Gender Identity Disorder vs Body Integrity Identity Disorder

Gender Identity Disorder vs Body Integrity Identity Disorder

It has become an accepted treatment for gender identity disorder to offer to suitable patients sex reassignment surgery (SRS). The classic description by someone with gender dysphoria of themselves is 

I'm a man trapped in a woman's body (or vice versa).

Thus the rationale for amputating healthy genital and other tissue is to "restore" the person to their "correct" body. 

There is a condition called body integrity identity disorder, also sometimes called apotemnophilia (although this term also applies to people with a fetish for amputees). People with this affliction have a deep-seated desire to become amputees. They will inflict lesions on the limb in order to procure a surgical amputation, risking death through septicaemia. Mo Costandi mentions a death in his article in the Guardian:
http://www.theguardian.com/science/neurophilosophy/2012/may/30/1
They may even attempt DIY amputations. There is evidence of specific brain lesions that will produce this disorder. In response to the persistent attempts by some patients to force amputations, one surgeon in a Scottish hospital began offering elective amputations for such patients (see link). However, this practice was stopped by the hospital management. 

The parallel with sex reassignment surgery is striking. It could be argued that BIID is different in that the goal is not a whole normal body. SRS is justified by medical consensus, and exempted from the prohibitions on clitoral excision under the Prohibitions of Female Circumcision Act 1985. WHO does not classify clitoral excision as part of SRS under female genital mutilation. On the grounds of consistency, it is difficult to understand why elective amputation is not seen as ethical.