I don't know about you, but I watched with laser-beam intensity when Bruce Jenner was interviewed by Diane Sawyer earlier this summer. At 65 years old, Jenner announced to the world that he was a "woman in my soul" and had been for a long long time. Announcing to Sawyer and the rest of us that he made the decision to fully transition from male to female, Sawyer asked him a series of questions about his status. What she didn't ask him about was BIID (Body Integrity Identity Disorder).
Now that "I am Cait" has aired (Jenner's reality series on cable), it is clear (to me at least!) that Jenner is currently a biological man from the waist down...while presenting herself as woman from the waist up. If ever there was a time to introduce us all to BIID, I believe this is it. As I have found, of the approximately 700,000 transgendered individuals in this country today, a very small percentage actually go forward and have the surgery to alter their genitals. This from a study out of Columbia University focused on the transgender community. Besides the intense pain associated with post-surgery recovery....lack of sensation associated with so-called "successful" surgical outcomes...and the visual reality of "This is what it looks like now?!"...it's no wonder that one doesn't choose to have the final surgery in order to be legitimately recognized in this country as a trans male or female. This also has helped me to understand why the violent assault rate, suicide rate, and murder rate is elevated among members of the transgender community generally speaking. (If one is going to present themselves as fully female or fully male...one has to be HONEST about that before their first "kiss" with an otherwise self-proclaimed heterosexual male or female!) Ask Jerry Springer. He has talked about this often enough on his show over recent years!
As friends and I have discussed, we can't figure out how Cait Jenner is going to turn out in this regard. She has stated that she was and has been always attraced to women---but in one of her recent episodes of "I am Cait", she claims she doesn't know what gender she'd date now. All I know is that if she's still male below the belt, it won't be pretty if her chosen female love interest is also male below the belt! Unless she chooses gender fluidity...which is a whole other issue for another blog post.
As one of the disorders suggested for review and consideration in the current DSM-5, BIID syndrome was described as far back as the early 19th century in the book "From Paralysis to Fatigue A History of Psychosomatic Illness in the Modern Era" by Edward Shorter. To make a long story short, a woman REALLY wanted a portion of her leg amputated in spite of no evidence to suggest she needed it (this was back in 1818). Her anxiety and suffering became so great, that "two surgeons of eminence in the country yielding to her entreaties, performed the operation. On completion of the amputation they were surprised to see that they had removed a normal joint."
Unlike people who suffer from BDD (Body Dysmorphic Disorder), which is recognized as a diagnosable psychiatric condition, people with BIID do NOT want to be rid of their body parts because they perceive them to be hideous, diseased, or faulty in any way. Rather, the body parts feel alien, as if they don't belong. In spite of their intact bodies, BIID patients do not feel whole.
In her recent book, "Falling Into the Fire", author Christine Montross, herself a psychiatrist and lesbian, discusses her own encounters with BIID patients. "The way in which personal identity seems inextricably linked to the desire for amputation has led to comparisons between BIID and gender dysphoria", states Montross. "In gender dysphoria (previously classified psychiatrically as gender identity disorder and in lay terminology as transsexxualism), people experience their gender as different from the one that their physical sex characteristics typically indicate." As Montross continues in her book, "These syndromes share a disconnect between the fundamental way in which a person feels his identity ought to be and the way that his body is."
Montross cites several studies in her book regarding BIID; one is an Amsterdam study where 54 individuals with BIID were administered a questionnaire. "Actual amputation of the limb was effective in all 7 cases who had surgical treatment." study administrator Rianne Blom writes. "Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life." One responder to the questionnaire revealed as much when he or she wrote, "I'm wondering if I am eligible to participate in this study, because since my amputation I do not have BIID feelings anymore."
"How then, as doctors, do we proceed?", asks Montross in her book. "A surgical procedure exists that appears to alleviate the anguish of people who are truly suffering. In attempts to treat the condition, medications have proved ineffective, and psychotherapy, as the British psychiatrist Russell Reid as put it, "doesn't make a scrap of difference in these people" At present no treatment exists that we know of that is anywhere near as helpful as the surgery." But what surgery are we talking about here folks? You can shave an adam's apple, create and/or remove breasts, narrow the jawline, and removed unwanted face and body hair. But can we really shrink (or increase?) the size of one's hands.....surgically "lighten up" or deepen one's voice...or create genitals that look and feel like the real thing? No, we can't. Acceptance is the key. Of oneself...and of others. Just be and remain honest; that is all we really needed in the first place...
Montross' book, to say the least, is beyond fascinating regarding her own experiences as a clinician treating BIID as well as the existing research concerning it. "Falling Into the Fire: A Psychiatrist's encounters with the Mind in Crisis" by Christine Montross.
Now that "I am Cait" has aired (Jenner's reality series on cable), it is clear (to me at least!) that Jenner is currently a biological man from the waist down...while presenting herself as woman from the waist up. If ever there was a time to introduce us all to BIID, I believe this is it. As I have found, of the approximately 700,000 transgendered individuals in this country today, a very small percentage actually go forward and have the surgery to alter their genitals. This from a study out of Columbia University focused on the transgender community. Besides the intense pain associated with post-surgery recovery....lack of sensation associated with so-called "successful" surgical outcomes...and the visual reality of "This is what it looks like now?!"...it's no wonder that one doesn't choose to have the final surgery in order to be legitimately recognized in this country as a trans male or female. This also has helped me to understand why the violent assault rate, suicide rate, and murder rate is elevated among members of the transgender community generally speaking. (If one is going to present themselves as fully female or fully male...one has to be HONEST about that before their first "kiss" with an otherwise self-proclaimed heterosexual male or female!) Ask Jerry Springer. He has talked about this often enough on his show over recent years!
As friends and I have discussed, we can't figure out how Cait Jenner is going to turn out in this regard. She has stated that she was and has been always attraced to women---but in one of her recent episodes of "I am Cait", she claims she doesn't know what gender she'd date now. All I know is that if she's still male below the belt, it won't be pretty if her chosen female love interest is also male below the belt! Unless she chooses gender fluidity...which is a whole other issue for another blog post.
As one of the disorders suggested for review and consideration in the current DSM-5, BIID syndrome was described as far back as the early 19th century in the book "From Paralysis to Fatigue A History of Psychosomatic Illness in the Modern Era" by Edward Shorter. To make a long story short, a woman REALLY wanted a portion of her leg amputated in spite of no evidence to suggest she needed it (this was back in 1818). Her anxiety and suffering became so great, that "two surgeons of eminence in the country yielding to her entreaties, performed the operation. On completion of the amputation they were surprised to see that they had removed a normal joint."
Unlike people who suffer from BDD (Body Dysmorphic Disorder), which is recognized as a diagnosable psychiatric condition, people with BIID do NOT want to be rid of their body parts because they perceive them to be hideous, diseased, or faulty in any way. Rather, the body parts feel alien, as if they don't belong. In spite of their intact bodies, BIID patients do not feel whole.
In her recent book, "Falling Into the Fire", author Christine Montross, herself a psychiatrist and lesbian, discusses her own encounters with BIID patients. "The way in which personal identity seems inextricably linked to the desire for amputation has led to comparisons between BIID and gender dysphoria", states Montross. "In gender dysphoria (previously classified psychiatrically as gender identity disorder and in lay terminology as transsexxualism), people experience their gender as different from the one that their physical sex characteristics typically indicate." As Montross continues in her book, "These syndromes share a disconnect between the fundamental way in which a person feels his identity ought to be and the way that his body is."
Montross cites several studies in her book regarding BIID; one is an Amsterdam study where 54 individuals with BIID were administered a questionnaire. "Actual amputation of the limb was effective in all 7 cases who had surgical treatment." study administrator Rianne Blom writes. "Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life." One responder to the questionnaire revealed as much when he or she wrote, "I'm wondering if I am eligible to participate in this study, because since my amputation I do not have BIID feelings anymore."
"How then, as doctors, do we proceed?", asks Montross in her book. "A surgical procedure exists that appears to alleviate the anguish of people who are truly suffering. In attempts to treat the condition, medications have proved ineffective, and psychotherapy, as the British psychiatrist Russell Reid as put it, "doesn't make a scrap of difference in these people" At present no treatment exists that we know of that is anywhere near as helpful as the surgery." But what surgery are we talking about here folks? You can shave an adam's apple, create and/or remove breasts, narrow the jawline, and removed unwanted face and body hair. But can we really shrink (or increase?) the size of one's hands.....surgically "lighten up" or deepen one's voice...or create genitals that look and feel like the real thing? No, we can't. Acceptance is the key. Of oneself...and of others. Just be and remain honest; that is all we really needed in the first place...
Montross' book, to say the least, is beyond fascinating regarding her own experiences as a clinician treating BIID as well as the existing research concerning it. "Falling Into the Fire: A Psychiatrist's encounters with the Mind in Crisis" by Christine Montross.