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Body Integrity Identity Disorder and Sexuality

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Written by Sean on Wednesday, June 11, 2008

I have received a query from someone else who has Body Integrity Identity Disorder, who is curious to know about my thoughts on why we don’t discuss sexuality as it relates to BIID. As this is an important topic, I thought I might as well write a public answer.

The person wrote the following:

Since you know a lot about BIID and know so many BIID fellows I am curious to know why so many BIID fellows have a problem to talk about the sexual aspects of this syndrome.

In my opinion it is absolutely necessary to talk about this, because if we don’t, there will be a huge risk of getting a wrong diagnosis. Sexuality is a strong motor and so it is in the case of this syndrome and it makes a therapist or doctor better understand if they knew about this aspect as well. In my mind, BIID is a relative to GID and not speaking about this special and sensitive aspect, sexuality, means that medical professionals will have a harder time to find the correct diagnosis. So, for example Dr. First suggests F68.2 as a possible diagnosis for BIID, which in my oppinion is wrong, because he underestimates the role of sexuality in BIID and this is a fault of many BIID fellows not openly talking about this aspect.

So, what do I think of all that? I think it’s a complicated situation.

First, I have to qualify my answer by explaining that in a way, every aspect of life has a sexual component to it. So with that understanding, yes, of course BIID is sexual.

Secondly, I have to further qualify my answer by saying that I believe that BIID does not include those who are sexually attracted to people with disabilities ("Devotees"). While it appears that several people who have BIID are also devotees, I do not believe there is a direct link. There is no more linkage between "wannabes" and "devotees" are there is a link between "smoking" and "drinking". Many people like to have a cigarette while they are having a drink, but it is not because you enjoy a drink that you automatically are a smoker. I admit this is not based on any evidence other than speaking with people a lot and personal observation..

I believe that sexuality is not the primary motivator in the vast majority of cases.

This belief is based on informal conversations I’ve had with people who have Body Integrity Identity Disorder over the last 15 years or so, as well as based on research papers such as Dr. First’s. In my case, for example, I do not wish to be paraplegic because the thought of being paralysed turns me on. In the case of paraplegia, it would be a bit silly to want to be paralysed because you think it would be providing sexual arousal, considering that the condition would mean that you could not get sexually aroused (in the same way you are while not paralysed). I am not the only one to feel this way. Many transabled people I know don’t have a sexual aspect to their desire, including many people requiring amputation(s).

I do not reject the fact that for some people, the idea of becoming disabled is indeed a sexual turn-on. And in that respect, the concept of a "philia" as labelled Apotemnophila by Dr. John Money may be appropriate to those people. However, I object to being classified as a sexual deviant because a relatively minor part of the "BIID community" happens to be turned on at the idea of having an impairment. I had to deal with therapist assuming my need was sexual in nature and I was referred to sexologists who could not do a blasted thing for me!

Then there is the fact that for a lot of people in the general public, a sexual deviance is perceived even more negatively than other things. I have heard people comparing BIID to paedophilia, calling us dangerous predators and suggesting we should be locked up for our own safety as well as that of others. Frankly, I have no desire to see that happen, particularly when there is no more sexual component to BIID as there is sexual component to riding a horse. Some people get off on it, but not the majority!

I have no idea what "F68.2" is. It is obviously a code referring to a diagnosis of some sort, but without knowing under which system it is being coded, I cannot figure it out. I have looked at the DSM-IV, but cannot find reference to that code. Could you please specify which condition you think Dr. First is suggesting?

I would agree that a better understanding of the condition will help everyone get appropriate treatment, but am far from sure that the role of sexuality is underestimated.

 

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20 Comments

1 On 12 June, 2008, Claire said:

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(apologies to C.J. - I copied this almost verbatim from an email I sent you yesterday).

I used to be adamant that there was no sexual component whatever to my BIID. I’m a devotee but I considered that a different thing. Then I went back to school and started using my chair regularly twice a week at school. Imagine my horror when, after a couple months, I started noticing that while driving, as I was approaching the university, I was getting sexually aroused…*in anticipation* of wheeling! It was a horrible feeling, not at all welcome, and not something that felt good. The moment I got into my chair it went away and never troubled me for the rest of the day. But I still get sexually aroused in the car if I know I’m going to be wheeling soon. So much for my absolute conviction that there was nothing sexual about it.
BUT…the point is that I started wheeling long before I ever felt this arousal, so sex was certainly not my motivation for wheeling. It was more of a side-effect.

 

2 On 12 June, 2008, Sean said:

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Could it be that you’re not actually turned on at the idea of wheeling, but rather that when you use your wheelchair you are happy, relaxed, and feeling more “yourself” and that state produces joy. And that as you’re driving towards that, your body reacts in advance of feeling that joy by becoming aroused? Dunno, just a thought

 

3 On 12 June, 2008, Claire said:

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I honestly couldn’t say. I just know that the feeling is uncomfortable. It’s like an entirely inappropriate reaction to what is going on.

 

4 On 12 June, 2008, Ronald said:

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I tried to get the ball rolling about a year ago on the topic of BIID and sexuality. I am now glad that it did not happen.

Such a discussion would have no doubt lead onlookers to come to the wrong conclusion about us. (especially the men) This would be especially true now, with the attention from Newsweek and the movie Quid Pro Quo. Sexuality is though a big part of who each of us are, and at some point we will all be faced with sexuality and BIID in the same sentence.

Sexual arousal in any situation is not wrong, the only thing that is important is how we deal with or act upon these feelings. If it becomes integrated in our own minds with BIID we should each face it and deal with it, not file it away or guilt it out of our minds. Arousal that occurs in a situation or as the result of an activity does not automatically lessen the importance of it, nor does it make it wrong, nor taboo.

 

5 On 12 June, 2008, John said:

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This is a question on which I am a little divided.

I don’t think that BIID has to have a sexual component and that it may develop in us in a non-sexual way; most of us have memories from early childhood–well before maturity–that seem to show BIID developing early on in life. Just read the earliest memories section of Transabled most of us recall incidents or thoughts from ages such as 5 - 10 years.

However, the rate of being both a devotee and having BIID (I am both, for instance) seems far higher compared to how frequent devotees or those with BIID appear to be in the general population. To me, that means that there really is a sexual component or that BIID is possibly multiple different conditions. Or perhaps, one of these conditions stimulates the development of the other. If BIID always comes first THAT would be non-sexual but if being a devotee comes first, well that would be a different matter.

Therefore, I have a hard time accepting that there is no direct link between devoteeism and BIID–too much that would have to be coincidental for that to be the case.

It will be very interesting to see the study that Dr. First is doing and I hope more studies on this with larger samples.

 

6 On 12 June, 2008, Claire said:

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I agree with you John. The comorbidity of BIID and devoteeism is too common to be written off.

 

7 On 12 June, 2008, Brice said:

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I suppose I could be classed as a devotee, but it is fantasizing about myself as disabled that brings arousal quickest and most intensely. Actually doing the disabled thing, on the other hand, settles me down, keeps the glands and hormones in much better order. And, as so many of us have experienced, BIID was with me long, long before sexual awareness or reaction, really as far back as I can remember.

 

8 On 12 June, 2008, Gordo said:

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Obviously, BIID affects everyone differently, just like how other psychological disorders like autism affects each person differently. As stated before by most people here, it may be true for some but not for others.

Personally, the only turn-on for me when it comes to BIID is the thought of losing bladder control in a real spinal cord injury, but I think it’s only because I’m a guy and anything to do with my “Charlie Browns and Linus” would be a turn-on. *ahem* Damn our guy characteristics!

 

9 On 12 June, 2008, Marie said:

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Autism is not a psychological disorder.

 

10 On 13 June, 2008, Gordo said:

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Oops, I stand corrected… Blame it on lack of sleep.

 

11 On 14 June, 2008, Chloe said:

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Hello everyone. This is my first post and I am feeling extremely scared. Of course it would have to be about such an intimate topic! I am the person Claire referred to in her first comment, and we had been discussing this, so it seemed appropriate for me to jump in.

In 2006 I had a back injury from a skiing accident. There was a minor partial T10 - T 12 lesion with some permanent nerve damage. I was told that I had come very close to being paraplegic. There are areas of complete sensory loss in my left leg, as well as left pubic area and part of my genitalia. There is also a very minor paralysis in a part of my left leg that is different from the area of main sensory loss. I identify as a complete T10 - T12 paraplegic. Close, but no cigar!

Since the accident I have been unable to bring myself to orgasm, either by masturbating or with my partner. The amount of sensory loss in my genitalia is not nearly enough to account for this. It is a purely psychological phenomenon wherein I don’t feel that I am “supposed” to be having orgasms via genital stimulation, as a paraplegic.

I identified as a paralyzed girl by the time I was five. Like John said, most of us had very early experiences with this. That would suggest that sexuality does not have a causal relationship with BIID. I have a lot more to say about this topic, but it seems better to break it up a bit.

 

12 On 14 June, 2008, Sean said:

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Welcome aboard Chloe, and thank you for “coming out” :) No reason to be afraid, we don’t bite :)

 

13 On 14 June, 2008, Chloe said:

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Thank you Sean. I shall continue.

Last Tuesday (10th June) my partner and I went out to dinner. She had suggested to me that it would be a good opportunity to wear my leg braces out in public for the first time, and she encouraged me to do it. After dinner we went to a party hosted by some friends she had recently made. For the first time ever I got to meet a whole bunch of new people while I was wearing leg braces. I had thought that I might feel self-conscious in this situation, but the reality was that I felt so completely comfortable and happy just being myself!

When I am wearing leg braces I do not feel in any way sexually aroused. In fact I would even go so far as to say that they are a turn off. However, I woke up several times that night feeling extremely sexually excited. I did not act on it of course (see my previous comment). I did not wear the leg braces at all on Wednesday, but I continued with an incredible sexual arousal all day (the day that Sean first posted on this topic). That night, about two hours after going to sleep, I woke up in the middle of an orgasm. It was as if my body had given itself what I had refused to give.

This seems somewhat analogous to Claire’s experience. Like her, I am not comfortable with it. It seems quite inappropriate. I don’t like it. It’s not supposed to be this way.

I think that Sean may really have nailed what is going on here (comment no. 2). I was definitely in a state of absolute joy after my first public appearance as myself. That certainly continued throughout Wednesday; and perhaps joy can indeed manifest as sexual arousal.

I’m not done with this topic yet. Can’t stop me now, ha ha!

 

14 On 14 June, 2008, Brice said:

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Hey Chloe, welcome aboard. Sean is a great moderator, you’re safe here.

 

15 On 15 June, 2008, Chloe said:

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Thank you Brice. I’ll keep going.

Besides having BIID, I am also a devotee. However, I am a devotee of a great many things. For example my partner is not physically disabled, but she is an incredibly gifted poet. This literary talent is a big turn on for me. It is something I don’t have, that I amire her for, and it makes me want to be like her. In fact I’d give my left leg to be able to write like her; ha ha ha!

Likewise a paraplegic woman has something that I want. I wish to be like her, and I admire her “talent’. For me there is no difference between this and poetic prowess, or a whole bunch of other things. Any of them could beget the stirrings of friendship, love and sexual feelings.

Perhaps it is a little different for me, as a lesbian, since someone who I would wish to be like could also be sexually attractive to me. It does make sense to me that having BIID could predispose one to becoming a devotee later in life, though it is by no means a necessary corollary.

 

16 On 17 June, 2008, Wheelman said:

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I consider myself to be a devotee and a pretender. I am not ashamed of that much at all. Sure at times I get nervous about it when a tuff social situation occurs, but very rarely do I let it stand in my way nor do I worry about it enough to stop me from being who I am.

I consider myself a devotee because, simply, I am attracted to someone in a wheelchair or who wears braces. Their medical devices become sort of like clothing to me. It’s not their disability that I am attracted too, but the way their legs look, helded tightly, strapped into their braces, or how their body looks in their wheelchair, and how the color suits them along with the style. Their medical devices, quiet latterly, becomes part of who they are and part of their appearance, but by no means is their devices completely who they are, just like a tank top isn’t who a “normal” woman is either. The medical devices are simply something that make me interested in the woman and what makes them look attractive to me.

As for the sexual side of myself as a devotee, I agree with Sean that pretty much everything in our lives can be considered sexual as the things that make us happy strike our emotions and our emotions power our sexual drives as well as other things, but at the same time, I somewhat disagree with the statement that devoteeism isn’t linked to the BIID movement. With that being said, I don’t really consider myself to be a member of the BIID movement because I am not a wannabee, and because I believe in my opinion that the BIID crowd has somewhat injured the rest of us out there who are not wannabees because we don’t see things their way and because of that I feel that we are attacked, shunned, and forced to keep quiet for fear that we might hurt their chances of forcing the medical world of seeing things their way. I believe that there are four basic steps too us and our uniqueness and that each one builds on the ones below it.

I believe that in order to be a pretender or a wannabee that you pretty much must contain at least some of the traits of the devotee. I believe that the reason we pretenders and wannabees are driven to like wheelchairs, disabilities, braces, amps, what ever your taste, is because we are somehow attracted to it for whatever reason there is. For the wannbees our there who say that they want to be disabled because they don’t feel complete, well what is it that you see in a disabled person that makes you feel complete? What is it that drives you to a wheelchair and do you not think that is an attraction to you?

As for my sexual drive, as I already mentioned, I am attracted to wheelchairs and braces, not a disability like paraplegia, but to the devices. What disability it is that causes a person to use such devices really isn’t all that important to me, it is somewhat important as I don’t really care for a complete disability leaving one completely unable to move their effected limbs at all, but even then I am still turned on some by it. I will openly admit that it is very hard for me to pleasure myself sexually without thinking about the devices that I am attracted too, and honestly I think that is true for a lot of us, but I think that a lot of us are too afraid to admit to that.

As for my pretending, I pretend like I do because I feel happy when I am in my wheelchair and braces. I feel like I am actually handsome and attractive to people. Growing up I always felt I was ugly. Maybe it was because of how strongly I was picked on by people growing up and constantly being told how ugly and unattractive I was, I honestly don’t know, but what I do know is that I feel I am more attractive and interesting when I am in my wheelchair and/or braces. I also know that I feel much more confident in myself when I am in my wheelchair. Normally I am very shy in general as a person, but when I am in my wheelchair I feel like I can finally go to social events and fit in without much or a problem. I also feel somewhat a feeling of protection when I am in my wheelchair, like things people say can’t hurt me.

Now, am I sexually attracted to my wheelchair and braces…in a large part no. When I go out and do things in my chair I don’t get a hard on, or anything like that. When I look at myself I don’t feel any type of sexual arousal by looking at myself, sure I feel happier and love seeing myself in my chair and I feel VERY HAPPY, happier than I have ever been in my life, but I do not get sexually stimulated just by that. I will admit that sometimes in my fantasies I look at my wheelchair sitting beside me and dream that some mad scientist is doing things to my body to make me need my wheelchair against my will and that does turn me on, but for that you have to understand my other sexual fantasies, if you know what I mean, in order to understand that.

I believe that the reason so many of us fear devotees and force strongly everyone not to associate themselves with the term devotee and try and divide the devotee community out from the rest of us is because simply they are too afraid of themselves to admit to how they feel. I believe that a good many of us fully realize we are devotees, but are simply too ashamed and scared to admit even to themselves that they are devotees because they don’t want to be judged by others and they don’t want to judge themselves.

Sure there are cruel, perverted, molester devotees out there who break every concept of rules to feed their sexual desires and who hurt everyone they come in contact with and who don’t care about disabled people, all they want is to get inside their pants so to speak. I say to that, there is always people like that for every thing. Why do you think there is so many strippers and hoers? I live with a guy right now who considers himself a player. To him, women are just sex toys for his enjoyment. The only reason women exist is to please him and to do his housework. So to say that all devotees are bad because a few out there go over the line and act in ways that are criminally wrong just like a lot of “normal” guys do with “hot” women is frankly insane. In happens with everything and everyone in life. We can not try and say we are not attracted to disabled people because we fear of being judged for the actions of these perverts, the only way people will come to accept and to understand a attraction to someone who is disabled is if we stand up and say we are and show them that not all of us are perverted like these scum who run around uncaringly hurting everyone in their path to feed themselves.

 

17 On 18 June, 2008, Chloe said:

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You make some interesting points, Wheelman.

What strikes me first is an underlying tension between those with BIID and devotees or pretenders, even though there is clearly some crossover. This reminds me very much of the “gender” community, of which I am a part on account of being intersexed. There are intersexed folks who don’t want anything to do with transsexuals. There are transsexuals who don’t want anything to do with cross dressers. I don’t care; I just like nice people. These boxes we put people in aren’t real anyway; they just facilitate communication. Many transsexuals find out that they do in fact have an intersex condition. Many people who identify as cross dressers later realise that they are indeed transsexuals. There is evidence that GID is part of the spectrum of intersex conditions in any case.

I don’t have a solution to this for our community, but I am very cognizant of Sean’s points about the dangers of BIID being seen as a sexual thing. For decades transsexuals were forced to lie about their sexuality in order to get any medical treatment. If an MtF (male to female) admitted to finding women attractive, no treatment. If they admitted to finding women’s clothing a turn on, no treatment. If we (people with BIID) had to claim to be completely asexual beings in order to get treatment, then that’s what I’d do.

About feeling complete: The psychological events of my childhood are completely consistent with my current need to be paraplegic in order to feel complete. I’ll not divert into that in this column though, as it is off topic. However, assuming that there is a neurological predisposition to BIID, one can never find a full explanation based only on psychology.

I truly, sincerely wish for my genitalia to be completely devoid of sensation. It is hard to reconcile that with an assertion that the wish is sexual in nature. We all bring different life experiences, religious affiliations, genders, upbringings, etc to the way we sexualize things. So we should expect a significant diversity in the way we connect BIID and sexuality. Part of my background is that I have a pretty low level of sexual desire. I attribute some of this to my intersex condition, having atrophied gonads that never produced normal amounts of either female or male hormones. Perhaps it is easier for me than for most to contemplate a complete lack of genital sensation.

Having said this, I am today experiencing a lot of sexual arousal after wearing leg braces in public all day yesterday and the day before. I was not at all aroused while wearing the braces. I have to admit I find this confusing. Yesterday I started seeing a psychotherapist/sexologist to explore this. I completely trust him not to try to talk me out of anything. I have known him for years as he also runs the intersex support group I go to.

 

18 On 18 June, 2008, Ronald said:

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I get the impression from what is posted here that there is intentionally a very thick line drawn between BIID and devs. and pretenders. BIID seems to be a deadly serious issue (as it is)without any discussion allowed about the ancilliary parts of our lives that may be part of BIID. Devs. and pretenders seem to be on the recreational end of the issue. If we do mix it all together, onlookers will wrongfully get the idea that BIID is a sexual thing, especially considering what one finds on the internet.

 

19 On 26 June, 2008, Chloe said:

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Another facet of this topic concerns the practical consequences of how BIID can affect one’s sexuality. I try to be careful not to use any leg muscles when my partner and I are making love. If my legs need moving she or I will move them with our hands. This is not a sexual turn on for either of us, but nor is it a turn off. It is simply that we both accept it as a consequence of my need to be paralysed.

 

20 On 26 June, 2008, Gordo said:

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Chloe, I guess that’s an important thing too. I mean, whenever I’m out pretending with my friend (the only real-life friend who knows about my BIID), we both understand that during the duration of the pretending, I am living as a paraplegic; until the pretending trip is over, I “don’t have the ability to walk.”

Breaking that rule during pretending (or, in your case, during sex) seems to shatter that world in a bad way.

I think it’s wonderful your partner is so understanding about this… I can only wish for the same for myself down the road, but I’m not counting on it. You’re really lucky.

 

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About Sean

Sean is transabled. His body image is that of an L2 paraplegic. He has been living pretty much 100% of his public life from a wheelchair for the last decade, but hasn't found peace of mind (and is unlikely to until he does become a para).