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Whose Body Is This, Anyway?by S.H., a female ex-wannabe
Another View Of The Amputee Wannabe Phenomenon
Warning: The origins of this testimony are unknown and it is very likely that this is not a true story. Yet, we believe that it represents quite well the feelings of the people with Body Integrity identity Disorder or wannabes. That is why we have chosen to reproduce it here. If you happen to be the author of this text, we would very much like you to contact us
In the two years since I first gained access to the Internet and World Wide Web, I have seen a fair amount of material concerning so-called "wannabes," individuals who harbor an intense desire to undergo amputation of a limb or limbs. Some of this material, including fictional stories and web sites that use digitally altered photographs that purport to show gorgeous women who have attained voluntary amputation, are so disconnected from reality as to verge on the hilarious. Some more-serious items are simply misinformed, either based on speculation or on psychological evaluation of wannabes who suffered from severe mental disturbances that may or may not have been connected to their desire for limb removal. None of it has seemed particularly relevant to the wannabe phenomenon as I understand it, and I think I understand it pretty well, at least so far as it pertains to me.
I am one-legged, female, married and 28 years old at this writing. I underwent voluntary left upper-thigh amputation when I was 16. This occurred with the consent of my parents and on the recommendation of my psychiatrist, following almost two years of therapy and evaluation, as treatment for an obsession with becoming an amputee that was interfering with every other aspect of my life. Or in other words, I was a wannabe, and was allowed to have an amputation because my doctors correctly believed that would be less disabling than my desire to have it. I consider myself extremely fortunate in obtaining the aid of physicians who saw my condition as a valid reason for surgery, as I was in having parents open-minded and loving enough to accept such a strange need on the part of their daughter and permit her to satisfy it.
I offer no explanation for the source of my desire for amputation. From the beginning of my school career I excelled academically and athletically. I made friends easily and was popular with my classmates. I was not sexually aroused by seeing or thinking about amputees, or by fantasies about being an amputee myself. I had no fetish for prosthetics or crutches, having never seen the former and feeling no desire to use the latter in the absence of an amputation. I was repulsed by thoughts of pain or being inferior to other people. I do not believe I had conscious or unconscious wishes to lower the standards of performance by which I was judged, attract the attention or pity of my peers, or make myself sexier, nor do I see myself as masochistic. Moreover, all such explanations were rejected by my psychiatrist prior to my surgery.
This is not to discount the possibility that other wannabes might have those motivations. It would be understandable if some did. My point here is that any all-inclusive theory, if there is one, cannot be valid unless it accounts for people like myself who were not so motivated.
I cannot totally reject the idea that exhibitionism was involved in my desire for amputation, because I am an exhibitionist by nature. In addition to being a typical child "show off" who enjoyed demonstrating my academic and athletic skills, from the time of puberty I found myself tremendously excited by the prospect or experience of making my female attributes available for masculine viewing. Beginning at age twelve or thirteen, I regularly exercised in the nude in front of my bedroom window while a male neighbor watched me from his house, and on numerous occasions I disrobed for various neighborhood boys, allowing them to see my breasts and vulva, all the while enjoying my body's power to give them erections. I found doing these things to be extremely arousing, and after each such episode I would retreat to my bathtub and masturbate to orgasm. Thus I suppose it might be that a belief I would be similarly aroused by being seen as an amputee (amputation being even more taboo than nudity) played a part in my wanting to be one.
On the other hand, I do not recollect having such thoughts on a conscious level, and I have never experienced sexual excitement at being observed by males while I was on one leg and crutches in the twelve years I've been capable of appearing publicly in that fashion. In this context I think it is significant that I frequently go without panties because that gives me a certain excitement in public even though I know my lack of underwear is not visible through my clothing, but am not aroused at all by having men look at me when I am wearing a swimsuit that leaves my stump completely exposed while concealing my genitalia. My exhibitionism does not seem to operate at an overtly sexual level where my amputation is concerned, but was and remains centered on the normal parts of my female anatomy.
There still remains the possibility I thought being an amputee would allow me to show off in a way that was extreme yet socially acceptable by simply going about my business on crutches, presenting other people with an exotic appearance rather than an act of skill, thereby obtaining the same satisfaction I got from doing well at sports and schoolwork. (As it turns out, such a belief might have been justified, because I do in fact obtain non-sexual gratification from being seen as able to perform everyday tasks as well as or better than most able-bodied people in spite of my obvious physical limitation, and I accept as fact that others would not find my performances so impressive were I not visibly one-legged.) I do not remember thinking this, but I mention it because it would be consistent with my enjoyment of showing off and it might have been something I accepted as a given without conscious thought.
As best I have been able to understand the feelings driving me to seek surgery, they seem to have fallen in three main areas: First, there is what I would categorize as a very strong but simple Šsthetic preference for the amputee form. Specifically, to my eye and all else being equal, a man or woman with one leg has always seemed more beautiful than a two-legged individual. I cannot explain the origin of this preference except to suggest it might have something to do with the asymmetry created by a single leg amputation. I do know I coveted this appearance for myself, in the heartfelt belief I would be more beautiful if I had it.
The second part of my desire comprised a raging curiosity about the sensations arising from amputation. For lack of a stronger word, I lusted to know what it felt like to have a stump instead of a leg. I wished to know all aspects of it with an intensity and urgency I cannot convey to anyone who has not experienced these same desires. Finally, I wanted the constant added challenge of life on one leg, of being handicapped in the sporting sense of the term. I believed with unquestioning faith that my life would be fuller if the activities of daily life were more difficult to accomplish. But it is important to realize I was not interested in punishing myself or holding myself back. What excited me was not the added difficulty, but the prospect of overcoming it. I was not seeking an excuse for failure or mediocre performance. I wanted to do everything well. I merely wished to increase the satisfaction I would obtain from that. One reason my psychiatrist felt justified in recommending surgery as suitable therapy for me was his understanding that these different aspects of my desire were not irrational in the context of the desired goal. Everything I wanted was attainable by and consistent with single leg amputation. I would have the altered form I thought most beautiful. I would experience the sensations normal to someone with a thigh stump. Most important, there was no reason to believe I could not perform at a superior level as an amputee. Some who hold forth on the supposed drawbacks of satisfying a desire to lose a limb seem untrammeled by actual familiarity with real amputees. They begin with the assumption that amputation must result in reduced employability and earning potential, and go downhill from there.
The plain truth, however, is that the absence of one leg need not cause serious loss of function. Although it is not as trivial a disability as, say, 20/40 myopia, on the overall scale of things it rates as no more than a relatively minor inconvenience for a person in reasonably good health and physical condition living in the United States or other urbanized countries with highly-developed infrastructure and laws protecting the rights of the handicapped. The many single-leg amputees I have met who state they can still do anything they like are not deluding themselves or attempting to make light of a bad situation. They are presenting a realistic appraisal of their capabilities. They lead normal lives. They earn incomes sufficient to support themselves and their families. They do not become outcasts rejected by their communities.
In fact, a surprising number of amputees actually come to like their altered body images because of the advantages they confer in many social situations. A pinned-up empty trouser leg is an effective tool for obtaining special benefits and consideration, and amounts almost to a guarantee that one will everywhere be treated with politeness and respect, if not kindness. We should hardly be surprised that some with involuntarily acquired amputations come to enjoy the effect of their exotic appearance on the people they encounter. If this is true of amputees who had limb loss thrust upon them, how much more likely is it that a realized wannabe will enjoy and continue to enjoy his altered body?
It would be foolish to base our judgments of wannabes' expectations on social and economic conditions that no longer exist. This is not the 19th Century. Most amputees operate in the mainstream of society, not as second-class citizens relying on the sufferance and largesse of the able-bodied for their survival. Wannabes are entirely justified in believing they will be able to lead a productive, virtually normal existence after achieving their desired limb loss, although some no doubt underestimate the discomfort and difficulty involved in recuperation and rehabilitation. I myself attained four-year and post-graduate university degrees as an amputee, and since completing my studies have consistently earned salaries commensurate with my age and education. In this respect, my life is arguably no different than it would have been if I had retained my left leg, except for the added happiness its absence has brought me.
One author has suggested that having achieved her desired amputation, the wannabe is more or less doomed to disappointment and regret once curiosity has been satisfied and the novelty wears off. He proposes this as a justification the medical community could use to deny the desired surgery as therapy for the wannabe. Of course this argument is based on the two presumptions that curiosity is the sole or major motivation for seeking amputation, and that the surgeon's belief that amputation will ultimately make his patient unhappy is ample reason to withhold it. Dealing with the latter point first, the medical community could reasonably assume most people might be made unhappy by limb removal for any reason, yet obviously they do not let this stop them from performing amputations where its suitability is indicated by medical rather than psychological reasons. It is inconsistent to argue that the patient's potential unhappiness is sufficient reason not to perform the surgery in one situation but not in another. The true question here is whether the wannabe's real unhappiness caused by the unsatisfied wish for amputation is exceeded by the potential unhappiness which might (but might not) follow amputation. Physicians have no way of knowing the answer to that question, and are not justified in denying surgery for the sole reason that the patient might be disappointed later. Indeed, if that were sufficient reason for doctors to refuse to perform an operation, what elective procedures would be done? Any operation entails the possibility that the patient will be disappointed sometime in the future. If there is even a reasonable chance that amputation might provide effective relief of chronic unhappiness that is sufficient to impair the wannabe's daily function, it is logical to suggest that the medical community might be obligated under its own code of ethics to consider amputation as a viable treatment. If the incapacitation created by an obsession with obtaining amputation is greater than is normally associated with limb loss, surely amputation becomes the superior option.
It may be true that unsatisfied curiosity provides the sole motivation for some individuals' wish to be amputated. I have no reason to think it does not. Speaking for myself, however, it was only one of the three main aspects of my desire for amputation, as I have already described. It was the most intensely felt of the three, and probably the only one that could not be even partially satiated except by surgery, but I always knew that my curiosity about the sensations of amputation would die almost as quickly as my severed leg if I succeeded in getting what I wanted. If curiosity had been my only reason, I am sure I would have been able to keep my desire under control and avoid surgery. Even at the ripe old age of sixteen I knew better than to take on a lifelong liability for the sake of momentary gratification. No, for me the most important reason to have my leg amputated was a deeply felt need to triumph over the handicap, to feel the satisfaction of overcoming the challenge of a permanent source of difficulty. This has continued to be the case. I was totally accustomed to the feel of my stump within a few days after surgery, but the gratification arising from living a successful life on only one leg continues unabated more than a decade later.
I suspect that few wannabes whose yearning for amputation is strong enough for them to actually seek satisfaction base their desire entirely on curiosity. The desire to know what amputation feels like is certainly powerful, but the very act of thinking about this is apt to produce other motivations.
But I do not think it is a foregone conclusion that a realized wannabe must inevitably experience disappointment and regret even if curiosity is the primary motivation. I do not have extensive statistical data, but I have maintained extended correspondence with five other individuals who also managed to achieve the wannabe-amputee transformation as teenagers, and I think their experiences should be considered even if they are not provably representative.
Two of these amputees are women, and the other three are men. Two are in their twenties, one is thirty-six, and the other two are over forty. All three men are single upper-extremity amputees by the simple expedient of deliberately putting their arms in the way of farm or industrial machinery. Both women are above-knee single leg amputees. One obtained surgical amputation as I did, via referral to a surgeon by her analyst. The other claims to have paid an acquaintance three hundred dollars to destroy her knee with a shotgun. Whether that claim is completely true I have no way of knowing, but I have met this person while she was on crutches, and can affirm that her limb loss is genuine. I can also state that she showed me a newspaper clipping reporting her as the victim of a hunting accident.
The time spent by these people in planning and preparation varied from years to practically none at all. As might be expected, two of the men accomplished their "accidents" impulsively, without prolonged thought. They saw their opportunities, and took them. The third man operated a large hydraulic metal-cutting shear in a steel-fabrication plant for over two months while contemplating whether he should fulfill his lifelong dream, finally sticking his arm under the blade three days before he was due to begin his last year of high school, severing it just above the elbow. One woman underwent psychoanalysis for three years before her therapist offered her the opportunity for surgery in a hospital operating room. (I found that interesting, as my own amputation was performed in my surgeon's office to avoid scrutiny by the staff at the local hospital where he normally did major procedures.) The shotgun victim took the longest to attain her goal, continually planning and replanning it from the time she was twelve until she was almost eighteen.
All five individuals told me that unbearable curiosity was their most compelling reason to give up their limbs, with two saying they had no other reason they were aware of. All five also said their amputations made them permanently happier, and that they would not do anything differently if given the opportunity to do so. They all expressed enduring satisfaction with their stumps and with their lives as amputees. I think it more than likely this is a skewed sample, as I wouldn't expect to learn about or hear from realized wannabes who have discovered their amputations were mistakes through the channels available to me, but I believe it does indicate that ultimate disappointment with voluntary amputation is not inevitable or even necessarily common. It also suggests that long-term satisfaction can result even when the wannabe is mainly consumed by curiosity.
In fact, I would contend that the reasons a wannabe desires to be amputated are probably not as important after the goal is achieved as the intensity of that desire. When one's wish to have a stump escalates past a certain level, it is the wish itself which becomes the primary problem, a dominating, all-consuming obsession that is itself a disability. At the point when I began psychoanalysis, I couldn't think about anything but becoming an amputee or accomplish anything more than the simplest tasks. I was functioning far below my normal level, and could do nothing about it. Even my psychiatrist could not help me regain full control of my mental processes. In the end I was given my amputation not because I wanted it, but because that was the only way to stop me from wanting it. And it worked. Regardless of the disadvantages that accompanied the loss of my leg, it ended my obsession. I could not continue to devote all my thoughts to obtaining something I already had. My mind was at peace from the moment I woke up after surgery, and the relief that afforded me was so great it didn't matter that I could no longer do some things that had been easy before. I had traded a large handicap for a small one, and the bargain was good.
So my friend who stuck his hand into the hay chopper because he wanted to know if he would really still feel his fingers afterward was not acting out of mere curiosity. It was the difficulty of living with the intensity of his curiosity that really impelled him. He'd been wondering about this question for so long and so hard that his mind wouldn't let it loose. The only way to free himself from it was to free himself of the hand. Once he did that, it didn't matter what the answer to his question might be (yes, he still feels his fingers, thirty years later, and can even wiggle them), because he finally knew what it was and could go on to other things. The relatively severe disability of a missing hand seemed trivial to him, compared to the misery he had undergone prior to his "accident." There was no letdown, no sense of disappointment, nor could there be, because he experienced only improvements. He got exactly what he wanted, and was willing to tolerate the physical consequences because at least they were endurable.
It is logical to ask why curiosity about the experience and sensations of amputation should reach such levels. After all, one can be intensely curious about many things without becoming obsessive. What is special about this thing? I think the answer to that is two-pronged. First, a desire to know exactly what an amputee feels can ONLY be satisfied by amputation. There is no satisfactory alternative. The amputee can try her best to describe her sensations, but they are peculiar to a physical configuration different than that of other human beings, and only someone with the same configuration can understand her description as she means it, and someone who has that configuration doesn't need her description. Second, and more important, the wannabe knows this curiosity CAN be satisfied. She can know exactly what sensations come streaming up from an amputation stump. All she needs is a primitive surgical procedure, and all her questions will be answered. It is this potential availability of the answers that leads her down the slippery slope. They are right there waiting for her, but always out of reach. It is like being on the brink of starving to death while a banquet lies waiting on the other side of an unbreakable glass wall. You might want to stop thinking about the food, but you can't help yourself.
This, as at least one other writer has pointed out, is where any analogy between amputation for wannabes and transsexual gender reassignment surgery breaks down. I have wondered what it would feel like to make love as a man, as I suppose countless other women have done. But such knowledge is unobtainable in the current stage of the medical arts. I could have a sex-change operation, but it would not give me the male experience. I would not be a man; I would be a woman with no vagina and an enlarged clitoris. I still could not learn what my husband feels when he rubs his penis back and forth in my body until his testicles discharge sperm and his prostate pumps semen into my vagina, for the simple reason that I would still have none of those specialized organs. Recognizing the futility of my curiosity, I am not tempted to pursue it. Since my curiosity is limited to the sensations of sexual intercourse and not to the other elements of male life which might attract a transsexual female, I am content to let it go unsatisfied and turn my attention to other matters.
That is not the situation with amputation, however. The wannabe is perfectly aware the answers he wants are available from a surgical procedure, and is not dissuaded by any sense that he cannot learn what he wants to know. To the contrary, his curiosity is encouraged by the knowledge that it can be perfectly satisfied, while at the same time it is frustrated by the difficulty and even danger of obtaining satisfaction. Is it any wonder he succumbs to mental gridlock?
The sensations I get from my stump might not be exactly what you feel in yours, but my stump is real, all that remains of a leg I no longer have. It is not simulated, Whatever I feel in my stump as I type these words is my brain's legitimate interpretation of the signals emanating from a severed and rearranged mass of atrophied muscles, blood vessels and nerves wrapped around a stub of bone. It matters not that your brain might experience the same stump differently, because I am still the genuine article. Once I succeeded in obtaining amputation I became an amputee, not some superficially altered cosmetic imitation of an amputee.
I am certain the irony of the transsexual-wannabe comparison escapes no thoughtful person. On the one hand we have the surgical removal of internal and external genitalia (and the breasts, in the case of a woman) and complete loss of reproductive function as part of a coordinated change in appearance that necessitates a drastic change in lifestyle and manner of dress in order to satisfy societal norms for the target gender, all without actually accomplishing the basic goal which is the purpose of the procedure. On the other hand we have the surgical removal of a single appendage with the only direct effect that of altering the way the patient walks, not even changing his appearance if he chooses to employ a prosthesis, while being entirely successful at producing the sensory and functional changes sought by the patient. Yet the first procedure is available to anyone who can passes the psychological screening and has the money to pay for it, while the second cannot usually be had for any price due to "ethical considerations" that may have nothing to do with the deepest psychological needs and qualifications of the person seeking it.
The attitudes surrounding other available elective procedures provide even greater contrast to the prevailing situation with amputation. As a woman I am entitled to have my breasts enlarged, reduced, reshaped or relocated as I desire, so long as I can muster the necessary funds and avoid acting like a raving lunatic. If have trouble pleasing my husband I can have my vagina tightened. I can also have myself sterilized, replace my natural teeth with crowns, get my face lifted, have my nose bobbed and my jawline altered, and so forth. I can even, believe it or not, have my labia retailored to better match my idea of what they ought to look like (even though I have somehow managed to struggle through twenty-eight years of life without ever seeing them or feeling a desire to do so). Some of these procedures could have serious effects on my life while others are intended only to alter my appearance in ways I hope to find pleasing, but what all have in common is availability on demand. If I can pay for them, I can have them. The medical community's position on this is, it is my body, and I am entitled to alter it in accordance with my notions of how it ought to look.
But somehow that position changes abruptly when the requested alteration affects my extremities. I am not permitted to seek alternatives to four limbs and twenty digits, even to relieve unbearable psychological pressures. Perhaps I am aware of receiving no discernible benefit from the smallest toe of my right foot, but if I ask to have that toe taken off in the belief it will improve the looks of my foot and make me feel a lot better about myself, I will be told that is an irrational request, that I need my toe even if I don't see that need.
Think about this. The same surgeon who tells me that the desire to lose a toe I will never miss is a sign of mental instability might well stand ready to change the shape of genital labia on request. Am I really less well-balanced than my sister who feels a need to alter the appearance of her little pink coochie? Maybe Sis and I are both disturbed, but the real irrationality here is in a system that caters to the disturbance of one, but not the other.
It is quite obvious that my desire to shed an entire leg is a different matter than someone's wish to have a minor toe clipped or a nose bobbed, but the difference is one of degree rather than basic principle. It IS my body. Were I convinced I would be a happier woman if only I could have a four-toed foot to fondle and gaze upon, who is to say I would be wrong with any pretense of genuine authority? Few sensible people would argue I would harm anyone but myself, or that the risk of that is more than trivial--people live their whole lives with missing small toes without being conscious of any meaningful loss. Going further, if I know about and am willing to accept such things as phantom pain, physical rehabilitation and a lifetime of inconvenience in order to obtain what I perceive as the benefits of having only one leg, who empowered my doctor to deny me what I want, in light of the many other things he is prepared to do at my request, some of which also have negative side effects and entail permanent alteration of function?
Which brings us back to sex-change surgery. The transsexual patient gives up functional genuine sex organs of one kind in exchange for something that vaguely resembles the other kind but doesn't work at all except in the most rudimentary sense of providing something which may be inserted in penis-like fashion or which will accept insertion of a penis. The simulated genitalia will most certainly not provide their owner with sensations anything like those routinely experienced by people who were born with the real thing, and he or she must be satisfied with whatever he or she gets. The necessary operations entail major discomfort and lengthy recuperation. Yet sex-change surgery is considered worthwhile medical treatment because it provides the physical appearance and semblance of function for which the transsexual has endured a lifetime of yearning at obsessional levels, thereby alleviating great mental torment and improving his or her overall emotional well-being.
I submit that when all facts are considered, if there is any difference in which procedure ought to be accepted, prescribed and performed, it ought to favor the wannabe-amputee transformation over sex-change surgery. In contrast to the latter, it provides exactly what the patient wants, not something that merely looks like it, and is therefore a more successful and effective procedure at the physical level. (To be as successful and effective, transsexual surgery would have to give me a complete and functioning set of male organs.) Leg amputation involves relatively little post-surgical pain compared to other major procedures, as well as brief hospitalization and relatively short recuperation. Removal of all or part of an arm imposes even less stress on the recipient's system, with patients often up and walking around only a few hours after the surgery is performed. Amputation is far more cost-effective than gender reassignment, with the total fees for above-knee leg removal being less than five thousand dollars even in an expensive American hospital, a small fraction of the price for a sex change. (The economics might not be quite so favorable in the case of surgery involving the torso, i.e., hemipelvectomy or forequarter amputation, but I have yet to hear of a wannabe desiring such a radical procedure, and cannot imagine one doing so.) As a significant downside, amputation frequently entails phantom pain of varying duration. I doubt many wannabes with a serious interest in pursuing surgery would regard that as other than a reasonable risk, however.
More to the point, amputation can work very effectively as a treatment for the wannabe's obsession. I can attest to this from my own experience as well as that of the aforementioned amputees with whom I have contact. There are also two cases of older men obtaining amputation through self-inflicted shotgun wounds which are well-known in the wannabe-devotee world, and these also experienced favorable results according to published accounts. Such anecdotal evidence does not constitute adequate grounds for doctors to offer a procedure as treatment for any condition, of course, but it should point the way to a more rigorous evaluation under controlled conditions, where the surgery is performed on carefully screened candidates.
Note that I am not suggesting sex-change surgery be abandoned. To the contrary. It continues to be performed because it has shown itself an effective means of bringing transsexuals a measure of tranquillity and contentment, thereby improving the overall quality of their lives. Rather, I propose that the mental torment undergone by wannabes be recognized as a seriously debilitating condition similar in nature to and as important as transsexualism, and that amputation not be ruled out as a reasonable way to treat it, just as gender reassignment is used to treat transsexuals. If this is done, I have every confidence that wannabes who are likely to benefit from amputation will be properly identified in psychological testing, and that amputation will come to be recognized as a valid therapy for the condition. Should that happen, wannabes will be able to come forward with some hope of finding the contentment they seek, and I believe we will find this is a much more common condition than has heretofore been thought.
The alternative, of course, is to continue the status quo. In that event, I would contend the medical community is guilty of maintaining serious inconsistencies in the way it approaches elective procedures, and of turning a blind eye to the overall well-being of an admittedly small part of the population who now have no legal, safe and effective means of treatment available to them, apparently for no better purpose than the propping up an outdated view of what constitutes necessary surgery. Then, as now, wannabes will be fully entitled to wonder why other major surgeries with no more serious purpose than to confer a desired change in appearance are available on request while our deepest desires and disabling frustrations are regarded as frivolous at best. Then, as now, we will ask the medical community, "Whose body is this, anyway?"
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