A New Way to Be Mad and the World's Gone Glad

Fifteen years ago the Atlantic Monthly published an article entitled A New Way to Be Mad. Reading it is not for the faint of heart. Writer Carl Elliot described what he called the 'new' phenomenon of healthy people seeking to amputate limbs. At the time fewer than a half dozen articles had been published on apotemnophilia. Elliott, who has a medical degree himself, writes that most people who intentionally cut off otherwise healthy limbs "feel that their body is incomplete with their normal complement of four limbs."

This feeling of being trapped in an incomplete body is why many doctors and psychiatrists use the term  body integrity identity disorder. In 1977 the Johns Hopkins psychologist John Money published the first modern case history of an individual intentionally amputating an otherwise healthy limb and coined the term apotemnophilia from the Greek "love for casting off." In the four decades since, the Internet has seen an explosion of people who coalesce around the desire to saw off healthy fingers, toes, arms, and legs.

Most of us gasp at the bizarre pictures of people cutting off and throwing away otherwise healthy limbs. Yet gender identity disorder is seen as very similar to body integrity identity disorder by most clinical professionals. Elliott quotes British psychiatrist Russell Reid as saying "Transsexuals want healthy parts of their body removed in order to adjust to their idealized body image. I saw that people wanted to have their limbs off with equally as much degree of obsession and need and urgency (as transexuals)."

In other words, there is little if any difference between Bruce Jenner, a man conflicted with gender identity disorder who intentionally cuts off his penis, and a person afflicted with body integrity identity disorder who intentionally cuts off an arm, leg,  foot, etc....  (edit: The Vanity Fair article states Bruce Jenner places the cutting off of his penis as Step 10 in the process of his transformation; a step he has not yet taken). Yet the world recoils at body integrity identity disorder and praises gender identity disorder.

Why the disparity?

Atlantic Monthly reporter Carl Elliott gives us an answer in his article. His words are profound, prophetic, and politically incorrect.

"Clinicians and patients alike often suggest that apotemnophilia is like gender-identity disorder, and that amputation is like sex-reassignment surgery. Let us suppose they are right. Fifty years ago the suggestion that tens of thousands of people would someday want their genitals surgically altered so that they could change their sex would have been ludicrous. But it has happened. The question is why. One answer would have it that this is an ancient condition, that there have always been people who fall outside the traditional sex classifications, but that only during the past forty years or so have we developed the surgical and endocrinological tools to fix the problem.  

But it is possible to imagine another story: that our cultural and historical conditions have not just revealed transsexuals but created them. That is, once "transsexual" and "gender-identity disorder" and "sex-reassignment surgery" became common linguistic currency, more people began conceptualizing and interpreting their experience in these terms. They began to make sense of their lives in a way that hadn't been available to them before, and to some degree they actually became the kinds of people described by these terms."

ESPN is bestowing on Bruce Jenner the Arthur Ashe Courage Award at the 2015 ESPY's this year. If Atlantic Monthly writer Carl Elliott is correct, a large number of young men will begin moving toward having their otherwise healthy penises cut off and discarded. It may be just a matter of another fifteen years before ESPN gives the courage award to someone who intentionally cuts off their arms, their legs, their ears, and their nose in order to feel normal.

I have several friends who have lost their limbs due to disease, combat, or natural birth deformities. They understand their identity is not determined by having healthy limbs, but if you ask them if they would have them back, they would say yes. They are looking forward to their day of restoration. They would also call those who intentionally cut off their limbs disturbed, and some might even go so far as Carl Elliott and call them mad.

I will have sympathy for anyone afflicted with this new psychological disorder for cutting off otherwise healthy limbs, but count me out as one who feels glad for this expression of the new mad.