Ramachandran on Phantom Penis

“One striking example of this we've seen recently is some work I've done talking to transsexuals; these are people who want sexual reassignment surgery. A typical remark from a transsexual male-to-female would be, 'I feel like a woman trapped in a male body, and this appendage, this penis, doesn't really belong to me and I want to get rid of it and I want to become a woman.' People always thought this was just psychological mumbo-jumbo but there is a significant number of people who experience this, and we started wondering about this and said: why? What's going on in their brain?

Now, it turns out that if 'normal people'...and I put it in quotes because it's important to emphasise that there's nothing wrong or abnormal about being a transsexual, it's part of the whole spectrum of human sexuality and sexual behaviour. But it is curious that most normal people who have carcinoma of the penis, which is not rare, and they have an amputation of the penis as a life saving measure, a majority of them, maybe about 80%, 85% of them, experience a phantom penis, including phantom erections. This is well known. Since this chap is saying his penis doesn't belong to him in the first place, what if his penis is amputated because he wants to become a woman, what happens then?

The answer is the majority of them don't experience a phantom penis. What's amazing is that your body image, which includes your genitals, is at least in part programmed by genes and your brain is hard-wired to incorporate the genitals as part of your body image. Even more amazing is the observation that women who undergo transgender sexual surgery who acquired an artificial penis, a majority of them since early childhood have experienced a phantom penis. This is absolutely extraordinary because it means that each of us has a brain-based body image which is detailed down to the fine anatomy, including your genitals.

If your brain body image does not match...normally your brain body image and your external morphology are synchronised in early development through hormones, through genetic mechanisms. If this gets uncoupled and they aren't in synchrony you end up with a body image that's morphologically male, so they experience a phantom penis. What's amazing is that all these years of culture being raised as a woman, as a girl, and even seeing that they don't have a penis does not correct this body image. This shows that even though your body image is extremely malleable, as we have shown with phantom limbs and mirrors and that sort of thing, it also turns out that there's a strong genetic contribution to your body image. This has, of course, great implications for understanding how your brain represents sexual behaviour and constructs body image.”

- From the transcript of a discussion with neuroscientist Ramachandran on Transsexuals and the phantom penis