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Apotemnophilia: Amputee Identity Disorder     

Apotemnophilia is a paraphilia in which the sexual interest typically centers on being or looking like an amputee. This disorder is also known as Body Integrity Identity Disorder (BIID) or Amputee Identity Disorder. It is followed by a strong desire to amputate one or more healthy limbs in order to live the desire.

Apotemnophilia is a paraphilia or a group of unrelenting sexual behavior patterns in which bizarre objects, rituals or situations are needed for sexual satisfaction. Mild forms of these conditions often occur in the lives of normal individuals, but in the case of a paraphilic person, these conditions are distinguished on the basis of insistence and exclusivity with which the sexuality of the individual centers on particular acts or objects in the absence of which orgasm is impossible.

In Apotemnophilia, the desire to look like or become an amputee is the most common form of sexual preference. This disorder should not be confused with acrotomophilia in which the sexual interest of an individual centers around individuals who are amputees. In apotemnophilia, the individual is overcome by the sexual desire to become an amputee. Some apotemnophiles seek the help of surgery in order to get an amputation or injure a limb on purpose so that they are able to become amputees.

An individual with apotemnophilia may be absolutely unsatisfied with his sexual relationship or become completely sexually dysfunctional on the realization of the desire to become an amputee. Such an individual might try to carry out an amputation on any of the healthy limbs of the body or seek surgery for the same. Most of the surgeons refuse to meet the demands of these patients and refer them to psychiatrists.


One of the most prominent problems in the treatment of this disorder is that most apotemnophiles do not seek professional treatment for the condition, but rather receive it only when they have been caught in the act, referred by a surgeon they approached for getting an amputation or on the request of their sexual partner. Thus, their motivations for change may often stem from a desire to do it for someone else rather than from a genuine desire to change.

Treatments that combine cognitive and behavioral elements have been moderately successful in effecting changes in deviant arousal and behavior patterns of fetishists. Moreover, there is increasing evidence that these treatments can result in significantly reduced rates of recidivism than seen in untreated individuals.

Another key component of treatment involves techniques commonly known as aversion therapy— aversive conditioning to deviant sexual fantasies. Other important forms of treatment comprise of cognitive behavioral programs that include social skills training and restructuring cognitive distortions that may be helping to maintain the deviant sexual arousal and behavior patterns.


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