Michelle Orange in Harper’s:
BID, body integrity dysphoria, is rare. Though experts are reluctant to estimate its prevalence, it is believed that at least a thousand people globally have the disorder. Medical recognition of the condition is growing, and its addition to the World Health Organization’s International Classification of Diseases (ICD) took effect last year. The ICD defines BID as “an intense and persistent desire to become physically disabled in a significant way”—to become, for example, a major-limb amputee, paraplegic, or blind—“with onset by early adolescence accompanied by persistent discomfort, or intense feelings of inappropriateness” regarding one’s body.
I learned of the ailment in 2011, the year that I met Dr. Michael First, a professor of clinical psychiatry at Columbia and an editor of the current Diagnostic and Statistical Manual of Mental Disorders (DSM), who had inaugurated an earlier term for the condition, body integrity identity disorder, in a 2005 study. First was then campaigning for BIID to be added to the DSM-5—what remains the most recent edition—which was in its deliberative stage. I was writing about those deliberations, specifically about the various political and institutional follies involved in defining normalcy. I was preoccupied, as well, with our culture’s competing blights of self-focus and self-alienation, and a possible synergy between them; how easily our efforts toward perfection can turn destructive. At the time, BIID seemed the ne plus ultra of this danger, a useful metaphor for an age on the verge, one might say, of dismantling itself.
More here.