Attraction to disability

Until the 1990s, it tended to be described mostly as acrotomophilia, at the expense of other disabilities, or of the wish by some to pretend or acquire disability. Bruno (1997) systematised the attraction as factitious disability disorder.[8] A decade on, others argue that erotic target location error is at play, classifying the attraction as an identity disorder.[7][9] In the standard psychiatric reference Diagnostic and Statistical Manual of Mental Disorders, text revision (DSM-IV-tr), the fetish falls under the general category of "Sexual and Gender Identity Disorders" and the more specific category of paraphilia, or sexual fetishes;[10] this classification is preserved in DSM-5.[11]

Desires to pretend to be disabled and acquire a disability are extensions of the pathological disorder. About half of all devotees occasionally pretend (43 percent of Nattress [1996], sample of 50). Avowed "wannabes" seem to number not more than five percent of the devotee-wannabe population, though Nattress (1996) found 22 percent of his sample of 50 had wanted to become disabled. Accordingly, Bruno (1997) puts those afflicted with versions of the paraphilia under the broad heading of Devotees, Pretenders, and Wannabes (DPWs), as used here.[8]

Well over half of DPWs have felt this pathological attraction since childhood, as typical in paraphilias. The Amelotatist (see References) found that 75 percent of its sample of 195 were aware of the attraction by age fifteen. Those attracted often cherish early memories of a sexuoerotic tragedy (a "first sighting") involving an object of their future attention, often an older member of the opposite sex, as stereotypical in paraphilic etiology. About a quarter report discovering the paraphilia in puberty and a few in maturity.

The aforesaid has given grounds for the attraction to disability to be represented as the continuum Bruno (1997) termed factitious disability disorder.[8] At its less-intense devotee end, there is sexualised fascination with the existential aspects of disability and its appearance. In its middle pretending area is strong desire to reproduce the sensations of disability. At its intense wannabe end is an imperative to acquire a disability which may prompt self-harm.

According to DPW fetishists, their attraction does not appear to pose dangers to DPWs' partners or third parties. However, it can be noted that the DSM-IV includes this paraphilia within the diagnostic criteria of psychiatric pathology. Fetishists raise objections to the characterization of their preference as an aberrant pathology. However, objections have also been raised by members of the disabled community on the grounds that such fetishes objectify and dehumanize them. Some people with disabilities willingly participate in the fetish subculture, for example, contributing model photos (e.g., Debbie van der Putten).

The Amelotatist found that 55 percent of a sample of 195 DPWs had dated disabled people, 40 percent had been sexually intimate with disabled partners, and 5 percent had current disabled spouses. Nattress (1993) found that 41 percent of a sample of 50 DPWs had, or were in, relationships with disabled partners.[12]

Relationships between DPWs and disabled people tend to be reported as being ordinary, the attraction being sated by the fact of the partner's disability. It appears that the attraction to disability is undisclosed in a proportion of DPW-disabled relationships. DPWs may press disabled partners to put their disabilities to the fore in intimate situations and exhibit them in social ones. Sexually, some DPWs have been reported to engage in active tactile observation as much as in intercourse.

That DPWs find it hard to satisfy both sexual and emotional needs is borne out in findings by both Nattress (1996) and Dixon (1983).[13] They report that, despite reasonable success in obtaining sexual contact with disabled people, just 21 percent of DPWs had had long-term relationships with disabled partners.

About half of DPWs fail to establish relationships with disabled people. "Second-best" options for them are relationships with pretenders and wannabes. Practically all DPWs have experience of relationships with able-bodied partners. Such relationships are also reported to be ordinary despite the (mostly undisclosed) attraction to disability on the part of one partner.

Although it is not common knowledge within mainstream communities, the internet has revolutionized the process by which DPWs can meet each other while pursuing meaningful relationships. Some of these individuals, however, have expressed a level of concern when it comes to their first face to face encounters. While most of these encounters are completely safe, there are important guidelines to provide a sense of security to either party who may feel vulnerable.[14]

Psychology views sadism and masochism as interchangeable, with voyeurism and exhibitionism as their respective aspects. Devotees’ observation-based behavior and preference for display-minded partners seem to support explanations 2 to 4. Devotee pornography tends to display the appearance of disability across a range of activities rather than focus on sexual situations.

Recent neuroscientific research suggests that apotemnophilia has a neurological basis.[15][16][17]

• Pumpkin, a sorority girl is drawn to a disabled man.
• Boxing Helena, a feature film concerning amputee fetishism
• American Horror Story: Freak Show features Elsa Mars (Jessica Lange), a German woman who had her legs amputated in an acrotomophilic film while working as a prostitute in Weimar Germany.
• Katawa Shoujo, a visual novel based on dating disabled girls.

• Abasiophilia – the fascination for disabled people who use leg-braces or other orthopaedic appliances
• Agalmatophilia – the desire for mannequins or for statue-like immobility, feigned or caused by illness or paralysis
• Acrotomophilia – the desire for partners with missing limbs
• Apotemnophilia – the desire to acquire a disability ("wannabeism," "transability", "transabled"); Body integrity identity disorder BIID
• Body dysmorphic disorder – the pathological dislike of one's own physique for subjective reasons
• Body modification – the deliberate altering of physique for non-medical reasons
• Disability pretenders – one who behaves as if disabled and/or alters their appearance so as to suggest they are disabled
• Handicap fetishism – another term for the broad range of attractions to disability
• Handicap principle – possible analogue from the animal kingdom
• Legbrace fetishism – the desire for partners who use leg braces; an aspect of abasiophilia
• Medical fetishism – a sexualised interest in observing medical practice and receiving medical treatment
• Munchhausen's syndrome – a psychological disorder whose sufferers feign illness and/or cause themselves self-harm