He could've filled three Pepsi cans. Maybe three and a half.

That's how much blood Talula estimates he lost the first time he tried to castrate himself.

Life had hit an all-time low. Depression hung around his shoulders like a lead suit. His libido had spiraled out of control, and he was masturbating as many as five times a day.

So in June 1994, at 37 years of age, Talula made a decision. He'd had enough. They had to go. He stripped naked and sat in his tub, Betadine solution in one hand, an Xacto knife in the other. He doused his genitals with the antiseptic until they glowed amber, then slowly, carefully, slit open his scrotum.

No anesthesia. No alcohol. Nothing.

His fingers searched the bloody pulp for the olive-size testes that had caused him so much torment, but he was starting to feel faint.

In that moment, everything made sense: The times he and his best friend would curl one another's hair and put on makeup. The way he used to tuck his penis between his legs and admire his profile. How he would tie string around his testicles until they changed from red to purple to blue. The countless nights he prayed himself to sleep: "Please, God, please let me wake up a girl."

As the drain swirled with blood, he considered folding up his insides, taking a bath and climbing into bed. Instead, he gritted his teeth and sawed straight through his left testicle.

"I just wanted to see what they looked like," he recalls quietly. "But I'd dug too deep. I'd gone overboard."

With that realization, he wrapped the gory mess in a washcloth, bound it with duct tape and drove 18 miles to the nearest hospital. The medics in the emergency room treated Talula as an unknown—neither male nor female—but patched him up anyway and sent him for a psych evaluation.

After three years obsessing over the remaining testicle, Talula did it again.

This time he had help from a "certain friend" he had always hoped would finish the job. Talula handed the friend a syringe full of Xylocaine and a Burdizzo, a 19-inch tool used to castrate bulls. As its mighty jaws clamped around his scarred scrotum, the pain throbbed like poison darts pricking his every nerve.

And then … relief.

The certain friend, honored to have helped, bowed on his way out the front door of Talula's mobile home, located somewhere along the Minnesota-Wisconsin border.

And Talula, well, he was the happiest person alive.

"It was grand," he says, in between long, audible draws on a cigarette. "I felt like Atlas, not having to carry the world."

For Talula to cut off his own testicles throws a wrench in society's idea of what it means to be male—or more profoundly, what it means to be human. Yet whenever voluntary castration enters the public dialogue, it's usually in the form of hypersensational headlines on the 11 o'clock news: Sex-Crazed Pedophiliac Would-Be Rapist Cuts Off Testicles!!!

The reality is far more complex.

Only one out of seven people who fantasizes about castration ever acts on the desire, and those who do have myriad reasons: some dislike the way testosterone affects their mind and body; some feel powerless in the face of their sexual urges or long for the "eunuch calm," a meditation-like state unimpeded by carnal desire; some do it for ascetic or cosmetic reasons; some are in the process of transitioning from male to female and view it as a cost-effective step on the road to full sex reassignment surgery; and some submissives consider castration the ultimate sacrifice in a sadomasochistic relationship.

"We are real people with real reasons," says Talula. "We live next door, we're down the street, at your work. We have mortgages, credit cards, cars and grandmothers. We're just people that prefer no sex."

And people who, given the choice, would rather not take matters into their own hands.

Talula didn't want to self-castrate, but he felt he had no other option. He was afraid if he told physicians or family members, they'd lock him away forever. He could either do it himself, or not do it.

What Talula didn't realize at the time was that he had a third option awaiting, scalpel in hand, in Philadelphia—the castration capital of the United States.

TABLESIDE MANNER: Philadelphia osteopath Felix Spector has performed "thousands" of elective castrations in his half-century career. "People pushed me for help and it worked out quite well," he says.

For nearly 40 years, thousands of people have traveled here to have their testicles removed by Dr. Felix Spector, a retired osteopath who had offices in North and South Philly, and around the corner from the Pain Center in the Gayborhood.

Unlike most trans-health professionals, Spector didn't follow the guidelines set forth by the Harry Benjamin International Gender Dysphoria Association, the regulatory body dedicated to the treatment of gender identity disorders. He never required that patients—transitioning or otherwise—undergo psychiatric counseling, take hormones or live outwardly as women.

The way he saw it, the Harry Benjamin guidelines created too many unnecessary hoops. By the time a person saved up enough cash to pay him a visit, they knew what they wanted. Spector believed his responsibility was to give it to them, "safely, correctly and with sympathy."

No questions asked, credit cards accepted.

Spector's Web site claimed he was "a founder of the field" and possessed "arguably more experience than almost any other doctor" in the treatment of trans people and men with overactive libidos. He even wrote a handbook on it—the $25 cost of which could be deducted from the price of surgery.

When I first interviewed the 89-year-old doctor, he spoke slowly and repeatedly jumbled names and dates. It was a struggle to hear him over the all-Mozart radio program he was blasting in the background.

Spector was born in Philadelphia in 1917 and graduated from the Philadelphia College of Osteopathic Medicine in 1943. After practicing general medicine in Texas, California and West Virginia, he moved back to Philly in 1954. Three years later, under dubious circumstances, he performed his first castration on a transsexual in Casablanca.

Word spread quickly about the good doctor who would lop off a person's testicles at their discretion. Patients described Spector as polite and grandfatherly, with a timid smile and a sly sense of humor—the kind of old man who flirts with pretty waitresses and cracks eunuch jokes to guys about to be castrated.

He was known for loading patients into his red Taurus and taking them on a whirlwind tour of Philadelphia, pointing out historic sites like Independence Hall and capping off with a cheesesteak at Pat's or Jim's. After surgery, he would snap their picture with a Polaroid camera.

"Proof you lived through it," he'd tease and write their name in the white border.

Business boomed with the advent of the Internet; at the height of his practice, Spector was doing 10 castrations a month at $1,600 a pop. For an additional $1,200, he'd also remove the scrotum.

"I saw the need for it," Spector says matter-of-factly. "People pushed me for help and it worked out quite well. Never had any kind of problems."

The night before surgery, Chris checked into a Center City bed and breakfast and shaved his entire scrotal region, just as Spector had instructed. In the morning, a chatty, well-fed nurse in her mid-40s greeted him upon arrival at Spector's Rodman Street home office.

"I walked in and thought, 'Oh my fucking God, what have I done?'" he remembers. "It was somebody's grimy front room with an exam table and a couple of stirrups. Papers and junk all over the place. There was nothing sterile about it."

Chris' first impulse was to turn around and go home, but he hadn't traveled this far to return with testicular baggage in tow.

He signed a consent form, paid the balance due and nodded when Spector asked him, "Do you know what you're doing? Are you ready to go? Let's do it."

The operation was done under local anesthesia, and ended quickly enough. Though Chris felt uneasy about the bandaging job, he walked the three blocks back to his hotel, rested and ate lunch. By the afternoon, he was being rushed into the E.R. at Jefferson Hospital on a blood-soaked gurney. Spector had improperly sutured a major artery and Chris was hemorrhaging internally.

The botched castration left him hospitalized for a week and required two corrective surgeries to remove blood clots and necrotic tissue.

"I was a real mess," admits Chris, who says he slipped into a "borderline psychotic" depression after the castration. "I would never want to put anybody through it. I tell the story of someone who thinks they were prepared, but wasn't. All I wanted was that aesthetic thing. I had no concept of the side effects."

Spector castrate George Mayo, an androgynous pet groomer from Maryland, also felt unprepared for the aftershock. But despite years of surprise hot flashes, he says he's never regretted his decision and doesn't believe Spector led him astray.

"Those who go to Spector already know they want it. I did my research," he says, then pauses. "Maybe I could have done more."

Still, Spector was better than the alternative.

OPEN MIND: Dr. Robert Winn, medical director at Philadelphia's Mazzoni Center for LGBT Health and Wellbeing, says although he has never treated a eunuch patient before, he wouldn't turn one away either.

When wannabe castrates could not afford Spector, they would often turn to the very place they found him: the Internet, where there exists a subculture of underground cutters willing to perform guerrilla surgeries in motel rooms, at medical fetish clubs and just over the Mexican border. Scissors, wire cutters and livestock elastrators are the main tools in a trade that sometimes uses Listerine as antiseptic and Tylenol for pain. Horror stories of desperate men blowing off their own balls with shotguns are endemic in eunuch culture, which partly explains why health professionals question their sanity. And why, in classic chicken-and-egg fashion, castrates resort to such drastic measures in the first place.

As head of the Eunuch Archive (www.eunuch.org), the Internet's largest support site for the castration-curious, Talula and other active participants try to act as a safety valve, educating visitors on the everyday realities of castration and cautioning them against street cutters.

Madison Abercrombie, a 31-year-old trans woman from rural Missouri, discovered the site too late.

Four years ago, Madison was named Michael and was newly married, working at his family's salvage yard and living the American dream. But one thing haunted him: He hated his genitals.

He tried confiding in doctors and church counselors, but they kept using words like "sick" and "perverse." And while he had heard of Spector's work, he couldn't afford the trip to Philadelphia. Random posts in a eunuch chat room eventually led him to underground cutter Jack Wayne Rogers, a Presbyterian minister and Boy Scout leader from a neighboring town.

Rogers' e-mails were short and impersonal, but Abercrombie was impressed by how well he knew the Bible. Rogers agreed to meet him at a motel room in Columbus, where, for $750, he would remove both his penis and testicles.

The surgery took seven hours and 20 minutes. Abercrombie says there were moments of pain so intense, she could feel the life bleeding out of her.

When Rogers realized the life actually was bleeding out of her, he told Abercrombie, "You can go to the hospital—just leave me out of it."

And with good reason—Abercrombie later learned that Rogers had been convicted on charges of obscenity and child pornography, and was suspected in the torture and killing of a 20-year-old man. The substandard operation left Abercrombie so grossly deformed, it took multiple surgeries to undo the damage. Three weeks ago, Abercrombie took the final step in her transition when a California doctor built her a new vagina.

"If I had not been turned away, if I'd just had some medical help setting goals of getting where I needed to be, it never would've happened," Abercrombie says shakily. "It's a cryin' shame."

But o

n Jan. 18, 2002, the Pennsylvania State Board of Osteopathic Medicine declared Spector an "immediate danger to the public health and safety" and suspended his license to practice medicine.

It wasn't the first time Spector had received troubling news.

In the 1940s and again in the 1960s, he was found guilty of performing then-illegal abortions. Also in the '60s, a Philadelphia judge sentenced Spector to two years' missionary work in Africa. Then in 1997, The Philadelphia Inquirer indexed his numerous problems with the law, which included falsifying pharmacy records, billing irregularities and performing a castration of "grossly inferior quality." Spector was recently named in a malpractice suit in the Philadelphia Court of Common Pleas; he denies culpability.

Patients with postsurgical complications have come back to haunt him on several occassions, as has another familiar name: Dr. Terrence Malloy. Chief of Urology at Pennsylvania Hospital and Spector's personal urologist, Malloy provided the expert testimony that led to Spector's 2002 suspension.

During regular checkups, Malloy says Spector would ply him for surgical techniques and treatment advice.

"He had the brass ones to say one time, 'Can I come and watch you do an orchiectomy?'" recalls Malloy, who denied Spector's requests for what he calls a "totally repugnant" surgery. "It's just common sense—a 35-year-old guy does not want his testicles taken off. That's the height of an abnormal psyche."

Spector says he's only under attack because he provided a "nontraditional service" in a profession whose values "were engendered during the Victorian era."

Malloy calls Spector a "quack" and a "butcher," and likens his methodology to assisted suicide: "This was not done for any lofty goal—it was done for money. It's the worst type of victimization [that] preys on the most vulnerable people in the American public."

Beyond ethical queries, the State Board suspension cited two lapses in Spector's malpractice coverage and stated that he was untrained, unqualified and unequipped to be castrating anyone. As an osteopath, Spector was licensed to perform surgery, but he was also obligated to explain its risks and alternatives to the patient. And while he admits to having no formal urological training, Spector says the standards of the American Board of Urology and the American College of Surgeons didn't exist when he first began his practice.

A State Board attorney who asked to remain anonymous offered this hypothetical situation: "Say you were having chest pains and you go to a surgeon. If he says, 'Let's cut you open and do a bypass,' and doesn't check for angina or try medication first, it's not that he did a bypass—it's that he didn't do all the things he's supposed to do to make sure you were a candidate for it."

Spector never had patients professionally screened for psychological disturbances or suggested they explore a short-term course of chemical castration, which is at least reversible. Sometimes he would tell them to think the operation over and call him back later. Sometimes he wouldn't.

STREET LIFE: Madison Abercrombie's genitals were butchered by an underground cutter four years ago. "If I'd just had some medical help setting goals of where I needed to be, it never would've happened," she says.

Can a physician be expected to follow standard protocol for a taboo surgery when there are no clear precedents, reliable data, peer-reviewed medical literature, textbooks or medical experts willing to discuss it?

"Look, all I can say is you can't treat a patient if what they want is crazy," says the attorney. "Accepted practice means knowing when to tell your patient that what they want is wrong."

Dr. Sherman Leis, founder of the Philadelphia Center for Transgender Surgery and one of the country's leading plastic surgeons for trans health care, echoes the attorney's sentiment. Leis follows the Harry Benjamin guidelines on a case-by-case basis, but says he'd never do a surgery that wasn't medically indicated. In fact, he finds the idea abominable.

"There are a lot of sick, psychotic people out there," says Leis of non-trans men seeking castration. "A legitimate doctor doesn't operate on somebody who is psychotic. That's incompetent medicine."

Chico State University anthropologist Tom Johnson and Dalhousie University anatomist and neurobiologist Dr. Richard Wassersug disagree that all voluntary castrates are necessarily psychotic. They've spent years studying and surveying members of the Eunuch Archive and researching the realities of androgen deprivation. Together, they're pioneering the sort of research that will ultimately be reviewed by peers, printed in medical journals, taught in classrooms and discussed openly between doctors and patients.

That's their hope, anyway.

"You still have doctors recycling prejudices from the Roman Empire, without looking at the very real eunuchs around them," says Johnson. "It's a human propensity to try to put everything into pigeonholes—this or that, either/or—without any consideration of the gradations between. There are not two sexes; there are probably 50."

Gary Taylor, Shakespearean scholar and author of Castration: An Abbreviated History of Western Manhood, concurs; he says eunuchs provide a blueprint for the first post-human. "We're entering a time when the possibilities of genetic engineering mean the potential for changing what it means to be human," says Taylor. "But not everybody is going to accept the implications of our capacity to alter human beings. That's the great philosophical and political problem of our future."

Until that day comes, people eke through the system whatever way they can.

Social workers at Philadelphia's Mazzoni Center for LGBT Health and Wellbeing have taken a harm-reduction approach, providing patients with nonjudgmental counseling and informational resources.

"We should be able to recognize the need and push for better treatments. Eunuch, gay, trans—doesn't matter," says Mazzoni medical director Dr. Robert Winn. "There should be no backroom abortions."

Sue Collins, Mazzoni's trans patient coordinator, started presenting as a woman three months ago and empathizes with the eunuchs' struggle.

"Everybody says this is the act of a freak, a demon," she says. "So all my life I tried to fight this demon inside me. Then I realized the real demon was society trying to tell me who I am."

When Collins came out as a woman, all but one of her old friends turned their backs. Her ex-wife cut off communication, as have two of their three children. "It's such a tragedy," she says. "Nobody wants this. Nobody wakes up one morning and says, 'Yeah, when I grow up, I want to cut my balls off.' We just want our bodies to fit with our minds and our souls. That's all we want."

Furthermore, they say, physicians have a responsibility to prevent imminent or foreseeable harm. Could it not be argued that rendering a patient's concerns crazy or invalid does the patient greater harm in the end?

"That is the ultimate question," says Paul Root Wolpe, a bioethicist at the University of Pennsylvania and the author of Sexuality and Gender in Society. "For some people, the standard of doing no harm requires that the surgeon actually perform the surgery. If they don't, ultimately the patient will undergo greater harm. But that has to be the absolute last step in a long treatment."

Wolpe calls this the "Kevorkian problem": Both Jack Kevorkian and Timothy Quill were advocates of doctor-assisted suicide, but Quill probed his patients in-depth and advocated a strong psychosocial relationship before he'd ever consider lethal measures. Kevorkian helped some patients die within 24 hours of meeting them.

"The idea of rampant autonomy ethics, where if you say you want it then what right do I have to ask you questions, is both therapeutically irresponsible and medically spurious," says Wolpe, adding that the moment a patient enlists a physician's help, that physician's moral standing becomes part of the equation. "Any doctor has a right not to perform an act they find unethical. And you don't have a right to compel them simply because you find it ethical. When you have a whole profession that finds [elective castration] problematic, you really need to examine why."

Jim, a 57-year-old eunuch castrated on a friend's kitchen table eight years ago, believes it is a gross double standard. "If a woman went in and said she wanted her ovaries removed, the doctor would say, 'We can set you up on this date and it'll cost you X amount of dollars,'" says Jim. "Male goes in and says 'I want 'em removed,' it ain't gonna happen. We're left out in no-man's-land."

Speaking as someone who performs sex reassignment surgery but has also been through the process herself, Dr. Marci Bowers of Trinidad, Colo., says most doctors lack perspective of what it's like to be on both sides of the gender divide: "Their self-esteem is so wrapped up in what goes on with their penis every day, they can't see the forest from the trees."

While Bowers has yet to castrate a non-trans male, she says she would consider it after proper psychiatric counseling. "It's very lonely to hold one of the only flags," she sighs. "But it's God's will. We have the high moral ground in what we're doing."

He has taken up residency in a 29-room Dickensian mansion—rumored to be one of the most haunted properties in Ohio—and spends most of his time cooking, reading medical journals and renting out rooms to thrill-seeking ghost hunters. He still hears from grateful patients now and again, but says he would just as soon put his past behind him.

During our final conversation (Spector's attorney advised him to cut off contact with City Paper after three phone interviews), he tells me he regrets nothing in his controversial career.

"I have no feeling of dread or having done any harm or any wrong," he says in a trembling, world-weary croak. "Philadelphia is full of people ready to tear you apart … [Malloy] has achieved his goal—he put me out of business."

In one sense, he's right. But what's more significant was the hearing examiner's conclusion that castrating patients with no physical or pathological condition added "insult to injury" by exacerbating pre-existing psychological problems.

Beyond the courts,

Spector's case wasn't helped by Italian filmmakers Gian Claudio Guiducci and Franco Sacchi's 2003 documentary American Eunuchs, which provided a damning look at his practice. The eunuch community was outraged by the film, and Spector refuses to discuss it.

He's sick of fighting.

Spector was recently diagnosed with pulmonary fibrosis. His words are garbled in violent coughing fits; it's hard for him to get a word in edgewise. The prognosis is grim, and the doctors at the "big hospital" in Pittsburgh have thrown their hands up.

"There's not a lot of justice in this world," he laughs bitterly. "Not a lot of justice."

What is the future of elective castration with Spector out of commission?

City Paper anonymously called a dozen urology practices in the Philadelphia area to see which, if any, were willing to castrate on an elective basis. Some receptionists reacted with shock and confusion, others as if they'd fielded the question before. One nurse expressed concern that we were taking "a step in the wrong direction."

One phone call, however, garnered very different results.

It was a call placed to Dr. Murray Kimmel, a board-certified urologist with offices located at 2301 Pennsylvania Ave.

"I've made over 12,000 people happy," Kimmel told us. (Formal calls to Kimmel's office went unreturned.) "People come to me from all over the country, all over the world. I must be doing something right, right?"

According to court documentation and Spector's now-defunct Web site, Kimmel was named an "associate" shortly after Spector's license was suspended in 2002; since then, Spector has assumed the role of middleman, making referrals, answering questions and collecting down payments.

Like his predecessor, Kimmel performs the surgeries on an outpatient basis and demands no psychiatric evaluation, therapists' letters or waiting period—just $2,000 in cash or money orders. He does, however, explain the procedure in great detail, stressing its irreversibility and discussing its aftereffects.

During our phone consultation, he grills us about our personal life (Are we married or single? How old are we? Do we masturbate at work? How many times a day?) and tells us a little about his. (He once received a hand-signed thank you note from President Eisenhower for teaching sailors how to be urology techs.)

He rambles tangentially, but there is one point he doesn't want us to miss: It's not his job to decide what's best for us. If we take the final cut, it's of our own volition.

We tell him we're sold and ask how soon he might be able to squeeze us in. As it happens, someone just cancelled their appointment on Monday.

How does 10 a.m. sound?

"This man is an exception rather than a rule," stresses Talula. "I do not know of one man on the Archive that would want to hurt a flea."

It's publicity like this, he says, that hurts the cause. "We need, as a eunuch community, a medical way to say 'Yes! I want to lose my testicles!' without getting sexual reassignment surgery," says Talula.

But until the medical establishment and society at large are willing to recognize another state of being—the gray area between male and female—Talula and people like him can do little more than boot up, log on and share their own horror stories. That, and hand out Kimmel's direct phone number.

"People will do it themselves if there's not an alternative," he says. "I know. I know because I did it."