I was in the midst of a discussion with @dopaminediscord regarding the ethical issues surrounding limb dysphoria (a.k.a. apotemnophilia) and the fascinating, neurological mysteries that surround it, in which some people actively seek out the amputation of a healthy limb because they don’t feel as though they it’s their own.

While we covered many avenues along the lines, including comparisons to other forms of body dysmorphia, I struggled to overcome my emotional alarm and aversion to the concept of choosing to amputate a healthy limb. As I’ve struggled with mobility loss and two autoimmune issues, I could never fathom wanting to lose what natural abilities I’ve retained, nor those I fight to recover.

Yet it occurred to me that there would be one avenue where such dysphoria would be acceptable: in a world in which cybernetic technology advanced to a point where a person would be enhanced by the loss of a natural limb, and replaced with a cybernetic one. We are already seeing significant advances in prosthetics that work as well as, and sometimes even better than, a person’s lost limb.


In The Grasp of Time, Robin and I have characters who are, by most definitions, cyborgs. They have implants in their brains to connect with an advanced, virtual world, and synthetic eye replacements that allow them to see more than they could with their natural eyes. The twins, Benny and Barney, each have had one of their arms amputated and replaced by attached prosthetic arms with unnaturally enhanced strength, dexterity, and more. Though, technically speaking, they did not choose this surgery for themselves.

If loss of a natural limb were seen as a normal body modification to gain cybernetic enhancements, then the practice would be accepted by the mainstream, and be seen akin to plastic surgery. Thus, those who actively wish to amputate limbs due to dysphoria, would find themselves facing fewer extremes in their goal to change their bodies to fit their view of themselves. While still an alarming concept, will be it be seen as such in twenty or fifty years? At what point does society’s accepted standards breach bodily autonomy? We still permit circumcision, despite its violation of the bodily autonomy of infants, yet would deny those who would choose an extreme body modification for themselves.

While bodily autonomy is sacrosanct, doctors also take an oath to do no harm. What is more harmful, to be faced with a lifetime in a body one hates and the accompanying depression therein? Or performing surgery to alleviate the dysphoria and its associated mental stress?

No matter what a given culture would choose in this case, it will be prosthetic technology that ultimately sets the global standard for future.

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