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The accumulating knowledge about the effects of castration was further extended to help MtF transsexuals: Untold millions of transsexuals over thousands of years have voluntarily sought and undergone surgeries vastly riskier and more dramatic in effect than mere castration. In these surgeries transsexuals are completely emasculated by total removal of the testes, penis and scrotum. No one knows precisely how it started, but such transsexual surgeries were well known by the time of ancient Greece and especially in sexually-permissive ancient Rome, and were often traditionalized in various "religious rituals" that provided the resulting "women" with a place in society. By undergoing these surgeries, young MtF transsexuals (if they survived) not only avoided becoming men, but also gained genitalia that looked somewhat like those of a woman.