I have written previously about the possibility that the minority of surgeons who carry out radical experimental procedures on misinformed, physically healthy people do so because they enjoy the work, and because nobody stopped them.
The case documented by Kasten (2024) added self-amputation to the list of treatments which progressive society no longer seems willing to question.
The male patient described in Kasten’s study was transgender and referred to using the ‘she’ pronoun in the published paper. This patient “was affected by BID and felt the need for amputation of both legs approximately 20 cm below the knees. No medical or psychotherapeutic therapies were sought; she was too embarrassed to express this need to a doctor or therapist.”
Kasten’s research subject perceived their feet as “false meat.” The paper does not judge the patient, and verges on admiration: “Since the amputation, she feels free and enjoys the appearance of her own body and is proud of having successfully mastered this challenge… there was no therapy, nor was there any recommendation for or against the dry ice method she used to get rid of her feet.”
Kasten’s paper includes a lengthy self-report by the patient studied, described as “exciting,” which is illuminating and worth quoting at length:
“At about the age of twelve, I watched the film “Robocop.” I was fascinated by the thought of losing an unwanted limb yet preserving function with a mechanical device… I then had a bit of an epiphany — what if I was a woman with no feet. This immediately felt right. Everything about this thought fitted with my ideal image for myself.”
. . .
“I cooled my feet with iced water and then managed to freeze them in dry ice. It took around 6 hours. I had guessed about a 50–50 chance of dying or achieving a successful outcome. I was so frustrated that these odds were acceptable. I stayed at home and went to bed with frozen feet. I don’t remember much after this, but I woke up in hospital… I underwent surgery and achieved bilateral below knee amputations. It was amazing… I was so much happier and also nobody had questioned my sanity! I was worried that I was going to be locked in a mental health facility, but no one noticed.”
“Then the problem struck. I was arrested by the police… they discovered that I had seen videos of an extreme pornographic nature and that I had arranged my own amputations. I was therefore investigated for possession of extreme pornography and insurance fraud… The benefit of being “discovered” is that I am now addressing my gender issues and have started feminizing hormone therapy. I am out to my friends as a transwoman.”
Let us recap that the DSM-5-TR and ICD-11 BID have categorically stated that the desire to remove body parts, sexual characteristics and gender dysphoria are unrelated. The psychiatric profession no longer stigmatises the most extreme manifestations of sadomasochism, let alone the everyday practice of sexual cruelty.
The patient in this case study went on to write about his wife: “It took her a while to understand (she did some research herself online which helped). She does see it as a “mental illness,” and I think the fact that all the psychiatrists and psychologists I have seen have said that I am otherwise sane has helped her.”