What is Body Integrity Identity Disorder?

Body Integrity Identity Disorder (BIID) is a medical condition in which the patient feels compelled to amputate one or more healthy limbs. Patients may also be drawn to disabilities such as blindness or paraplegia. Serious research on Body Integrity Identity Disorder began in the late 1990s, when psychologists recognized it as a condition much like Gender Identity Disorder. For people who are unfamiliar with Body Integrity Identity Disorder, the condition can seem very confusing.

As is the case with Gender Identity Disorder, Body Integrity Identity Disorder appears to start in childhood. From a young age, the patient has a sense of incompleteness which he or she feels can only be resolved by removing a limb or undertaking a drastic body modification. The roots of the condition are not fully understood, although numerous theories have been posited. As the patient grows older, the thoughts and longings associated with the condition can be very isolating, as the patient may believe that he or she is alone in feeling this way.

Because Body Integrity Identity Disorder is not widely understood in general society, the patient can feel anxious, depressed, and frustrated, much as transgender individuals do. He or she may try to suppress the urges in an attempt to fit in, or go in the opposite direction, pretending that the amputation has already taken place. Some people with the condition express jealousy when they see amputees, and they may ultimately seek an elective amputation.

Most surgeons and medical professionals will not offer elective amputation and similar procedures because they feel it is against medical ethics. As a result, patients with Body Integrity Identity Disorder often have trouble finding treatment. Some attempt to amputate their limbs themselves, a potentially very dangerous solution. Others may visit underground practitioners, who may not operate in safe conditions. More commonly, the patient severely injures the limb in question, in the hopes of forcing a doctor to amputate.

Dr. Michael First was one of the earliest medical professionals to recognize and attempt to define the condition, in the hopes of making treatment available to patients who need it. A definition of the condition will be included in the DSM-V, which is projected for a 2012 publication. Inclusion in the DSM-V will make the condition much easier to treat, as it will be more widely recognized by the medical community. Patients with Body Integrity Identity Disorder hope that someday elective surgical procedures may be available to help them, much like the gender reassignment surgery used to treat people with Gender Dysphoria.