Case reports of 6 patients who were able to relieve or end the pressure caused by Body Integrity Dysphoria

Abstract: Background: Body Integrity Dysphoria (BID) is a strange disorder in which the external body does not match with the mental image of the body. Those affected usually feel that a body part (e.g., a leg, a foot, an arm, or a hand) is not part of their body. They perceive this limb as foreign and not belonging to them. Methods: The article describes the fate of six patients who found different ways to escape the mental pressure caused by BID. Results: The first patient was able to have an amputation in a clinic; afterward, he felt well and was extremely satisfied with his new physical condition. The second patient suffered a serious road traffic accident with multiple fractures of one leg; his life was saved, and he spent a long time in a rehabilitation clinic. Due to the pain and difficulty walking, he realized that life is easier with two healthy legs, and he was able to abandon the need for amputation. The third individual case described here survived the pressure of BID by pretending; he couldn't afford an expensive amputation abroad. He then met a disabled woman with a double thigh amputation. He found that being able to love her in her disabled state was enough for him and his own desire for an amputation faded into the background. The fourths patient suffered from the comorbidity of being transgender (male to female) and the urge to amputate his/her right leg. Since gender reassignment was easier to achieve than surgical removal of the leg, the patient initially decided to undergo gender reassignment. However, afterward, she felt much more at home in her body and no longer considered the leg surgery necessary. The fifth case described here was able to convince the authorities that he suffered from a severe neurological disorder. He then lived in a wheelchair for some time with the status of severely disabled. However, he eventually became bored with not being able to do anything independently and ended his disability. The last patient made numerous attempts to cope with the pressure of BID. He ultimately died in a motorcycle accident, and it is unclear whether he deliberately caused the accident to cause the loss of a leg. Conclusions: Most of the six case studies probably do not contain a general solution for all BID sufferers, but they show that BID is also a psychological phenomenon and that focusing on other aspects can reduce the need for acquiring a disability. Ultimately, there are many different forms and degrees of severity of BID and each affected person will likely have to find his/her own solution.