# Genital nullification > Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Genital_nullification > Markdown URL: https://mediated.wiki/source/Genital_nullification.md > Source: https://en.wikipedia.org/wiki/Genital_nullification > Source revision: 1350111290 > License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/) {{short description|Surgical procedure}} {{Use dmy dates|date=April 2026}} [[File:AMAB nullification 1 year in 1.jpg|thumb|A person [assigned male at birth](/source/assigned_male_at_birth) one year after genital nullification surgery]] [[File:Psychedelic666 - Genital nullification.jpg|thumb|A person [assigned female at birth](/source/assigned_female_at_birth) four weeks after genital nullification surgery]] '''Genital nullification''', also known as '''gender nullification surgery''' or simply '''nullification''', refers to surgical procedures which result in the removal of all [genitalia](/source/genitalia). It may be performed as a form of [gender affirming care](/source/gender_affirming_care) for [transgender](/source/transgender) and [gender diverse](/source/gender_diverse) individuals, as [body modification](/source/body_modification) for aesthetic purposes, or as a [sexual practice](/source/Kink_(sexuality)). Genital nullification is an uncommon procedure for which limited [scientific literature](/source/scientific_literature) is available. It may take place as a single or multi-stage procedure, with surgical methods varying based on patient anatomy and goals – a nullification procedure may involve [penectomy](/source/penectomy), [orchiectomy](/source/orchiectomy), [scrotectomy](/source/scrotectomy), [vaginectomy](/source/vaginectomy), [hysterectomy](/source/hysterectomy), [salpingo-oophorectomy](/source/salpingo-oophorectomy), and/or [urethrostomy](/source/urethrostomy). Genital nullification is an irreversible procedure with significant impacts on sexual, reproductive, and urinary function. Individuals who have received or wish to pursue nullification are sometimes known as '''nullos'''. ==Procedure== thumb|A diagram illustrating one method of nullification for patients assigned male at birth using a midline incision Genital nullification procedures vary by patient anatomy, patient goals, and surgical methods. Nullification may be performed as a single procedure or over multiple stages.{{Cite journal |last1=Ramirez |first1=Mayra Lucas |last2=Wangamez |first2=Maria |last3=Huynh |first3=Rachel |last4=Butler |first4=Christi |year=2025 |title=Surgical considerations for genital reconstruction options for gender-diverse individuals assigned male at birth |journal=Plastic and Aesthetic Research |doi=10.20517/2347-9264.2025.10 |issn=2347-9264 |oclc=896972841 |doi-access=free}} In individuals [assigned male at birth](/source/assigned_male_at_birth), genital nullification involves a combination of [penectomy](/source/penectomy) (removal of the [penis](/source/penis)), [scrotectomy](/source/scrotectomy) (removal of the [scrotum](/source/scrotum)), and [orchiectomy](/source/orchiectomy) (removal of the [testicle](/source/testicle)s).{{Cite journal |last1=Ascha |first1=Mona |last2=Rigsby |first2=Siri |last3=Shoham |first3=Maia |last4=Akhavan |first4=Arya Andre |last5=Swanson |first5=Marco |last6=Streed Jr |first6=Carl G. |last7=Gurjala |first7=Anandev |last8=Morrison |first8=Shane D. |last9=Pang |first9=John Henry |last10=Satterwhite |first10=Thomas |year=2024 |title=Individually customized gender affirming genital procedures: techniques and considerations |journal=[The Journal of Sexual Medicine](/source/The_Journal_of_Sexual_Medicine) |volume=21 |issue=9 |pages=827–834 |doi=10.1093/jsxmed/qdae075 |issn=1743-6109 |lccn=2004243877 |oclc=56519822}}{{rp|277}} The [urethra](/source/urethra) is shortened and a [urethrostomy](/source/urethrostomy) can be created to allow the patient to more easily urinate while sitting. Patients may opt to preserve or remove the [nerves](/source/nerves) of the penis – if preserved, the [glans](/source/glans) may be de-[epithelialised](/source/Epithelialization) and placed beneath the skin or left exposed to attempt to maintain sexual sensation. The [prostate](/source/prostate) is typically left intact during nullification procedures, as [prostatectomy](/source/prostatectomy) carries the risk of complications relating to urinary function. Patients with intact prostates may still be capable of the production and [ejaculation](/source/ejaculation) of [seminal fluid](/source/seminal_fluid) and of achieving [prostate orgasm](/source/prostate_orgasm)s.{{rp|277}} In individuals [assigned female at birth](/source/assigned_female_at_birth), genital nullification involves a combination of [vaginectomy](/source/vaginectomy) (removal of the [vagina](/source/vagina)), [hysterectomy](/source/hysterectomy) (removal of the [uterus](/source/uterus)), [salpingo-oophorectomy](/source/salpingo-oophorectomy) (removal of the [ovaries](/source/ovaries) and [fallopian tubes](/source/fallopian_tubes)), and removal of the [labia](/source/labia) and/or [clitoris](/source/clitoris). Patients may opt to remove or preserve the clitoris – if preserved, the clitoris may be de-epithelialised and placed beneath the skin to attempt to maintain sexual sensation. Genital nullification is an irreversible procedure that permanently impacts sexual, reproductive, and urinary function and carries a risk of complications including [nerve damage](/source/nerve_damage), [infection](/source/infection), [chronic pain](/source/chronic_pain), and [scarring](/source/scarring). Patients who undergo nullification have limited options for future [genital reconstruction surgeries](/source/genital_reconstruction_surgeries) and require life-long [hormone replacement therapy](/source/hormone_replacement_therapy).{{Cite book |last1=Akhavan |first1=Arya Andre |title=Gender Affirming Vaginoplasty |last2=Quint |first2=Meg |last3=Satterwhite |first3=Thomas |publisher=[Academic Press](/source/Academic_Press) |year=2025 |isbn=978-0-443-21776-0 |editor1-last=Selvaggi |editor1-first=Gennaro |pages=265–280 |chapter=Chapter 23 - Individually customizable procedures for patients Assigned Male at Birth (AMAB) |doi=10.1016/b978-0-443-21776-0.00023-6 |oclc=1513132611 |editor2-last=Djordjevic |editor2-first=Miroslav L.}}{{rp|276}} Due to the rarity of nullification procedures, limited patient outcome and complication data is available.{{Cite journal |last1=Claeys |first1=Wietse |last2=Wolff |first2=Dylan T. |last3=Zachou |first3=Alexandra |last4=Hoebeke |first4=Piet |last5=Lumen |first5=Nicolaas |last6=Spinoit |first6=Anne‐Françoise |year=2025 |title=Variant genital gender‐affirming surgery: a systematic review |journal=[BJU International](/source/BJU_International) |volume=135 |issue=1 |pages=40–53 |doi=10.1111/bju.16513 |issn=1464-410X |oclc=610415745|hdl=1854/LU-01KES7E8FWGSJTECJQX3VCY6KX |hdl-access=free }} ==Patient demographics== [Transgender](/source/Transgender), [gender non-conforming](/source/gender_non-conforming), and/or [non-binary](/source/non-binary) individuals may seek genital nullification as a form of [gender affirming care](/source/gender_affirming_care), however, the procedure is not exclusive to these demographics. Patients may seek nullification to alleviate [gender dysphoria](/source/gender_dysphoria) in relation to the presence of genitalia, [erogenous](/source/erogenous) sensation, or [erectile tissue](/source/erectile_tissue) function. Others may simply desire a more neutral external appearance. Individuals pursuing genital nullification for the purpose of gender affirmation may also pursue [mastectomy](/source/mastectomy) or [nipple removal](/source/nipple_removal) procedures.{{Cite book |last1=Stitt |first1=Alex L. |title=ACT for Gender Identity: The Comprehensive Guide |date=2020 |publisher=[Jessica Kingsley Publishers](/source/Jessica_Kingsley_Publishers) |isbn=978-1-78592-799-7 |location=London and Philadelphia |oclc=1089850112}}{{rp|43}} In the context of gender affirming care, genital nullification is sometimes referred to as a form of non-binary [genital gender-affirming surgery](/source/Gender-affirming_surgery); it is considered a non-standard surgical option compared to the binary [vaginoplasty](/source/vaginoplasty) or [phalloplasty](/source/phalloplasty) procedures that are traditionally offerred to patients seeking genital gender-affirming surgery.{{Cite journal |last1=Van Sickels |first1=Nicholas |last2=Wong |first2=Jennifer W. H. |last3=Villacorta-Cari |first3=Evelyn |last4=Lee |first4=Steph E. |last5=Fallin-Bennett |first5=Keisa |year=2025 |title=State-of-the-Art Review: Data and Trust to Improve Care for Transgender and Gender-Diverse Patients |journal=[Clinical Infectious Diseases](/source/Clinical_Infectious_Diseases) |volume=80 |issue=2 |pages=e16–e30 |doi=10.1093/cid/ciae480 |issn=1537-6591 |oclc=24308833 |doi-access=free}} Some patients seeking genital nullification identify as [eunuch](/source/eunuch)s, a subculture of individuals assigned male at birth who wish to remove their genitals or make them non-functional, typically through [castration](/source/castration) or [emasculation](/source/emasculation).{{Cite book |last1=Agapoff |first1=Jamie |title=Encyclopedia of Sexual Psychology and Behavior |last2=McCoy |first2=Ruby T. |last3=Bongar |first3=Bruce |publisher=[Springer](/source/Springer_Publishing) |year=2024 |isbn=978-3-031-08956-5 |editor1-last=Shackelford |editor1-first=Todd K. |location=Cham, Switzerland |pages=1–4 |chapter=Eunuchs |doi=10.1007/978-3-031-08956-5_2516-1 |oclc=1525656907}}{{Cite journal |last1=Coleman |first1=E. |last2=Radix |first2=A. E. |last3=Bouman |first3=W. P. |last4=Brown |first4=G. R. |last5=de Vries |first5=A. L. C. |last6=Deutsch |first6=M. B. |last7=Ettner |first7=R. |last8=Fraser |first8=L. |last9=Goodman |first9=M. |last10=Green |first10=J. |last11=Hancock |first11=A. B. |last12=Johnson |first12=T. W. |last13=Karasic |first13=D. H. |last14=Knudson |first14=G. A. |last15=Leibowitz |first15=S. F. |year=2023 |title=Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 |journal=[International Journal of Transgender Health](/source/International_Journal_of_Transgender_Health) |volume=23 |issue=sup1 |pages=588–592 |doi=10.1080/26895269.2022.2100644 |issn=2689-5277 |lccn=2019202035 |oclc=1127649197 |doi-access=free |last16=Meyer-Bahlburg |first16=H. F. L. |last17=Monstrey |first17=S. J. |last18=Motmans |first18=J. |last19=Nahata |first19=L. |last20=Nieder |first20=T. O. |last21=Reisner |first21=S. L. |last22=Richards |first22=C. |last23=Schechter |first23=L. 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A. |last119=Arcelus |first119=J.|pmc=9553112 }} This group should not be confused with individuals who solely [fantasise](/source/Sexual_fantasy) about castration or emasculation or who may instead be experiencing a [paraphilia](/source/paraphilia), [body integrity dysphoria](/source/body_integrity_dysphoria), [body dysmorphia](/source/body_dysmorphia), or a religious fervor.{{rp|267–268}}{{Cite journal |last1=Wassersug |first1=Richard J. |last2=McKenna |first2=Emma |last3=Lieberman |first3=Tucker |year=2012 |title=Eunuch as a gender identity after castration |journal=[Journal of Gender Studies](/source/Journal_of_Gender_Studies) |volume=21 |issue=3 |pages=253–270 |doi=10.1080/09589236.2012.681178 |issn=0958-9236 |lccn=2001238211 |oclc=321078833}} Eunuchs may or may not identify as transgender or gender diverse, with some identifying their gender simply as eunuch, and nullification procedures sought by this demographic may or may not be considered gender-affirming care. Not all eunuchs pursue full genital nullification, and not all individuals who have undergone castration or nullification identify as eunuchs. Some individuals may pursue genital nullification as a form of [body modification](/source/body_modification) for aesthetic purposes and/or as part of a [sexual practice](/source/Kink_(sexuality)) such as [BDSM](/source/BDSM). These individuals may self-identify using the term "nullo" and are considered rare within the extreme body modification community.{{Cite book |last1=DeMello |first1=Margo |title=Encyclopedia of Body Adornment |publisher=[Greenwood Press](/source/Greenwood_Press) |year=2007 |isbn=978-0-313-33695-9 |location=Westport, Connecticut |pages=9, 55–58 |lccn=2007016304 |oclc=181159689}} Being an uncommon procedure with little description in [medical literature](/source/medical_literature), few medical practitioners are willing or able to perform genital nullification.{{rp|267–268}} Some patients are hesitant to pursue the procedure or express their wishes to medical staff out of fear of discrimination or denial of care. Some individuals instead seek out [unlicensed](/source/Practicing_without_a_license) surgeons, known in the body modification community as "cutters", or attempt [self-surgery](/source/self-surgery).{{rp|267–268}} ==See also== * The [Skoptsy](/source/Skoptsy), a Christian [sect](/source/sect) in the [Russian Empire](/source/Russian_Empire) known for removing breasts and genitalia for religious reasons ==References== {{Reflist}} ==External links== * {{Wiktionary-inline|nullo}} * {{Commons-inline}} Category:Surgical removal procedures Category:Reproductive system Category:Genital modification and mutilation Category:Transgender health care Category:Plastic surgical procedures --- Adapted from the Wikipedia article [Genital nullification](https://en.wikipedia.org/wiki/Genital_nullification) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Genital_nullification?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.