to think body dysmorphia should never result in removal of healthy tissue

[Dancingsquirrels]

People will rightly be horrified by this story about a surgeon taking steps that resulted in his legs being amputated https://www.bbc.co.uk/news/articles/c5yvpx20le2o

And yet when a young girl / woman wants her breasts removed, TRA think it's something that should be encouraged

I know I'm preaching to the choir here

I hear you. It’s amazing to me that many people will read this story and be horrified while simultaneously cheering on the ‘rights’ of young people to mutilate their bodies in order to be their authentic selves.

And actually, not just young people- people of any age. Why is it that people can clearly see the surgeon amputation story as an example of profound mental illness, but not people with trans identities having their bodies mutilated? What is the difference between having your legs removed and your penis/testicles/breasts removed based on a feeling/overwhelming desire? I just keep coming back to the conclusion that a large proportion of people are really fucking stupid.

How do you feel about cosmetic surgery then? Breast reduction, nose jobs, tummy tucks? The only purpose they serve is to make people feel better about themselves. Should we consider the recipients mentally ill as well?

I would agree with you but this surgeon deliberately damaged his own tissue to the point of needing removal so I don’t think it’s a great example. I suppose the comparison would be if someone froze their penis so that the blood supply was compromised and tissue was dying. You’d have to operate then as medically necessary.

I don’t think inverting someone’s penis and turning them into a lifelong patient has ever been a reasonable response.

I suppose the difference to me is that these things don’t tend to need ongoing care from NHS and are funded privately. I don’t think you should be able to have surgery abroad then shunt that burden on to NHS if things go wrong either. Although thst would be tricky to work in practice.

I think it’s fair to assume that in an otherwise healthy person, the primary driver behind putting oneself through the risks of cosmetic surgery is psychological rather than physiological, yes. Don’t you?

Count me outta your “choir” - thanks :)

I mean it's obviously not the same thing, the guy is a nutcase and he's committed insurance fraud. But the OP is about how we should be equally horrified by the removal of healthy tissue. My point is that it's hypocritical to pretend that breast removal in transmen is horrific whilst breast reduction in healthy women is all fine.

In this case, the man has permanently disabled himself. It's not the same thing at all.

Breast reduction in healthy women can be for medical need. Large breasts can cause significant back pain for example.

If that’s how you see trans - “blokes having their dicks chopped off” - I think you need to educate yourself a bit & try to be a bit more nuanced.

@SoSoLong Honestly in many cases- yes, I do believe that. Katie Price for example. There are thousands like her. I’d suggest there is a scale of cosmetic intervention from a nose job for someone with a very large or misshapen nose all the way up to multiple cosmetic surgeries for people who looked perfect normal to begin with and are spending tens of thousands on BBL, gigantic breasts, multiple facelifts. I would say that somewhere along that scale, mental illness becomes a factor. Having your legs or genitals removed is pretty extreme.

A person with a very large nose is unfortunately likely to receive unpleasant comments from others, and I could see why one procedure might feel worth the risk in order to go about your life able to blend in and not attract stares or comments. But a person who looks completely ordinary to begin with having extreme surgeries is a different thing. Functionality is a factor too- having a nose job is unlikely to affect nasal function and may even improve it (depending on what is done). Whereas having legs or genitals removed is very obviously going to impact the healthy functioning of your body.

And as PP said, I don’t think the NHS should fund surgeries where there is no physical medical need, whether that is limb amputation, castration, mastectomy, rhinoplasty or having horns attached to your head or a tail grafted to your rear end.

I suppose the question then is whether these procedures should be allowed at all?

In cases where they will make you a medical patient long term, in a way that you wouldn't have been otherwise, I'd say no.

excess breast tissue can cause medical complications. I know someone who got a breast reduction because all that extra weight was causing back problems and really impacted her ability to do sports etc They were whoppers.

I also know someone who asked to have her healthy breast removed when needing a mastectomy for one due to cancer as she feared reoccurrence ( NHS said no) I’d of thought it was fairly reasonable to want to be even and in the circumstances.

It is a bit of a grey area in all fairness. I wouldn’t expect it to be done on NHS unless there was a medical need.

I don't get your point. Of course it's psychological. So is putting lipstick on. Just because it's psychological doesn't mean it's a mental illness - unless it turns into an addiction. Are you genuinely saying that women who have cosmetic surgery are mentally ill? If that's your view, fair enough. I don't share it.

Sorry to de-rail but did he amputate his legs himself or just damage them so much that they had to be amputated? The story he spun was that he got an infection on a camping trip that led to sepsis - he was on this trip with his wife so was she aware that it was a fabrication and complicit in some kind of insurance fraud?

https://www.google.com/amp/s/www.bbc.com/news/uk-wales-64861273.amp

Healthy tissue is removed all the time by cosmetic surgeons, often for no more substantial reasons than pure vanity.

Healthy tissue is also damaged all the time, for the same reasons above.

I don't agree with any of it, but then neither would I want to live in a society where the law controls what we can do with our own bodies to the extent of mandating whether or not we're allowed nose jobs or tummy tucks.

But if, as in this case, he's going to need extra medical support and care as a result of this disability he's inflicted on himself - what then?

The law already does control what we do with our own bodies. We can't remove and sell our own kidneys for example. So where is this line drawn?

You could ask the same question of any disability or illness inflicted on oneself through e.g. smoking, highly dangerous sports, or going abroad to a dodgy surgeon for a BBL. The self-infliction condition is not alone reason enough to ban something or to deny someone care. If it was then an awful lot would need banning.

And yes, the law does control what we do to our bodies to an extent. I said I would not want to live in a society where it controls them to the extent of mandating whether we're allowed nose jobs etc.

But the impact of action on outcome isn't remotely similar if we compare smoking with cutting off your own legs. Surely this is obvious?

And sure, most people don't want to live in a society where the law mandated whether we are allowed nose jobs.

But the question here is whether they want to live in a society where people can wilfully and unnecessarily cut off their own legs?

Which is why I said where do we draw the line?

I know someone who knew this man through his workplace. Based on their description of him I wondered if he was autistic. (They had very positive experiences working with him but described him as a bit odd, quirky etc. I don't want to say too much more to protect people's privacy.)

Interestingly, there's a strong correlation between autism and trans identification too. Body dysmorphia (eg anorexia) and gender dysphoria are both common with autism.

Interesting.

I think more research needs to be done into the causes of body dysmorphia and potential treatments (that do not involve cutting off healthy body parts).

But the impact of action on outcome isn't remotely similar if we compare smoking with cutting off your own legs. Surely this is obvious?

It's directly analogous if you need a lung removing thanks to cancer or emphysema.

But the question here is whether they want to live in a society where people can wilfully and unnecessarily cut off their own legs?

He didn't cut off his own legs. He caused sufficient damage to them that they required removing surgically. I would hope we'd all agree that, no matter what the circumstances of the injury, we don't just leave people with necrotic tissue to let them die a slow painful death from sepsis. In this case amputation was required to save his life.

Which is why I said where do we draw the line?

Which line specifically are you referring to here? Because in this case the question the NHS was facing wasn't "is this cosmetic surgery too extreme?", the question was "do we amputate this dead tissue or do we leave this man to die?".

What about men having their legs broken in order to be taller? Is that a mental illness? Warning, sensitive image in the link.

https://www.theguardian.com/lifeandstyle/2025/aug/17/being-short-is-a-curse-the-men-paying-thousands-to-get-their-legs-broken-and-lengthened