The Comparison of BIID and GID

A few days ago, Christina Stephens, a friend and partner of JT Eberhard posted a fantastic and fascinating piece on Body Identity Integrity Disorder over at Eberhard’s blog, WWJTD.

BIID, while one of those things that is widely “known of” (in the pub quiz night “ever heard of those people who voluntarily choose to have their limbs amputated” kind of way) is certainly not widely understood. Christina’s article was a wonderfully non-judgmental and well-researched look at the phenomenon. It basically stems from an incongruity between one’s internal “body map”, or the way that the mind or self “expects” the body to be, and the body’s actual physical configuration. This can create a profound sense of alienation, disquiet or disgust associated with a given limb, extremity, sensory ability or virtually any aspect of the body.

As is fairly common to these discussion, Christina referenced comparisons between BIID and GID, Gender Identity Disorder, the underlying condition that drives transsexuality. GID is also a disconnect between internal “body map” and the actual configuration of the physical body, in this case along the lines of gender. It creates a similar sense of alienation, disgust and so on. Specifically, Christina noted a similarity between the types of argument used against an individual with BIID’s right to elect for surgery to ease the incongruity between body and internal self, and noted how many of the same ethical justifications we’ve ultimately formulated for gender transition are applicable to “voluntary’ amputations or other procedures available to individuals with BIID.

These comparisons, however, have a tendency to put me very much on guard. In the comments, I expressed my discomfort with the comparison, with which I have a long and troubled history. I may, however, have jumped the gun a bit and reacted emotionally before giving it full consideration.

Basically, I have an immediate and strongly negative reaction to the comparison of BIID to GID. This is largely based, as said, on a troubled history. Part of that is the degree to which I’ve seen the comparison based on a conception of transition and genital surgery for transsexuals (SRS), particularly male-to-female, as being an essentially reductive procedure, the “amputation” and loss of the genitals (rather than a reconfiguring), the idea that transition is a de-sexing of the body (rather than re-sexing), that we are mutilating ourselves, sacrificing something, becoming lesser beings, destroying our bodies, etc. Basically everything that goes along with the framing of transition and SRS in terms of “cutting off your dick”.

An additional element is the frequency with which I’ve seen the comparison trotted out as a means of discrediting transition, or an individual’s right to choose transition, and also a means of justifying various “gatekeeping” models in which very strict requirements are established that one must meet before being “permitted” to transition or receive hormones or surgery or whatever. The argument typically goes: “well what about those crazies who want to cut off their arms and stuff? Should they just be allowed to go ahead and do that?” My initial internal response is “Well, yes. They should. It’s their bodies”, but I am well aware of where that would lead the conversation. For one, they’d immediately dismiss my position as indefensible, they would proceed to provide increasingly exaggerated examples of why an individual should not be permitted to in all instances make decisions regarding their health (suicide being an inevitable example), they would assume that it’s patently absurd of me to think this is okay, and most importantly, it would allow them to frame the discussion around the implicit concept that transition and SRS are indeed a reduction of the body, mutilation, self-inflicted harm and a sacrifice of health or functionality. And no… they aren’t. So instead, my reaction is to focus on why that comparison is inadequate and damaging, and reflects a profound misunderstanding of the nature of transition (and typically also a misogynist assumption of femaleness as being a “lesser” or “inferior” state to maleness).

So when I see the comparisons made, even in an understandable way, such as Christina’s article where it was being used in a more or less perfectly reasonable manner as a touchstone on the bio-ethics of issues of body map, self-conception and related treatments or surgery, I nonetheless have a knee-jerk negative reaction, my tranny sense tingling, my warning klaxons blaring, and every fiber of my being screaming no no no, they’re DIFFERENT!!!

But the thing is, they’re not totally different. And sometimes comparisons between the experiences of different particular groups is perfectly valid, and a useful means of articulating nuanced aspects of the issues surrounding them. Isn’t it a bit selfish of me to insist that just because some people who understand neither BIID nor GID have used the comparison as a means of invalidating the latter that people who are seeking to help build awareness about BIID be not permitted to use the similarities as a means of articulating things like the bio-ethical considerations?

Yes, I hate the negative ends to which this comparison has been applied. But hopefully I would be able to muster the compassion and generosity to not throw a fit when the comparison is applied towards positive ends.

But on the other hand… would it be a lack of compassion to simply ask that care be taken when using this comparison, to do so carefully, with awareness of the negative conclusions that can (and will) be drawn, and take care to articulate the differences that exist between the two conditions?

What I see as the primary difference is precisely that concept of reduction or loss. Alhough concepts of health or optimal human ability are, to a degree, subjective and culturally mediated, I think it’s both valid and possible to posit models of general basic human physical health / ability, and mental health / ability. Relative to such models, the overall psychological benefit of transition in comparison to the physiological harm is much more clear and less ambiguous than in the case of procedures for BIID. There is virtually no actual loss of health or function in the case of transition… the only real example of such we can point to is fertility. All other potential losses are purely socio-cultural. In the case of BIID, however, there is almost by definition a majour loss of function or ability (which is weighed against the possible benefit to mental health). The individual pursuing the treatment may not personally regard it as a loss,  but relative to an overall model of optimal human health and ability? I’m afraid it wouldn’t be unreasonable to regard it as such.

I’ve heard statements before to the effect that if we lived in a society where everyone is blind, blindness would not be a disability. Or if we lived in a society where everyone can fly, our current level of mobility would be regarded as a disability. We don’t, however. We live in a sighted, grounded society, and relative to those standards and conditions we have certain things that are regarded as disability and that create difficulties in the lives of those who have them.

However, it’s entirely possible that my own biases, my own negative preconceptions, and a general feeling of squeemishness regarding BIID is playing into the degree to which I dislike the comparison. I’ve been doing advocacy work for too long to be able to just toss aside the possibility of my own privilege and able-ism impacting how I view things.

In the comment thread, it was suggested that my desire to distance myself from BIID was simply do to negative feelings about it, and about disability in general. I don’t feel that was my sole motivation, but I completely can’t rule it out as a factor, either. I reminded myself of how many LGB individuals will sometimes express a desire to distance themselves from the trans community, using arguments such as “they make us look bad” or “what am I supposed to have in common with some freak who wants to cut his dick off?” (motif noted).  And furthermore, there is the pattern even within the trans community itself of some transsexuals opposing the “transgender umbrella”, and specifically wanting to distance themselves as much as possible from drag queens, cross-dressers, genderqueer people, etc. Even further, amongst transsexuals you will find straight, femme, androphillic, post-op women wishing to distance themselves from trans lesbians, butch trans women and tomboys, non-ops and so forth. An endless matryoshka nesting doll set of hierarchies and prejudices.

Is that what I was doing? Simply trying to distance myself on the basis of “it will make us look bad!” and not wanting to be associated with a “lesser” class of identity? If I had written a post in which I used a comparison of the treatment of gay men and women to trans men and women as a touchstone in articulating persecution on the basis of deviation from prescribed sexual and gender roles, how would I react to a gay man objecting that I shouldn’t make that comparison? That it is dangerous, and if I do make it, I should only do so while carefully articulating the differences? I think I wouldn’t react very positively, and would likely regard his distaste for the comparison to be motivated by transphobia.

So it seems that I, like everyone, do have some cultural baggage that needs a bit of unpacking, and I should probably do a bit of thinking about my preconceptions of disability. However, this doesn’t for a moment change the fact that comparisons between BIID and GID have been used as a means of discrediting my identity. Nor does it change the firm belief I have that education, clarity and understanding, and the stamping out of misinformation, is of extreme and paramount importance in moving forward towards acceptance of both trans people and other maligned groups, such as those with BIID.

I’m not really sure what exactly to think about all this at the moment. Only that it has me thinking, and questioning my positions. And that’s always a good thing. So thank you, Christina.

Featured image is the Motor Homonculus, a visual representation of the amount of mental space devoted to controlling the movements of different parts of the body. This particular image is from autismindex.com