Trans-abled

I think most of us here in the debates section have a passing knowledge of what transgender/gender dysphoria is. Basically, someone with gender dysphoria feels like their gender and their body don't align and feel uncomfortable with their body as a result. But what about something often informally called being "transabled"? It's an informal term for a condition usually known as BIID, or "Body Integrity Identification Disorder". I think you have heard of articles about individuals who actually committed to the "form" that they wanted by amputating their legs or arms before.

Here are some examples of articles with the experiences of people with BIID. [1] [2]

Papers: [x] [x]

It's a very rare condition, usually manifesting itself in the idea that the patient believes that part of their body somehow shouldn't exist or be dysfunctional, usually in the form of amputation of a limb, but also sometimes manifests itself in the form of an urge to blind, deafen, or paralyze oneself. It is quite similar to what gender dysphoria is like in that a patient feels that their body is not what they perceive it to be in their mind and have an urge to fix their bodies until they reach their "mental" image of how they view themselves. Feel free to elaborate, transgender folks, if you have some ideas yourself.

I bring this up because it has deep moral and ethical implications regarding the disorder. For the person involved it can be just as dysphoric as someone with gender dysphoria, but because of the incredible implications of the condition they see themselves as and the consequences of that action, and the stigma from mainstream society both on the disability itself and the yearning to become disabled, it is incredibly difficult to be able to obtain transition safely, and many individuals resort to self mutilation.

It is not something with an easy answer.

Some questions to answer.

• What are the ethical implications of the disorder in general?
• Should the condition be viewed as analogous to gender dysphoria, or should it be viewed as nothing more than an identity disorder?
• Should doctors offer surgery to allow people to modify themselves in this way? What if the condition has continued for many years?
• Are people who suffer from this condition people who need acceptance or need to be changed?
• Some people cope with the disorder by "pretending" to be disabled. For example, they may always use a wheelchair even if they don't physically need one. What is your reaction to this?

Feel free to add more discussion than this, this is just a starting point.

It's a mental disorder. The fact that people attach some sort of stigma to that term is tangential to its classification. From Wikipedia:

A mental disorder, also called a mental illness or psychiatric disorder, is a mental or behavioral pattern or anomaly that causes either suffering or an impaired ability to function in ordinary life (disability), and which is not a developmental or social norm.

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As for how to best handle the disorder, that would be a question for a psychiatric professional, I think.

What I found interesting was that these people are under heavy scrutiny by others. I guess I can't be totally surprised, I mean I know they're two different beasts entirely, but I must admit Munchausen Syndrome did come to mind.

As far as ethics go, would it be fair to compare this to assisted suicide? One's seeking a permanent solution, one that is highly unethical in nature, but it would alleviate the pain. Obviously being disabled and deceased are quite different, which might be the basis of my stance if I ever decide on one.

That's actually a really interesting perspective that I never even thought of. Ethically, both face the same challenges. In fact, what's really interesting is that many people subconsciously have a feeling that being disabled is almost akin to being dead or somehow worse, which contributes gravely to the stigmatization these individuals face. People are afraid of going blind, deaf, or losing a part of their body, and feel like it is the "end of their life" in a subjective sense, so the condition extremely difficult to empathize with. And because of the permanent nature of removing someone's limbs, spinal paralysis or blindness, it's ethical questions are most certainly comparable to suicide.

I was reading yesterday that one of the most unusual things about BIID which I think separates it from someone trying to kill themselves or self harm is how specific and consistent the need is. it is often reported that BIID patients report a very consistent description of what "is wrong" with their affected body part or sense. For example, a person with a desire to amputee themselves almost consistently provides the exact same area over and over again. More interesting however is that it is often reported that the affected limb, area or sense is more difficult to manage or learn new activities with than the general population. On the other hand, people who self harm are not consistent and often simply just harm themselves for the sake of being unable to internalize their problems anymore - this lack of focus appears to be a distinguishing factor from something like BIID. There are suggestions that it may be a disorder in body mapping, which only raises more ethical questions.

And I agree with Twocows in that it is definitely a disorder, but the real problem is that no treatment, outside of the surgery itself, is effective in most cases. In a few cases ADHD medication does help though, oddly enough, from what I've read. But in most cases the actual amputation or other surgery is often the only thing that actually stops the discomfort entirely, making this even more controversial. I don't really think that a disorder deserves stigmatization though. Many people have various disorders, some absolutely crippling, and the stigma makes things worse, which in of itself can lead to suicide.

For the record, I really hate the term "trans-abled" because it suggests that they should go about this change, when in reality something like this should be heavily investigated before that option is even available. But it gets the point across! lol

EDIT: Added some research on the OP since articles kind of do a ****** job for accurate information

I'm not sure I agree with the connection in the name to being transgender. It sounds far more like a more extreme version of a physical issue I sometimes get. There's a nerve in your upper thigh that you can pinch and it can either result in debilitating pain or numbness. It happens to me a lot, always with the numbness result. I looked it up and if the pain is constant, the only solution is to remove that nerve, numbing that area of your leg forever. This is in fact causing yourself to be partially disabled, but it's necessary to remove the pain. To me, this mental disorder is the same way - it's not a wish to be in the body of a disabled person because their mental state is disabled, but a discomfort caused by a part of their body that can only be truly cured by removing that part of their body. It's a fine line between medical condition and identity, but I think this treads just barely on the medical side.

I would imagine thinking of it that way would remove a lot of the stigma as well; no one looks at a person who had their arm amputated because of severe infection and says "why did you do that? you're so weird", and if it's presented as "my eyes were causing me incredible mental distress and the only cure was to remove them", it would be more understandable then "I just feel like I should be disabled".

Oryx said:

I would imagine thinking of it that way would remove a lot of the stigma as well; no one looks at a person who had their arm amputated because of severe infection and says "why did you do that? you're so weird", and if it's presented as "my eyes were causing me incredible mental distress and the only cure was to remove them", it would be more understandable then "I just feel like I should be disabled".

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Whilst this may be true for some, the articles and papers linked seem to suggest it's to do with body image and not about avoiding pain/being uncomfortable.

With which I have to ask - how is this different to being transgendered? Why is it this (seems) to be labelled as crazy whereas wanting to remove/alter genitals is not?


/devilsadvocate

Magic said:

Whilst this may be true for some, the articles and papers linked seem to suggest it's to do with body image and not about avoiding pain/being uncomfortable.

With which I have to ask - how is this different to being transgendered? Why is it this (seems) to be labelled as crazy whereas wanting to remove/alter genitals is not?

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I think it may be because it's not fully understood yet to be the case. While there have been studies on it there aren't enough to be conclusive. The sensory forms are extremely understudied, as well. I agree, I think it has more in common with being transgender than a psychological disorder, but at the same token I think ultimately it boils down to the fact that there is no physical impairment that you have to take into consideration if, in a perfect world, you could change your sex with no issues or limitations. That issue would exist in these individuals, which automatically makes it more difficult to approach.

i am reluctant to include this disorder in any transgender discussion unless the disorder itself directly correlates with the person in question's gender identity and what they perceive their identity to be

Aphrodite said:

i am reluctant to include this disorder in any transgender discussion unless the disorder itself directly correlates with the person in question's gender identity and what they perceive their identity to be

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It is not related to gender identity, because a disability is not related to gender.

However, this is not a transgender discussion. It may be related, because evidence seems to correlate it with a problem with internal body mapping, which is similar to what those who are transgender encounter, which means that, while it should not be placed in something like LGBT (as it has nothing to do with gender or sexuality), it may be rooted in the same problem/similar problem that those who are transgender face. Unfortunately, research is scant due to the rarity of the disorder. Thus, comparisons are made to transgender individuals but no correlation is directly made. In fact, many people with BIID identify with their birth gender and report no questions about their gender identity.

Trans-abled is a phrase that is sometimes used to help people understand what someone with BIID feels like, which is essentially that they have an intense desire to "transition" into being disabled. There is no discussion about gender here. As I have stated previously I don't really agree with it because it implies that transitioning is the most desirable option, when in reality, due to the nature of the condition, this is an extremely difficult choice to be able to make.

Please discuss the topic at hand because this topic has nothing to do with transgender individuals, bar the fact that their symptoms may have a related cause. If you are not willing to input any discussion on the topic itself, then please do some research (which I provided in the first post) and input your feelings on the actual condition.

Implying that identity is only something that applies to gender ignores other possibilities. Many people have a related condition, Bodily Dysmorphic Disorder, where they feel like their physical appearance doesn't match their inside identity which causes a lot of distress to the sufferer. There is also DID, where the patient believes that they are more than one individual. Just because it's not what you necessarily understand doesn't mean that it isn't a possibility that you have considered, and just like how transgender people have to explain to others who will never understand that their feelings are very real, those with BIID and BDD have to explain to others that their feelings are very real as well, regardless of whether the root of their problem is psychological or physiological, which some evidence seems to imply with BIID.