Koro: The Genital Retraction Syndrome
Genital retraction syndrome (GRS) is an unusual, culture-bound phenomenon that has attracted considerable attention in many areas of the world community, especially Asia and Africa (Schroer, 2008). GRS, known under a variety of local names or phrases that mean "shrinking penis," is most widely referred to as koro. A man afflicted with koro typically believes that he is the victim of a contagious disease that causes his penis to shrink and retract into his body, an alarming prospect made worse by local tradition or folklore that adds the warning that this condition is usually fatal (Kovacs & Osvath, 2006; Vaughn, 2003). The belief in koro is thousands of years old, and numerous accounts of its existence have surfaced in Malaysia, Indonesia, China, India, and several countries in West Africa. The term koro is believed to derive from the Malaysian word for "tortoise," the association being the capacity of the tortoise to retract its head and legs into its body (carapace). In Malaysia the word for "tortoise" is often used as a local slang word for "penis" (Vaughn, 2003).
Although koro sometimes manifests as an isolated anomaly in a single individual (Ritts, 2003), it is most commonly expressed as a fast-spreading social belief that affects hundreds or even thousands of males, causing widespread panic and hysteria. One such instance took place in Singapore in 1967 (Vaughn, 2003). A rapidly spread rumor that contaminated pork was causing penis shrinkage resulted in Singapore hospitals being swamped with thousands of men who were convinced that their penises were shrinking and retracting. Many of these men had used mechanical means—clamps made from chopsticks, weights hung from their penises, and even relatives or friends grabbing firmly on to their "disappearing" anatomy—to keep their penises from slipping away. A coordinated public education program initiated by local physicians resulted in the eventual dissipation of this mass hysteria with no fatalities or lost penises, although many bruised private parts were undoubtedly left in its wake.
The mass-hysteria nature of GRS was also reflected in an epidemic of koro in northeastern India in 1982. It was caused by a fast-moving rumor that the penises of boys were shrinking. Thousands of panicked parents brought their sons to hospitals, usually with their penises bound up or otherwise restrained to prevent further shrinkage. This epidemic
Male Sexual anatomy and physiology
was quelled by medical authorities, who toured the region with loudspeakers to reassure anxious citizens. The authorities also conducted large-scale public measuring of penises at regular intervals to demonstrate that no shrinking was taking place (Nixin, 2003).
In countries along the west coast of Africa, from Cameroon to Nigeria, koro is commonly associated with black magic and sorcerers and typically involves penis theft rather than retraction (Schroer, 2008; Vaughn, 2003). Outbreaks of "penis thievery" have been reported in Nigeria, Cameroon, Ghana, and Ivory Coast. These episodes usually involve public accusations of penis theft, usually as the result of an unexpected or unwelcome touch from a stranger (Dzokoto & Adams, 2005; Mather, 2005). Accused perpetrators of penis snatching are often physically assaulted and sometimes killed by angry victims and other concerned citizens (Abidde, 2008).
Epidemics of koro are best explained as anxiety-based delusions that are modeled and communicated among vulnerable men (Mather, 2005; Schroer, 2008). GRS appears to have much in common with the Western phenomenon of panic attacks, with the added dimension of sexual overlay. In some Asian and African cultures where sexual anxiety is high and stories of genital retraction are common, it is not surprising that a man might panic in response to widespread rumors of genital retraction or thievery, especially when such rumors are reinforced by his own observations of the natural process of genital shrinking in response to cold or anxiety (McLaren & Ringe, 2006). Furthermore, when a man’s guilt and/or anxiety arise out of real or imagined sexual excesses, he can be easily transformed into a prime candidate for irrational beliefs and receptivity to the seemingly bizarre syndrome of koro (Ritts, 2003).