Thursday, January 29, 2015

Men Who Crave Amputation

Given our politically correct age and given that the transgendered are now an oppressed class, it took courage for New York Magazine to look at the question of Body Integrity Identity Disorder (BIID).

And to treat it as a psychiatric condition, falling somewhere between a mania and a delusion.

A patient with BIID knows exactly what he wants. He wants to have one of his healthy limbs amputated. Since he is convinced that his left leg is not really part of his body, he believes that whoever put it there made a mistake. He believes that he will never be whole until it has been amputated… above the knee.

New York Magazine explains:

Rather than a coherent psychological disorder, BIID is better thought of as a cluster of conditions, united by the strong sense in a sufferer that a limb, usually a leg, shouldn’t be attached to their body — a sensation of not “fitting” one’s body akin to gender dysphoria.

Note well that the condition resembles “gender dysphoria,” the technical term for those who believe that their true gender identity differs from their biological gender identity. That is, the transgendered.

It is worth noting that gender dysphoria, like BIID, is a belief. It is not a scientific fact. And, like BIID, it manifests itself in an extra belief-- that the problem can only be solved by surgery.

A BIID sufferer, quoted in the article, describes his belief as obsessive.

In his words:

My biggest problem is a complete secret: I have an unexplainable desire to do something that most people would dread. I want to have my left leg amputated, just above the knee. I strongly feel that my left leg just shouldn’t be on my body. I’ve thought about it obsessively every single day of my life.

The patient describes how his mind relates to his offending limb:

It’s a strong feeling that I should have been born without my left leg. If I make eye contact with it and I’m not fully concentrating on something else, I obsessively think: This leg shouldn’t be there. And it’s very disturbing because I know that’s not normal. It’s like my brain perceives my body without a left leg. I can be talking to someone and suddenly unable to focus on what they are saying because I’m thinking about my leg and wishing it wasn’t there.  It’s an overwhelming urge. I might be dozing on a recliner and I get this weird feeling around my knee that that’s where it needs to be off. The busier I am the more I can control it, but if I get stressed the thoughts intensify.

What triggered the disorder? He explains:

When I was about 5 or 6. I was in downtown L.A., and since it was just after the war, there were lots of amputees around. I vividly remember seeing a man get off a streetcar. He had a peg leg and I thought: I wish that were me. Later, I began to tuck my foot right up behind my bottom when I was in bed at night — little kids are very flexible. I’d then place the covers down over my knee so it looked like there was nothing there.

And he had other experiences that added to the childhood trauma:

When I was a kid, a relative’s husband got his hand stuck in a machine and he cut some of his fingers off. I recall visiting them and they were playing cards with another couple he’d met through rehab. I shouldn’t even remember any of this except this other guy had lost his left leg. He was sitting in a chair, wearing a pair of jeans, and his leg was off above where the cuff of the jeans were so the cuff was empty. 

It stuck in my mind. It was around the same time I saw the guy with a peg leg. Later a close male relative who was a race-car driver got in a bad accident and ended up having his leg amputated.

Was the problem caused by a series of incidents that appeared to be connected? Did their confluence suggest that someone was trying to tell him something? Perhaps, but I do not know.

For the record, the man's understanding of the etiology of his condition will not change his condition. It will not persuade him to abandon his other delusional belief, namely that surgery can solve his problem.

For most of his life this man had kept his condition a secret. When he told his second wife, he felt some relief, but he saw that she was distressed by the information. He chose to stop talking about it.

He has done online research into those who have undergone the operation. (You are not surprised to learn that some of these people manage to get the operation done. Some manage to hurt themselves so badly that the operation becomes inevitable.) The results were less than encouraging:

But there are some people I have exchanged emails with, via an online group. All of them have had left leg amputations. They still obsess about their limbs and talk about other amputations even though the leg is gone and they claim to be much happier. My dream is if I had this leg amputated it would all go away and I’d be a normal person, with a fake leg. That’s the difference between me and these other sufferers. Having the leg gone but still being plagued by these thoughts would make my life worse. 

Some people insist that surgery has cured them, but large numbers of those who have had their left legs removed have discovered that they still suffer from their obsessive cravings.

At a time when it is becoming impossible to discuss gender dysphoria, and at a time when the strength of an individual’s conviction is an accepted reason for damaging hormone treatment and gender reassignment surgery, it is helpful to see these obsessions or manias in psychiatric terms, the better not to make them a human rights issue.

Or to make the transgendered pawns in the culture wars.

In a culture where more than a few people believe that there is no very significant difference between biological males and biological females and where people also believe that everyone can choose his or her gender identity, regardless, using individuals who have serious psychiatric disorders to advance a cultural agenda is frankly cruel.

Culture warriors seem to want to trot out those who suffer from gender dysphoria as proof that gender is a social construct, or better, that it can be corrected surgically.

To them, this condition proves definitively that biology is not destiny. It proves that we can, with the aid surgery, make ourselves whatever we want to be.

I would add that we do not know whether all the talk about the transgendered is causing people to convince themselves that they have the condition when they do not.

After all, gender dysphoria is an obsessive belief. Since cultural attitudes impact belief, even to the point of producing waves of certain psychiatric disorders—like hysteria during the Victorian period—it might well be that the current glorification of the transgendered is persuading more people that they have the condition. 


Anonymous said...

"I obsessively think: This leg shouldn’t be there. And it’s very disturbing because I know that’s not normal."

No shit? Well that's a good place to start!

Ares Olympus said...

re: ...we do not know whether all the talk about the transgendered is causing people to convince themselves that they have the condition when they do not.

So the predicament is if "intersex" is biologically real in a tiny fraction of the population, it might be better to not talk about it, since it'll make people unhappy, and it might confuse people.

I admit the idea of surgical solitions seems repulsive in the extreme.

I'd perhaps put it in the same category as any cosmetic surgery. And the same problem happens there - you know someone who is unhappy about how they look, and get surgery and it seems successful, you're more likely to consider your own.

What's irrational is any certainty of belief, that you'll feel better about yourself after a surgery than before, I mean assuming it goes entirely as planned.

Ideally there would be a way to test such beliefs before you invest in irreversible surgeries.

It is interesting to think about the fact that our appearances have been in part "sexually selected" over tens and hundreds of thousands of years. And we might be close to being able to genetically modify our children's appearance to be taller or whatever is currently in fashion.

So for me the whole problem comes down to "choice", as long as things seem random and predetermined, we accept whatever we are, but if someone says we can be something else, Pandora's box is opened and self-hatred becomes a legitimate state of mind, if you're too "cowardly" to get mutilated into some different ideal than you are.

It reminds me of Dr. Seuss's Sneetches, a sucker is born every minute, and all you need is peer pressure and irrational beliefs.

Anonymous said...

"It’s a strong feeling that I should have been born without my left leg."

Apparently he was born without a brain.