Richard WassersugUniversity of British Columbia | UBC · Faculty of Medicine
Richard Wassersug
PhD University of Chicago
About
370
Publications
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Introduction
Skills and Expertise
Additional affiliations
January 2011 - present
January 2011 - July 2019
Publications
Publications (370)
We describe here the sexual histories and characteristics of 338 individuals with interests in castration (orchiectomy) and, more broadly, genital ablation (i.e., orchiectomy, penectomy, and/or nullification), recruited from the Eunuch Archive. We compared four groups: those who only fantasize about castration (Fantasy, n = 66), those who wish to b...
Although Androgen Deprivation Therapy (ADT) is effective in controlling prostate cancer (PCa) and increasing survival, it is associated with a myriad of side effects that cause significant morbidity. Previous research has shown that PCa patients starting on ADT are neither fully informed nor well-equipped to manage the breadth of ADT’s side effects...
Background
Educational programs that enhance healthcare providers’ competence in managing the care of patients with sexual dysfunction following prostate cancer treatments are needed to facilitate comprehensive sexual health treatments for patients and their partners.
Aim
In this study we evaluated the impact of a real-world online sexual health e...
Background
Although uncommon, some individuals assigned male at birth (AMAB) seek voluntary genital ablative procedures, and others fantasize about it.
Aim
To learn more about the views of genital ablation and injuries in those who aspire to be castrated as compared with those who only fantasize about it.
Methods
A survey was run on the Eunuch Ar...
Introduction:
To promote comprehensive care of patients throughout the androgen deprivation therapy (ADT) prescribing process, the Prostate Cancer 360 (PC360) Working Group developed monitoring and management recommendations intended to mitigate or prevent ADT-associated adverse events.
Methods:
The PC360 Working Group included 14 interdisciplin...
Two of the most fundamental questions in tadpole biology, also applicable to most small, under‐studied organisms are: (1) ‘Why are they built the way they are?’ and (2) ‘Why do they live where they do?’ Regrettably, despite significant progress in most aspects of tadpole biology, the answers to these questions are not much better now than they were...
Introduction
Sexual dysfunction (SD) is a prevalent and distressing side effect for survivors of prostate cancer (PCa). Unfortunately, many health care practitioners (HCPs) report a lack of training and confidence in addressing the sexual health needs of PCa patients. Consequently, many PCa patients do not receive the comprehensive sexual healthcar...
Background
Little is known about childhood experiences, outcomes, and self-recollections of those men who were voluntarily castrated as adults.
Aim
The study sought to determine how learning about castration before and after 13 years of age is associated with differential childhood experiences, outcomes, and self-recollections of those who were vo...
Background and purpose:
Over the past decade, patient engagement (PE) has emerged as an important way to help improve the relevance, quality, and impact of health research. However, there is limited consensus on how best to meaningfully engage patients in the research process. The goal of this article is to share our experiences and insights as me...
The concept of “patient-centered care” (PCC) emphasizes patients’ autonomy and is commonly promoted as a good healthcare practice that all of medicine should strive for. Here, we assessed how six medical specialties—pediatrics, OBGYN, orthopedics, radiology, dermatology, and neurosurgery—have engaged with PCC and its derivative concepts of “person-...
Some men elect castration voluntarily without any clear medical reason. Here we aim to document their perception of genital ablation and injuries to better understand their motivations for castration. Participants completed an online survey with open-ended questions related to their perspectives on castration, genital ablation, and genital injuries...
In rare cases, some male individuals are sexually attracted to men who have their genitals removed. We investigate here if paraphilic attraction to men without genitals was associated with childhood experience, body image, and thoughts/behaviors related to body modification. An online survey, consisting of both validated questionnaires and question...
Introduction
Erectile dysfunction (ED) can lead to reduced sexual intimacy in men. The external penile prosthesis (EPP) is a device to help them participate in penetrative sex.
Aim
We investigate factors that may affect the willingness of individuals with ED to try an EPP and explore how the EPP could be presented most effectively to such patients...
One of the important aspects of stakeholder engagement in cancer care and system planning is hearing from individuals who have been diagnosed with cancer about the impact of the diagnosis and treatment on their lives. Hearing stories from the perspectives of cancer survivors offers opportunity to gain new insight and understanding about experiences...
The Eunuch Archive (EA) is an online community which includes individuals who read and write sexual fantasies with themes related to castration and eunuchs. Here we analyzed the 100 stories rated highest by EA readers among the >8800 currently posted. Our goal was to gain insights into commonalities within, and specifics of, castration sexual fanta...
Prostate cancer patients may experience disturbed sleep as a result of their diagnosis or treatment. This study sought to evaluate disturbed sleep and excessive daytime sleepiness in newly diagnosed patients and those receiving androgen deprivation therapy (ADT). This study was conducted with 74 patients. Subjective data using the Pittsburgh Sleep...
Background
Prostate cancer (PCa) is often diagnosed early with prolonged survival, which makes sexual quality of life (QoL) an increasingly important treatment consideration, but existing QoL questionnaires have limited applicability for men who-have-sex-with-men (MSM) beyond penile erections and penetrative sex.
Aim
We aimed to create a validated...
PurposeThe primary objective was to determine the feasibility of implementing the TrueNTH SHAReClinic as a pan-Canadian sexual health and rehabilitation intervention for patients treated for localized prostate cancer.Methods
The feasibility study was designed to evaluate the accessibility and acceptability of the intervention. Participants from fiv...
Objectives
Patients with prostate cancer (PCa) benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programmes that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success.
Methods
We compared the FC Prostata football...
Having a life partner significantly extends survival for most cancer patients. The label given to the partners of cancer patients may, however, influence the health of not just the patients but their partners. “Caregiver” is an increasingly common label for the partners of patients, but it carries an implicit burden. Referring to partners as “careg...
Objective
The concept of ‘patient-centered care’ was touted as a pillar of good clinical practice and endorsed by the US Institute of Medicine in a seminal 2001 publication. We explore the extent to which differing medical specialties have engaged with the concept over the last 20 years and how and why this attention has varied among a sample of me...
Introduction:
Considerable observational evidence suggests that cancer online support groups reduce feelings of isolation, depression and anxiety, enhance coping and self-management, and lead to better informed patients. Other studies indicate that cancer online support groups can increase distress. Yet no studies theorise the complex, context-dep...
Some genetic males undergo voluntary castration, with and without hormonal supplementation. Here, we investigate the sexual function of 163 such individuals (average age = 52 ± 16-years-old). Specifically, we explored how hormonal, social, and psychological factors play a role in their sexual function. In this study, 47% identified their gender as...
Background
Androgen deprivation therapy (ADT) may affect cognitive function in men with prostate cancer (PCa). This study examined whether insomnia symptoms mediate the relationship between ADT and perceived cognitive function and whether depressive symptoms, fatigue severity, and physical activity moderate the strength of this relationship.
Metho...
Objectives
This paper (1) sought to compare sleep, mood and physical symptom profiles of men with prostate cancer (PCa) who experienced subjective and objective cancer-related cognitive impairment (CRCI) during the first year of treatment and (2) examine if fluctuations in mood and physical symptoms are associated with change in subjective or objec...
A 12-year-old boy lost both testes after testicular torsion. He is now 14, and his father wants to know if the boy should immediately start supplemental testosterone or if he might reasonably choose to live as a eunuch. The boy does not yet express any strong opinion except that he is embarrassed about his weight gain. We advised the father that th...
Purpose
Prostate cancer (PCa) patients benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programs that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success.
Methods
We compared the FC Prostata football (soccer) l...
Background and objective: Luteinizing hormone-releasing hormone
agonists (LHRHa) suppress gonadal hormone production and are commonly used to
treat prostate cancer (PC) in men and conditions ranging from uterine fibroids to
estrogen-sensitive cancers in women. They are also used to delay sexual
development in children considering gender reassig...
Introduction
Factors influencing patient behavior regarding risk of prostate cancer (PCa) and outcomes of PCa treatments are poorly understood. Similarly, how PCa treatments affect patient sexual function and sense of their masculinity has not been fully investigated. A better understanding of the relationship between sex and gender for patients wi...
PurposeFear of cancer recurrence (FCR) is a significant problem for individuals diagnosed with a variety of different cancers. To date, FCR has not been studied in males with breast cancer. The objective of this study was to examine the severity of FCR in males with breast cancer.Methods
Males with breast cancer participated in an anonymous online...
e17046
Background: Sleep disturbances and cancer related fatigue are commonly associated. Prostate cancer patients may suffer from disturbed sleep as a result of their diagnosis and following treatment, especially with androgen deprivation therapy (ADT). Wrist actigraphy is a non-invasive objective method of sleep data collection. This feasibility...
Cancer patients vary in their comfort with the label “survivor”. Here, we explore how comfortable males with breast cancer (BC) are about accepting the label cancer “survivor”. Separate univariate logistic regressions were performed to assess whether time since diagnosis, age, treatment status, and cancer stage were associated with comfort with the...
Some genetic males seek voluntary castration. We designed a survey to compare the psychological, sexual, and childhood experiences for subgroups of men with extreme interest in castration. The survey was posted on the Eunuch Archive, an online platform for individuals interested in the topic. Data from 822 individuals were included in the analyses....
For a patient to be effective as a “patient representative” within a health-related organization, work and more than just accepting an honorific title is required. I argue that for a patient to be most effective as a patient representative requires different types of background knowledge and commitment than being a “patient advocate”. Patients need...
A 12-year-old boy lost both testes after testicular torsion. He is now 14, and his father wants to know if the boy should immediately start supplemental testosterone or if he might reasonably choose to live as a eunuch. The boy does not yet express any strong opinion except that he is embarrassed about his weight gain. We advised the father that th...
Background
Testosterone is associated with sexual desire and performance in men, but little is known about cognitive mechanisms underlying this relationship. Even less is known about the influence of estradiol, despite its production from testosterone, and high receptor density in brain regions related to male sexual behavior.
Method
We used eye-t...
Background: Cancer-related cognitive impairment (CRCI), sleep disturbance, insomnia, mood changes, and fatigue are reported side effects of androgen deprivation therapy (ADT). Little research has examined how the association between symptoms and their progression during the first year of treatment. The objective of the current study was to compare...
Managing sports injuries is clinically challenging. Although new techniques can delay musculoskeletal deterioration and promote tissue restoration, they are not widely used. Thus, there is a critical need to promulgate these new methods. In recent years, “tissue engineering” approaches have been developed for improving the regeneration of cartilage...
For grazing animals that share spatial and alimentary resources, the relationship between differences in oral morphology and the physical properties of substrates can help explain how and where species forage. The substrates may require different efforts from animals to access and remove food from their surfaces. Variation in oral morphology may pr...
Androgen deprivation therapy (ADT), a common treatment for prostate cancer, is associated with physical, psychological, and sexual side effects that reduce patients’ quality of life. The authors designed an educational program to prepare patients for managing these side effects. This paper describes an implementation model for national disseminatio...
We report here on survey data from 11 genetic males, who had voluntary penectomies without any explicit medical need, yet did not desire testicular ablation. This group was compared to a control group of men who completed the same survey but had no genital ablation. The penectomy group was less likely to identify as male than the control group. The...
The South American frogs of the family Cer-atophryidae (three genera, twelve extant species) display unusual larval diversity and developmental variation despite rather similar adults. Many adult features of ceratophryids are associated with terrestrial/fossorial habits and resistance to desiccation; however, adults of the genus Lepidoba-trachus ar...
The Eunuch Archive (EA) is a website where registered members can post for others to read and rate sexual fantasies that involve genital mutilation and ablation. The EA includes over 8,000 stories. We have previously explored common features of 100 top-rated EA stories. We reasoned that understanding such fantasies may be a step toward recognizing...
The South American frogs of the family Ceratophryidae (three genera, twelve extant species) display unusual larval diversity and developmental variation despite rather similar adults. Many adult features of ceratophryids are associated with terrestrial/fossorial habits and resistance to desiccation; however, adults of the genus Lepidobatrachus are...
Introduction
It has been theorized that there are 2 subgroups within the male-to-female (MtF) transgender population: individuals who are predominantly androphilic and those who are predominantly gynephylic or interested in both male and female partners.
Aim
To explore the role of a dichotomous distribution of age at dysphoria onset in individuals...
In nature, tadpoles encounter food on substrates oriented at different angles (e.g. vertically along stems, horizontally on the bottom). We manipulated the orientation of food-covered surfaces to test how different orientations of surfaces affect tadpoles’ feeding efficiency. We studied taxa that differed in the oral morphology of their larvae and...
Background:
Androgen deprivation therapy (ADT) for prostate cancer has numerous side effects. Clinical guidelines for side effect management exist; however, these are not always integrated into routine practice. What remains undocumented and therefore the objective of this study, is to describe patients' willingness to employ established strategie...
Men being treated for prostate cancer (PCa) commonly report a diminished sense of their masculinity, but it is not clear what contributes to that perception. Here we examined the literature to explore the characteristics most commonly used to describe diminished masculinity in PCa patients. Data were extracted from 42 peer-reviewed articles that re...
Men’s health research is dominated by biomedical research, and those working within biomedicine are often unaware of discourses on the topic of men’s health within the field of masculinities studies. We argue that incorporating social sciences in biomedical research would greatly benefit men’s health, but these fields have differing worldviews that...
Background and Objective: We explore here men’s health research as practiced by health sociologists versus andrologists.
Material and Methods: We start by examining the occurrences of terms related to sex and gender in the literature of the two fields as a way to characterize and contrast their disciplinary differences. A sample of 30 terms that d...
There is no consensus on how masculinity is manifested in our species. Here we argue that masculine displays vary in terms of how rapidly they emerge. The most rapid masculine displays are reflexive, primal, and shared with males of other social primate species. We suggest that these behaviors evolved to protect the individuals and others in his so...
178
Background: Androgen deprivation therapy (ADT) is a common treatment for advanced prostate cancer (PCa), but ADT typically impairs men’s sexual function and couples’ relationships. We offer an educational program to help PCa patients and their partners manage ADT related side effects and to maintain a strong dyadic relationship while the patien...
Introduction
Testosterone is known to regulate male sexual interest, but the exact way that androgens influence men's sexual cognition remains unclear.
Aim
To investigate the influence of androgen deprivation (AD) on visual responses to sexually suggestive stimuli in men treated for prostate cancer with AD therapy.
Methods
Patients with AD-treate...
Objective:
To determine whether an education session alleviates distress for both patients with prostate cancer and their partners; and whether their partner's attendance at the session; and disease, treatment, and sociodemographic characteristics affect changes in distress levels.
Patients, subjects and methods:
We identified men with untreated...
Erectile dysfunction (ED), the most commonly reported sexual problem for men, reduces the
quality of life for both patients and their partners. Even when physiologically effective, long-term adherence
to ED treatments is poor. We review here the implication of having patients’ partners involved in ED
treatment, starting with treatment selection. We...
Background: Androgen deprivation therapy (ADT) is the most common systemic treatment for prostate cancer (PCa), but has many adverse effects that reduce patients’ quality of life and that of their partners. In 5 Canadian cities, we offer an educational program designed to help PCa patients and their partners manage ADT side effects as well as maint...
194Background: Diagnoses of cancer distress both patients and their partners. Providing accurate information about diagnosis and treatment options promotes active and informed decision-making and can decrease distress and anxiety. We sought to determine whether an education session alleviated distress for both prostate cancer (PC) patients and thei...
Objectives:
To compare quality-of-life (QoL) outcomes at 6 months between men with advanced prostate cancer receiving either transdermal oestradiol (tE2) or luteinising hormone-releasing hormone agonists (LHRHa) for androgen-deprivation therapy (ADT).
Patients and methods:
Men with locally advanced or metastatic prostate cancer participating in...
Background: Androgen deprivation therapy (ADT) is commonly used
to treat prostate cancer, but has many adverse effects that can directly
impair patients' quality of life and indirectly that of their intimate partners.
In five Canadian cities, we offer a program on how patients and
their partners can stay physically and emotionally healthy, and co‐s...
This study investigated how men adapt to erectile dysfunction and other sexual side-effects of prostate cancer treatment. The study recruited nonheterosexual and heterosexual men using an anonymous, international, online survey (N = 558). This article focuses on a qualitative analysis of answers (n = 348) to one open-ended question on sexual practi...
Tamoxifen is an off-label option to treat men for breast cancer, infertility, and idiopathic gynecomastia. Lately, tamoxifen has been proposed as a treatment to prevent gynecomastia in prostate cancer patients receiving antiandrogen therapy. We reviewed the adverse events (AEs) reported in studies of men prescribed tamoxifen for these conditions to...
Introduction and Objectives: Androgen-deprivation therapy (ADT) is commonly
used to treat prostate cancer, but has many adverse effects that
can directly impair patients’ quality of life and, indirectly, that of their
intimate partners. In five Canadian cities, we offer a program on how
patients and their partners can stay physically and emotionall...
Introduction: Some men seek castration outside a clear medical need. This study explored how their sexuality changed after castration.
Aim: To explore changes in preferred gender(s) of sexual attraction, fantasy, and relationships in voluntarily castrated men with or without gonadal hormone therapy.
Methods: A questionnaire was posted at http://www...
Men diagnosed with prostate cancer through regular PSA screening seem to be healthier and have better overall survival than men in the general population. According to Professor Wassersug, this highlights the benefits for men in paying regular attention to their overall health. Mike Kirby provides a commentary on page 17.
From a Darwinian perspective we live to reproduce, but in various situations genetic males elect not to reproduce by choosing medical treatments leading to infertility, impotence, and, in the extreme, emasculation. For many men, infertility can be psychologically distressing. However, for certain genetic males, being infertile may improve their qua...
The Neotropical frog genera Ceratophrys, Chacophrys and Lepidobatrachus form the monophyletic family Ceratophryidae. Although in- and out-group relationships are not fully resolved, the monophyly of the three genera is well supported by both morphological and molecular data. Much is known about the morphology of the ceratophryids, but there is litt...
INTRODUCTION:
There is much popular discussion on strategies to facilitate multiple orgasms in men (ie, 100,000+ hits in Google), yet the topic has not received an objective comprehensive review in the literature.
AIM:
To review the literature on male multiple orgasms.
METHODS:
We searched the literature for publications on "male multiple orgasms"...