors may contribute to explaining male genital self-mutilation behaviors.