‘Hopper’ no more? The bizarre case of the self-amputating surgeon and the implications for a eunuch gender identity

A descent into the world of fetishism

Sep 23, 2025

Note: This is a guest post from Peter Jenkins, a counsellor, supervisor, trainer and researcher in the UK and a member of Thoughtful Therapists.

The UK is still reeling from the publication of the Cass Review in 2024, which seeks to limit provision of so-called gender-affirming medical care for children. This landmark development was followed earlier this year by the clear statement (and legal bombshell) from the UK Supreme Court that the terms male and female are rooted in biological sex when applying equality law. These changes mirror current legal and medical disputes over the status for gender identity affirming care in the US, with recent Presidential Executive Orders and the closure of leading US gender clinics. Much less media attention has been paid, however, to the prosecution of a UK surgeon for causing a double amputation of his own body, as the realisation of a long-held fetish linked to an underground London castration cult. Peter Jenkins, of Thoughtful Therapists, looks at some of the chilling background and implications of this bizarre incident.

Fetish: sexual desire in which gratification is strongly linked to a particular object, or activity, or a part of the body other than the sexual organs.

Sometimes, reports in the media of body modification seem so bizarre that they just beggar belief. One such story was that of Neil Hopper, 49, who recently pleaded guilty in the Magistrate’s Court, in Truro, Cornwall, UK, to two counts of fraud, by making a false representation concerning his amputated legs. After deliberately packing his own legs in dry ice, in order to damage them irreparably, he required a double amputation below the knee. The obvious irony here was that Hopper was a well-known and widely respected vascular surgeon, with specialist expertise in amputation. However, he also had a powerful sexual fetish driving him to achieve the amputation of his own legs. Basking in the media spotlight as a heroic sepsis survivor, as the famed ‘bionic surgeon’, and potentially as the world’s first disabled astronaut, Hopper went on to make fraudulent insurance claims to the tune of almost half a million pounds.

The bare facts, however bizarre, unfortunately do not really do justice to the background story and to the wider, disturbing implications of this case. Hopper was not acting on his own, but was in turn closely associated with Marius Gustavson, the leader of a secretive castration cult in London. Gustavson was given a life sentence in 2024, with a minimum term of 22 years for carrying out amateur castration operations, together with his five co-defendants, who were given similarly heavy jail sentences. Described as a cult, the group groomed and encouraged potential vulnerable victims to take a willing part in their grisly activities, which were then streamed to a ready audience of viewers, or sold as videos. In some cases, the brutal and inept removal of penis and testicles would go radically wrong, leading to catastrophic blood loss and to the need for emergency hospital care. However, perhaps surprisingly, this did not lead directly to their accidental discovery, or even to police investigation of the group’s bizarre activities.

Email links to London castration cult

Hopper liaised closely with Gustavson about how to best achieve the amputation of his own legs, sending around 1,500 emails to him at around this time. He also purchased three videos of operations from the Eunuch Maker site, leading to the additional charges brought against him of possessing extreme pornography. In court, Hopper was described as having the dual conditions of body integrity dysmorphia, and gender dysphoria. The police initially investigated Hopper through his incriminating emails exchanged with Gustavson. This email trail cast a new and very different light on the surgeon’s original claim that his amputations were due to sepsis, rather than being deliberately caused by self-inflicted damage.

In one sanitised version, this news story begins and ends just there – neatly contained, with no loose ends left over. ‘Surgeon with a paraphilic disorder contacts leader of castration cult, causes amputation of his own legs, and is found out’ – justice done, story filed and quickly forgotten.

Just safe and consensual kink?

However, there is yet more background to come out, which has only been reported, seemingly, at local level by Cornwall Live. The latter was contacted by Michael (not his real name), with significant additional background on Gustavson, the infamous Eunuch Maker.

"I went to London for a bit of kink," Michael tells us with disconcerting honesty. "I went up there for sex. I am a kinky person. It seemed like a good idea at the time. And through a friend of a friend I met up with Gustavson. The friend said he was a serious player. And it was all 'safe, sane and consensual'. Except it was none of those things."

Michael claimed he was offered £50,000 to undergo castration by Gustavson. “I was totally groomed into it. No-one would ever agree to this. It is so insane. No-one consents to being beaten up, mutilated, castrated or murdered." Michael was effectively castrated via the use of clamping of his testicles with Burdizzo clips, normally used by vets in treating cattle. Suffering severe and crippling after-effects, Michael had emergency treatment back at his local hospital in Cornwall, but his injuries were not officially reported and investigated, until his counsellor urged him to go the police in 2019. "I had to do it because of the hundreds of people being mutilated and castrated by Gustavson. It's not unique at all. There were 22,000 members registered on the Eunuch Maker."

Normalising paraphilia in the name of progress

According to Michael, the local police investigation led to Gustavson then being arrested and charged. However, he “wonders why no alarm bells rang with either the Met [PJ: London] Police or London's ambulance service when so many calls were being received to Gustavson's London address over mutilations gone wrong.” The suspicion voiced by him in his interview is that this supposedly consensual torture and violence was almost seen as being legitimate and tolerable, and that the police allegedly seemed somehow reluctant to take action in the face of perceived trans sensitivities.

Some of the wider implications of the Hopper and Gustavson cases have already been explored by key commentators, such as Malcolm Clark (the Secret Gender Files) and Mia Hughes (author of The WPATH Files, and Director of Genspect, Canada). Mia Hughes, for example, points to the crucial, but gradual process of normalising sexual deviancy, by reclassifying paraphilias simply as sexual health issues in successive editions of key psychiatric diagnostic manuals, such as DSM 5 and ICD 11.

WPATH and the Eunuch Files

There is also the overtly provocative stance of the World Professional Association for Transgender Health (WPATH), in strongly arguing the case that the term eunuch be accepted as a valid and legitimate gender identity, in its controversial and now heavily discredited Standards of Care. This stance has been directly challenged by Genevieve Gluck, by pointing out that the so-called research evidence for the eunuch claim included reference to an online repository of abuse, featuring graphic castration reports and fantasies about children and young people.

In fact, the Scottish National Health Service triggered a serious security alert, usually associated with a major terrorist incident, by casually posting a weblink to the eunuch abuse portal as part of its online discussion of the WPATH Standards of Care. As if yet more evidence of the normalisation of abuse to children was needed, this major data security breach was, of course, quickly brushed over in the subsequent official investigation – nothing to see here at all, so just move along…

The case for amputation as a cure for Body Integrity Disorder?

There is a further unexpected twist to this story, with the recent publication of a case history in an academic journal, first picked up by Daniel Howard James, writing in Genspect. This academic case study seems to bear more than a passing resemblance to the apparently unique circumstances of Neil Hopper’s successful drive for amputating his own feet. Erich Kasten, who has published previously on Body Integrity Disorder (BID), has published a case study of a patient who also achieved the loss of his feet by packing his legs in dry ice. This case study, while anonymised, makes seems to make little attempt to protect the real identity of the patient from being revealed via the process of deductive identification. This is a real risk with highly unusual and distinctive cases of this kind.

Kasten states that the patient contacted him post-amputation, and completed a retrospective BID self-assessment. This showed significant relief from their troubling psychological symptoms. Kasten describes the social stigmatization and discrimination previously experienced by the patient with regard to their BID, contrasting this with the enormous relief which followed once finally rid of their offending feet.

Essentially, Kasten constructs an argument here in favour of elective amputation of body parts as a potential solution to the psychological suffering caused by Body Identity Disorder. This is on the basis of a thinly disguised and highly problematic single case example. In terms of discrimination, Kasten points to the “persecution by the police” in investigating and prosecuting the hapless patient, as if this was an illustration of enforcing criminal sanctions solely for initiating elective amputation. However, the case material described makes it very clear that police prosecution was for the patient’s possession of extreme pornography and for insurance fraud directly related to the amputation, and not for the simple fact of the amputation itself.

Elective amputation – the canary in the coalmine?

The point of Kasten’s argument becomes clearer when he laments the fact that elective surgery is now widely available for patients diagnosed with Gender Dysphoria, but apparently not for those with BID. “For decades, there have been surgical solutions for GD in many countries, often in highly specialized clinics, so that people with GD can achieve their desired gender” (Kasten, 2024: 7). This overlooks the growing trend for pre-surgical pharmacological treatments for gender dysphoria, such as puberty blockers and cross-sex hormones, to be denied to patients under the age of majority in Western Europe, and increasingly so in the US. Surgical interventions for under 18s with gender dysphoria, such as double mastectomies, are also now restricted by law in many US states.

Kasten suggests for patients with unresolved BID that “society should consider the possibility of surgery in a hospital to avoid worse suffering” (Kasten, 2024: 7), in deference to the over-riding principle of patient autonomy. This flawed argument completely underestimates the degree of public and professional revulsion for such a step. But perhaps Kasten does appreciate this. Perhaps he is just testing the water here, feeling his way along a darkened cellar with a captive canary in a birdcage, as an early warning sign for invisible pockets of gas, seeing if anyone notices or reacts strongly to his plea in support of elective amputation?

Conclusion

The Hopper self-amputation case and its links to the deeply disturbing Gustavson castration cult are quite bad enough in themselves, even if these are quickly erased from our awareness by the restlessly moving finger directing our intake of online social media. In terms of broader moral and ethical themes, Hopper’s motivation and behaviour speak volumes about an almost bottomless capacity for deception, of friends, family, the media and general public, as well as of himself, perhaps. Also rarely mentioned are the profound social costs of the drive to assuage his burning fetish to achieve his longed-for stumps, costs calculated not least in terms of deceptively attained medical care, fraudulent insurance claims, and the cost of later police investigation. Extreme, violent pornography is also a significant leitmotif at work here, linked to the striking, abject failure of adult safeguarding. And finally, there is something important, but very elusive and hard to pin down at work in our culture here, about the effects of normalising the abnormal, of permitting the growing acceptance of the surgical damage done to healthy bodies, of making all-too-real the eternal fantasy of physically becoming something other than what we are born with…

But the Hopper case is supposedly only about a unique, one-off bizarrerie, a never to be repeated case of the self-amputating surgeon, brought low by his overweening ambition. There’s no wider lesson at all to be discerned, explored or appreciated here about trans identity and its realisation via medical transition…

Or is there?

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