Desire for non-mutilative disability in a nonhomosexual, male-to-female transsexual.

In adults, the desire for a healthy limb amputation has been reported in both the lay press and the scientific literature. While the etiology of this condition is currently unknown, prevailing theories have tended to conceptualize the phenomenon as paraphilic in origin. In this report, we present the case of a 25-year-old, nonhomosexual male-to-female transsexual who manifested an intense desire to be afflicted with a nonmutilative neurological disability (multiple sclerosis). The patient categorically denied sexual attraction towards the thought of being an amputee or physically disabled. Hypotheses are proposed for the development of this condition with special emphasis accorded to the significance of the preferred target disability.