Ongoing Research Project: Life, Death and In Between

Body Integrity Dysphoria

Body Integrity Dysphoria (BID) is a rare and complex condition characterised by an intense, persistent desire to become physically impaired. Despite its recognition in the International Classification of Diseases (ICD-11), the causes of BID remain unclear. There are no definitive psychological or neurological indicators that account for the overwhelming urge to amputate a healthy limb. Instead, BID is believed to arise from multifactorial occurrences, similar to those proposed for Gender Dysphoria. Individuals with BID are fully rational and acutely aware of the unusual nature of their desire. The affected limb, which may not be represented in the individual’s mental body map, can disrupt proprioception, leading to the perception of the limb as alien—an appendage that needs to be removed, causing a profound sense of dysphoria.

Over the years, symptoms akin to BID have been classified under various names, including Body Identity Integrity Disorder, Body Dysmorphic Disorder, Xenomelia, and Amputee Identity Disorder. However, it wasn’t until the introduction of the ICD-11 that BID received an official definition, legitimising it as a recognised condition. Despite this recognition, a standard therapeutic approach has yet to be established, presenting significant ethical challenges for both patients and healthcare professionals.

Dr. Loriga has been involved with BID for more than a decade, working closely with both physicians and individuals who have, or claim to have, the condition. His goal is to create a safe network that connects individuals, raises awareness of BID, and fosters understanding and support for those affected by this complex condition while also addressing the significant moral, ethical, and legal ambiguities that continue to surround it today.