All was going well until legal problems emerged to spoil the story.
In the pantheon of sensational headlines this one is somewhere near the top: British surgeon who arranged for his legs to be amputated is jailed for insurance fraud and possessing extreme pornography.
Dr Neil Hopper (49), a respected NHS vascular surgeon, who had performed many amputations on patients over the years, froze his legs with dry ice. Becoming gangrenous, first his feet were removed, then both legs below the knees. Hopper was applauded for returning to work as a surgeon, applying to be a parastronaut with the European Space Agency and earning the 2020 Amplifon Awards for Brave Britons.
All was going well until legal problems emerged to spoil the story.
Hopper had told insurers that the amputations arose from sepsis, rather than being self-inflicted, obtaining a rather nice payout of £466,653. Added to this he had pornographic videos showing amputations and other extreme body modifications from the Eunuch Maker website.
The code of Hammurabi in ancient Babylon prescribed this
punishment for a doctor convicted of inept surgery: amputation of the hands.L. M. Boyd
This site was run by the alarming Marius Gustavson, a man of extremes by any standards, who had ensured removal of his leg and penis, in addition to eating human testicles and keeping body parts as ‘trophies’.
Gustavson led a body modification ring, carrying out male castration, penis removal and other procedures on people as young as 16.
To show that there is a market for this kind of thing, between 2017 and 2021 the site pulled in more than £300,000. To protect the public, if not himself, Gustavson was jailed last year for life with a minimum term of 22 years.
Hopper bought videos showing men having their genitals removed. He also exchanged 1500 messages with Gustavson about how he had done his amputations, saying: “It’s going to be awesome being a double amputee.” He sent a photo of his bandaged feet with a message: “It feels so cool. No feet!”
The court was told that he had dreamed of having his legs removed and “a sexual interest in becoming an amputee” that progressed to an irresistible compulsion.
Hopper had felt he was in the wrong body from a young age, wanting to be female. This led to a strong identification with body integrity identity disorder and those with a desire to amputate their limbs.
He was jailed for 32 months and given a Sexual Harm Prevention Order for 10 years. Unsurprisingly, he was removed from the medical register and his work investigated but no problems were found. Dr Hopper had become Mr Hopalong.
Related
Of Hopper’s future post-incarceration plans we are not told but, like other voluntary amputees, he is likely to have an excellent rehabilitation; of his other activities it remains to be seen.
Sexual apotemnophilia—now more commonly referred to as body integrity dysphoria (BID) or body integrity identity disorder (BIID)—is a condition that involves the persistent desire to amputate a healthy limb or become disabled, often accompanied by sexual arousal related to the idea of amputation. It may involve preference for amputees or the eroticization of prosthetics, stump play or related imagery.
“Amputation—Every endeavour, which skill and experience can suggest, must be made before mutilation of the body, by the removal of even the smallest portion of one of its members, is resorted to.”
Robert Liston, Elements of Surgery
Individuals may attempt self-amputation or seek surgeons willing to perform the procedure. They can go to extremes, such as using ligatures, snow or even putting the limb on a railway line for a train to go over.
There is growing acceptance of surgical removal although it must be said that the ethical field is murky and unresolved. Surgeons who removed limbs for this reason have faced disciplinary inquiries but usually been exonerated.
Acrotomophilia is the term used to describe sexual attraction to amputees. This is classified as a paraphilia (an atypical sexual interest). The term comes from Greek: akron (extremity/limb), tomos (cut), and philia (love/attraction). These feelings begin in childhood, often after encountering someone with an amputation. In darknet amputee communities they are called “devotees”; those who still seek amputation are “wannabees” while those who imitate amputees are “pretenders” (akin to cross-dressing in transsexuals) – the terminology is always coy.
Some conditions are primarily about sexual arousal (paraphilias), while others are more about identity and embodiment (like BIID and xenomelia); sometimes they overlap. Most candidates are seeking a sense of wholeness or completeness – the mismatch between their bodies and their identity. Some have seen the condition as a modified form of transsexualism and the similarities are unavoidable.
The dysphoric feelings arise early, mostly before puberty. Most are heterosexual males with a small number of female and intersex candidates. The majority desire amputation of the left leg which may suggest the lateralisation of the condition to the right brain. Less than a quarter in surveys wished to fully transition. Women desire bilateral or greater amputation, suggesting a difference in brain lateralisation to men.
BIID/aptomnophilia should be distinguished from psychotic disorders, somatoparaphrenia, body dysmorphic disorder (where the preoccupation is with a defect in appearance) or CRPS (where the limb is affected by severe pain and other changes).
Some research suggests the condition arises from insula and right parietal lobe dysfunction which may connect with the work of Vilayanur Ramachandran (mirror image therapy), even leading to a cure.
In the cultural world, there are novels, invariably sensational and poorly written, if not pornographic, for devotees. Public attention was attracted by JG Ballard’s 1973 novel Crash with automobile accidents as a source of eroticism and sexual attraction to amputees.
As Hopper’s case indicates, contrary to earlier beliefs, there is often overlap between apotemnophilia, acrotomophilia and transsexualism. What future lies ahead for him remains to be seen but his story indicates that limb lopping is not as much an outlier event as thought.
More cases are likely to come forward and hopefully the research will proceed until a cure is found. For the rest of us, keeping our limbs just where they were intended to be will remain the norm.
Robert M Kaplan is a forensic psychiatrist who writes about body identity, changes and mutilation as postmodern phenomena.
