Emasculation is the removal of both the penis and the testicles, the external male sex organs. It differs from castration, which is the removal of the testicles only, although the terms are sometimes used interchangeably. The potential medical consequences of emasculation are more extensive than those associated with castration, as the removal of the penis gives rise to a unique series of complications. There are a range of religious, cultural, punitive, and personal reasons why someone may choose to emasculate themselves or another person. Consensual emasculation may be seen as a form of body modification that enhances a recipient's identification with their community or sense of self. By comparison, non-consensual emasculations, such as those performed punitively or accidentally, may constitute genital mutilation. The medical treatment for an emasculated person differs depending on whether the procedure was consensual. The term emasculation may be used metaphorically to refer to the loss of a man's masculinity. A man is said to be emasculated when he loses or is deprived of a characteristic traditionally associated with being a man, such as power or independence. Method There are several different methods of emasculation. Both the penis and testicles may be removed simultaneously using a sharp instrument, such as a knife or razor or swords. Non-crushing vascular clamps may also be used in medical surgery to cut off blood circulation and reduce bleeding. Alternatively, the penis and testicles may be removed at different stages in time. Medical surgeons use this method when performing surgery on trans women who want their genitals removed over multiple sex reassignment surgeries (male-to-female), rather than in a single sitting. Medical consequences Short-term consequences of emasculation include bleeding and infection. Historically, death was also a potential complication, although the prevalence is disputed. Long term complications include incontinence, urethral stricture, urine retention, urinary tract infection, urine extravasation and bladder stones. Some studies have found that emasculation may cause a range of physiological changes, such as a shortened torso, widened stomach and hips, increased height, bowed legs, and an elongated skull. Additionally, emasculates typically have less or no facial and body hair, increased fatty tissue or gynecomastia, and a feminine fat pattern distribution. The physiological effects of emasculation are more severe for people who undergo the procedure before the onset of puberty. Reasons Cultural Imperial China Emasculation was performed in China on men to create palace eunuchs for the Imperial court. The practice dates