Apotemnophiles (from the Greek, apo, away from + temnien, to cut) are individuals who exhibit an intense desire for one of their own limbs to be shorn off. The available evidence suggests that a strong motivation for many of them, if perhaps not every single case, is autoerotic in nature. In 2005, the psychiatrist Michael First published a study on what is probably safe to say remains the largest sampling of apotemnophiles on record. First questioned fifty-two subjects who reported having experienced a lifelong wish for an “elective amputation.” Fourteen of them had already gone ahead and done it. As far as he could gather, the subjects were otherwise normal, non-psychotic citizens from around the world who just happened to want a healthy limb removed. Nearly all were gainfully employed and college-educated. Eighteen had even gone to grad school and had advanced degrees. So we can’t just shrug them off as dumb. To the contrary, most realized how bizarre it sounded to other people that the only thing that could make them feel like a complete person was, ironically, to have one of their arms or legs banished to the medical waste bin.

First points out that the condition can’t be reduced to Body Dysmorphic Disorder, since apotemnophiles suffer no delusions about the body part being defective in any way, nor are they embarrassed or ashamed of its appearance. Still, much like transsexuals who say they are born into the wrong body, they just can’t shake the feeling that their “true” self is an amputee. And it’s difficult enough finding a surgeon willing to perform a sex change operation; when it comes to getting one to agree to saw off a healthy arm or leg because the patient is convinced it doesn’t belong there, you can imagine how challenging a task that would be. Many apotemnophiles are so desperate to incarnate their self-identity as an amputee that they go to extraordinary lengths to rid themselves of the misfit body part. First uncovered people who’d crushed their legs under gym weights, or used shotguns, chainsaws, a wood chipper and even dry ice to liberate an extraneous appendage.

Most of these people understood that such methods were insanely dangerous, yet they felt it was the only solution. Besides, if they caused enough damage, a surgeon would be forced to finish what they started, leaving a designer stump rather than a lumpy, do-it-yourself look. For those who hadn’t the intestinal fortitude to sever a limb outright, many were in the process of ratcheting up their pain tolerance by clipping off a measly little toe or finger with a pruning shear or a hammer and a chisel. All still wanted a major limb amputation afterwards. The biggest regret for those who’d managed to get it done was that they hadn’t done it sooner. “I am absolutely ecstatic; I’m in possession of myself and my sexuality,” said one. “It finally put me at peace,” said another, “I no longer have that constant, gnawing frustration.”

Apotemnophiles are very specific about their own idealized amputated form. The most enviable alteration by far was an above-the-knee leg job.

First's analysis revealed that such irrepressible urges typically set upon these individuals during their childhoods; for some, even their earliest memories involved feigning a missing limb. Most traced their peculiar desire to being exposed to a specific amputee, either in person or through media images—someone they experienced as provocative and beguiling, a positive figure with whom they identified, perhaps. At adolescence, this image became eroticized for most of the sample, and they’d take to, say, folding a leg behind them while watching themselves in a mirror and masturbating. At the time of the interview, when the average age of the men in the study was nearly fifty, 72 percent of them still reported feeling sexually excited whenever they pictured themselves as an amputee.

I discuss paraphilias like this one, and much, much more, in my new book Perv: The Sexual Deviant in All of Us, which will release on October 8, 2013. Follow me @jessebering (#DailyDeviant). For more on all things deviant, and to find out if I'll be visiting a city near you for the Perv book tour, visit www.jessebering.com.