Complete self-mutilation of male genitals as a severe form of psychiatric manifestation of HIV: A case report with review of literature

Genital self-mutilation (GSM) is a rare event that is commonly associated with psychotic disorders. However, such injuries have also been reported in nonpsychotic patients as a result of either bizarre autoerotic acts and attempts at crude sex-change operation by transsexuals or secondary complex religious beliefs and delusions regarding sexual guilt. We report a case of GSM in a human immunodeficiency virus (HIV)-positive individual who not only severed his penis, scrotum, and testes completely as a result of internal conflict and frustration but also refused any further treatment toward reconstruction owing to his guilt.