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Skoptic syndrome is a condition in which a person is preoccupied with or engages in genital self-mutilation (e.g. castration, penectomy). The definition of skoptic syndrome is a gender dysphoria found under the DSM IV section 302.6 : Gender Identity Disorder Not Otherwise Specified.
Skoptic syndrome can sometimes be motivated by intense sexual guilt, in which the genitals become identified as the source of the guilt-inducing sexual desire. This leads to desire for removal of or damage to the genitals.
In most sufferers, mutilation will begin on a small (almost harmless) scale immediately before the onset of puberty (usually about 12-14). By the late teens it is common for the self-harm to become more extreme, integrated with masturbation routines, and dependent on arousal.
In adulthood, some individuals seek castration from an "underground cutter" (an unqualified person with enough knowledge to perform the surgery in the home), or from a professional urologist.
Female birth-control pills such as Cyproterone Acetate (Brand name: Androcur) or Depo-Provera can be used to block the effect of androgens on the body, thereby cutting testosterone production and causing atrophy of the testicles. This method is often favoured by prospective eunuchs and their supporters as a first step, because it is largely reversible and non-invasive.
Dr. John Money, "The Skoptic Syndrome: castration and genital self-mutilation as an example of sexual body-image pathology.", Journal of Psychology and Human Sexuality, Volume 1 1988