Becoming a victim of dismemberment due to a car accident, time spent on the battlefield, or being born with a genital abnormality, can lead to grievous psychological complications throughout a man’s life. Researchers at the Wake Forest Institute for Regenerative Medicine in North Carolina recognized the mental and emotional hurdles a man without a penis would lead with the possibility of gender identity loss and a self-conscious romantic life. After nearly 25 years of laboratory grown penis experiments, researchers have reached the safety stage and will soon be testing on human men.
"The rabbit studies were very encouraging," Dr. Anthony Atala, a pediatric urological surgeon and the director of the Institute, who oversaw the team's successful engineering of penises for rabbits in 2002 and 2008, told The Guardian. "But to get approval for humans we need all the safety and quality assurance data, we need to show that the materials aren't toxic, and we have to spell out the manufacturing process, step by step."
Atala began his work in 1992, specializing in treating children born with genital abnormalities. After finding success in the earlier stages of Atala’s penis project in 2002, he said it was not only impressive that they were able to reconstruct a penis, but a real medical milestone in tissue and organ engineering because the penis is one of the most complex organs they’ve attempted to engineer. His team already successfully created fully functional bladders in 1999, but the penis has several functions to complicate the process, unlike the bladder.
The penis is still unable to achieve an erection, which limits them from penetration and ultimately our most fundamental instinct: reproduction. But the function of a penis goes beyond the physical aspect and enters an important realm in a male’s mental perspective. Without a penis, a man can experience castration anxiety, which Sigmund Freud discussed in one of his earliest psychoanalytic theories based on the overwhelming fear of damage or loss of one’s penis. It’s typically caused by already existing penile damage that haunts a man throughout his life, even if it hasn’t limited his sexual reproduction.
With the alarming rate of mutilation to the U.S. troops in Afghanistan, it is of utmost importance a man reinstates his identity by having a penis despite its inability to achieve an erection. The number of U.S. soldiers who experienced severe genital wounds tripled in 2011, and the loss of one limb doubled from 2008 to 2010 because of an increase in improvised explosive devices (IED) used on the battlefield, according to the Army Times. One Marine, and undoubtedly many more, reported if he lost his manhood he wouldn’t want to live through it. This isn’t about just being able to have sex; this is ensuring men have the ability to identify their gender and to reinstate strength and masculinity after such a devastating loss.
"Our target is to get the organs into patients with injuries or congenital abnormalities," said Atala, whose research is currently funded by the U.S. Armed Forces Institute of Regenerative Medicine with a long-term goal of providing penis regrowth procedures for soldiers sustaining battlefield injuries. However, his original passion stemmed from preventing newborn baby boys from being given a sex-change at birth due to being born with ambiguous genitalia. "Imagine being genetically male but living as a woman. It's a firmly devastating problem that we hope to help with."
Limitations Of Laboratory Penises
Currently, the method limits Atala’s team from providing female-to-male sex reassignment surgery because it requires a patient’s own penis-specific cells. These newly grown penises have only gone through testing with rabbits and are currently undergoing the safety, function, and durability testing to prepare them for human testing in the next five years. The penises are used with a donor penis and sanitized to expunge any donor cells and then the male patient’s own cells are grown in culture for four to six weeks and injected into the shaft — muscle and blood vessel cells and all. The trick is using a male’s own cells to dramatically decrease the risk of immunological rejection, which occurs when the body recognizes it as a foreign and dangerous invader.
"My concern is that they might struggle to recreate a natural erection," Atala said. "Erectile function is a coordinated neurophysiological process starting in the brain, so I wonder if they can reproduce that function or whether this is just an aesthetic improvement. That will be their challenge."
When first tested with genetically engineered penises in 2002, once the 18 rabbits recovered from their surgery, they attempted to have sex within 30 seconds of being placed in a cage with a female. Atala reported they were able to penetrate and produce sperm with their new generated penises, but at about the stamina and efficacy of a 60-year-old penis, versus their goal of a 30-year-old. Now with the advent of a nearly complete lab-generated penis, Atala and his team hope to achieve erections for sexual intercourse. What is the point of having a penis if you can’t fulfill the most fundamental and innate function of reproduction — arguably the reason for our existence?
"If we can engineer and replace this tissue, these men can have erections again," said Dr. James Yoo, a collaborator of Atala's at Wake Forest Institute, who is working on bioengineering and replacing parts of the penis to help treat erectile dysfunction. "As a scientist and clinician, it's this possibility of pushing forward current treatment practice that really keeps you awake at night."