Forensic and clinical insights into the eshmun complex: A case of scrotal self-mutilation with phenol in a gender dysphoric individual.

The Eshmun complex is a term coined to describe self-genital mutilation or auto-castration under psychiatric disorders. Self-mutilation of the genitals can be an unfortunate outcome of different delusional beliefs regarding belonging to another gender or chronic substance abuse leading to self-harm. The result can be a minor injury or an adverse event, such as a fatality. In either case, the patient should undergo a medical and detailed psychiatric evaluation and counseling. We describe a case involving a 24-year-old man who arrived at the hospital's emergency department. With an alleged history of self-instillation of a household cleaning liquid containing phenol into the scrotum using a needle and syringe. Upon examination of the injured region, a puncture wound was discovered in the left testicle, accompanied by a noticeable buildup of fluid. A short psychological examination revealed his desire for a sex change and a previous attempt at self-genital mutilation.