285:, BID is included under the category "Disorders of bodily distress or bodily experience". It is "characterised by an intense and persistent desire to become physically disabled in a significant way (e.g. major limb amputee, paraplegic, blind), with onset by early adolescence accompanied by persistent discomfort, or intense feelings of inappropriateness concerning current non-disabled body configuration. The desire to become physically disabled results in harmful consequences, as manifested by either the preoccupation with the desire (including time spent pretending to be disabled) significantly interfering with productivity, with leisure activities, or with social functioning (e.g. person is unwilling to have close relationships because it would make it difficult to pretend) or by attempts to actually become disabled have resulted in the person putting his or her health or life in significant jeopardy. The disturbance is not better accounted for by another mental,
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in which he surveyed fifty-two people with the condition, a quarter of whom had undergone an amputation. Based on that work, First coined the term "body integrity identity disorder" to express what he saw as more of an identity disorder than a paraphilia. After First's work, efforts to study BID as a
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To the extent that generalizations can be made, people with BID appear to start to wish for amputation when they are young, between eight and twelve years of age, and often knew a person with an amputated limb when they were children; however, people with BID tend to seek treatment only when they are
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or by interview with researchers that they have resorted to self-amputation of a "superfluous" limb by, for example, allowing a train to run over it or otherwise damaging it so severely that surgeons will have to amputate it. However, the medical literature records few cases of self-amputation apart
375:. This is influenced by personal decision and desire. According to ISH News, transable people go through the process by physically injuring themselves in a way that causes lifelong disabilities, satisfying their aspiration to be disabled. The transable person could want to become
257:. Family psychiatric history does not appear to be relevant, and there does not appear to be any strong correlation with the site of the limb or limbs that the person wishes they did not have, nor with any past trauma to the undesired limb.
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630:"Transabled women lost in translation? An introduction to: '"Extreme" transformations: (Re)Thinking solidarities among social movements through the case of voluntary disability acquisition'"
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411:. The condition received public attention in the late 1990s after Scottish surgeon Robert Smith amputated limbs of two otherwise healthy people who were desperate to have this done.
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response is significantly different above and below the line of desired amputation, and the line of desired amputation remains stable over time, with the desire often beginning in
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As of 2014 the cause was not clear and was a subject of ongoing research. However a small sample of people with body integrity dysphoria connected to their left leg have had
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Outcomes of treated and untreated BID are not known; there are numerous case reports that amputation permanently resolves the desire in affected individuals.
367:(which can also be referred to as being trans-able) is the term used to describe an able-bodied person's need to alter his or her body in order to develop a
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and other techniques. Research provisionally found that people with BID were more likely to want removal of a left limb than right, consistent with
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Prior to the release of the ICD-11, the diagnosis of BID as a mental disorder was controversial. There was debate about including it in the
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321:. It has been included in the ICD-11, which reached a stable version in June 2018, as 'Body integrity dysphoria' with code 6C21.
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First, MB; Fisher, CE (2012). "Body integrity identity disorder: the persistent desire to acquire a physical disability".
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De
Preester, H (May 2013). "Merleau-Ponty's sexual schema and the sexual component of body integrity identity disorder".
1537:
1435:
869:"Apotemnophilia, body integrity identity disorder or xenomelia? Psychiatric and neurologic etiologies face each other"
606:
789:
Bou Khalil, R; Richa, S (December 2012). "Apotemnophilia or body integrity identity disorder: a case report review".
1352:
Davis, Jenny L. (2012). "Narrative
Construction of a Ruptured Self: Stories of Transability on Transabled.org".
1133:"Becoming disabled by choice, not chance: 'Transabled' people feel like impostors in their fully working bodies"
273:. The amount of gray matter missing was correlated to the strength of the patients' desire to remove their leg.
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407:; namely, sexual arousal in response to a partner's amputation. Publications before 2004 were generally
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Apotemnophilia : information, questions, answers, and recommendations about self-demand amputation
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1242:"Clinical and theoretical parallels between desire for limb amputation and gender identity disorder"
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Lawrence, A. A. (2009). "Erotic target location errors: An underappreciated paraphilic dimension".
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of surgically amputating the undesired limb of a person with BID are difficult and controversial.
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Some become somewhat more comfortable with their own bodies by pretending they are amputees using
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Dua, A (February 2010). "Apotemnophilia: ethical considerations of amputating a healthy limb".
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much older. People with BID seem to be predominantly male, and while there is no evidence that
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BID is a rare, infrequently studied condition in which there is a mismatch between the mental
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Body
Integrity Identity Disorder: Psychological, Neurobiological, Ethical and Legal Aspects
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of a limb, usually a leg, or to become blind or deaf. The person sometimes has a sense of
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as primarily sexually oriented. In 1986 Money described a similar condition he called
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Apotemnophilia was first described in a 1977 article by psychologists Gregg Furth and
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or by blocking their vision or hearing. Some people with BID have reported to the
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Desire to have a sensory or physical disability, discomfort with being able-bodied
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is relevant, there does seem to be a correlation with BID and a person having a
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Davis, Jenny L. (1 June 2014). "Morality Work among the
Transabled".
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and resulting in harmful consequences. BID appears to be related to
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Mental disorder characterized by a desire to be physically disabled
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looked for possible causes in the brains of people with BID using
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999:"The science and ethics of voluntary amputation | Mo Costandi"
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and the physical body, characterized by an intense desire for
1159:"Transability Makes People Get Disabled by Choice - ISH News"
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241:, who self-amputated one of his legs below the knee in 1968.
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connected with the desire for loss of a limb, movement, or
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1430:(Rev. (05/15/2002). ed.). Bloomington, IN: 1stBooks.
670:"Desiring disability: What does it mean to be transabled?"
443:. This work did not completely explain the condition, and
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that showed less gray matter in the right side of their
189:. People with this condition may refer to themselves as
920:"Body Image: Neural Basis of 'Negative' Phantom Limbs"
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Baril, Alexandre; Trevenen, Kathryn (14 April 2016).
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and other tools to help their dysphoria, by using a
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30:"BIID" redirects here. For the organisation, see
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747:Neuroethics — Challenges for the 21st Century
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569:Brugger, P; Lenggenhager, B (December 2014).
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531:"ICD-11 – Mortality and Morbidity Statistics"
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19:"Self-amputation" redirects here. See also
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414:In 2004 Michael First published the first
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333:for BID; there are reports of the use of
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1471:Stirn, A.; Thiel, A.; Oddo, S. (2009).
1426:Furth, Gregg M.; Smith, Robert (2000).
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1199:Medicine, Health Care and Philosophy
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166:characterized by a desire to have a
32:British Institute of Interior Design
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447:research has been ongoing as well.
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177:or feeling discomfort with being
25:Amputation § Self-amputation
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867:Sedda, A; Bottini, G (2014).
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295:Disease of the Nervous System
107:Knowing an amputee as a child
1475:. Pabst Science Publishers.
1100:10.1371/journal.pone.0034702
997:Costandi, Mo (30 May 2012).
918:Longo, Matthew (June 2020).
713:10.1080/01639625.2014.855103
634:Medicine Anthropology Theory
587:10.1097/WCO.0000000000000151
575:Current Opinion in Neurology
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335:cognitive behavioral therapy
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116:Cognitive behavioral therapy
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1249:Archives of Sexual Behavior
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751:Cambridge University Press
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1538:Types of mental disorders
1374:10.1525/sop.2012.55.2.319
1366:10.1525/sop.2012.55.2.319
1354:Sociological Perspectives
1319:10.1080/00224490902747727
1261:10.1007/s10508-006-9026-6
1211:10.1007/s11019-011-9367-3
1030:Journal of Medical Ethics
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1240:Lawrence, A. A. (2006).
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472:Body dysmorphic disorder
467:Attraction to disability
331:evidence-based treatment
271:superior parietal lobule
136:Body integrity dysphoria
45:Body integrity dysphoria
1307:Journal of Sex Research
1042:10.1136/jme.2009.031070
142:), also referred to as
421:neurological condition
158:, and formerly called
668:Shad (11 June 2015).
487:Silver Spring monkeys
482:Disability pretenders
255:personality disorders
181:, beginning in early
1533:Causes of amputation
1165:. 16 December 2022.
647:10.17157/mat.3.1.388
1091:2012PLoSO...734702B
745:Levy, Neil (2007).
369:physical impairment
305:must be ruled out.
68:Clinical Psychology
1497:Complete Obsession
886:10.2147/NDT.S53385
391:or anything else.
301:." A diagnosis of
291:neurodevelopmental
197:Signs and symptoms
1505:episode on BIID (
1482:978-3-89967-592-4
1463:978-0-684-85395-6
1450:A Leg To Stand On
1403:10.1159/000330503
930:(11): 2191–2195.
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477:Body modification
416:clinical research
247:sexual preference
187:somatoparaphrenia
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493:Quid Pro Quo
491:
457:Abasiophilia
445:psychosexual
425:neuroimaging
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409:case studies
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365:Transability
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360:Transability
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329:There is no
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162:, is a rare
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103:Risk factors
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1397:(1): 3–14.
1036:(2): 75–8.
982:19 December
972:icd.who.int
879:: 1255–65.
847:29 December
753:. pp.
535:icd.who.int
299:Malingering
287:behavioural
183:adolescence
179:able-bodied
94:Usual onset
50:Other names
1528:Amputation
1522:Categories
1507:transcript
1173:19 January
1143:19 January
1013:13 January
640:(1): 136.
613:13 January
514:References
401:John Money
389:paraplegic
373:disability
251:paraphilia
230:wheelchair
226:prostheses
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1382:145521213
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729:144412724
721:0163-9625
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841:Archived
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678:Archived
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595:25333602
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1502:Horizon
1163:YouTube
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283:ICD-11
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1370:JSTOR
1331:S2CID
1284:(PDF)
1273:S2CID
1245:(PDF)
1223:S2CID
1054:S2CID
950:S2CID
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