I’ve written here a few times about a condition to which I referred as apotemnophilia, a craving to have a body part amputated. I had never considered the parallels, as this article does, to gender dysphoria and gender transition. Being transabled, or having body integrity identity dysphoria, refers to the feeling that one is a disabled person trapped in an able body, that one is meant to be an amputee. The anthropologist Jenny Davis has written about the variety of ways transabled people express what she has called their “impairment needs”:
The term wannabe refers to those who want/need to have a physical impairment. Pretenders act out their impairment-needs by, for example, folding an appendage, inserting ear plugs, wearing opaque contacts, walking on crutches, wheeling themselves in a chair, or wearing neck/leg/back braces. Devotees experience fetishistic attractions toward the physically impaired bodies of others…
The natural reaction to transablism (which I admit I felt when I wrote about apotemnophilia) is one of incredulity or abhorrence. Exploring that reaction, it seems to be based on the assumption that amputation is a choice, or a learned preference, for the affected person. And the choice of such a “socially devalued bodily state” as disability is stigmatized. But Davis’ investigation suggests that it might rather be thought of as essential. Again, this is in many ways parallel to the experiences of transgendered people as I understand them. Until gender dysphoria was understood and accepted, it seemed to many that the choice to transition was the problem, or the disorder, rather than the solution for the affected person. In both the transgender and the transable situations, wanting to transition is a route toward being one’s true self rather than departing from it. Transable people, observes Davis, often initially resisted a notion of wanting to stable themselves which they found abhorrent, but lost the battle. In the subset of “wannabes” who had sought psychotherapy for their amputation urges, therapy was never successful in changing the desires or relieving the distress. In contrast, it appears that those who have obtained a desired amputation find relief in ways they have been unable to get by other means.
So accepting the concept of body integrity identity dysphoria challenges us to consider the assertion that transabled people seeking amputation ought to be able to get them from reputable surgeons. If denied, many may either patronize disreputable back alley surgeons, injure a limb to compel medical amputation, or attempt to do it to themselves. Other elective surgical procedures are used to make the body conform better to social ideals; why shouldn’t people be allowed to change in ways with which society is less comfortable?
Of course, the parallel to gender transition may break down in at least one way. Satisfying the desire to maim or disable the body may entail enormous financial costs to care for the resultant lifelong disability. Thus, it may not merely be a matter of respecting the right to autonomy.
Via JSTOR Daily