Transabled

being disabled

Here, in chapter 7.1 of Autoheterosexual: Attracted to Being the Other Sex, I show the disability dimension of autosexual trans identity, with a focus on those who want to become amputees.

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Although it’s uncommon, there are people who have perfectly functional limbs yet want to get them amputated.

This desire comes from autoacrotomophilia, a sexual interest in being an amputee.

Autoacrotomophilia is what happens when acrotomophilia, a sexual attraction to amputees[i], gets inverted toward the self. This autosexual interest has traditionally been called apotemnophilia[ii], but that name obscures its autosexual nature so I’ll be calling it “autoacrotomophilia” instead.

Within the amputee admirer subculture, acrotomophilic people are devotees and autoacrotomophilic people are wannabes.

Most people who are attracted to amputees have also fantasized about being an amputee[iii]. This association goes the other way, too: most people who want an amputation are sexually attracted to amputees[iv].

In order to achieve their desired embodiment, autoacrotomophilic people commonly bend their legs or arms while imagining that their knees or elbows are amputation stumps. This act is called pretending. It’s analogous to the temporary cross-gender embodiment attained by autohets through crossdressing.

When embodying their amputee selves, autoacrotomophilic people may experience body integrity euphoria: positive mood shifts associated with perceptions of disabled embodiment.

Similarly, when perceiving shortcomings of disabled embodiment, they may experience negative mood shifts known as body integrity dysphoria. Over time, body integrity dysphoria can develop into enduring dissatisfaction and unhappiness with having fully functional limbs.

People with body integrity dysphoria commonly identify as transabled. There are other manifestations of transabled identity based on paralysis, blindness, or other forms of disability[v], but the most common kind of transableism involves a desire for limb amputation.

A study that interviewed fifty-two people with an intense, long-term desire for limb amputation found that most of them first felt that desire by eight years of age[vi]. A majority first became aware of their autoacrotomophilia after seeing an amputee, and among those who remembered their first exposure to an amputee, most wanted to get amputated in the exact same location.

The most common primary reason they gave for seeking a limb amputation was to restore their identity as an amputee[vii]. The most common secondary reason was either sexual arousal or a sense of well-being[viii]. Ultimately, all three reasons were important to them[ix]. These same three motivations of identity, sexuality, and well-being are also central motivators for transsexuals.

Many participants in this study also showed signs of gender issues. The group of people who had previously wished to be the other sex, felt that their body was the wrong sex, or been aroused by crossdressing was fully half the size of the nonhomosexual group as a whole[x]. That’s a far higher rate than in the general nonhomosexual population—an overlap that aligns with the idea that autoacrotomophilia and autoheterosexuality share a common cause.

All of the autoacrotomophilic people who had their limb amputated at their preferred location were happy with their decision. Their testimony, which touched on themes of identity, sexuality, and well-being, strongly resembled how transsexuals talk about their decision to undergo sex reassignment surgery.

One reported, “it finally put me at peace…I no longer have that constant, gnawing frustration”. Another said, “The only regret is that I did not have it earlier; since I had it done 5 years ago, I’ve felt the best I’ve ever felt”[xi].

Other studies on autoacrotomophilia and body integrity dysphoria have found similar results:

• Onset almost always occurs at a young age, between early childhood and early adolescence[xii]

• Most autoacrotomophilic people are sexually attracted to amputees, to pretending to be one, and to imagining themselves as one[xiii]

• The most common reasons given for desiring amputation involve feeling whole or complete, increasing well-being, or attaining sexual satisfaction[xiv]

• Those who undergo amputation report afterward that it helped them[xv]

Like autoheterosexuality, autoacrotomophilia drives a sexual desire to resemble the object of attraction in both appearance and behavior. The testimony of post-op autoacrotomophilic people also accords with the sexual explanation for their condition.

For instance, one amputee said, “There is an aesthetic sexual complex, in addition I find the kind of walking very erotic”[xvi]. Another derived satisfaction from dealing with the same day-to-day obstacles that other amputees experience: “I have enjoyed working to find ways to overcome these minor difficulties”[xvii].

After getting surgery, autoacrotomophilic amputees commonly reported feeling euphoric, happy, ecstatic, relieved, or joyful. “I was as happy as I’d ever been and I was really horny, too!”, reported one such amputee[xviii]. Another shared, “I do not regret my choice to get an amputation at all…I love waking up and seeing my stump there. My stump is still very erotic”[xix].

Becoming an amputee brought their bodies in line with their idealized self-image, bringing a lightness and ease to everyday life not felt previously. They had a newfound ease in relating to others, and chronic stress dissipated. The most common regret was simply that they hadn’t done it earlier[xx].

Body Integrity Disorder as a Neurological Disorder

Some researchers of body integrity disorder have moved away from focusing on sexuality and instead shifted toward emphasizing neurology[xxi].

Researchers who favor a neurological explanation have shown a preference for the term xenomelia over previous terms like body integrity identity disorder and apotemnophilia[xxii]. They might point to research indicating reduced activity or structural differences in the right parietal lobe[xxiii], or differences in skin conductance below the desired amputation point[xxiv].

This research may ultimately help us understand the brain structures responsible for creating mental representations of our own bodies, but these differences in brain structure are unlikely to be the ultimate cause of the body integrity incongruence that autoacrotomophilic people experience.

A sexual interest in being an amputee is rare in the general population, but it’s the norm among people who seek amputation. This is a strong signal that sexuality drives body integrity dysphoria. The alternative, desexualized explanation overlooks the obvious role that sexuality plays here.

Autoacrotomophilic people commonly report that their desire for amputation increases when they see amputees or when they are lonely[xxv]. If the desire to truncate limbs comes from sexuality, this response makes complete sense: seeing amputees reminds autoacrotomophilic people of what they long to be, and loneliness is a sign that their sexual needs are unmet.

On the other hand, it’s not clear why loneliness would affect the desire for limb amputation if flawed mental self-representations from dysfunctional brain structures are the ultimate cause of body integrity dysphoria.

In Sum:

• Autoacrotomophilia is a sexual attraction to being an amputee. It is the autosexual version of acrotomophilia, a sexual attraction to amputees. It’s common for acrotomophilic people to have both the allosexual and autosexual sides of this attraction.

• In order to temporarily embody that which they love, autoacrotomophilic people commonly simulate disability by using prosthetics, bending their limbs, or imagining themselves as amputees. Those who desire permanent embodiment may seek limb amputation.

• Autoacrotomophilia can make someone experience good or bad feelings about the perceived intactness of their body. These feelings of body integrity euphoria and dysphoria shift how they think of themselves over time, and eventually some of them come to identify as amputees. Autoacrotomophilic transableism is the most common form of transableism, but other forms based on paralysis or blindness also exist.

• Autoacrotomophilic transableism fits the autosexual pattern. It starts manifesting in childhood or early adolescence. It’s associated with sexual interest in amputees and sexual interest in being one. Those who desire amputation commonly give reasons such as increasing well-being, expressing their sexuality, or feeling whole or complete. After amputation, they feel more at peace with themselves and their sexuality.

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[i] Money and Simcoe, “Acrotomophilia, Sex and Disability.”

[ii] Money, Jobaris, and Furth, “Apotemnophilia.”

[iii] Dixon, “An Erotic Attraction to Amputees,” 10.

[iv] First, “Desire for Amputation of a Limb,” 926; Blom et al., “Role of Sexuality in Body Integrity Identity Disorder (BIID),” 4.

[v] Blom, Hennekam, and Denys, “Body Integrity Identity Disorder.”

[vi] First, “Desire for Amputation of a Limb,” 924.

[vii] First, 922.

[viii] First, 922.

[ix] First, 923.

[x] First, 921,925; Lawrence, “Clinical and Theoretical Parallels Between Desire for Limb Amputation and Gender Identity Disorder,” 265.

[xi] First, “Desire for Amputation of a Limb,” 926.

[xii] Blom, Hennekam, and Denys, “Body Integrity Identity Disorder,” 3; Blom et al., “Role of Sexuality in Body Integrity Identity Disorder (BIID),” 4; Hilti et al., “The Desire for Healthy Limb Amputation,” 7; Aoyama et al., “Impaired Spatial-Temporal Integration of Touch in Xenomelia (Body Integrity Identity Disorder),” 99.

[xiii] Blom et al., “Role of Sexuality in Body Integrity Identity Disorder (BIID),” 4; Stone et al., “An Investigation of Lower Limb Representations Underlying Vision, Touch, and Proprioception in Body Integrity Identity Disorder,” 7.

[xiv] Blom et al., “Role of Sexuality in Body Integrity Identity Disorder (BIID),” 4; Blanke et al., “Preliminary Evidence for a Fronto-Parietal Dysfunction in Able-Bodied Participants with a Desire for Limb Amputation,” 4.

[xv] Blom, Hennekam, and Denys, “Body Integrity Identity Disorder,” 4; Noll, “Body Integrity Identity Disorder (BIID),” 222.

[xvi] Noll, “Body Integrity Identity Disorder (BIID),” 225.

[xvii] Noll, 226.

[xviii] Noll, 227.

[xix] Noll, 227.

[xx] Noll, 227.

[xxi] De Preester, “Merleau-Ponty’s Sexual Schema and the Sexual Component of Body Integrity Identity Disorder,” 177.

[xxii] McGeoch et al., “Xenomelia,” 1314.

[xxiii] Hilti et al., “The Desire for Healthy Limb Amputation,” 327; McGeoch et al., “Xenomelia,” 1314.

[xxiv] Brang, McGeoch, and Ramachandran, “Apotemnophilia,” 1306.

[xxv] Blanke et al., “Preliminary Evidence for a Fronto-Parietal Dysfunction in Able-Bodied Participants with a Desire for Limb Amputation,” 7.