The parallels between BID and the trans movement go back decades, as explored in 2000 in an astonishingly prescient article in the Atlantic, titled “A New Way To Be Mad”. “Clinicians and patients alike often suggest that apotemnophilia is like gender-identity disorder,” the piece states, “and that amputation is like sex-reassignment surgery.”

Nearly a quarter of a century ago, when transgenderism and apotemnophilia were both exceedingly rare, the Atlantic prophesied that such disorders are ripe for social contagion: “when so many people profess uncertainty about who they really are, is it possible that the desire for this particular identity might spread?”

Now amputeeism is finally catching up. A 2018 ethics analysis in a Cambridge University Press publication concludes that there is “no logical difference between the conceptual status of BIID and transsexualism”. It goes on to say that, “given that individuals with transsexualism are offered gender reassignment surgery it seems to us that individuals with BIID ought at least to be considered for treatment, including elective amputation in some cases.”

This brings us to the 20-year-old patient who turned to medical professionals to alleviate his mental suffering, to validate his identity, and to prevent him from performing self-amputation. “His determination grew to find a method to get rid of those fingers he perceived as intrusive, foreign, unwanted,” his case study states. “Working in a sawmill, he considered building a small guillotine to cut his fingers.”

But what would it mean to accept the amputee identity at scale, the way we have accepted trans rights as a universal humanitarian movement? Drawing exact parallels, we would likely see a total saturation of amputee culture, from amputee story hour to centring amputee voices in DEI training, and doctors warning parents of the very real suicide risks for amputee-identifying children whose parents refuse to accept them as surgically modified cripples or invalids. Advocates would talk of being “assigned able-bodied at birth” to persuade activist teachers and medical associations to adopt the absolutist position that any attempt to talk kids out of amputee surgery amounts to “conversion therapy”.

The journalist Mia Hughes recently asked readers to imagine a society in which amputee advocates enjoyed the same cultural and political victories as trans advocates.

“Imagine there were a sudden 4000% increase in teens identifying as amputees, but we were all forbidden from being concerned. Instead we were supposed to celebrate it,” she posted on X. “Imagine schools teaching children as young as kindergarten that some people have amputee identities, that they get to choose how many limbs they have. Posters promoting body mutilation adorned the walls of many classrooms.”

As Hughes made clear, there will be no end to a radical egalitarianism that reduces the boundaries between health and illness to political power dynamics.

Based on the civil rights paradigm, once accepted as a protected identity, amputee rights would demand equitable representation in all spheres of public life — athletics, employment, arts and literature, K-12 curricula, Hollywood casting and Google search results.

The days of the amputee identity being classified as a “disorder” may well be numbered, and profuse apologies will be forthcoming from psychiatric professionals who ended up on the wrong side of history. And in the era of “amputee-affirming care”, perhaps the public will one day behold the apotemnophilia flag fluttering prominently at the White House.