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Surgical castration has a long and ugly history — from ancient Athenian man-slaves and 18th-century Italian castrati to 19th-century America, when a man named Dr. Harry Sharp castrated nearly 200 inmates, aiming to reduce the likelihood that they would offend again. But it wasn’t until the 1940s that the use of hormone therapy surfaced as a way of lowering testosterone and reducing “pathological” sexual behavior in men. (The death of British code-breaker and computer pioneer Alan Turing was famously attributed to suicide over the female hormone treatment mandated by a court after he had been caught having sex with men and convicted of “gross indecency,” although this has since been disputed by Turing’s biographer.)

These days, the treatment is associated with sex offenders or people with troubling sexual fantasies they fear they will act on. In 2000, doctors started using a drug designed to treat prostate cancer to lower men’s sexual urges. The drug Lupron tricks the hormone in the brain that tells the pituitary gland to produce testosterone. Dr. Renee Sorrentino is one of a handful of psychiatrists offering Lupron to patients in Massachusetts. She first saw the drug in action while working in Canada and was amazed at how it changed men’s lives by “turning down the sexual volume of the mind,” allowing patients to work through the causes of their behaviors with therapy. Sorrentino says that about 20 percent of her current Lupron patients are there voluntarily, often desperate to curb their troubling sexual thoughts or actions.

One of her patients, a 62-year-old man from Massachusetts, started taking shots of Lupron after his wife discovered he’d spent the last eight years sleeping with prostitutes. Identifying as a sex addict, he felt the only way to stop his behavior — and save his 45-year marriage — was to medicate his body into submission.

How long have you been on Lupron?

For about a year and a half now, and it’s absolutely fantastic. I haven’t had an erection in over a year.

Why is that “fantastic”?

I was going to see prostitutes behind my wife’s back, lots of them. It became a cycle I couldn’t escape. When I wanted to have sex it was like a drug addiction. Now I can see that I was constantly chasing that high. It was part of the excitement. As soon as it was over I was miserable. I’d think: What did I just do?

By the time I got to Dr. Sorrentino I was desperate. I told her I wanted to be physically castrated.

So you introduced the idea?

I would have done anything to stop.

Had you tried other things?

My wife caught me. I was surprised that she didn’t just throw me out. She said she was married and she wanted to repair it.  But I had to get therapy.

The first therapist didn’t want my wife in the room when she talked to me but I thought it was important for her to hear it so she could heal. Also, I didn’t want her to think I was telling her one thing and the therapist something else. After a few sessions it just wasn’t working. She prescribed me some drug, like Xanax, and we did talk therapy.

Did the anti-anxiety medication help at all?

It made me a little mellow, but it didn’t stop the thoughts, deep down I wasn’t happy. And they disinhibit you, which wasn’t ideal. She referred me to a therapist who was convinced it was depression. He went through my whole life history trying to figure out where it came from. I said, Look that’s great, but I don’t care what’s causing it. I need to cut out the behavior then we can do all the analysis you like. He didn’t want to do it that way. He referred me to Dr. Sorrentino, who practices chemical castration.

Had you ever heard of that before?

My wife knew a little bit about it because she reads all these trash magazines, but I had only heard it used on pedophiles or sex offenders.

Did you think of yourself as a kind of monster, like them?

I was willing to chop my testicles off to save the marriage. I was prepared to do it because it made my wife comfortable.

What happened when you saw Dr. Sorrentino? Did you take the drug right away?

We started with six sessions of talk therapy where we tried a few different cognitive behavioral techniques to reduce my sexual thoughts. One was simply an elastic band on my wrist. When I thought about a prostitute I’d pull on it. At first, I found myself doing it a lot. It really made me aware how often it was on my mind.

We also talked about possible side effects: You might gain weight, grow breasts, experience night sweats and hot flashes – that kind of thing. I did put on a little weight, but I have never had any other adverse effects. It can also make your bones brittle, which puts you at risk for osteoporosis, but I take Fofamax, which is supposed to help reduce that potential. I also take over-the-counter calcium.

Did you have sex with your wife before that first shot of Lupron?

No, we didn’t even want to do it one last time. We wanted to move as quickly as possible.

Can you remember your first injection?

Sure. It was in the butt. I was surprised that I could feel the chemical stinging as it slowly went in. It hurt. It took at least two shots before I noticed my sexual thoughts slowing down. And I could still get an erection for a couple of months.

And then?

I completely lost the ability to get it up. The thoughts happened, but much less frequently and there was nothing I could do about it. I wasn’t going to go and try to have sex when I was in that state. So I guess it physically stopped me right away. But I was still in a dark place because the thoughts were impacting my work. Then the thoughts started to fade away. Before I went on Lupron I was thinking about having sex with a prostitute over 30 times a day. After six months I would only have the thoughts a few times a day.

Do you ever worry that the drug will suddenly stop working?

I don’t, but I can tell when the 30 days are up because I have the thoughts more. Which is a little concerning. I start to feel a tiny bit of urge, but it’s all mental. I still can’t get an erection.

Is there any way that you can describe what your thought process is like now? Is it that you still have fantasies but they don’t arouse you, or have you stopped thinking about sexual things in general?

You can’t block everything out of your mind; it just doesn’t work that way, but if I have a sexual thought there’s nothing I can do about it. Do I ever have dreams at night and then wake up and think about them? I do, but clearly not as frequently as before. I think the lower testosterone keeps those thoughts to a minimum, but they still happen. I just can’t act on them. I try to masturbate and can’t. I wasn’t about to go to a prostitute and get laughed at because I couldn’t get it up.

Was the fact that you wouldn’t be able to experience sexual arousal a concern for you or your wife?

No. It was the only way to save my family. The alternative was much worse. My wife was happy because she knew she didn’t have to worry about me when I wasn’t in her sight.

So you don’t miss sex?

It wouldn’t bother me if I never had sex again, ever, for the rest of my life. My shrink was shocked when she heard that, and said we need to work on it. But I have filled my life with other things. I spend a lot of time with my grandchildren. I’m back at school doing a masters so I have filled up the time I was spending doing crazy sexual stuff with more “normal” activities. I’d say my life is back to where it was when all this started, other than the fact that I can’t have sex.

Did it change the appearance of your genitals?

There was no physical change at all.

Is it like, say, when you have been drinking and your mind is turned on but your body won’t cooperate?

Exactly. Mentally I think, Hey, I am ready for it; physically, sorry, it’s not happening. The two parts are not talking to each other. It is very frustrating and when it happens I try to think of something I don’t like to distract myself.

What happens when you see an attractive woman, on the street or TV, do you still like to look at their bodies?

I haven’t lost interest. A female body is beautiful no matter what. I like to look even if I can’t touch. I am still physically attracted to women.

When did you first think of that attraction as a problem to be addressed?

I was 50 years old the first time I slept with a prostitute and she was the second person I’d ever had sex with. I lost my virginity to my wife and neither of us had had sex before. I had a normal childhood. My parents stayed together. I lived in a blue-collar neighborhood. I was very shy and I didn’t really date. I was a nerd and introverted. I went completely quiet around girls.

When I was 50, my job suddenly took me out of state for four days a week. Once, when I was out of town, I went to a strip club. That first visit was primarily motivated by boredom, but my job was also extremely stressful and I needed some relief. When you’re alone in a hotel room four nights a week you start to crave amusement and company. I thought, I’ll have a couple of drinks and I’ll see some sexy girls. It will be a nice diversion.

Did you regret the fact that you’d only ever had sex with your wife?

I didn’t think about it that way. The relationship was great. The sex was great. We had a son, who is now an adult with kids. Even that first time I went to the strip club it wasn’t as if I was thinking I’m going to find a stripper to have sex with. I never thought that.

But that changed once you got there?

It really did. It was seedy and creepy, but I liked it. And I knew right away that I liked it too much. I’m a compulsive person, and when I get my mind set on something I just focus on that. So I kept going back. The first few times it was no big deal, and then I went into a little room at the back to get more comfortable. I met a girl who said she was looking for a boyfriend and she liked older men. We started seeing each other. I was getting attention from a beautiful 25-year-old woman. It filled the time. We had sex. Things seemed great. She had small breasts so she asked me to pay for a boob job, which I did. She ended up taking me for a lot of money. I was a novice and she was skilled. I kept saying to myself, This is crazy, I’m giving her $7,000, and I have only known her for a few months. 

What happened when your wife found out about that woman?

I admitted it straight away. I was sitting in my hotel room and she was on the phone begging me to come home. She was devastated and concerned about my health. When I got home she said she didn’t know what to do. We discussed divorce, we went to marriage counseling, but that didn’t really help. And the darkest part is that at that point I wasn’t willing to give it up, so I told her whatever she wanted to hear even though I knew I wanted to keep doing it – even in front of the marriage counselor. That was pretty poor on my part.

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Then I stopped for two years after that, but only because my wife was watching our money and bills more closely. I knew if I did it again and got caught I’d lose my family. I pictured myself an old man alone in a studio apartment, masturbating, surrounded by empty pizza boxes. But I missed the adrenaline rush. I started thinking about it more and more, and that’s when I got back into it.

What was a typical encounter like?

At first we would usually sit and talk.  That part is so very awkward, unless it was someone I’d seen before. You are both sizing each other up, and then she would usually ask what you want to do.

I didn’t want to say, “Oh, well, I want to have anal sex.” Which is what I often wanted. It’s so awkward for two strangers, staring at each other, talking about sex acts. I was always anticipating that first ten minutes and I always hated it. I did have one lady whom I saw more frequently than the rest because she lived nearby, and with her it was a daddy-little-girl thing. That wasn’t necessarily what I was into, but it was pretty good with her. She’d stand there in her school uniform while I undressed her. We talked about it afterward, and would plan for the next time. With the others I couldn’t wait to get out of there. I had unprotected sex with her.

Was that a fantasy you had always had or did it escalate during the encounters?

It escalated and it got to the point where, if they were willing, so was I. When I had a condom on it felt like they weren’t really into me. If it was unprotected it was more of a relationship thing and maybe that’s what I was really looking for with these girls. It made it more thrilling, but maybe I also wanted to connect with them more.

Did you ejaculate inside them when you weren’t wearing a condom?

Yes. I was always so excited and my brain wasn’t thinking about things like pregnancy or AIDS. I’d always feel terrible when it was over — sad and dirty, and I’d regret that I didn’t have any self-control. I felt like I’d engaged in behavior that’s beneath me. I’m a professional person, I should have been able to control my thoughts and emotions. I beat myself up a lot. But when it wore off I’d be planning again.

Did you act on it more when you got used to the guilt?

Yes. I became skilled at putting it to the side. Like most men, I compartmentalize my emotions pretty well. The frequency just became more and more. The highs didn’t last as long. It got to the point where I had to do it once a week.

When it started up again after the two-year break, was there something that prompted it?

I think the relationship got stale day-to-day, and because I was out of town I was really consumed with work. I was running a critical project and I had all the eyes and ears of senior management on me. I had lots of responsibility and I felt like nothing could take me down. I got whatever I wanted. I thought I was king. I was living a seedy life. I’d never have had the guts to do that before. I felt invincible.

How did you cover it up from your wife?

I cleaned up at work. I’d use baby wipes on my genitals. I also asked them not to wear perfume. I had a list of questions and that was No. 1. I’d also ask if they had pets, because hair was a real concern. I kept one of those sticky rollers with me at all times. I had a toothbrush and mouthwash in my desk. I was pretty good.

Do you think you could count the number of prostitutes you’ve had sex with?

I guess I would say more than 50, less than 100.

Did you ever kiss them?

Yes. And that was the same sort of intimacy as when we didn’t use a condom. Sometimes, if I felt comfortable enough, I’d perform oral sex on them.

I’m curious to know if Lupron has impacted how you feel about your masculinity at all?

If anything I feel like more of a man now. I didn’t feel worthy. I was exposing myself to so much risk: I just felt so very bad about myself. I was in a dark, dark place. All the planning and stressing wore me out.  The night before I was supposed to see somebody, I couldn’t sleep, I worried about getting caught. I would always think I should just back out, until I convinced myself, Sorry, bud, you’re going. You are gonna do it. Sorry, bud.

How long do you think you’ll be on Lupron? Do you have anxiety about going off the medication or about being on it for the rest of your life?

My therapist would like me to go off it at some point, but I am not willing to talk about that right now. It’s really only the health risks that concern me. But my bone density has stayed the same since I started taking the shots, so that’s good. I’m petrified of those thoughts coming back.

What’s your relationship like with your wife, now?

It’s better. We go away on vacation, we hug and kiss – nothing more than that and she doesn’t mind because she would prefer that she didn’t have to worry about what I’m doing. And it’s great that she’s feeling that way. I really appreciate everything she’s done for me. I don’t think I’d be alive today if she didn’t step in.

What’s your response to people who don’t believe in this treatment or make the argument that you are just masking the problem with drugs and you should have more self-control? Or that you were acting out for a reason and that shouldn’t be medicated …

I really felt I was addicted to this behavior. And any addiction requires some sort of treatment, right? I think I was predisposed to it and it wasn’t something I could control. Believe me, I would come home, feel miserable, and say I am never doing this again.

Did your wife ever think the addiction model was just an excuse?

She knew it was beyond my power to stop, but we still don’t know what underlying cause triggered me to do this. I have to figure that out soon. I am not going off Lupron until I know why. Of course I ask myself: Do I love my wife? Maybe I don’t and that’s why I was able to do this to her. I don’t think I feel that way, but I don’t know.

Do you think that sense of control is why you opted to have sex with prostitutes instead of having an affair?

I think that’s definitely part of it. I could have easily gone to a bar and tried to pick up a woman, but I went to a strip club instead. I definitely wanted the physical thing without emotional involvement, but I did get emotionally involved with that first woman …

Do you ever worry that your wife will seek out sexual intimacy elsewhere? Do you feel guilty that she has had to sacrifice her sex life, too?

She’s the type of person who values truthfulness. I have never thought she’d cheat on me. She’s had plenty of opportunity. Some of our best friends were famous rock stars and she spent lots of time with them on the road. She had the opportunity if she wanted to, but I trust her. She’s an extrovert, but only to a point. She wouldn’t step on my toes or make me feel unimportant.

I understand that a sexless life is better than the hell you were in before, but do you miss sex at all?  Do you long for the days before this all happened?

Our sex life initially was very good. Do I sometimes wish I could go back to those times? Yes. Does she think about it? I don’t know. She’s accepted that it can’t happen. I think that’s human nature to want to go back to when things were better.

Do you worry about her happiness or her sexual fulfillment?

You know I don’t, because she’s a staunch Catholic and she would never leave. The contract of marriage is very high on her morality list. She has filled the sexual void with other things. She owns her own business, she frequently travels. Friday night is still date night for us. Whether we go to dinner, shopping, bowling, or to a movie, it’s a night that we have guarded against using for other things. I think that’s helped.

Is there any sort of intimacy between you and your wife?

I don’t pleasure her, but there was a period between the first time I acted out and the second when I was trying to repair the marriage and we were having oral sex. We were getting toward that, but I wasn’t really pushing her. I wanted her to be more comfortable. She was really against it for a while. There was certainly climax on her part and my part. Then I screwed it up by going to see prostitutes again.

Was she reluctant to have intercourse because she was worried about disease or was it because she saw it as more meaningful than the other acts?

I think it was the importance of the act. I was tested, so she was comfortable that I didn’t have any diseases. I think it was more that it was a bigger step for her. The oral sex was a half-step in between. Before that it was manual, toys and stuff.

Does you wife still masturbate, does she have any sexual fulfillment at all?

No, and she was never one to masturbate. I think that her Catholic upbringing discouraged that.

Do you think if chemical castration didn’t exist, you actually would have tried to plan a physical castration?

Yeah, I would have. But the hardest part would be finding someone who would do that.

Have you ever interacted with anyone else who is on Lupron?

My doctor has group therapy, but I always say no. I don’t really care about other people’s stories. I said I don’t care how he got here. We are all in this together and that’s a wonderful thing, but once I have told my story, what am I going to be doing for the next few hours? I don’t want to sit in a circle and stare at each other. That’s not going to work for me.

Do you think things would have turned out differently if you could have had sex with a prostitute every now and then, but stay married to your wife?

If I had addressed that with her I think she would have been okay with it. She’s always been sexually open. Maybe if I had just said, look, I don’t want to go out and cheat on you but I really want to explore my sexuality and I want to have sex with a prostitute, I think she would have been fine with that quite frankly.

See the original article on NYmag.com.