The extreme body modification subculture that led 'eunuch maker' to have his penis removed

Warning: The following article contains graphic details of extreme physical mutilation.

Before his potentially deadly "eunuch maker" operation was foiled, Marius Gustavson boasted online that he had removed a part of his body to "look like a Ken doll".

The 46-year-old recruited a man to cut off his penis with a kitchen knife at his north London flat, and two others to remove his nipple and freeze his leg to the point of amputation.

A total of ten men admitted their involvement in carrying out extreme body modifications that were streamed on Gustavson's website on a pay-per-view or subscription basis.

The Norwegian national was today handed a life sentence with a minimum term of 22 years the Old Bailey having admitted multiple counts of conspiring to and causing grievous bodily harm (GBH) to five men. The offences included removing a man's penis, clamping others' testicles, and freezing a victim's leg to the point of amputation.

Former NHS domestic assistant David Carruthers, 61, Janus Atkin, 39 - who had studied to be a vet - retired chemist Peter Wates, 67 and Romanian national Ion Ciucur, 30, previously pleaded guilty to conspiracy to commit GBH between 2016 and 2022.

They were jailed for 11 years, 12 years, 12 years, and five years and eight months respectively

Carruthers' partner Ashley Williams, 32, and German Stefan Scharf, 61, also pleaded guilty to causing grievous bodily harm with intent and were each jailed for four and a half years.

Jacob Crimi-Appleby, 23, Damien Byrnes, 36, and Nathaniel Arnold, 48, have already been sentenced - to three years and eight months, five years, and two years suspended respectively - all having pleaded guilty to GBH.

The court heard Gustavson was the "willing victim" when Byrnes cut off his penis, Crimi-Appleby froze his leg with dry ice so it had to be amputated in hospital, and Arnold removed the tip of his nipple.

Judge Mark Lucraft KC said the procedures "were done for sexual motives in addition to financial gain" after Gustavson made thousands from the website and £18,500 in disability benefits. He now uses a wheelchair.

'Nullos and cutters'

Gustavson was part of an online subculture of "genital nullification" whereby "cutters" remove the genitals and other body parts of consenting "nullos".

The video played in court where Crimi-Appleby poured dry ice on his leg for two hours was entitled "The Eunuch Maker Movie - A Null Set Production".

In recent years, the most well-known case has been that of Japanese artist Mao Sugiyama who, at the age of 22 in 2012, willingly had his penis and testicles removed, before tweeting: "Please retweet. I am offering my male genitals (full penis, testes, scrotum) as a meal for 100,000 yen… I will prepare and cook as the buyer."

Having been tested to confirm it was free of disease, he charged five diners around £160 to eat his penis.

In Gustavson's case, the court heard doctors considered diagnosing him with body integrity identity disorder (BIID) while he was in hospital recovering from his amputation, with his defence lawyer claiming a psychiatrist has now given him that diagnosis.

Dr Naomi Murphy, a consultant clinical and forensic psychologist, tells Sky News Gustavson appears to have a sexual sub-type of BIID.

She says in both cases, patients become fixated with a limb or body part and "seek its amputation as they believe that will resolve all their problems".

"It's a mental disorder - but the person isn't psychotic," she says. "They know the part of their body is healthy but they don't feel right with it there."

High-profile examples include Scottish surgeon Robert Smith, who in 2000 performed several amputations on patients he believed had BIID at the Falkirk and District Royal Infirmary. He was stopped, but argued they could have taken their own lives without the procedure.

David Openshaw, from Australia, also froze his leg in dry ice for six hours, eventually forcing doctors to amputate it.

It mostly occurs in men, but there are cases in women.

Several reasons people try to remove their penises

Dr Murphy was previously clinical director of a secure unit at HMP Whitemoor for people who had committed serious violent and sexually violent crimes.

She says there have only ever been 400 BIID cases documented worldwide and most present in an arm or a leg.

While unable to comment on specific reasons in this case, she says of the documented cases involving penises: "The two main reasons these people try to remove their penises is a history of childhood sexual abuse, whereby if as a child their penis became aroused, the adult can then become angry with it or feel betrayed by it, so want to remove it out of self-hatred.

"The other group is more associated with sexual taboos.

"Either they are taboo to themselves, for example, a homosexual who is holding a lot of internalised homophobia, or people who are sexually attracted to something that's illegal, so they attack their penises to reduce the risk of sexual assault."

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Dr Murphy adds that BIID patients are often "attracted to the idea of disability".

"They've come to associate being disabled with care and nurturance. So amputation is an extreme way of forcing people to care for them."

She adds that this stems from a need for attention, often developed as a result of trauma, abuse or neglect in childhood.

Professor Craig Jackson, professor of workplace health psychology at Birmingham City University, says he believes the concept of "expressive, transformative violence" may also be at play.

"He may have thought the world saw him as insignificant or unsuccessful," he says. "But by doing this to himself or someone else, doing it with competency, and making money out of it as well, he may have thought 'society should think carefully about how it considers me'.

"'I'm not a loser, I'm actually very dangerous and I'm competent'. He's trying to become something 'more' and is using violence to express that."

In mitigation, his defence lawyer said his body modifications gave him "feelings of empowerment and greater acceptance of himself".

'Rare but nothing new'

While cases of extreme body modification like this are rare, Professor Jackson says they are "nothing new".

He believes enterprises similar to Gustavson's go undetected worldwide that are "much more successful and professionally run".

"This isn't isolated or a one-off. There's a great fetishisation for body modification and missing limbs on the dark web.

"So the defendant was essentially a content provider and would have known he had to keep providing content that people would keep paying for - so wanted something more extreme and more graphic.

"They weren't using high-tech encrypted sophistication. There will be smarter, more professional outfits around the world that are nowhere near being detected."

The recruitment of someone who works in a medical environment isn't uncommon in cases of extreme body modification, he adds.

Co-defendant Nathaniel Arnold, who removed Gustavson's nipple, was a nurse at Chelsea and Westminster Hospital, where he stole local anaesthetic. He pleaded guilty to the theft of lidocaine.

Professor Jackson said that while vetting operations have been stepped up in policing, pre-employment screening of doctors and nurses "have never been very successful at filtering out individuals who go on to use their profession to offend".

"Whether it's pills on the black market, stealing of scalpels and other surgical tools, these are offences that happen a lot more than people are willing to recognise."

Risk to unwitting dark web users

Gustavson, his co-defendants, and their victims may have given consent, but that "should not be used as a defence", criminologist Dr Elena Martellozzo says.

"No one should be able to give consent to anything like this," the associate professor in criminology at Middlesex University tells Sky News.

While Gustavson was a willing victim himself, he encouraged his 'cutters' to carry out the offences, which is against the law.

She also warns that those who may have been inadvertently exposed to the content online have not given theirs.

"There is a very important point here about the significant risk that these recordings could find their way back to the dark web, which is notoriously difficult to monitor and regulate.

"They pose a grave danger to vulnerable individuals, including young people, who may encounter this distressing content online."

She adds that some may seek to engage in copycat offences, while others could get into legal trouble for having such extreme content in their internet search history.

Crimes 'unusual - even by prison standards'

Aside from problems left behind by his content, Professor Jackson believes Gustavson presents challenges himself.

He argues that with personality disorders so highly prevalent in prisons, other prisoners with mental ill-health issues or disordered personalities may be susceptible to being recruited by someone with BIID.

Professor Jackson believes Gustavson could present a challenge for the prison system because he could be a danger to other prisoners as well as himself.

"He's going to come across a lot of people with mental disorders or substance issues who may also be led to believe they don't need their penises or other limbs and would be willing to trade them within the prison environment."

Dr Murphy, who has worked with diagnosed psychopaths, says these offences will be seen as "unusual - even by prison standards".

In terms of potential treatment and rehabilitation for such offences, she adds: "S-BIID does not need to lead to self-castration.

"The underlying causes might lend themselves to treatment via anti-depressants and or anti-libidinal medication in conjunction with talking therapies."