Abstract

This chapter introduces the moral and ethical dilemmas associated with on-demand amputations for Body Integrity Dysphoria (BID), mainly focusing on whether BID-related surgeries can be ethically aligned with gender-affirming surgeries. Through an examination of the four-principle approach to bioethics—beneficence, non-maleficence, autonomy and justice—the chapter analyses the fairness and accessibility of care for individuals seeking BID-related amputation. The chapter poses a voluntarily provocative question: should BID-related amputations be considered on par with Sex Reassignment Surgeries (SRS)? If not, what are the morally relevant factors that set them apart? The idea proposed is that, as of today, no morally relevant criteria exist to accept SRS and reject BID’s wish for amputation. Rather than advocating for BID surgeries, however, the chapter highlights the moral and practical challenges that medical practitioners face, along with the knowledge gaps in distinguishing ethically and morally relevant differences between these two types of procedures.