Gender dysphoria and body identity dysphoria

Back in early 2005 I found myself watching a documentary on Discovery Channel on the topic of body identity dysphoria (BID) [1]. It followed this young woman who spent much of her time looking for a surgeon who would amputate her legs. Not because she had any medical problems, but simply because it felt 'right' to her to not having legs. She could recall seeing this person in a wheelchair as a child, with that person having the same kind of amputation as she ended up seeking for herself years later.

Not long after watching that documentary I found myself dealing with first the suspicion of me being transgender, quickly followed by the growing realisation that I had to be intersex. The memories of watching those BID sufferers faded to the background, until recently, when I found myself considering BID again, this time in the context of gender dysphoria and similar disorders.

Briefly put, BID is the desire to have invasive surgery performed on one's body in order to amputate healthy body parts, or to lose parts of one's body's functionality. The source of this desire appears to be in the brain's view of the body, with the functionality or parts that are deemed undesirable falling outside of this mapping.

For BID sufferers amputation or induced paralysis appears to be the only real solution, as ethically convoluted this solution may be. This is similar to with gender dysphoria (GD), where those affected will describe a strong desire to have their genitals removed, along with many other characteristics of their body. So-called sex-reassignment surgery involves the removal of one's existing genitals, and the surgical creation of a facsimile approximation of the opposite sex's genitals.

In both cases the hope is that by giving in to the desire for surgical interference, the psychological suffering will cease, and the person can live a normal life again. In the case of BID, the suffering can increase to the point where the person will self-amputate. Both BID and GD are very real forms of suffering, without a clear solution, or cause.


Looking back on the past fourteen years that I spent dealing with my intersex condition, I can see the many choices that I had to make in order to find myself. Most strongly of all, I can see the weird medical attitude towards BID, GD and intersex cases.

With the first, there's little inclination by doctors to assist surgically. With the second it's becoming easier and easier to the point where even children can apply, and with the third 'normalisation' surgery is forced on unwilling intersex individuals - including infants - but actual medical help is not available.

I consider myself fortunate to not have any kind of dysphoria or medical disorder. Yet I'm not blind to the horrific irony that while BID and GD require intense psychological and medical attention and are met with guarded caution, the medical approach towards intersex is one of overly enthusiastic surgical intervention.

With intersex there's no protocol, real-life test, psychological evolution or the like. Nobody will weigh the ethics of chopping up the genitals of an intersex infant, or ask whether it's proper to subject an adult intersex person like myself to psychological pressure to undergo 'normalisation' surgery and to be repeatedly told that I am not capable of making decisions myself, that I should rely on the doctors.

With BID and GD individuals are born with a problem. With intersex individuals are born without a problem, but have problems created for them.

I wish all three groups could get the help that they need.


Maya


[1] https://en.wikipedia.org/wiki/Body_integrity_dysphoria