Amputee Fetishism and Genital Mutilation Case Report and Literature Review

Authors
Thomas N. Wise, Ram C. Kalyanam

Source
Amputee fetishism and genital mutilation: Case report and literature review (2000). Journal of Sex and Marital Therapy, 26, 339–344. Not publicly available; subscribers only - avalailble through Taylor and Francis.

Abstract
A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the Internet. The patient had a long-standing amputee fetish, which evolved into eroticized genital mutilation. The transformation of the preferred fetish occurred in a setting of depression due to environmental stressors. The literature about amputee fetishism, also called "apotemnophilia," is reviewed, and possible connections with the genital mutilation are discussed.

Analysis
"The connection between genital self-mutilation and amputee fetishism has not been reported (p. 339)" I think that’s a significant and important statement, which seems to be forgotten later on during the study.

"The patient [...] was taken to the hospital, where his penis was reattached [...]. The genital mutilation was his second attempt to remove his penis (p. 340)" Why do the medical professional insist on reattaching? Living without a penis is not life-threatening, and if the person is obviously not delusional, or psychotic, it seems silly to keep putting back something that wasn’t wanted. Of course, later in the case report it is shown that the guy stated that he didn’t know why he did it.

"The exciting element of the idea was the actually cutting off of the penis as well as the image of his penile stump (p. 340)"

"He also spent many hours masturbating to his amputee pornography collection (p. 340)" The author fails to make a link between the behaviour described in the first quote, and that of the second quote. In the first, the actions described related to apotemnophilia, whereas in the second, they relate to acrotomophilia ("devotee"). I say apotemnophilia as it is clear the guy was turned on at the idea of being a "penis amputee", and this was not a case of BIID. I say acrotomophilia rather than dev, for the purpose of staying within "medical jargon".

"At no time did he ever wish to personally have an amputated limb (p. 341)" This reinforces my earlier statement that Mr A was more a case of acrotomophilia than of BIID. Typical BIID stems from a very young age (pre-pubescent anyway), whereas Mr A’s case was something that occurred in his 50’s.

"There was no evidence of psychotic thought processes, hallucinations, delusions, or other evidence of loosened associations (p. 341)" This is a regular pattern and an important one to note.

"The patient continued to remain interested in amputee eroticism but denied any renewed interest in mutilating his genitals. (p. 342)" This supports the idea that there is a difference between acrotomophiles and "wannabes".

"Contemporary study of amputee fetishism was initiated by John Money, who named this fetish 'apotemnophilia' (Taylor, 1976). The incidence of this fetish is unknown but may be significant, because there are numerous Internet sites that sell both erotic literature and vieotapes of amputees, surggesting that there is a wide market for such pornography. (p. 342)" This illustrates well that the author does not understand the difference between acrotomophilia and apotemnophilia. The sites he mentions cater to the "devotee", whereas he means that those sites are reflective of apotemnophilia’s needs. While both conditions are sometimes present in the same individual, they are separate and should be treated differently.

"Although the two phenomena may be separate, it is equally plausible to suggest that the fantasy of phallic amputation was an upward displacement from the amputee fetish (p. 343)" Here the author is saying that apotemnophilia is a direct result of exacerbated acrotomophilia. He suggests it is plausible that one result from the other, but despite repeated statements contradicting that theory, he still suggest it. This suggestion becomes even weaker when e consider that it is based upon the study of one case from one individual.

"Stoller has suggested that, psychodynamically, such paraphilias are erotic manifestiations of hatred toward maternal figures (p. 343)" Hmm, Ok, I hate my mum, but...