Voluntary Amputation

May 9, 2005 9:41 AM

Whole: A Documentary Currently airing on the Sundance Channel, Whole is a documentary about people who either have or want to become voluntary amputees (concept previously discussed here.) Director Melody Gilbert examines the condition and its implications in interviews with doctors, amputees and "wannabes" like Baz, who froze his own leg with dry ice to make himself feel whole. Gilbert also directed the documentary about even crazier people: people who want to get married at the Mall of America.
posted by dios (43 comments total)

I'm beginning to get the feeling that documentary filmmakers (and the writing staff at CSI*) have been scouring the net in search of bizarre fetishes to structure films and episodes around. This makes for interesting TV, and quite frankly, after watching, one feels like a paragon of normalness, decency and mental health.

*so far they've done furries, chubby chasers, infantilism, wife swapping, and "friction parties."
posted by jonmc at 9:51 AM on May 9, 2005

I'd be curious to see this documentary only to find out how these mental health clients feel after the surgery - I mean like years later. Is their illness sated by this one procedure or do they desire to continue to chop away until there is nothing left?
posted by j.p. Hung at 9:59 AM on May 9, 2005

j.p.- the documentary is interesting. One of the amputees said he was just peachy after the surgery. He just really needed to get rid of his leg. Now that he has, he is perfectly happy (and his wife is ok with it, too). But I was concerned about the motivations of some them. There was one person interviewed who wanted to have his leg amputated since he was a boy. He recalled seeing his neighbor who lost his leg in WWII coming home and seeing his family rush out to hug him. He mentioned how he wanted that loving family feeling and that he has wanted to be an amputee since then to achieve what his neighbor had. I doubt that getting his leg removed is going to create a loving family.
posted by dios at 10:05 AM on May 9, 2005

I've seen this, it's pretty interesting. From what I remember, their illness feels "cured" once they become an amputee.
posted by agregoli at 10:06 AM on May 9, 2005

From the "Body Integrity Identity Disorder" page:

"These individuals are not psychotic. In fact, a diagnosis of psychosis excludes a diagnosis of BIID. BIID has been most commonly compared to Gender Identity Disorder (GID)."

I can't wait till stuff like this pops up: "I was born a badger in a primate's body. I will need several extensive series of surgeries and implants and years of chemical therapies so I can realize my true self." Then once that happens you'll see cases of folks who are REALLY pocket calculators, or something.

There have been people who've had "sex reassignment" surgery who've regretted it, and got themselves only another, more serious problem. When will we start reading about people who want their legs back? I also wonder if this "disorder" was so prevalent before Geek Love was published, not because I think Dunn did anything wrong but because people love playing "monkey see, monkey do".

Oh and by the way, I gladly admit to being "insensitive" on this issue, so don't waste pixels accusing me of it.
posted by davy at 10:20 AM on May 9, 2005

I'd love to have some voluntary amputees - I hear they're fantastically easy to exploit.
posted by davelog at 10:23 AM on May 9, 2005

I can't wait till stuff like this pops up: "I was born a badger in a primate's body. I will need several extensive series of surgeries and implants and years of chemical therapies so I can realize my true self."

Davy- obviously you missed the new season of South Park.
posted by papakwanz at 10:27 AM on May 9, 2005

The gender reassignment documentary was weird too. (I need to quit watching the Sundance channel late at night... it freaks me out more than horror movies). In this one documentary, there was a lesbian couple and one of them really wanted to become a man. The woman tried to be supportive, but worried how it would effect their relationship. Sure enough, the transgendered one that sort of became a man decided that he preferred gay men, and the relationship fell apart. So, this woman thought she was really a gay man as opposed to being a straight woman... it boggled my mind.
posted by dios at 10:31 AM on May 9, 2005

I can't wait till stuff like this pops up: "I was born a badger in a primate's body. I will need several extensive series of surgeries and implants and years of chemical therapies so I can realize my true self." Then once that happens you'll see cases of folks who are REALLY pocket calculators, or something.

And then the episode of South Park will break for a commercial. Come on, man. Other than that circus freak guy who tattooed himself green and a couple of Goth kids who ruin their future job prospects by getting their tongues forked, the abilty to alter yourself into an animal is a bit farfetched.

People have this disturbing attitude about transgendered people that always seems to diverge toward fantasy scenarios out of science fiction. "What's next? They'll want to turn into woodland creatures next!" Well, golly, it's a good thing that, you know, doesn't exsit in the realm of physical possibility, then, or else it might actually have a bearing on the sex-change issue.
posted by XQUZYPHYR at 10:34 AM on May 9, 2005

I'm with Davy. Their desire is obviously a symptom of some underlying problem. For what it's worth I'm dead against gender reassignment for the same reason. I would support it in cases where the person's genes reflect their feelings, but otherwise it is like allowing an anorexic to have stomach stapling because she "feels" fat.
posted by milkwood at 10:36 AM on May 9, 2005

These folks need counseling, not amputation.
[shudders]
posted by nofundy at 10:52 AM on May 9, 2005

What milkwood and nofundy said.
posted by Specklet at 11:01 AM on May 9, 2005

The anecdotal evidence notwithstanding, I'd be pretty curious to see studies of the mental well-being of the amputees. The studies on gender reassignment surgery are pretty unequivocal about there being no positive change in feelings of well-being or depression etc etc. post-surgery. Johns Hopkins U used to perform the surgeries but stopped when the study results came out.

I think that the commonly used definition of psychosis (the DSM definition, which relies on disordered thoughts) tends to miss the point. Another way to think about psychosis is as the absence of doubt in the face of reality. Not just poor reality testing, or tangential thoughts, but an inability to admit the possiblity that things might be other than how you see them. In that regard people who are convinced that there 'true' self has no left arm are certainly psychotic.
posted by OmieWise at 11:07 AM on May 9, 2005

Shades of Baron von Munchausen's syndrome.
posted by peacay at 11:21 AM on May 9, 2005

Re: ignorant comments from milkwood, nofundy, etc.

Like it or not, the before/after transformation of voluntary amputees is remarkable. It's hard to understand for people who've not experienced it, but they really are "in the wrong body" and that body just happens to have too many limbs/fingers, as odd as that may sound. It's not some psychotic or suicidal/self-destructive impulse -- it's a corrective impulse.

Counselling and drugs do NOTHING to alter it. The ONLY way to cure it is amputation, at which point the person almost always wholly normalizes and loses interest in the subject, since their internal and external bodies are now in sync.

Anyway, it's a lot more normal and healthy that cutting off the end of a male baby's penis in order to appease the gods.

PS. I have spent the last ten years documenting this subculture via my website and I have also written several books on the subject.
posted by glider at 12:07 PM on May 9, 2005

even crazier people: people who want to get married at the Mall of America

LOL
posted by caddis at 12:09 PM on May 9, 2005

Stan: "Dude, is Kyle's dad a dolphin?"
Cartman: "He's a Jewish dolphin . . . a Jewphin."
posted by brain_drain at 12:19 PM on May 9, 2005

You are correct that I am ignorant about the matter glider.
But my emotional reaction is still to shudder.
Also I don't even like tattoos, so a grain of salt is recommended with my ignorant comments. I'm having a difficult time imagining this being a healthy and normal desire.

That's quite a web site glider.
Do you posit that body mutilation is a normal and acceptable practice then? My curiosity is aroused.
posted by nofundy at 12:20 PM on May 9, 2005

Perhaps these people should donate their unwanted appendages to people suffering from Phantom Limb Syndrome.
posted by fungible at 12:25 PM on May 9, 2005

glider I almost linked to the part of your website about this. I didn't when I realized how messed up the rest of the stuff is. It may make sense on the individual level for these people to want it because it comports with their personal perception, but that doesn't make it any less psychotic. It is not normal to want to lose a limb. Period. If some people are wired that way, then its a faulting wiring job. We don't blame them, but we don't have to act as if it is normal either.
posted by dios at 12:29 PM on May 9, 2005

Thank you glider for sharing your deep insight. Just for interest's sake though, where would you join the line? If a person wanted all four limbs amputated in order to feel whole, would you support that? And by the way I don't even know where to begin in countering your baseless, ridiculous assertion that "Counselling and drugs do NOTHING to alter it. The ONLY way to cure it is amputation" And before anyone else jumps in let me be the first to say that people pay a premium for that sense of wholeness. Sometimes it costs them an arm and a leg.
posted by milkwood at 12:30 PM on May 9, 2005

glider writes " Re: ignorant comments from milkwood, nofundy, etc."

Give me a break. Saying it's normal doesn't make it so, normalizing it doesn't make it ok, documenting anecdotal evidence on your website doesn't make contrary opinions less 'ignorant.'

What about someone who hates blacks, feels physically sick when around them, can't imagine drinking from the same water fountain? Is that alright, should we normalize it, should we defend it against all the legitimate questions that it raises? When something is turned inward it is not automatically ok, as in, defensible as a sign of good mental health that should be unquestionably accepted.

Not incidentally, it doesn't make me feel better about voluntary amputation that it is associated (even in part) with body modification sub-cultures. It's pretty easy to imagine how some people in such sub-cultures are interested in extremity as an expression of their membership. In that context voluntary amputation could easily look like any other form of oneupmanship.
posted by OmieWise at 12:31 PM on May 9, 2005

You're right, I am ignorant, but I still do not believe that amputation is ever a viable solution. You will never convince me that a desire to have a limb removed is natural. There is something wrong psychologically or chemically with these people, and counselling and medication would surely help.
posted by Specklet at 12:33 PM on May 9, 2005

Dios:

Curiosity question: I understand that you find people who think that having a certain limb is "mismatched" or "unnecessarily present" are not right in the head, and that their desires should not be considered normal. That said, do you support or oppose the removal of said limbs? That is, if they're wired wrong, and you can't change the wiring in their head, do you have a problem with removing the limb so that their reality matches their miswiring?

(For reference, I'm quite neutral / ambivalent / undecided-with-no-intention-to-decide about the subject. I'm just curious which way you fall on the issue)
posted by Bugbread at 12:46 PM on May 9, 2005

These people have the right to do whatever the hell they want with their bodies. Just because it sqicks you out doesn't mean that they haven't thought long and hard about what they want. You really have no right to dictate what would be best for them.

I'm not arguing for surgery on demand--I think it would probably be wisest to have a substantial period of counseling to help prevent regrets.

People are allowed, even encouraged, to get all sorts of body modification surgery, whether liposuction, breast augmentation, penis enlargement, rhinoplasty--and no one questions their sanity. It's only when it's something where you can't understand why someone could possibly desire it, that the mentally unsound label get slapped on.

Further, we all engaged in body modification to various degrees. We have our hair styled, we shave our legs or faces, we exercise, we choose our fashions, get our ears pierced, use makeup, or perhaps get a tattoo. It's all a matter of degree.

Further, these two groups aren't really all that similar. The amputees are very specifically focused on their body, and for them, the surgery is sine qua non. Whereas for transsexuals, surgery isn't really the point, rather, it's acceptance in the social gender role that they feel comfortable in. The surgery is something that helps them better fit in our world of bigotry. In fact, most female-to-male transsexuals don't bother with genital surgery--it being extremely expensive with rather poor results.

Right now, we just don't really know why these people have the desires that they do, but that doesn't make them any less real for the people who have them. It's been pretty recent since Gay was a mental illness, and we're still struggling with the idea that depression is a real disease.

By the way, OmieWise, that Johns Hopkins study on SRS outcomes was produced by Paul McHugh, who became head of the Hopkins program with the explicit intent on shutting it down because he thought it was mutilation. It's long since been discredited as bad science. (He also sheltered pedophiles from the police.) All recent studies show a retransition rate of less than one percent. It's very well understood these days that transsexuality is a real phenomenon which cannot be eliminated anymore than homosexuality. There is a treatment which does have a significant, positive outcome on their lives, and that is living in their desired gender role. Further, there is some strong evidence that these people have brains physically more in common with the sex that they wish to become.

If surgery makes their lives better, I think it would be immoral to stand in their way.

I would really suggest reading some of the studies, or better, getting to know some of these people personally before you form a judgment.
posted by cytherea at 1:07 PM on May 9, 2005

So, this woman thought she was really a gay man as opposed to being a straight woman...

It could be that she felt that whatever she seemed to be, her True Self was something else. Like those poor kids who persuade themselves that they've been abducted or something, that their REAL parents are fabulous royalty. In any case, I'm with OmieWise that it's psychotic.

But no, I'm not saying they don't have a right to do whatever they want with their bodies. You too have a right to mutilate yourself if you feel like it, just as you have a right to become a crack addict, an abstract artist, or a Moonie. Go ahead, chop yourself up.

Oh and cythera, I've known "mtf transexuals" personally; in many cases I think "What a waste, just be a pretty queen". To me that seems like the root of transexualism, i.e. internalized homophobia. So I see no reason why so many would focus on the surgery, but so many do: it seems like "becoming a woman" is the price they think they have to pay for being a bit fey and/or attracted to men (or enjoying men being attracted to them).

But I'm not sure what accounts for wannabe amputees though; maybe some people don't think they have enough problems to overcome already. They're welcome to some of mine, though for some reason "compressed nerves serving the arm from degenerated discs and vertebrae in the neck" doesn't seem very glamorous -- yet. ("To be as thou art!")
posted by davy at 1:32 PM on May 9, 2005

cytherea writes " By the way, OmieWise, that Johns Hopkins study on SRS outcomes was produced by Paul McHugh, who became head of the Hopkins program with the explicit intent on shutting it down because he thought it was mutilation. It's long since been discredited as bad science. (He also sheltered pedophiles from the police.) All recent studies show a retransition rate of less than one percent. It's very well understood these days that transsexuality is a real phenomenon which cannot be eliminated anymore than homosexuality. There is a treatment which does have a significant, positive outcome on their lives, and that is living in their desired gender role. Further, there is some strong evidence that these people have brains physically more in common with the sex that they wish to become. "

There are some problems with the Hopkins study, but I think that the main point is worth considering, although I stated it badly up above. People who get sex-reassignment surgery do not tend to have better outcomes than those who do not, but receive other forms of treatment. In other words, people who choose to get surgery do not have better lives than those who do not. I have seen critiques of the study, but I've yet to see positive studies to the contrary (although I really would like to, if you have some or know of some please post or email via my profile). Retransition rates are not the same thing as saying that the surgery improves lives.

I'm not a huge McHugh booster, but your characterization of him is, I think, way off. He didn't become head of Hopkins Psychiatry in order to shut down the gender clinic. And his role in the debates about recovered memory seems largely borne out by the post-event analysis. There were huge problems with the recovered memory debacle of the Eighties. I understand the politics behind it, and the need to give respect to victims, but there was clearly a lot of bad therapy going around. (And I believe that despite at least two women close to me who remembered previously forgotten molestation later in life, memories corroborated by other evidence). I'm not aware of any instances in which McHugh sheltered anyone from the police, although he certainly did argue that recovered memory was not adequate evidence, in the absence of other corroboration, with which to convict someone.

I'm not sure what to make of your statement about gendered brains.
posted by OmieWise at 1:40 PM on May 9, 2005

If surgery makes their lives better, I think it would be immoral to stand in their way.

Do you think it's immoral to try and stop a young woman who is regularly cutting herself in order to cope with her emotional/psychological stress? By your logic, if it makes her feel better (and although she might bleed a little, she's not in danger of killing herself), it's immoral to stand in her way.

Sure, lots of people get nose jobs and liposuction, but they don't have the incredible compulsion that these "wannabes" seem to have. I truly believe they're genuinely ill.
posted by Specklet at 2:01 PM on May 9, 2005

Glider-

I looked through more of BME, and your own blog because I was interested in trying to understand your position, which you did not really flesh out in your post. You made mention of a talk you gave after which people who were against extreme body mod (which I am not particularly, I just don't think it's best viewed as normal) said that they could understand your position on it much better. Could you include some of your arguments here?
posted by OmieWise at 2:01 PM on May 9, 2005

Serious question.

So - people with this disorder - do some of them get prosthetics after having the sound limb removed or not? If they do, is that considered 'cheating'?

"I can't stand to have my real leg made of flesh and bone, but a $40,000 prosthesis made of metal and silicon and electronics? Gimme!"
posted by spinifex23 at 2:35 PM on May 9, 2005

Davy, the problem with calling these people psychotic is that, when given the battery of psychological tests, they can't be distinguished from the control group.

If you want to call them psychotic, then we'll have to change what we mean by psychotic.

Sexual orientation is independent from gender identity. I can't see how homophobia would be a cause--it's much easier to be gay, and many FTMs start out in the lesbian community. Some MTFs may focus more on the surgery because it's more difficult for them to be accepted as women without it. And, odd though it seems, it's not uncommon for trans people to change their orientation after they transition--hormones? fluidity? identity issues gone? Who knows. Most don't though; the proportion of gay/lesbian transsexual people is pretty close to that of the general population.

My point, really, is that we have no idea what is making these people tick, and to slap them with the crazy label is really a matter of prejudice that extends far beyond body modification to just about anything we're not comfortable with. In the past we've done this to gay people, political dissidents, people with sexual fetishes, feminists--really, anything that undermined the dominant value system.

These cases are fascinating, because they really test and make clear the structures of our moral and social systems--they demonstrate how little tolerance we have for people who challenge our conventions.

I happen to think that self-mutilation (cutting) has to do with abuse or trauma, much like anorexia. At least, that's been the case with the people i've known--and I think something along those lines might be a good test. How does the individual feel about their desire or behavior? Do they want to stop? Where does they think it comes from?

But if it can't be cured with therapy, and it makes them feel better, then I don't think we should stop them.

If you put yourself in the shoes of an amputee wannabe, and have a choice between being miserable and depressed for the rest of your life or losing a limb and being happy, and you can't be cured of this, I think it would be pretty clear what decision you would make. It's not like they asked to be that way.
posted by cytherea at 2:47 PM on May 9, 2005

So - people with this disorder - do some of them get prosthetics after having the sound limb removed or not? If they do, is that considered 'cheating'?

It is implied that they do indeed use prosthetics.

From the 4th link:

The pretender describes a nondisabled person who lives as if he or she has a disability, using medical equipment or paraphernalia (i.e., wheelchairs, crutches, braces, taping limbs together) in order to feign amputation...

...Many amputees return to their lives rejuvenated, energetic, and feeling able-bodied. Many go on to accomplish fantastic feats such as skiing, mountain climbing, racing cars, entrepreneurship-activities that the obsessiveness of the disorder squashed prior to their amputation (G. Furth, personal communication, 2001; M. First, personal communication,2oo2).

cytherea, self-mutilation doesn't necessarily involve abuse or trauma, and the mutilators don't necessarily want to stop, or even see that it's a problem. That said, no, I don't know what it's like to not feel "whole" until I have a leg chopped off, but I still think that the compulsion to do so is not a desire for extreme body modification, but an illness, and should be treated as such.
posted by Specklet at 3:09 PM on May 9, 2005

I've always wanted handicapped parking, too.
posted by DaShiv at 3:54 PM on May 9, 2005

OmieWise, there's a dirth of studies on the web, unless you've got a subscription to the journals. But at least you can read some of the abstracts.

But here's a recent ethical analysis concerning transsexuals and assisted reproduction, which mentions and summarizes many of the pertinent studies.

The article on sex differences in transgender brains is available online, with full text.

Transsexual persons seem to have serious issues with Dr. McHugh. At the same time that the EU adopted the consensus view, he was instrumental in convincing the Catholic church that they are mentally ill, to not recognize their gender, and not allow them to marry (a person of either sex).

Specklet, I think we really need to be careful with the whole illness thing. What does that really mean? For a cold or a virus, it's pretty clear cut (or not: when we're talking about genes in a big pool it gets pretty murky. I remember reading an article which argued that malaria, due to it's prevalence, and our failures at eradication, really didn't fit the definition...)

But it's a bit more difficult with minds. I mean, who really thinks rationally all the time? Is a belief in irrational or unprovable things an illness? Some people refuse medical treatment because of their religious beliefs--with serious detrimental consequences for themselves and their children. Others drink strychnine and get snakes to bite them. Some vote for Bush--with serious detrimental consequences for everyone. But to me, the belief in a sky spirit seems completely insane.

I think we can construct a much more robust medical ethics if we focus on improving the happiness and functioning of people's lives, and not so much time on etiology and the epistemology of illness.
posted by cytherea at 4:30 PM on May 9, 2005

People have this disturbing attitude about transgendered people that always seems to diverge toward fantasy scenarios out of science fiction.

Yeah, while this voluntary amputee stuff is pretty vanilla, really.
posted by dreamsign at 6:53 PM on May 9, 2005

The problem with the "slippery slope is bullshit" people is that slippery slopes sometimes reflect reality.

"Oh, they just bring up bigamy to throw a wrench into the redefinition of gay marriage concept -- it won't happen." Except that people do want it and once you admit that the "original" definition of marriage has no particular sanctity, you do have to permit other kinds of marriages in order to be logically consistent.

"Oh, this animal-mod stuff is bullshit -- you just bring it up to throw a wrench into the whole perfectly normal redefinition of the human body". Dude, we have furries. Furries. You think someone won't want animal mods? Seriously? It's not even really a question of "want". Someone wants an arm less, a paw, well that's preference and first-world pampered ennui for you. You "need" one less limb, that tail, because you don't feel "right" without it -- yes, that's a psychological problem, the same way that the weight-loser keeps thinking he or she needs to lose weight because they look in the mirror and see something other than what is there. They are divorced from reality.
posted by dreamsign at 7:03 PM on May 9, 2005

Yeah, but furries are still a tiny, tiny subculture (maybe 10,000 worldwide). They're just heavily active on the 'net, so they seem bigger. If one out of 500 million people, fifty years from now, decides to turn into a tortoise, I don't think it's worth worrying about, considering other problems the world has.
posted by Tlogmer at 10:58 PM on May 9, 2005

cytherea: 'I think we can construct a much more robust medical ethics if we focus on improving the happiness and functioning of people's lives, and not so much time on etiology and the epistemology of illness.'

Tlogmer: 'I don't think it's worth worrying about, considering other problems the world has.'

I have seen the documentary, or one like it, and like a Nick Broomfield documentary it encourages as many questions as it answers and tells us as much about ourselves as the subject when we try to answer them.
posted by asok at 3:01 AM on May 10, 2005

To me that seems like the root of transexualism, i.e. internalized homophobia. So I see no reason why so many would focus on the surgery, but so many do: it seems like "becoming a woman" is the price they think they have to pay for being a bit fey and/or attracted to men (or enjoying men being attracted to them).

My car has a thousand magic pixies that live between the front two wheels and make it go. "Petrol" or "gas" is just the official name for pixie juice. Admittedly, I haven't opened the bonnet and looked, but the explanation makes sense to me.
posted by ArmyOfKittens at 4:34 AM on May 10, 2005

A few years ago I came across this article in the Australian newpaper (sorry it's a bit small):



I then came across this amazing article in the LA Weekly about the actual surgeon who performed the cut.. among other things:

Dallas Denny, an Atlanta-based transgender author and activist who periodically posts warnings about Brown on the Internet, says that among transsexuals he was known as "Table Top Brown" for his willingness to operate in kitchens, garages and motel rooms. "Patients were waking up in parked cars or abandoned in hotel rooms. There was no screening and no aftercare. Anyone who walked in the room was a candidate."

The other ghastly side to apotemnophilia (not for the squeemish).
posted by strawberryviagra at 6:32 AM on May 10, 2005

I'd like to refer back to cytherea's comment:

"These people have the right to do whatever the hell they want with their bodies. Just because it sqicks you out doesn't mean that they haven't thought long and hard about what they want. You really have no right to dictate what would be best for them."

Aside from the creative use of the word "sqick", this is a feeling that most of us share: our bodies are our own, and we should be able to do with them what we want.

But is this really true? I'm not referring to the abortion/choice debate (although one certainly could), but rather to the suicide and euthanasia controversy. Few people would argue with the cancer patient who refuses painful treatment in order to die a dignified death. However, few would stand by and let a depressed 23-year-old friend kill himself just because his girlfriend dumped him. Indeed, we as a society (and even as individuals) will forcibly restrain such a person and prevent him from acting upon his wishes.

So, we've already got a legal and ethical precedence of preventing people from acting upon their body in certain circumstances. While we don't want to outlaw tattooing or piercing ears, we do want to remember that the suicidal person (and perhaps the amputee wannabe) is, in fact, mentally ill, and not able to rationally decide for themselves.

That's the tricky part, of course. Many suicides are convinced that they are making the right decision, and they will vehemently (sometimes violently) object to anyone who tries to stop them. We don't listen to them, of course. We keep them from doing what they want to do. We might even lock them up against their will. Should we also do this for those who desire amputation?
posted by math at 7:11 AM on May 10, 2005

Cytherea:
People are allowed, even encouraged, to get all sorts of body modification surgery, whether liposuction, breast augmentation, penis enlargement, rhinoplasty--and no one questions their sanity.

Sure we do: it's a question of degree. Most people don't have a problem with common elective body modifications, cosmetic surgeries, and the like. But, when taken to extremes, people do tend to question those choices.

The questioning becomes more pointed when the elective procedure is irreversible, as the ones we're discussing are. Certain procedures are more controversial than others. And those attitudes change over time. But there are some good, objective reasons why its probably a bad idea to chop off a perfectly functioning limb, even if you feel a compulsion to do so.

So don't lump anyone who questions this particular desire in with those who think tattooing and nose jobs are morally wrong.
posted by wheat at 7:49 AM on May 10, 2005

We keep them from doing what they want to do. We might even lock them up against their will.

But we never succeed in preventing someone who is determined to die, from dying. They'll hang themselves, smash their head against the wall, stick their head in the toilet, whatever it takes.

So given that, there must be a middle ground by which we can give these (suicidal, BIIDs, trans, etc) people pause to consider the full scope of their desire and the opportunity to develop an alternative course of action; and, if in the end they remain firm in their conviction, help them accomplish their goal via the best means possible.
posted by five fresh fish at 8:19 AM on May 10, 2005