The Cutprice Guignol

Please note that this article will contain graphic discussion of genital mutilation and amputation.

“I’m quite defined by my job. Neil Hopper: father, husband and surgeon.”

When Neil Hopper told Nicola Bryan, a BBC reporter, how important his job was to him in 2023, it didn’t raise any red flags. Why would it? Hopper was, in many ways, an inspirational success story – a consultant vascular surgeon, employed at Royal Cornwall Hospitals NHS Trust since 2013, Hopper was a well-respected medical professional who routinely performed amputations as part of his job. However, a few years into his career, he was faced with a situation that would put him, for a change, on the operating table.

Hopper had fallen ill, he claimed, during a camping trip with his family in April 2019; retiring to bed for an early night, he had woken the next morning confused and speaking “gobbledygook” to his wife, who had swiftly contacted a friend to get him taken to hospital. There, he was informed that he had sepsis – his toes had already started to turn blue, and Hopper was subject to several weeks of treatment, including the removal of his toes and skin grafts to the soles of his feet. However, Hopper feared that this approach might impact his ability to return to work as a surgeon, and, after consulting with medical staff, he decided to entirely remove his legs below the knee. “I opted not to have hundreds and hundreds of operations,” he told Bryan. “But just to have one to sort it out.”

The interview with Hopper was tagged with “inspiring stories”; it focused on Hopper’s newfound zest for life in the wake of the amputation, the support his wife had offered him, his application to become a para-astronaut. And that’s probably the last we’d have heard from Hopper, now 49, in the mainstream media, had it not been for the shocking story that unfolded with Hopper at its centre earlier this year – a story about castration fetishes, voluntary amputation, and the internet marketplace of the EunuchMaker.

A few years before Hopper lost his legs in 2019, Marius Gustavson’s eleven-year marriage was coming to an end. Gustavson, a Norwegian native who had moved to the UK in 2012 after several fraud charges in his home country, struggled as he went through a separation in 2016. Seeking control over his life once more, Gustavson began to engage with an online subculture of men known as “nullos”. Short for genital nullification, “nullos” are men who have removed their penis and testicles, often for the purposes of paraphilic fetish, and, within months, Gustavson would make a move to join their ranks.

In December 2016, Gustavson would make contact with sex worker Damien Byrnes, whom he offered £500 for the task of cutting off his penis and recording the process. Gustavson, who eventually reduced the payment to just £50, convinced Byrnes to go through with the act, and in Feburary 2017, Byrne attended Gustavson’s home where he carried out Gustavson’s request. In front of a camera, Gustavson was restrained and anesthetized before Byrne cut off his penis with a four-inch kitchen knife. “Well,” Byrne remarked towards the end of the footage. “That’s one off the bucket list”.

Gustavson, predictably, spent a brief period in hospital in the coming days for the treatment of his amputated penis, but was discharged within a few days with a referral for psychiatric care. However, the video that Byrne and Gustavson had made would soon form the basis for Gustavson’s new online moniker, EunuchMaker – and the grim business that came with it.

Gustavson would, in his corner of the internet, likely be most easily recognised under the title that he shared with his pay-per-view website, EunuchMaker. The website, which operated between 14th January 2018 and 1st March 2021, sold and streamed videos of various men having parts of their bodies mutilated or removed entirely. Gustavson offered a number of tiers for paying subscribers, with annual subscriptions down to individual payments for specific videos. Gustavson also offered castration and penis removal to paying customers, several of whom were offered cuts of the video profits that would be earned from selling the videos to the EunuchMaker audience. He worked alongside several other men, who were later charged alongside Gustavson in the creation and dissemination of these videos, which would become central to the case against them in coming years.

The contents of the videos are, in short, stomach-churning. In sentencing remarks in 2024, Judge Mark Lucraft described Gustavson’s work as “little more than human butchery”. The videos, according to court documents, had “clear sexual overtones”, including Gustavson masturbating the victims during the procedures, and were intended for an audience of people who fetishized amputation and castration. In a few cases, medical equipment was used, but for the most part, household objects like kitchen knives were employed for the work, alongside tools used for castrating livestock, including a Burdizzo clamp. Men’s penises and testicles were injected with unknown fluids before or during removal; penile nerves were removed in part or entirely. Gustavson kept the testicles of several of these men in jars around his home, and would go on to use several of the amputated body parts for cannibalistic purposes, including using one man’s amputated testicle in a salad.

Often taking place in Gustavson’s home, the operations were far from sterile, and, in one case, emergency services had to be called to attend to a victim with severe haemorrhaging, which Gustavson claimed to authorities had been caused by an accident with a kitchen knife. During this video, according to reports, the victim can be heard telling Gustavson and his accomplices that he does not want to die; he required emergency surgery after the mutilation, but survived.

As with most fetishes, some research has been conducted in an attempt to make sense of the motivations of those engaged with it, and castration and penis removal has been the focus of a few really interesting papers. An analysis of fictional stories posted to the EunuchArchive (a fetish website dedicated to those interested in castration and penis removal, unrelated to Gustavson’s work) published in the Archives of Sexual Behaviour in 2019 posited the theory that removal of the genitals served as the ultimate act of submission and sacrifice of sexual pleasure for a dominant partner, while another paper linked paraphilic interest in men who had gone through genital nullification to a range of childhood experiences, from seeing an animal be castrated to playing with action figures with smooth genital areas. It might seem like a fetish so niche as to be almost unheard of, but those involved in this community were far more widespread – and more profitable – than you’d think. EunuchMaker amassed over 22,000 users during its three years of operation, with Gustavson earning an estimated £300,000 from his exploits.

Gustavson himself would, in early 2019, once again turn the knife (proverbial and literal) on himself. This time, Gustavson, with the help of one of his co-conspirators, would place his left leg in a bucket which the other man then filled with dry ice. Once Gustavson was satisfied that the leg had been damaged beyond saving -around eight hours after the beginning of the process – he attended a local hospital where his leg was removed from just below the knee.

During this time, Gustavson had been in contact with a repeat customer of EunuchMaker.com. This man, who had purchased three videos of various men having their genitals mutilated or removed, discussed with Gustavson in more than 1500 messages his own interest in amputating his legs, which Gustavson was happy to advise him on, having just been through the process himself. Just a few months after Gustavson had removed his left leg, the customer of the EunuchMaker would go on to use the same process to damage his legs beyond repair, using ice and dry ice purchased days online days before to freeze his legs which led to their eventual amputation in May 2019.

This man, of course, was Neil Hopper. And, when one of Gustavson’s victims reported Gustavson and the EunuchMaker site to the police in 2021, the correspondence between Hopper and Gustavson was uncovered, and the truth behind Hopper’s apparently-inspirational story came to light. After Gustavson was jailed for twenty-two years for his involvement in the EunuchMaker site, along with six of his co-conspirators, Hopper’s case was brought to trial after the exposure of his messages in 2023.

While the EunuchMaker case grabbed headlines for its shocking and salacious nature in 2024, Hopper’s case came to court only a few months ago, with Hopper charged in September 2025 for fraud (owing to the false representation to insurance companies of the loss of his legs as being due to illness) and possession of the videos he purchased from the EunuchMaker site. Hopper pleaded guilty to the charges, and was sentenced to thirty-two months in prison – but the nature of his job raised many more questions about his motivations for working in his chosen field, and just how it might have impacted his patients.

Hopper was struck from the medical register after the discovery of his involvement with Gustavson in March 2023, but had worked as a surgeon in Cornwall for more than a decade by the time of his arrest. The Royal Cornwall Hospital Trust carried out an internal review, which they have since stated showed “no evidence whatsoever to indicate any risk or harm to patients at our hospitals” as a result of Hopper’s work there, saying that none of the amputation cases that he was involved in were in any way influenced by the nature of his apparent fetish and that the decision to amputate, in every case, was supported by medical records.

However, medical negligence firm Enable Law have called for an independent review into Hopper’s case after being contacted by one-time patients of Hoppers, writing on their website that these patients were not interviewed as part of the internal review on Hopper’s behaviour and practices, and that those who were patients of Hopper via his private practice in Duchy had not been considered at all in these investigations. Mike Bird, a partner at Enable Law, said of the patients that some “have had life-changing surgery and are now worried it was not really needed“. While it’s impossible to make sense of Hopper’s exact motivations when he carried out the various amputations over the course of his career, it’s not hard to see where these concerns come from – when a person has a paraphilia so profound that it leads to the amputation of body parts and purchase of illegal pornography, how can it be meaningfully ascertained that it did not leak over into work where he performed similar acts on other people?

But perhaps one of the most enduring questions from this case is just why Hopper – and others who came into contact with Gustavson during the course of his time as the Eunuch-Maker – were willing to go to such extreme lengths to remove otherwise-healthy body parts. During Hopper’s mitigation procedure, it was stressed that Hopper had suffered body dysphoria regarding his feet, and had long-hoped to remove them to ease his discomfort in his body. He expressed regret over the false representation of his amputation, he would later admit, but not the fact of the amputation in and of itself. Gustavson, as mentioned above, claimed to suffer from Body Integrity Identity Disorder (BIID), a disorder characterized by intense and life-altering discomfort with a healthy body part and the incessant and distressing feeling that it should be removed or damaged beyond use.

While the term BIID was coined in 2004, it was not till 2022 that the disorder was recognised in the International Classification of Diseases under disorders of bodily distress, described thus:

“…an intense and persistent desire to become physically disabled in a significant way (e.g., major limb amputee, paraplegic, blind), with onset by early adolescence accompanied by persistent discomfort, or intense feelings of inappropriateness concerning current non-disabled body configuration. The desire to become physically disabled results in harmful consequences, as manifested by either the preoccupation with the desire (including time spent pretending to be disabled) significantly interfering with productivity, with leisure activities, or with social functioning (e.g., person is unwilling to have a close relationship because it would make it difficult to pretend) or by attempts to actually become disabled having resulted in the person putting his or her health or life in significant jeopardy.”

The number of cases of BIID, due to the stigma around the disorder and the relatively new recognition of it, are not known, but are estimated to affect less then 1% of the population. There are a number of cases that have entered the public consciousness before that of the Eunuch Maker, perhaps most significantly Jewel Shuping, a woman from North Carolina who, in 2006, used drain cleaner to render herself blind after years of discomfort and dysphoria around her functioning eyes. Generally, the focus of those with BIID is the amputation or paralysis of a certain limb or limbs, with the most common focus being the left leg (the same one that Gustavson removed). There’s significant overlap with fetish and sexual motivations, according to some studies, with one identifying between 40-70% of those seeking to change their body in such a way as having, at least, secondary sexual motivations.

Gustavson, for his part, maintained that his attempts to mitigate his own BIID and to offer the same opportunity to others who felt hampered by certain parts of their body came from a place of kindness. In a report quoted in the court documents related to the case, Gustavson “has not expressed any particular remorse, as he feels that he has helped the victims…When asked what he could have done differently, he said that he should have kept the webpage with it’s original purpose and “helped people.””

Gustavson claimed that those involved in his videos consented to the procedures being carried out on them, though that consent is not viewed as meaningful under UK law, and, frankly, raises many questions even outwith a legal standpoint. Given the unsterile environments these procedures were taking place in, the overt sexual pleasure Gustavson took from the acts, and the financial benefit to both Gustavson and, allegedly, the men involved in these videos, it’s exceptionally hard to believe that these actions came from a place of pure altruism. One victim of Gustavson, speaking anonymously to the media after Gustavson’s incarceration, said that the lead-up to his “voluntary” penectomy was marked by the death of several close friends, a severe decline in his mental wellbeing that nearly led to an involuntary sectioning, and drug abuse, with Gustavson eventually offering him £50,000 to go through with the removal of his penis. If this is any way reflective of the status of those involved in Gustavson’s videos, it’s obvious that meaningful consent was hardly at the forefront of the operation, let alone treatment for those suffering with BIID.

The disorder is, with fair justification, controversial amongst communities of people living with disability that they did not inflict on themselves, with some viewing it as an appropriation of their struggles and a drain on already-limited resources for disabled people. For those who have not chosen to have their disabilities, it can seem galling for able-bodied people to deliberately make the choice to take up a mantel that has materially affected their quality of life.

The disorder becomes even more controversial, though, when it comes to the matter of whether or not sufferers should be allowed to modify their bodies in line with their desires. A Scottish surgeon, Robert Smith, faced enormous backlash after he performed a number amputations on otherwise-healthy patients suffering from BIID to remove the offending limbs – he claimed that the matter was one he had taken very seriously, and that he believed it was the “only possible redress for this quite seriously disabling condition”. Mo Constadi, writing for the Guardian in 2012, endorsed the idea of offering surgery to those suffering from BIID, suggesting that “offering a clean surgical amputation to those BIID sufferers who really want it would therefore minimize the harm that they might cause to themselves by taking matters into their own hands”. A 2014 study on twenty-one people suffering with BIID who had gone through with amputation found that “none of the patients regretted the surgery and a change for the better was seen in almost all areas of life”.

Much like Hopper, in fact, who holds no regret over the fact of his double amputation. Gustavson similarly consented to the removal of organs and limbs, and several of the men who approached him to have their bodies mutilated paid him to do so. I want to make it very clear that I think it’s right that Gustavson and his co-conspirators faced charges for what they did, given the exploitative nature created by the sexual and financial motivations of the circumstances, nor do I believe that Hopper should have been spared from prosecution for fraud and possession of illegal pornography. But these cases raise interesting questions about the nature of what we are able to consent to, both legally and ethically, when it comes to body modification.

The gut reaction on hearing about these people who have chosen amputation is a hard one to shake; for those of us without BIID, the thought of choosing to make those changes to our bodies is virtually unthinkable, even aberrant. But making other changes via surgery and other invasive procedures doesn’t carry the same stigma. Various voluntary aesthetic surgical procedures are legal and available in the UK and across the world that carry risks of injury or even death.

You could argue that the potential for paraphilic motivations should be a prohibiting factor, but the bimbofication fetish, for example, often employs extreme cosmetic surgery as a central tenet, and those involved are not limited based on their potential sexual enjoyment of the aftereffects. Are beauty standards an influential factor? If missing your lower legs was perceived as a beauty standard on the same level as, say, having large breasts, would voluntary amputation be as socially and legally acceptable as breast augmentation? If someone truly wishes to remove a part of their body, and is entering the process with fully-informed consent, should they be allowed to? Should the potential strain on services offered to disabled people be considered as part of that choice? Where is the line drawn between what we allow people to access for the sake of their own body image and what we don’t?

I don’t have the answers to these questions, but I’m really intrigued to hear your opinion on the matter in the comments below. I understand this is a really emotive issue and I’m not a person with BIID or someone living with a disability, so please feel free to share your perspective and criticism on this piece if you fall into those groups.

Further Reading on Fetish, True Crime, and the Internet:

The Sex Slave, the BDSM Blog, and the Murder: A Deep Dive into the Delia Day Case

Autassasinophilia, Fetish Forums, and the Early Internet: The Murder of Sharon Lopatka

“In The End, I Watched Him Go”: The Criminal Case of Suicide-Baiting via Internet

Sources:

Sentencing Remarks on Gustavson Case

The Girl Who Wants to Get Rid of Her Left Leg—Body Identity Dysphoria – Erich Kasten

Crown Prosecution Service report on Hopper case

(header image via BBC)