I have written about appreciating cognitive difference and there is a great deal of literature that expounds on seeing the value of neurodiverse conditions. Appreciating the lifestyle of those with differences is part of understanding the value of diversity. I have also asked, as have many who study these problems: where do we draw the line between appreciating diversity and diagnosing illness? A recent publication draws on this distinction very well, mentioning a very specific, potentially neurological, disassociation between a person and their body. Carl E. Fisher and Michael B. First wrote an article in 2011 published by Columbia University, which discusses the particularly troublesome diagnosis of Body Integrity Identity Disorder and its relationship to Neurodiversity. The title of their article, “Examining the ‘Neuro-‘ in Neurodiversity: Lessons from Body Integrity Identity Disorder” describes the uneasy tension between personal freedom as championed by the label of Neurodiversity and the harm that diagnoses seek to protect individuals from. While it also explores the question of Neurodiversity’s claim to represent ‘neurological difference’, this is not as relevant to the point I’d like to discuss. 

This unquestionably largest part of the paradox of Neurodiversity is deciding what constitutes the boundaries between dangerous self-harm and an individual’s right to dispose of their body as they see fit? Strong libertarians would insist that people have a right, generally, to do as they please with their own body, as it is their property. A majority of people, I think, would disagree. The nature of body integrity identity disorder is puzzling. Often, those identified as having this cognitive difference have an obsession with amputation which they trace to experiences witnessing or interacting with amputees at a young age [1]. Their desire to remove one, or more of their limbs, is considered to be part of a disorder. The question, which is not quite addressed by Fisher and First, but is, perhaps, more pertinent to Fisher and First, is the question of line-drawing. 

It seems a soft practice of line-drawing to consider any form of body modification as more extreme than others when major changes are taking place voluntarily. Take examples like extreme tattoos or cases of plastic surgery that border on absurdity. Do these cases involve any diagnosis? Where is the point concerning body modification where one considers self-harm as imminent? Is this marked as an irreversible change in one’s physical appearance? 

I think these questions underlie the significance in considering the value of differences from multiple perspectives. In the case of some body modifications cultural objectivism is required, take the practices of some tribal people, pre-contact. Bodily modification can be a form of cultural practice akin to artistic expression, a way to mark oneself as a part of a group, or perhaps differentiate oneself. How does this question relate to the larger question of cognitive difference? 

If “cognitive difference”, meaning Neurodiversity manifested as both psychiatric difference and/or neurological difference, is entirely something that has its origins in the involuntary, then do people have a right to engage in those behaviors irrespective of the potential harm? 

I see the engagement of the issue as one that repeats itself in debates about exercises of all sorts of freedoms. Take the example of the debate over “the right to bear arms”. A right to X to often entails auxiliary manifestations of that right, such as with firearms: a right to bear arms leads to a strong cultural appropriation designating the importance of firearms in this society [2]. The right to dispose of one’s body, though, seems to have broader implications on socially acceptable definitions of the rights inherent to self-possession.

It seems that the right to dispose of ours bodies as we please, like so many other rights, is contingent upon the acceptance of mainstream society’s definition of the exercise of that right. Perhaps the fracturing of a distinct American cultural identity that comes with changing social and cultural demographics will lead to a better understanding of the motivations behind those socially acceptable definitions of behavior.