Patients with body integrity identity disorder (BIID) experience a strong desire for amputation from very early on. BIID patients are often dismissed when they share their wish for amputation with surgeons. Consequently, patients resort to self-amputation, including complications and sometimes death. BIID patients are not psychotic and are mentally competent to oversee the consequences of an elective amputation. The authors offer arguments in favor of elective amputation.
Keywords: Amputation; Hippocratic oath; body integrity identity disorder; body-ownership; ethical dilemma; euthanasia; gender dysphoria; surgery; treatment.